Anatomic Regions — Clinical MRI

First Experiences with the World’s First MAGNETOM Vida

June 12, 2017 by Mike Notohamiprodjo MD

This review focuses on 8 critical questions regarding gadolinium deposition in the brain and body, with the answers and discussion therein important for future regulatory decisions and clinical practice. [...]

Filed Under: brain, Clinical Imaging, heart, liver, Software & Hardware Updates, whole body
Tagged With: CLINICAL IMAGING, CLINICAL METHODS & TECHNIQUES, CLINICAL UPDATES, NEW TECHNOLOGIES & ADVANCES, SOFTWARE & HARDWARE UPDATES

Assessing Brain Volumes Using MorphoBox Prototype

June 12, 2017 by Alexis Roche

Filed Under: brain, Clinical Imaging, Clinical Methods & Techniques, Clinical Updates
Tagged With: brain, tissue volume

High-resolution, Anatomically-accurate Diffusion-weighted Imaging of Orbital and Sinonasal Lesions with RESOLVE

April 26, 2017 by Yan Sha

This paper reviews four recently published studies where RESOLVE was shown to be clinically effective in the diffusion-weighted imaging of sinonasal and optic pathologies. It also demonstrates the clinical value that RESOLVE brings to the detection and characterization of the diseases in these regions. [...]

Filed Under: Anatomic Regions, brain, Clinical Imaging, Clinical Methods & Techniques, Clinical Updates, New Technologies & Advances, Software & Hardware Updates
Tagged With: 3diffusion-weighted, and throat, ear, nose, RESOLVE

Overview of Magnetic Resonance Fingerprinting

April 28, 2016 by Vikas Gulani

This overview of Magnetic Resonance Fingerprinting describes the basic concepts of MRF and illustrates some clinical applications. [...]

Filed Under: brain, Clinical Imaging, Clinical Methods & Techniques, Clinical Updates, New Technologies & Advances, the joints
Tagged With: 7T, brain, musculoskeletal

New ‘ADC & b-value’ Tool in syngo.via

April 28, 2016 by Julien Gervais

This article describes the feature ‘ADC & computed b-value’ available on Siemens’ syngo.via VB10. This new tool provides an increased degree of freedom in the choice of the b-value for disease detection and characterization. [...]

Filed Under: brain, Clinical Imaging, Clinical Methods & Techniques, Clinical Updates, New Technologies & Advances, the joints
Tagged With: 7T, brain, musculoskeletal

MR-Guided Biopsies of the Prostate in Supine Patient Position

April 28, 2016 by Florian Schneider, M.D.

The article shows that targeted biopsies of the prostate under direct MRI-guidance are a reasonable complement to ultrasound biopsy techniques. The presented cases show that exact targeting of the most suspicious portion of a tumor is crucial for correct classification and consequently best therapy decisions. Especially in case of relatively small lesions, direct MR-guidance has clear advantages over fusion techniques. [...]

Filed Under: abdomen, Clinical Imaging, Clinical Methods & Techniques, Clinical Updates, New Technologies & Advances, pelvis
Tagged With: prostate, T2-weighed

Pediatric Pathologies that have Leukocoria as Presenting Sign: the Podium

January 31, 2016 by Paolo Galluzzi

The article features the clinical and imaging signs and differential diagnosis of Retinoblastoma, persistent fetal vasculature and Coats’ disease. View/Download [...]

Filed Under: brain, Clinical Imaging, Clinical Methods & Techniques, Clinical Updates, New Technologies & Advances, the joints
Tagged With: 7T, brain, musculoskeletal

Safety of the Gadolinium-Based Contrast Agents for Magnetic Resonance Imaging, Focusing in Part on Their Accumulation in the Brain and Especially the Dentate Nucleus

March 26, 2016 by Val M. Runge, MD

The established class of intravenous contrast media for magnetic resonance imaging is the gadolinium chelates, more generally referred to as the gadolinium-based contrast agents (GBCAs). [...]

Filed Under: brain, Clinical Imaging, Clinical Methods & Techniques, Clinical Updates, Contrast Media Updates
Tagged With: brain, CLINICAL IMAGING, CLINICAL METHODS & TECHNIQUES, CLINICAL UPDATES, NEW TECHNOLOGIES & ADVANCES

Case Report: Clinical Usability of MyoMaps in Myocardial Infarction

February 29, 2016 by Masashi Nakamura, M.D.

These case reports show that current advances in T1 and T2 mapping and ECV quantification might have the potential to improve the diagnosis of cardiovascular disease, refine myocardial risk stratification and guide patient personalized therapeutic strategies. View/Download [...]

Filed Under: Cases, Clinical Imaging, Clinical Methods & Techniques, Clinical Updates, heart, New Technologies & Advances, Vessels
Tagged With: 7T, brain, musculoskeletal

Cardiovascular Magnetic Resonance Teaching Network

March 1, 2016 by Jeanette Schulz-Menger, M.D.

The article introduces a novel teaching approach allowing time-effective teaching as well as an ongoing quality control. The aim is to enable CMR in all settings – hospitals of different sizes as well as in outpatient departments. [...]

