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index [2022/01/24 21:55] – Kristen Scheitler, MD @k_scheitler Via Twitter administrator@icnapedia.orgindex [2024/03/23 20:48] (current) – biju.hameed@gmail.com
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-~~AUTHORS:off~~ +~~DISCUSSION: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: +
- +
-1. T2 FLAIR +
-2. T1 post-contrast  +
-3. DWI +
-4. GRE/SWI/SWAN/T2* +
- +
-1. T2 FLAIR: "What is grossly abnormal?" +
-anything abnormal = bright on T2 FLAIR +
-2. 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|}} +
-3. 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|}} +
-4. 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|}} +
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