Critical Imaging Diagnoses: - Radiology
Critical Imaging Diagnoses: - Radiology Critical Imaging Diagnoses: - Radiology
Pupil - Intrinsic Ocular Muscle “Blown Pupil” MR and CT Imaging Checklists • Morphologic Features – Mass Effect • Yes, proportional • Less than expected • No mass effect – Abnormal WM Signal • Vasogenic Edema • Demyelination • Infiltrating neoplasm – Ring Lesion • Necrotic Neoplasm • Reactive (e.g. abscess) • Fluid or Inflammatory MR and CT Imaging Checklists BP 180/135, HA, Hemiplegia • Morphologic Features – Mass Effect • Yes, proportional • Less than expected • No mass effect – Abnormal WM Signal • Vasogenic Edema • Demyelination • Infiltrating neoplasm – Ring Lesion • Necrotic Neoplasm • Reactive (e.g. abscess) • Fluid or Inflammatory MR and CT Imaging Checklists Long-standing Headache (yrs) • Morphologic Features – Mass Effect • Yes, proportional • Less than expected • No mass effect – Abnormal WM Signal • Vasogenic Edema • Demyelination • Infiltrating neoplasm – Ring Lesion • Necrotic Neoplasm • Reactive (e.g. abscess) • Fluid or Inflammatory Two Pts: Compare Mass Effect Long-standing Headache (yrs) New onset Seizures AVM – No Mass Effect GBM – Has Mass Effect
MR and CT Imaging Checklists • Morphologic Features – Mass Effect • Yes, proportional • Less than expected • No mass effect – Abnormal WM Signal • Vasogenic Edema • Demyelination • Infiltrating neoplasm – Ring Lesion • Necrotic Neoplasm • Reactive (e.g. abscess) • Fluid or Inflammatory Vasogenic Edema • A type of interstitial edema produced by abnormally increased capillary permiability • Spreads from site of abnormal vessels at ~7-10 mm/week • May reach a steady-state state – can’t t estimate age of lesion from extent of edema • Spreads along association tracts > cortico- spinal tracts >>> commissures • Finger-like pseudopods of watery white matter Meningioma with extensive Edema MR and CT Imaging Checklists Glioblastoma Multiforme • Morphologic Features – Mass Effect • Yes, proportional • Less than expected • No mass effect – Abnormal WM Signal • Vasogenic Edema • Demyelination • Infiltrating neoplasm – Ring Lesion • Necrotic Neoplasm • Reactive (e.g. abscess) • Fluid or Inflammatory T1-gad Neoplastic cells extend into the edema … and beyond, into the “normal” WM T2
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Pupil - Intrinsic Ocular Muscle<br />
“Blown Pupil”<br />
MR and CT <strong>Imaging</strong> Checklists<br />
• Morphologic Features<br />
– Mass Effect<br />
• Yes, proportional<br />
• Less than expected<br />
• No mass effect<br />
– Abnormal WM Signal<br />
• Vasogenic Edema<br />
• Demyelination<br />
• Infiltrating neoplasm<br />
– Ring Lesion<br />
• Necrotic Neoplasm<br />
• Reactive (e.g. abscess)<br />
• Fluid or Inflammatory<br />
MR and CT <strong>Imaging</strong> Checklists<br />
BP 180/135, HA, Hemiplegia<br />
• Morphologic Features<br />
– Mass Effect<br />
• Yes, proportional<br />
• Less than expected<br />
• No mass effect<br />
– Abnormal WM Signal<br />
• Vasogenic Edema<br />
• Demyelination<br />
• Infiltrating neoplasm<br />
– Ring Lesion<br />
• Necrotic Neoplasm<br />
• Reactive (e.g. abscess)<br />
• Fluid or Inflammatory<br />
MR and CT <strong>Imaging</strong> Checklists<br />
Long-standing Headache (yrs)<br />
• Morphologic Features<br />
– Mass Effect<br />
• Yes, proportional<br />
• Less than expected<br />
• No mass effect<br />
– Abnormal WM Signal<br />
• Vasogenic Edema<br />
• Demyelination<br />
• Infiltrating neoplasm<br />
– Ring Lesion<br />
• Necrotic Neoplasm<br />
• Reactive (e.g. abscess)<br />
• Fluid or Inflammatory<br />
Two Pts: Compare Mass Effect<br />
Long-standing Headache (yrs)<br />
New onset Seizures<br />
AVM – No Mass Effect<br />
GBM – Has Mass Effect
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