Filed Under: Cases, Clinical Imaging, Clinical Methods & Techniques, Clinical Updates, heart, New Technologies & Advances, Vessels

Launch of the world’s first 7 T MR platform intended for clinical use (Siemens)

June 22, 2015 by MRI

Erlangen, Germany, May 31, 2015 — Siemens announced at the Toronto ISMRM (International Society for Magnetic Resonance in Medicine) meeting the launch of the world’s first 7 T MR platform intended for clinical use. Important advances include a new, light, actively shielded magnet with zero helium boil-off and dual operating modes, enabling rapid switching between research […] [...]

Filed Under: brain, Clinical Imaging, Clinical Methods & Techniques, Clinical Updates, New Technologies & Advances, the joints
Tagged With: 7T, brain, musculoskeletal

CAIPIRINHA – Revisited

November 18, 2015 by Felix Breuer

The development ofmulti coil receiver hardware as well as dedicated parallel acquisition techniques (PAT) and respective reconstruction methods allowed for a significant decrease of acquisition times in almost all clinical applications. This article provides a brief overview of 2D- and MS-CAIPIRINHA. [...]

Filed Under: brain, Clinical Imaging, Clinical Methods & Techniques, Clinical Updates, New Technologies & Advances, the joints
Tagged With: 3T, musculoskeletal, perineural

Accelerated Diffusion Tensor Imaging of Skeletal Muscle Using Simultaneous Multi-Slice Acquisition

December 18, 2015 by Lukas Filli, M.D.

Simultaneous multi-slice acquisition with CAIPIRINHA reduces the scan time in diffusion-weighted MRI. In this article, early experience with this technique for accelerated DTI of skeletal muscle is shown. [...]

Filed Under: brain, Clinical Imaging, Clinical Methods & Techniques, Clinical Updates, New Technologies & Advances, the joints
Tagged With: 3T, musculoskeletal, perineural

Simultaneous Multi-Slice (SMS) Imaging for Pre-Surgical BOLD fMRI and Diffusion Tractography: Case Illustrations

December 29, 2015 by Andreas J. Bartsch

The presented case studies illustrate that SMS can increase the statistical confidence of fMRI and diffusion tractography results. These gains may be used to increase spatial image resolution and coverage, to improve spatial coregistration to high-resolution anatomical scans for intra-operative neuro-navigation, and / or to shorten acquisition times. [...]

Filed Under: brain, Clinical Imaging, Clinical Methods & Techniques, Clinical Updates, New Technologies & Advances, the joints
Tagged With: 3T, musculoskeletal, perineural

Quiescent Interval Single-Shot (QISS) Lower Extremity MRA for the Diagnosis of Peripheral Artery Disease: Case Presentations

December 29, 2015 by Akos Varga-Szemes

Case presentation of non-contrast QISS MRA providing high diagnostic accuracy for the detection of hemodynamically significant arterial stenosis of the lower extremities at both 1.5 and 3T. [...]

Filed Under: brain, Clinical Imaging, Clinical Methods & Techniques, Clinical Updates, New Technologies & Advances, the joints
Tagged With: 3T, musculoskeletal, perineural

Point-of-Care MR Imaging and How We can Learn from Other Imaging Modalities. Thoughts on a Potential New Strategy

November 18, 2015 by Gustav Andreisek

The article introduces point-of-care MRI, an extremely focused and goal-directed examinations strategy, that could reduce examination time and patient comfort. [...]

Filed Under: brain, Clinical Imaging, Clinical Methods & Techniques, Clinical Updates, New Technologies & Advances, the joints
Tagged With: 3T, musculoskeletal, perineural

Simultaneous Multi-Slice (Slice Accelerated) Diffusion EPI: Early Experience for Brain Ischemia and Cervical Lymphadenopathy

November 18, 2015 by Val M. Runge, MD

In single shot EPI, the entirety of k-space is traversed after one shot (excitation). Readout-segmentation acquires k-space in multiple shots for reduced TE and encoding time. Real-time reacquisition of unusable shots is also supported. [...]

Filed Under: brain, Clinical Imaging, Clinical Methods & Techniques, Clinical Updates, New Technologies & Advances, the joints
Tagged With: 3T, musculoskeletal, perineural

Clinical Case: 3 Tesla MR Neurography-Guided Posterior Femoral Cutaneous Nerve Block

October 2, 2015 by Jan Fritz, M.D.

The high SNR available at 3T provides the ability to perform high-resolution MR neurography-guided perineural injections for highly accurate visualization of small nerve as well as needle targeting and perineural injection. This case report demonstrates how this techniques facilitates accurate targeting of the PFCN. Download/View PDF [...]

Filed Under: brain, Clinical Imaging, Clinical Methods & Techniques, Clinical Updates, New Technologies & Advances, the joints
Tagged With: 3T, musculoskeletal, perineural

syngo MR XA10 – Your New Work Environment for More Comfortable Scanning and Intuitive Image Processing

March 8, 2017 by Alexander Aulesjord

In this article we share some of our experiences over the last few years with MR upgrades. [...]

Filed Under: Anatomic Regions, brain, Clinical Imaging, Software & Hardware Updates
Tagged With: abdomen, bones, brain, heart, spine

Case Series: Utilization of the Pediatric 16 Coil for 1.5T and 3T Systems

March 8, 2017 by Miriam R. Keil, Ph.D.

