Wednesday, January 13, 2010

Lhermitte-Duclos disease (dysplastic cerebellar gangliocytoma) -MRI

LDD presents on the MR as a nonenhancing unilateral lesion in the cerebellum with mass effect on surrounding structures. The lesion is hypointense on the T1 weighted images and hyperintense on the T2-weighted images with alternating parallel hyperintense and isointense stripes which are characteristic for the disease. These bands correspond to the inner molecular layer and the granular layer of the cerebellum. Tonsillar herniation and hydrocephalus are quite common and are caused by the mass effect of the lesion to the adjacent cerebellar parenchyma. On the DWI the high signal intensity is due to T2-shine-through effect. This is a 17 year old female. Also note tonsillar herniation and syrnix in the upper cervical spine.

Submitted by Dr Sangeeta Aneja, MD Head of Dept, LLRM Meerut.

Tuesday, January 12, 2010

Acute disseminated encephalomyelitis-MRI

MRI in ADEM demonstrates regions of high T2 signal, with surrounding oedema. Punctuate, ring or arc enhancement is often demonstrated along the leading edge of inflammation. The center of the lesion, although high on T2 and low on T1 does not have increased restriction on DWI (D/D abscess), nor however does it demonstrate absent signal on DWI as one would expect from a cyst. This is due to increase in extra cellular water in the region of demyelination. However, absence of enhancement does not exclude the diagnosis.
Second opinion by -Teleradiology Providers

Friday, January 08, 2010

Congenital Absence of Adductor Muscles

Note is made of absence of the adductor group of muscles on the right side consistent with congenital absence. There is relative hypertrophy of the fatty tissue on the right side. This is a 9month old female with suspected CDH.

Further reading
Pediatr Radiol. 1981;11(3):157-9. Unilateral absence of thigh muscles confirmed by CT scan. Peterson JE, Currarino G

Tuesday, January 05, 2010

Asbestos Exposure-CT

CT is more sensitive than clinical evaluation for the detection of asbestosis but is inevitably less sensitive and less specific than pathologic evaluation. For the asbestos-exposed individual, CT is useful for the evaluation of suspected lung masses, particularly rounded atelectasis &  for identifying pleural plaques. CT also will identify and quantify emphysema as a cause of physiologic impairment.

Reported by -Teleradiology Providers

Monday, January 04, 2010

Intraparenchymal Haemorrhage on MRI

Mnemonic       Stage                    T1                              T2
It Be           Hyperacute           isointense (I)                  hyperintense (B)

IdDy           Acute                     iso to hypointense (I)      hypointense (D)

BiDdy         Early Subacute       hyperintense (B)              hypointense (D)

BaBy          Late Subacute        hyperintense (B)              hyperintense (B)

Doo Doo    Chronic                hypointense (D)              hypointense (D)

Groove Pancreatitis-MRCP

Groove pancreatitis is a form of chronic segmental pancreatitis affecting the groove in the region of the pancreatic head, duodenum, and common bile duct. Cystic dystrophy of the duodenal wall, an entity that is most likely related to groove pancreatitis, is characterized by the presence of cystic lesions in the thickened wall of the second portion of the duodenum.

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