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| ====== Radiological features of neuropathologies ====== | ====== Radiological features of neuropathologies ====== |
| | ^ Radiological characteristics of neurological pathologies ^||||||| |
| | | Pathology | Ultra-sound | CT | MRI-T1 | MRI-T2/FLIR | DWI | MRS | Other sequences | |
| | | Oedema | Diffuse echogenicity | Hypodense.\\ 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, then hyperintense after a few days. \\ Hypointense in chronic lesions | Hypointense early.\\ Hyperintense cavity in later lesions | | | | |
| | | Abscess | | Hypodense.\\ Contrastenhancing | Hypointense | Hyperintense.\\ Surrounding oedema hyperintensity typical | Hyper-intense/low ADC (restricted diffusion) | | Perfusion-imaging:\\ Decreased perfusion indices | |
| | | Demyelination | | Hypo-dense/normal | Hypointense.\\ 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) | | | | |
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| |Radiological characteristics of neurological pathologies |||||||| | Differential of ring-enhancing lesions.\\ Infective: toxoplasmosis, cystericosis; TB, miliary bacterial abscesses.\\ Haemorrhage.\\ Lymphoma, high-grade glioma.\\ Demyelination.\\ Tumour. |
| |Pathology |<font 11pt/Arial,sans-serif;;black;;inherit>Ultra-sound</font> |CT |MRI-T1 |MRI-T2/FLIR |DWI |MRS |Other sequences | | |
| |Oedema |Diffuse echogenicity |Hypodense. \\ | |
| 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, then hyperintense after a few days. \\ | |
| Hypointense in chronic lesions |Hypointense early. \\ | |
| Hyperintense cavity in later lesions | | | | | |
| |Abscess | |Hypodense. \\ | |
| Contrastenhancing |Hypointense |Hyperintense. \\ | |
| Surrounding oedema hyperintensity typical |Hyper-intense/low ADC (restricted diffusion) | |Perfusion-imaging: \\ | |
| Decreased perfusion indices | | |
| |Demyelination | |Hypo-dense/normal |Hypointense. \\ | |
| 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) | | | | | |
| |Differential of ring-enhancing lesions. \\ | |
| Infective: toxoplasmosis, cystericosis; TB, miliary bacterial abscesses. \\ | |
| Haemorrhage. \\ | |
| Lymphoma, high-grade glioma. \\ | |
| Demyelination. \\ | |
| Tumour. |||||||| | |
| {{tag>neurolists}} | {{tag>neurolists}} |
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| | Also see: [[systematic_approach_to_mr_images]] |
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| 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. | 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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