In this article we share some of our experiences over the last few years with MR upgrades. [...]

Filed Under: Clinical Imaging, diffusion-weighted imaging, fat saturation, soft tissues, Software & Hardware Updates
Tagged With: abdomen, bones, brain, heart, spine

Case Series: Utilization of the Pediatric 16 Coil for 1.5T and 3T Systems

February 3, 2017 by Bac Nguyen, RT

In this article we share some of our experiences over the last few years with MR upgrades. [...]

Filed Under: abdomen, Anatomic Regions, bones, brain, Clinical Imaging, Clinical Updates, heart, Software & Hardware Updates, spine
Tagged With: abdomen, bones, brain, heart, spine

Long-term Experience with MR Upgrades

November 23, 2016 by Christos Loupatatzis, M.D.

In this article we share some of our experiences over the last few years with MR upgrades. [...]

Filed Under: brain, Clinical Imaging, Clinical Updates, Software & Hardware Updates
Tagged With: abdomen, brain, the joints, vessels

Rapid Estimation of Myelin for Diagnostic Imaging (REMyDI)

November 23, 2016 by Tobias Granberg

The article describes a new MRI myelin detection model to measure the presence of myelin by its effect on the surrounding cellular water, and discusses clinical applications of this technique. Download/View PDF [...]

Filed Under: brain, Clinical Imaging, Clinical Methods & Techniques, Clinical Updates, New Technologies & Advances
Tagged With: brain

fit-Upgrade: A Success Story

June 1, 2015 by Stephan Zangos

The fit-upgrade for 1.5 and 3T systems remains an economically attractive approach for an aged MR system. By improving system performance and workflow, the number of examinations can be increased, together with improved image quality, with little effort. Download/View PDF [...]

Filed Under: Anatomic Regions, Clinical Imaging, Clinical Methods & Techniques, Clinical Updates, New Technologies & Advances, Software & Hardware Updates, whole body

First Experiences with the Whole-Body Dot Engine

June 1, 2015 by Stephan Zangos

Whole-body MRI is beneficial in many clinical scenarios including bone marrow, infectious and rheumatic diseases. The Whole-Body Dot Engine provides fast and robust image quality across all patients, with fewer errors or need for repeated examinations. It ensures that all stations of a multi-station examination are performed with a consistent FOV and spatial resolution while […] [...]

Filed Under: Anatomic Regions, Clinical Imaging, Clinical Methods & Techniques, Clinical Updates, New Technologies & Advances, Software & Hardware Updates, whole body

Val M. Runge, MD – ASNR 2015 – Pearls and Pitfalls in Neuroradiology of Cerebrovascular Disease – The Essentials with MR and CT

May 17, 2015 by MRI

This educational exhibit was presented at the ASNR 2015 meeting, with imaging performed on a 3 T Siemens Skyra MR system. The full reference for the exhibit is given below. Runge V, Smoker W, Valavanis A. Pearls and Pitfalls in Neuroradiology of Cerebrovascular Disease – The Essentials with MR and CT. ASNR 53rd Annual Meeting, […] [...]

Filed Under: brain, Clinical Imaging, Clinical Methods & Techniques, Clinical Updates, Meet The Experts, New Technologies & Advances, Val M. Runge

Val M. Runge, MD – ASNR 2015 – Simultaneous Multi-Slice (Slice Accelerated) Diffusion EPI

May 17, 2015 by MRI

This educational exhibit was presented at the ASNR 2015 meeting, with imaging performed on a 3 T Siemens Skyra MR system. The full reference for the exhibit is given below. Runge V, Richter J, Beck T, Piccirelli M, Valavanis A. Simultaneous Multi-Slice (Slice Accelerated) Diffusion EPI. ASNR 53rd Annual Meeting, April 25-30, 2015, Chicago, Illinois […] [...]

Filed Under: brain, Clinical Imaging, Clinical Methods & Techniques, Clinical Updates, Meet The Experts, New Technologies & Advances, Val M. Runge

Practical Considerations for the Evaluation of the Neuroforamina in Routine Spine Imaging at 3T. A Case Series

May 11, 2015 by Marc-André Weber, MD, M.Sc.

Pathologies of the neuroforamina are one of the most frequent indications for spine surgery. However, in standard MRI with axial and sagittal planes and relatively thick slices (>3 mm) the diagnostic information may be limited for proper evaluation of the nerve roots. Prof. Marc-André Weber et al. (University Hospital Heidelberg, Germany) share practical tips on […] [...]

Filed Under: cervical, Clinical Imaging, Clinical Methods & Techniques, Clinical Updates, lumbar, spine, thoracic

Subarachnoid hemorrhage

November 17, 2014 by Val M. Runge, MD

subarachnoid hemorrhage well seen on T2 fl2d coronal GRE, subarachnoid hemorrhage of unknown reason, may have small thrombosed cortical vein – very small, on pre-contrast T1, also likely small adjacent skull hemangioma, seen on both CT and MR Part of the on-line supplement to Neuroradiology – The Essentials with MR and CT (© 2015) [...]

