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Radiological features of neuropathologies
| <font 12pt/Arial,sans-serif;;black;;inherit>Radiological characteristics of neurological pathologies</font> | |||||||
| <font 11pt/Arial,sans-serif;;black;;inherit>Pathology</font> | <font 11pt/Arial,sans-serif;;black;;inherit>Ultra-sound</font> | <font 11pt/Arial,sans-serif;;black;;inherit>CT</font> | <font 11pt/Arial,sans-serif;;black;;inherit>MRI-T1</font> | <font 11pt/Arial,sans-serif;;black;;inherit>MRI-T2/FLIR</font> | <font 11pt/Arial,sans-serif;;black;;inherit>DWI</font> | <font 11pt/Arial,sans-serif;;black;;inherit>MRS</font> | <font 11pt/Arial,sans-serif;;black;;inherit>Other sequences</font> |
| <font 11pt/Arial,sans-serif;;black;;inherit>Oedema</font> | <font 11pt/Arial,sans-serif;;black;;inherit>Diffuse echogenicity</font> | ||||||
Reduced grey-white matte differentiation; sulcal pattern flattened</font> |<font 11pt/Arial,sans-serif;;black;;inherit>Hypointense</font> |<font 11pt/Arial,sans-serif;;black;;inherit>Hyperintense</font> |<font 11pt/Arial,sans-serif;;black;;inherit>Hyperintense.
Cytotoxic: Decreased
ADC (restricted diffusion)
Vasogenic: Increased
ADC (increased diffusion)</font> | | |
| <font 11pt/Arial,sans-serif;;black;;inherit>Mitochondrial cytopathy</font> | <font 11pt/Arial,sans-serif;;black;;inherit>Focal hypo-densities</font> | <font 11pt/Arial,sans-serif;;black;;inherit>Hypointense</font> | <font 11pt/Arial,sans-serif;;black;;inherit>Hyperintense</font> | <font 11pt/Arial,sans-serif;;black;;inherit>Vasogenic pattern in MELAS</font> | <font 11pt/Arial,sans-serif;;black;;inherit>Lactate doublet peak in mitochondrial disorders; NAA/Cr reduced</font> | <font 11pt/Arial,sans-serif;;black;;inherit>Perfusion-imaging: increased perfusion indices</font> | |
| <font 11pt/Arial,sans-serif;;black;;inherit>Infarction</font> | <font 11pt/Arial,sans-serif;;black;;inherit>Decreased echogenicity</font> | <font 11pt/Arial,sans-serif;;black;;inherit>Hypodense</font> | <font 11pt/Arial,sans-serif;;black;;inherit>Hypointense</font> | <font 11pt/Arial,sans-serif;;black;;inherit>Hyperintense in chronic lesions (lags DWI changes)</font> | <font 11pt/Arial,sans-serif;;black;;inherit>Hyperintense with decreased ADC (cytotoxic pattern) in recent lesions. Normal/increased ADC in older lesions</font> | <font 11pt/Arial,sans-serif;;black;;inherit>Lactate increased, NAA/Cr reduced,</font> | <font 11pt/Arial,sans-serif;;black;;inherit>Perfusionimaging: increased MTT, reduced CBF (reduced perfusion)</font> |
| <font 11pt/Arial,sans-serif;;black;;inherit>Haemorrhage</font> | <font 11pt/Arial,sans-serif;;black;;inherit>Increased echogenicity</font> | <font 11pt/Arial,sans-serif;;black;;inherit>Hyperdense</font> |
Hypointense in chronic lesions</font> |<font 11pt/Arial,sans-serif;;black;;inherit>Hypointense early.
Hyperintense cavity in later lesions</font> | | | |
| <font 11pt/Arial,sans-serif;;black;;inherit>Abscess</font> |
Contrastenhancing</font> |<font 11pt/Arial,sans-serif;;black;;inherit>Hypointense</font> |<font 11pt/Arial,sans-serif;;black;;inherit>Hyperintense.
Surrounding oedema hyperintensity typical</font> |<font 11pt/Arial,sans-serif;;black;;inherit>Hyper-intense/low ADC (restricted diffusion)</font> | |<font 11pt/Arial,sans-serif;;black;;inherit>Perfusion-imaging:
Decreased perfusion indices</font> |
| <font 11pt/Arial,sans-serif;;black;;inherit>Demyelination</font> | <font 11pt/Arial,sans-serif;;black;;inherit>Hypo-dense/normal</font> |
Contrastenhancement in acute lesions</font> |<font 11pt/Arial,sans-serif;;black;;inherit>Hyperintense.
Focal lesions with surrounding oedema (hypointense rim) in tumefactive lesions</font> |<font 11pt/Arial,sans-serif;;black;;inherit>Variable ADC.</font> |<font 11pt/Arial,sans-serif;;black;;inherit>Increased choline/Cr; myo-inositol and lactate peak.
Decreased NAA/Cr</font> | |
| <font 11pt/Arial,sans-serif;;black;;inherit>Tumour (glioma)</font> | <font 11pt/Arial,sans-serif;;black;;inherit>Hypodense. Perilesional oedema and contrastenhancement in high-grade lesion</font> | <font 11pt/Arial,sans-serif;;black;;inherit>Hypointense. Contrastenhancement in high-grade lesion</font> | <font 11pt/Arial,sans-serif;;black;;inherit>Hyperintense. High-grade lesions have oedema</font> | <font 11pt/Arial,sans-serif;;black;;inherit>Hypointense/high ADC (more restricted diffusion in high-grade)</font> | <font 11pt/Arial,sans-serif;;black;;inherit>Increased choline/Cr ratio; decreased NAA/Cr</font> | <font 11pt/Arial,sans-serif;;black;;inherit>Perfusion imaging: increased perfusion indices in high-grade lesion</font> | |
| <font 11pt/Arial,sans-serif;;black;;inherit>Fat/lipoma</font> | <font 11pt/Arial,sans-serif;;black;;inherit>Increased echogenicity</font> | <font 11pt/Arial,sans-serif;;black;;inherit>Hypodense</font> | <font 11pt/Arial,sans-serif;;black;;inherit>Hyperintense, No contrast enhancement</font> | <font 11pt/Arial,sans-serif;;black;;inherit>Hyperintense</font> | |||
| <font 11pt/Arial,sans-serif;;black;;inherit>Calcification</font> | <font 11pt/Arial,sans-serif;;black;;inherit>Increased echogenicity</font> | <font 11pt/Arial,sans-serif;;black;;inherit>Hyperdensities</font> | <font 11pt/Arial,sans-serif;;black;;inherit>Variable (subtle)</font> | <font 11pt/Arial,sans-serif;;black;;inherit>Hypointense (subtle)</font> | |||
Infective: toxoplasmosis, cystericosis; TB, miliary bacterial abscesses.
Haemorrhage.
Lymphoma, high-grade glioma.
Demyelination.
Tumour.</font> ||||||||
Source: Forsyth R, Newton R, eds. Paediatric Neurology (Oxford Specialist Handbooks in Paediatrics). 3 ed. ed. Oxford, UK: Oxford University Press; 2017. https://oxfordmedicine.com/view/10.1093/med/9780198784449.001.0001/med-9780198784449.
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