Radiology MRI

46 years old presents with neurological symptoms from upper extremities. MRI shows significant cervical spinal stenosis that is due to  Ossification of the Posterior Longitudinal Ligament (OPLL) . This is know to progress even after laminoplasty. Surgeons are interested in staging of OPLL. Therefore we perform CT that helps in evaluation of calcifications. Staging of OPLL depends on extension of calcifications, if those are interrupted, continuous or mixed. In this case calcifications are interrupted - type B. This has prognostic value concerning the progress of the disease after laminoplasty. See also staging and overview in this excellent article: Yoshiharu Kawaguchi - Progression of Ossification of the Posterior Longitudinal Ligament Following en Bloc Cervical Laminoplasty

T1 weighted images from 3T MRI showing Subdural Hemorrhage (SDH) in the left occipital region in this one week old neonate. Note high signal of SDH on T1 sequence without contrast due to Methemoglobin . There is also Caput Succadeneum . You can also see SDH on transversal T2 as low signal (black), as high signal (white) on transversal Inversion Recovery (IR) sequence, followed by sagittal T2 and coronal T1. Especially on sagittal T2 note Subarachnoid Space compressed by SDH. Such perinatal SDH are not so rare, however are difficult to find on Ultrasound as they are located in periphery and often do not cause large displacement.

This patient is known with Neurofibromatosis Type 1 (von Recklinghausen Disease) . Note enlarged optic nerves on coronal T2, as well as thickened optic chiasm on coronal T1 with Gadolinium and thickened optic tracts on transversal T1 with Gadolinium. This is due to Optic Glioma . There is very little, almost no contrast enhancement. Last image, transversal T2, showing tumor infiltration in the optic tract as well as Focal Areas of Signal Intensity (FASI) - that show no enhancement. Also note enhancing  Subcutaneous Neurofibroma , more FASI and how the thickened optic chiasm looks on sagittal T1.

Note high density in the cranial part of the basilar artery (BA). First image showing normal density in the part without thrombus, the second transversal image more cranial showing thrombus, that is also visible on sagittal image. Normally basilar artery can be of higher density, however in this case you can see difference in various parts of the artery. There is also clinical information that plays significant role in diagnosis. CT Angiography (CTA) confirms diagnosis of Basilar Artery Thrombosis (Basilaris Thrombosis) showing lack of contrast in the apical part of the basilar artery. Patient was transferred immediately to Angiography Lab for selective catheterization and thrombolysis. Image on the left showing occlusion of BA and image on the right showing excellent recanalization after thrombolysis. Follow up MRI has shown only a small cortical infarct in the upper parts of cerebellum as rest after the incident. Also in favor for this patient was pre...