Filed Under: Anatomic Regions, brain, Meet The Experts, Neuroradiology - The Essentials with MR and CT, Textbooks
Tagged With: hemorrhage

ACOM aneurysm

October 14, 2014 by Val M. Runge, MD

A flow void is noted in the region of the anterior communicating artery (ACOM) on an axial T2-weighted image, with signal intensity corresponding to arterial flow on an axial source image from a 3D TOF MRA. CE MRA images further confirm the aneurysm, with the right A1 segment of the ACA noted to be very […] [...]

Filed Under: Anatomic Regions, brain, Chapter ONE - Brain, Meet The Experts, Neuroradiology - The Essentials with MR and CT, Val M. Runge
Tagged With: Vascular Lesions

ACA aneurysm

October 27, 2014 by Val M. Runge, MD

Note the prominent pulsation artifact in the first image (a FSE T1-weighted scan at 3 T), seen propagating in the left-right dimension. On the post-contrast image (a short TE GRE scan), the aneurysm is well depicted, other than partial volume effects (due to the 4 mm slice thickness). This 2D scan is relatively immune to […] [...]

Filed Under: Anatomic Regions, brain, Chapter ONE - Brain, Meet The Experts, Neuroradiology - The Essentials with MR and CT, Val M. Runge
Tagged With: Vascular Lesions

Ankylosing spondylitis, chronic disease

October 23, 2014 by Val M. Runge, MD

There is marked irregularity and sclerosis of the sacroiliac joints bilaterally. Fatty changes are noted as well, in the sacrum, bordering the joint. There is little edema within the bone adjacent to the sacroiliac joints. All are findings consistent with long standing disease. Part of the on-line supplement to Neuroradiology – The Essentials with MR […] [...]

Filed Under: Anatomic Regions, Chapter THREE - Spine, Meet The Experts, Neuroradiology - The Essentials with MR and CT, spine, Val M. Runge
Tagged With: Degenerative Disease

Ankylosing spondylitis, hip disease

October 24, 2014 by Gang Wu MD

One-third of individuals with AS develop hip and shoulder involvement. Bilateral disease, with joint effusions and synovial enhancement are characteristic. Additional less common findings include subchondral bone marrow edema, erosive destruction, and fatty accumulation. (Case provided courtesy of Reto Sutter, MD, Leitender Arzt, Radiologie, Uniklinik Balgrist, Zürich) Part of the on-line supplement to Neuroradiology – […] [...]

Filed Under: Anatomic Regions, Chapter THREE - Spine, Meet The Experts, Neuroradiology - The Essentials with MR and CT, spine, Val M. Runge
Tagged With: Degenerative Disease

Ankylosing spondylitis, sacroiliac joint disease

October 24, 2014 by Gang Wu MD

In this patient with long standing disease, joint space irregularity and adjacent fatty changes predominate. (Case provided courtesy of Reto Sutter, MD, Leitender Arzt, Radiologie, Uniklinik Balgrist, Zürich) Part of the on-line supplement to Neuroradiology – The Essentials with MR and CT (© 2015) [...]

Filed Under: Anatomic Regions, Chapter THREE - Spine, Meet The Experts, Neuroradiology - The Essentials with MR and CT, spine, Val M. Runge
Tagged With: Degenerative Disease

Ankylosing spondylitis, with bony ankylosis of the sacroiliac joints

October 23, 2014 by Val M. Runge, MD

In this 44-year-old patient, coronal images of the pelvis reveal fusion of the sacroiliac joints bilaterally. Sagittal images of the lumbar spine show vertebral body squaring and a bamboo like appearance due to diffuse ankylosis (and syndesmophytes). There is vertebral body fusion at multiple levels, with loss of disk space height and abnormal signal intensity […] [...]

Filed Under: Anatomic Regions, Chapter THREE - Spine, Meet The Experts, Neuroradiology - The Essentials with MR and CT, spine, Val M. Runge
Tagged With: Degenerative Disease

Anterior and posterior fusion defects of C1

October 23, 2014 by Val M. Runge, MD

Note the well corticated margins and absence of a discrete fracture line. Such fusion defects are congenital in nature, and are primarily incidental findings. Incomplete posterior fusion can be seen in normal children up to the age of 10, with bony fusion typically occurring by age 5. Clefts of the posterior arch occur in 5% […] [...]

Filed Under: Anatomic Regions, Chapter THREE - Spine, Meet The Experts, Neuroradiology - The Essentials with MR and CT, spine, Val M. Runge
Tagged With: Normal Anatomy - Imaging Technique - Common Variants

Cervical cord hemangioblastoma

September 25, 2014 by Val M. Runge, MD

Cervical cord hemangioblastoma, in a patient with von Hippel Lindau syndrome. A small enhancing intramedullary lesion is noted at C4, with mild accompanying vasogenic edema. 75% of spinal cord hemangioblastomas are sporadic, 25% occur in association with von Hippel Lindau syndrome. Spinal cord hemangioblastomas most commonly occur posteriorly within the cord, as in this patient. […] [...]

Filed Under: cervical, Chapter THREE - Spine, Meet The Experts, Neuroradiology - The Essentials with MR and CT, spine, Val M. Runge
Tagged With: Neoplasms

Chondrosarcoma of the cervical spine

October 23, 2014 by Val M. Runge, MD

The left lamina of C2 is involved by a focal mass lesion, which is slightly expansile in nature. A somewhat characteristic feature of the histologic diagnosis, reflecting hyaline cartilage, is the marked hyperintensity on the T2-weighted scan. There is moderate enhancement post-contrast, which as with the other findings (with the exception of the appearance on […] [...]

