Brain MRI - Revision history

Jdiamond: additional explanation of what flair imaging shows

2017-05-09T15:58:53Z

additional explanation of what flair imaging shows

← Older revision		Revision as of 15:58, 9 May 2017
Line 29:		Line 29:
	===Fluid Attenuation Inversion Recovery (FLAIR)===		===Fluid Attenuation Inversion Recovery (FLAIR)===
	[[File:FLAIR Brain.png\|150px]]		[[File:FLAIR Brain.png\|150px]]
	*Appears as T2 images with hypointense CSF		*Appears as T2 images with hypointense CSF- cancels out CSF so you can differentiate CSF from other fluid
	*Ideal for identifying tumors/GBS		*Ideal for identifying tumors/GBS
	*Also used to identify leptomeningeal enhancement in meningitis		*Also used to identify leptomeningeal enhancement in meningitis

Rossdonaldson1: /* See Also */

2017-02-18T20:41:48Z

Rossdonaldson1: /* Ordering Studies */

2017-02-18T20:41:25Z

Ordering Studies

← Older revision		Revision as of 20:41, 18 February 2017
Line 10:		Line 10:
	{{MR studies CVA/TIA}}		{{MR studies CVA/TIA}}

	*Contrast only needed if concern for malignancy/mass		''Contrast only needed if concern for malignancy/mass''

	==MRI Modalities==		==MRI Modalities==

Rossdonaldson1: /* Ordering Studies */

2017-02-18T20:41:01Z

Ordering Studies

← Older revision		Revision as of 20:41, 18 February 2017
Line 9:		Line 9:
	==Ordering Studies==		==Ordering Studies==
	{{MR studies CVA/TIA}}		{{MR studies CVA/TIA}}

			*Contrast only needed if concern for malignancy/mass

	==MRI Modalities==		==MRI Modalities==

Rossdonaldson1: /* Ordering Studies */

2017-02-18T18:18:02Z

Ordering Studies

← Older revision		Revision as of 18:18, 18 February 2017
Line 8:		Line 8:

	==Ordering Studies==		==Ordering Studies==
	~~===Ordering for Rule-Out [[~~CVA~~]] or [[~~TIA~~]]===~~		{{MR studies CVA/TIA}}
	*[[MRI Brain]] with DWI (without contrast) '''AND'''
	*Cervical vascular imaging (ACEP Level B in patients with high short-term risk for stroke):<ref name="ACEP">ACEP Clinical Policy: Suspected Transient Ischemic Attack[https://www.acep.org/Physician-Resources/Policies/Clinical-policies/Clinical-Policy-Suspected-Transient-Ischemic-Attack/ full text]</ref>
	**MRA brain (without contrast) '''AND'''
	**MRA neck (without contrast)
	***May instead use Carotid CTA or US (Carotid US slightly less sensitive than MRA)<ref>Nederkoorn PJ, Mali WP, Eikelboom BC, et al. Preoperative diagnosis of carotid artery stenosis. Accuracy of noninvasive testing. Stroke. 2002;33:2003-2008.</ref> (ACEP Level C)

	==MRI Modalities==		==MRI Modalities==

Rossdonaldson1: /* Ordering for Rule-Out CVA or TIA */

2017-02-18T18:17:35Z

Ordering for Rule-Out CVA or TIA

← Older revision		Revision as of 18:17, 18 February 2017
Line 10:		Line 10:
	===Ordering for Rule-Out [[CVA]] or [[TIA]]===		===Ordering for Rule-Out [[CVA]] or [[TIA]]===
	*[[MRI Brain]] with DWI (without contrast) '''AND'''		*[[MRI Brain]] with DWI (without contrast) '''AND'''
	*Cervical vascular imaging (~~to predict~~ short-term risk):<ref name="ACEP">ACEP Clinical Policy: Suspected Transient Ischemic Attack[https://www.acep.org/Physician-Resources/Policies/Clinical-policies/Clinical-Policy-Suspected-Transient-Ischemic-Attack/ full text]</ref>		*Cervical vascular imaging (ACEP Level B in patients with high short-term risk for stroke):<ref name="ACEP">ACEP Clinical Policy: Suspected Transient Ischemic Attack[https://www.acep.org/Physician-Resources/Policies/Clinical-policies/Clinical-Policy-Suspected-Transient-Ischemic-Attack/ full text]</ref>
	**MRA brain (without contrast) ~~(ACEP Level B in patients with high short-term risk for stroke)~~		**MRA brain (without contrast) '''AND'''
	**MRA neck (without contrast)		**MRA neck (without contrast)
			***May instead use Carotid CTA or US (Carotid US slightly less sensitive than MRA)<ref>Nederkoorn PJ, Mali WP, Eikelboom BC, et al. Preoperative diagnosis of carotid artery stenosis. Accuracy of noninvasive testing. Stroke. 2002;33:2003-2008.</ref> (ACEP Level C)
	Carotid US~~/CTA/MRA in patients with high short-term risk for stroke~~ (~~ACEP Level B)~~
	~~***~~Carotid US is slightly less sensitive than MRA~~, but useful for carotid stenosis eval~~<ref>Nederkoorn PJ, Mali WP, Eikelboom BC, et al. Preoperative diagnosis of carotid artery stenosis. Accuracy of noninvasive testing. Stroke. 2002;33:2003-2008.</ref> (ACEP Level C)

