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