Filed Under: Anatomic Regions, Chapter THREE - Spine, Meet The Experts, Neuroradiology - The Essentials with MR and CT, spine, Val M. Runge
Tagged With: Neoplasms

Chronic dens fracture

October 24, 2014 by Gang Wu MD

A type II odontoid fracture is present, with non-union (pseudoarthosis). (Case provided courtesy of Reto Sutter, MD, Leitender Arzt, Radiologie, Uniklinik Balgrist, Zürich) Part of the on-line supplement to Neuroradiology – The Essentials with MR and CT (© 2015) [...]

Filed Under: Anatomic Regions, Chapter THREE - Spine, Meet The Experts, Neuroradiology - The Essentials with MR and CT, spine, Val M. Runge
Tagged With: Trauma

DISH (diffuse idiopathic skeletal hyperostosis) in the cervical spine

October 23, 2014 by Val M. Runge, MD

In DISH (also known as Forestier disease) there is calcification and ossification of ligaments and entheses (the connective tissue between bone and a tendon or ligament) involving the vertebral column. Ossification of the anterior longitudinal ligament is common (and often marked), and may occur in conjunction with ossification of the posterior longitudinal ligament (OPLL). Both […] [...]

Filed Under: Anatomic Regions, Chapter THREE - Spine, Meet The Experts, Neuroradiology - The Essentials with MR and CT, spine, Val M. Runge
Tagged With: Degenerative Disease

Epidural hematoma, spine, illustrating image composition

October 28, 2014 by Val M. Runge, MD

Composed sagittal T2-weighted, T1-weighted, and post-contrast T1-weighted images are presented. Each image is an automatically generated composition of two high-resolution independent cervicothoracic and thoracolumbar image acquisitions. The patient was on aspirin and Plavix, and presented with urinary retention and poor anal sphincter tone, consistent with a lesion compressing the conus medullaris. A predominantly deoxyhemoglobin epidural […] [...]

Filed Under: Anatomic Regions, Chapter THREE - Spine, Meet The Experts, Neuroradiology - The Essentials with MR and CT, spine, Val M. Runge
Tagged With: Infection and Inflammation

Hydatid cysts of the sacrum, ileum and L5

October 24, 2014 by Gang Wu MD

In the spine, with hydatid disease, there is typically slow resorption of trabeculae, without bony expansion, with a conglomeration of daughter cysts. This accounts for the multilocular appearance on MR, with high signal intensity on T2-weighted sequences. (Case provided courtesy of Reto Sutter, MD, Leitender Arzt, Radiologie, Uniklinik Balgrist, Zürich) Part of the on-line supplement […] [...]

Filed Under: Anatomic Regions, Chapter THREE - Spine, Meet The Experts, Neuroradiology - The Essentials with MR and CT, spine, Val M. Runge
Tagged With: Infection and Inflammation

Hyperflexion injury with a clay-shoveler fracture

October 24, 2014 by Gang Wu MD

CT depicts an avulsion fracture of the spinous process of C6. MR reveals additional important findings, including the extensive posterior paraspinal muscular injury (edema), disruption of the interspinous ligament, compression fractures (marrow edema) involving multiple contiguous cervical and thoracic vertebral bodies, and extensive prevertebral edema as well as fluid (hemorrhage). Note that the cord appears […] [...]

Filed Under: Anatomic Regions, Chapter THREE - Spine, Meet The Experts, Neuroradiology - The Essentials with MR and CT, spine, Val M. Runge
Tagged With: Trauma

Ivory vertebra, metastatic prostate carcinoma

October 24, 2014 by Gang Wu MD

The ivory vertebra describes a dense sclerotic vertebral body on plain film or CT, with the correlate on MR being very low signal intensity on both T1- and T2-weighted sequences. L2 and S2 are involved in this fashion in the presented case, with additional metastatic lesions noted posteriorly in L1 and L3, together with mild […] [...]

Filed Under: Anatomic Regions, Chapter THREE - Spine, Meet The Experts, Neuroradiology - The Essentials with MR and CT, spine, Val M. Runge
Tagged With: Neoplasms

Klippel-Feil

October 24, 2014 by Gang Wu MD

There is vertebral nonsegmentation at two levels, one involving a hemivertebra, together with a prominent scoliosis of the cervical spine. Also present is an anterior fusion defect of C1. (Case provided courtesy of Reto Sutter, MD, Leitender Arzt, Radiologie, Uniklinik Balgrist, Zürich) Part of the on-line supplement to Neuroradiology – The Essentials with MR and […] [...]

Filed Under: Anatomic Regions, Chapter THREE - Spine, Meet The Experts, Neuroradiology - The Essentials with MR and CT, spine, Val M. Runge
Tagged With: congenital disease

Lipoma, tethered cord, hydromyelia, block vertebrae

October 23, 2014 by Val M. Runge, MD

The cord extends at least to the S1 level, with dilatation of the central canal within that portion visualized (hydromyelia). A small lipoma is noted within the bony spinal canal posteriorly at the S1 level. The axial scan at this level reveals the cord near its termination/posterior tethering, with the lipoma immediately contiguous bilaterally. Fusion […] [...]

