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index [2022/01/24 21:55]
administrator@icnapedia.org Kristen Scheitler, MD @k_scheitler Via Twitter
index [2022/01/24 22:21] (current)
administrator@icnapedia.org
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-====== Quick yet systematic approach to MR imaging of brain lesions ====== 
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-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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