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--- index [2020/02/01 17:38] – created icna
+++ index [2022/01/24 21:55] – Kristen Scheitler, MD @k_scheitler Via Twitter administrator@icnapedia.org
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+<nspages .:content -h1 -actualTitle -textPages="Index"  -exclude:index>
+~~AUTHORS:off~~
+====== Quick yet systematic approach to MR imaging of brain lesions ======
+In general, there are 4 MR sequences that will tell you 99% of what you need to know:
+. T2 FLAIR
+. T1 post-contrast
+. DWI
+. GRE/SWI/SWAN/T2*
+. T2 FLAIR: "What is grossly abnormal?"
+anything abnormal = bright on T2 FLAIR
+. T1+gadolinium*: "Where is the BBB disrupted?"
+Also:
+-"What is the vascular composition?"
+always compare T1+gad sequences to pure T1 without contrast (if also bright on pure T1, then BBB not necessarily disrupted)
+{{::fj1ehv3x0aykaij.jpg?200|}}
+. DWI*:
+bright = abnormal = "diffusion-restricting" = could be hypercellularity, ischemia, demyelination, abscess, &c
+**the above applies only if the corresponding area is dark on ADC sequence (if also bright on ADC, then just T2 shine-through)**
+{{::fj1eh_ixsay4td-.jpg?200|}}
+. GRE/SWI/SWAN/T2*: helps to distinguish nuances among entities on your differential.
+in general, abnormal = dark (blood, vascularity, &c; abscesses tend to have dark rims on SWI)
+{{::fj1eipkx0aihgp_.jpg?200|}}