Filed Under: Anatomic Regions, Chapter THREE - Spine, Meet The Experts, Neuroradiology - The Essentials with MR and CT, spine, Val M. Runge
Tagged With: congenital disease

Meningioma (WHO grade I, meningotheliomatous in type), cervical spine

October 13, 2014 by Val M. Runge, MD

A large, homogeneously enhancing, intradural extramedullary mass lesion is noted anteriorly within the thecal sac at the C2 level. There is prominent deformity and compression of the cord, long standing in nature, without evidence of edema or gliosis. Note the characteristic flat margin of the lesion along the dura. Part of the on-line supplement to […] [...]

Filed Under: Chapter THREE - Spine, Meet The Experts, Neuroradiology - The Essentials with MR and CT, spine, Val M. Runge
Tagged With: Neoplasms

Migrated disk fragment

October 28, 2014 by Val M. Runge, MD

There is mild loss of disk space height (and thus substance) at L5-S1. A left paracentral disk herniation is noted, at this level, together with superior migration. Note the slight hyperintensity of the superiorly migrated portion of the disk on the T2-weighted scan, consistent with a free fragment (which is also suggested by the extent […] [...]

Filed Under: Anatomic Regions, Chapter THREE - Spine, Meet The Experts, Neuroradiology - The Essentials with MR and CT, spine, Val M. Runge
Tagged With: Degenerative Disease

Multiple sclerosis, cervical and thoracic cord lesions

September 25, 2014 by Val M. Runge, MD

An enhancing cervical cord lesion is noted on sagittal and axial images, located at the C2 level, with an additional thoracic lesion (which did not enhance) depicted on a lower axial T2-weighted section. Neither lesion respects gray-white matter boundaries, as seen on the axial T2-weighted scans, a common finding for MR lesions of the cord. […] [...]

Filed Under: Anatomic Regions, cervical, Chapter THREE - Spine, lumbar, Meet The Experts, Neuroradiology - The Essentials with MR and CT, spine, Val M. Runge
Tagged With: Demyelinating Disease

Neurofibromatosis type 1

October 24, 2014 by Gang Wu MD

Dural ectasia and a lateral meningocele are present. Also noted are scalloped vertebrae and scoliosis. All are characteristic findings. (Case provided courtesy of Reto Sutter, MD, Leitender Arzt, Radiologie, Uniklinik Balgrist, Zürich) Part of the on-line supplement to Neuroradiology – The Essentials with MR and CT (© 2015) [...]

Filed Under: Anatomic Regions, Chapter THREE - Spine, Meet The Experts, Neuroradiology - The Essentials with MR and CT, spine, Val M. Runge
Tagged With: congenital disease

Acute cerebellar hemorrhage

September 25, 2014 by Val M. Runge, MD

Acute cerebellar hemorrhage, hypertensive. A large acute parenchymal hemorrhage is seen in the left cerebellar hemisphere, on sagittal, axial, and coronal reformatted images from a non-contrast CT exam. Note the vasogenic edema circumferential to this hematoma. Hemorrhage is also seen in the fourth ventricle on the axial image, with interstitial edema and ventricular enlargement noted […] [...]

Filed Under: Anatomic Regions, brain, Chapter ONE - Brain, Meet The Experts, Neuroradiology - The Essentials with MR and CT, Val M. Runge
Tagged With: hemorrhage

Acute infarction of the caudate head and lentiform nucleus

September 19, 2014 by Val M. Runge, MD

Both structures are supplied by the lateral lenticulostriate arteries, which originate from the MCA. The caudate nucleus is also supplied by the medial lenticulostriate arteries, which arise from the ACA. The recurrent artery of Heubner, which supplies the anteromedial caudate nucleus and the anteroinferior internal capsule, is the largest of the medial lenticulostriate arteries, and […] [...]

Filed Under: Anatomic Regions, brain, Chapter ONE - Brain, Meet The Experts, Neuroradiology - The Essentials with MR and CT, Val M. Runge
Tagged With: Infarction

Acute lacunar infarction, posterior limb of the internal capsule

October 18, 2014 by Val M. Runge, MD

The patient was hypertensive, and presented for CT (which was negative) with acute hypoesthesia involving the left side of the body. The MR was obtained 15 hours later, and reveals a small acute lacunar infarct in the internal capsule on the right. Due to the ability to detect cytotoxic edema, with diffusion weighted imaging, MR […] [...]

Filed Under: Anatomic Regions, brain, Chapter ONE - Brain, Meet The Experts, Neuroradiology - The Essentials with MR and CT, Val M. Runge
Tagged With: Infarction

Acute medial medullary infarct

September 25, 2014 by Val M. Runge, MD

Abnormal hyperintensity is noted in the right medial medulla on both T2- and diffusion-weighted scans, which corresponds to vasogenic and cytotoxic edema, respectively. The medial medulla is most often described as being supplied by the anterior spinal artery. The medial medullary syndrome, also known as Dejerine syndrome, is caused by infarction of this region. It […] [...]

Filed Under: Anatomic Regions, brain, Chapter ONE - Brain, Meet The Experts, Neuroradiology - The Essentials with MR and CT, Val M. Runge
Tagged With: Infarction

Paget disease of the lumbar spine and pelvis

October 24, 2014 by Gang Wu MD

Both the L1 and L2 vertebral bodies (together with their respective posterior elements) are involved, with the vertebral bodies expanded in the antero-posterior dimension and L2 a characteristic “picture frame” vertebra. There is involvement as well of the pelvis together with the sacral vertebral bodies. Coarse and thickened trabeculae are particularly evident in the iliac […] [...]

Filed Under: Anatomic Regions, Chapter THREE - Spine, Meet The Experts, Neuroradiology - The Essentials with MR and CT, spine, Val M. Runge
Tagged With: Infection and Inflammation

Acute parenchymal hemorrhage, due to an underlying AVM

September 25, 2014 by Val M. Runge, MD

Acute parenchymal hemorrhage, due to an underlying AVM. A large acute parenchymal hematoma is noted in the right frontal lobe. Post-contrast, there is tubular like enhancement within and immediately posterior to the hemorrhage, most consistent with acute extravasation of blood. The coronal thick MIP from the CTA study reveals a small nidus of arterial enhancement […] [...]

Filed Under: Anatomic Regions, brain, Chapter ONE - Brain, Meet The Experts, Neuroradiology - The Essentials with MR and CT, Val M. Runge
Tagged With: hemorrhage, Vascular Lesions

Cholesterol granuloma

October 18, 2014 by Val M. Runge, MD

A large expansile lesion is noted in the right petrous apex, hyperintense on both T1- and T2-weighted scans, without diffusion restriction or internal contrast enhancement. The imaging findings are characteristic, with one exception – that a peripheral hemosiderin rim is not present. The lesion was resected through a transnasal, transclival route. Part of the on-line […] [...]

Filed Under: Anatomic Regions, Chapter TWO - Head and Neck, Head and Neck, Meet The Experts, Neuroradiology - The Essentials with MR and CT, Val M. Runge
Tagged With: Infection and Inflammation

Acute subarachnoid hemorrhage from a small ACOM aneurysm

September 25, 2014 by Val M. Runge, MD

The images presented include an axial unenhanced CT, a coronal MIP from the CTA, and a 3D magnified view of the aneurysm from the CTA, obtained using volume rendering technique (VRT). The latter shows the distal internal carotid artery, the two anterior cerebral arteries, and the small multi-lobulated aneurysm originating from the ACOM, near its […] [...]

Filed Under: Anatomic Regions, brain, Chapter ONE - Brain, Meet The Experts, Neuroradiology - The Essentials with MR and CT, Val M. Runge
Tagged With: hemorrhage, Vascular Lesions

Acute superior cerebellar artery (SCA) infarction

September 25, 2014 by Val M. Runge, MD

Acute superior cerebellar artery (SCA) infarction, with an accompanying small unilateral pontine infarct. Hypodensity is seen on CT in a portion of the SCA territory, with hyperintensity on axial T2-weighted MR (and sagittal FLAIR), both due to vasogenic edema. The presence of restricted diffusion is confirmed on the ADC map, reconstructed from the diffusion scans. […] [...]

Filed Under: Anatomic Regions, brain, Chapter ONE - Brain, Meet The Experts, Neuroradiology - The Essentials with MR and CT, Val M. Runge
Tagged With: Infarction

Acute subdural and parenchymal hemorrhage, from an underlying AVM

September 25, 2014 by Val M. Runge, MD

Acute subdural and parenchymal hemorrhage, from an underlying AVM, in a patient with fibromuscular dysplasia (FMD). Intracranial aneurysms are a well known associated finding in FMD, with the occurrence of intracranial arteriovenous malformations less common. On axial CT, both the acute subdural and parenchymal hematomas are well demonstrated, together with midline shift and compression of […] [...]

Filed Under: Anatomic Regions, brain, Chapter ONE - Brain, Meet The Experts, Neuroradiology - The Essentials with MR and CT, Val M. Runge
Tagged With: hemorrhage, Vascular Lesions

Cholesterol granuloma, orbit

October 14, 2014 by Val M. Runge, MD

More common sites for a cholesterol granuloma include the petrous apex, middle ear and mastoid antrum. The lesion, when in the orbit, presents as an extraconal mass, in the superior-temporal quadrant. Differential diagnosis includes the lacrimal gland tumors. Although post-contrast T1-weighted scans are presented, the lesion was hyperintense pre-contrast (and specifically demonstrated only peripheral enhancement). […] [...]

Filed Under: Anatomic Regions, Chapter TWO - Head and Neck, Head and Neck, Meet The Experts, Neuroradiology - The Essentials with MR and CT, Val M. Runge
Tagged With: orbit

Anaplastic astrocytoma (WHO grade III), CT and MR

October 18, 2014 by Val M. Runge, MD

A focal, mildly hyperdense, lesion is noted on CT in the right centrum semiovale, with restricted diffusion and no abnormal contrast enhancement. rCBV is mildly elevated. The hyperdensity on CT is unusual, with the diffusion restriction (confirmed on the ADC map, not shown) correctly suggesting a higher-grade lesion, with the lesion appearing on other scans […] [...]

Filed Under: Anatomic Regions, brain, Chapter ONE - Brain, Meet The Experts, Neuroradiology - The Essentials with MR and CT, Val M. Runge
Tagged With: Neoplasms

Anaplastic ependymoma (WHO grade III), in an 18 month old infant

October 18, 2014 by Val M. Runge, MD

There is a large enhancing extra-axial mass lying within the 4th ventricle and extending into the foramen of Luschka on the left. Heterogeneity of the lesion with cystic and necrotic areas is characteristic, along with the previously described findings. Most patients are one to five years in age, and present – as this child – […] [...]

Filed Under: Anatomic Regions, brain, Chapter ONE - Brain, Meet The Experts, Neuroradiology - The Essentials with MR and CT, Val M. Runge
Tagged With: Neoplasms

Aneurysm, cavernous carotid artery

October 13, 2014 by Val M. Runge, MD

A small mass lesion is noted within the left cavernous sinus on both CT and MR (axial imaging), with CT revealing enhancement therein. MRA confirms this to be an aneurysm, with the DSA provided for comparison (from an initial balloon test occlusion study). This 12 mm aneurysm of the cavernous segment of the internal carotid […] [...]

Filed Under: arteries of the brain, brain, Chapter ONE - Brain, Meet The Experts, Neuroradiology - The Essentials with MR and CT, Val M. Runge
Tagged With: Vascular Lesions

B cell lymphoma

October 14, 2014 by Val M. Runge, MD

A hyperintense periventricular mass lesion with accompanying vasogenic edema is noted in the right occipital lobe. The mass is hyperintense on DWI, with disruption of the blood-brain barrier (enhancement) demonstrated post-contrast. The mass had restricted diffusion (reflected by the high SI on DWI), which is compatible with primary CNS lymphoma, a diagnosis confirmed at surgery. […] [...]

Filed Under: Anatomic Regions, brain, Chapter ONE - Brain, Meet The Experts, Neuroradiology - The Essentials with MR and CT, Val M. Runge
Tagged With: Neoplasms

Brain metastases, melanoma

September 25, 2014 by Val M. Runge, MD

Pre- and post-contrast axial T1-weighted scans are illustrated. Pre-contrast, several small lesions in the frontal lobes, in particular on the left, demonstrate hyperintensity. Numerous small nodular enhancing lesions are noted post-contrast, all at the gray-white matter junction. Hemorrhagic metastases are seen in up to 15% of brain metastases. A mnemonic for the primary tumors that […] [...]

Filed Under: Anatomic Regions, brain, Chapter ONE - Brain, Meet The Experts, Neuroradiology - The Essentials with MR and CT, Val M. Runge
Tagged With: Neoplasms

Calvarial metastasis from breast carcinoma, with hyperostosis frontalis interna

October 18, 2014 by Val M. Runge, MD

A large lytic skull lesion is noted on CT, along with benign thickening along the inner table of the frontal bone (an incidental finding). MR depicts well the soft tissue mass within the skull, which is slightly expansile and easily distinguished pre-contrast from the adjacent fatty marrow, with enhancement post-contrast. Part of the on-line supplement […] [...]

Filed Under: Anatomic Regions, brain, Chapter ONE - Brain, Meet The Experts, Neuroradiology - The Essentials with MR and CT, Val M. Runge
Tagged With: Neoplasms

Cavernous malformation, with an associated developmental venous anomaly

September 25, 2014 by Val M. Runge, MD

On CT, a small, well delineated, hyperdense, round, focal lesion is seen pre-contrast, to the right and posterior to the fourth ventricle. On axial T2-weighted scans, a complete hemosiderin rim is demonstrated, together a “popcorn ball” appearance centrally, with mixed high and low signal intensity – all characteristic for a cavernous malformation. Just lateral and […] [...]

Filed Under: Anatomic Regions, brain, Chapter ONE - Brain, Meet The Experts, Neuroradiology - The Essentials with MR and CT, Val M. Runge
Tagged With: Vascular Lesions

Pancoast tumor

October 24, 2014 by Gang Wu MD

An apical soft tissue mass is present, with invasion of the adjacent vertebral body (visualized by the lucent defect therein). (Case provided courtesy of Reto Sutter, MD, Leitender Arzt, Radiologie, Uniklinik Balgrist, Zürich) Part of the on-line supplement to Neuroradiology – The Essentials with MR and CT (© 2015) [...]

Filed Under: Anatomic Regions, Chapter THREE - Spine, Meet The Experts, Neuroradiology - The Essentials with MR and CT, spine, Val M. Runge
Tagged With: Neoplasms

Scheuermann disease

October 24, 2014 by Gang Wu MD

Only a sagittal midline T2-weighted scan is presented. However this is sufficient to visualize the characteristic thoracic kyphosis, with involvement of 3 contiguous vertebrae. There is anterior wedging of the vertebral bodies and disk space narrowing, the latter greatest anteriorly. (Case provided courtesy of Reto Sutter, MD, Leitender Arzt, Radiologie, Uniklinik Balgrist, Zürich) Part of […] [...]

Filed Under: Anatomic Regions, Chapter THREE - Spine, Meet The Experts, Neuroradiology - The Essentials with MR and CT, spine, Val M. Runge
Tagged With: Degenerative Disease

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