	==MRI Modalities==		==MRI Modalities==

Rossdonaldson1: /* Ordering for Rule-Out CVA or TIA */

2017-02-18T17:54:42Z

Ordering for Rule-Out CVA or TIA

← Older revision		Revision as of 17:54, 18 February 2017
Line 9:		Line 9:
	==Ordering Studies==		==Ordering Studies==
	===Ordering for Rule-Out [[CVA]] or [[TIA]]===		===Ordering for Rule-Out [[CVA]] or [[TIA]]===
	*[[MRI Brain]] with DWI (without contrast) '''~~and~~'''		*[[MRI Brain]] with DWI (without contrast) '''AND'''
	*Cervical vascular imaging (to predict short-term risk):<ref name="ACEP">ACEP Clinical Policy: Suspected Transient Ischemic Attack[https://www.acep.org/Physician-Resources/Policies/Clinical-policies/Clinical-Policy-Suspected-Transient-Ischemic-Attack/ full text]</ref>		*Cervical vascular imaging (to predict short-term risk):<ref name="ACEP">ACEP Clinical Policy: Suspected Transient Ischemic Attack[https://www.acep.org/Physician-Resources/Policies/Clinical-policies/Clinical-Policy-Suspected-Transient-Ischemic-Attack/ full text]</ref>
	**~~MRI with DWI/~~MRA in patients with high short-term risk for stroke ~~(ACEP Level B~~)		**MRA brain (without contrast) (ACEP Level B in patients with high short-term risk for stroke)
	**Carotid US/CTA/MRA in patients with high short-term risk for stroke (ACEP Level B)		**MRA neck (without contrast)

			Carotid US/CTA/MRA in patients with high short-term risk for stroke (ACEP Level B)
	***Carotid US is slightly less sensitive than MRA, but useful for carotid stenosis eval<ref>Nederkoorn PJ, Mali WP, Eikelboom BC, et al. Preoperative diagnosis of carotid artery stenosis. Accuracy of noninvasive testing. Stroke. 2002;33:2003-2008.</ref> (ACEP Level C)		***Carotid US is slightly less sensitive than MRA, but useful for carotid stenosis eval<ref>Nederkoorn PJ, Mali WP, Eikelboom BC, et al. Preoperative diagnosis of carotid artery stenosis. Accuracy of noninvasive testing. Stroke. 2002;33:2003-2008.</ref> (ACEP Level C)

Rossdonaldson1: /* Ordering Studies */

2017-02-18T17:50:02Z

Ordering Studies

← Older revision		Revision as of 17:50, 18 February 2017
Line 9:		Line 9:
	==Ordering Studies==		==Ordering Studies==
	===Ordering for Rule-Out [[CVA]] or [[TIA]]===		===Ordering for Rule-Out [[CVA]] or [[TIA]]===
	*[[MRI Brain]] DWI and ~~cervical~~ vascular imaging predict short-term risk ~~for stroke in patients presenting with suspected TIA~~<ref name="ACEP">ACEP Clinical Policy: Suspected Transient Ischemic Attack[https://www.acep.org/Physician-Resources/Policies/Clinical-policies/Clinical-Policy-Suspected-Transient-Ischemic-Attack/ full text]</ref>~~. When feasible, physicians should obtain:~~		*[[MRI Brain]] with DWI (without contrast) '''and'''
			*Cervical vascular imaging (to predict short-term risk):<ref name="ACEP">ACEP Clinical Policy: Suspected Transient Ischemic Attack[https://www.acep.org/Physician-Resources/Policies/Clinical-policies/Clinical-Policy-Suspected-Transient-Ischemic-Attack/ full text]</ref>
	**MRI with DWI/MRA in patients with high short-term risk for stroke (ACEP Level B)		**MRI with DWI/MRA in patients with high short-term risk for stroke (ACEP Level B)
	**Carotid US/CTA/MRA in patients with high short-term risk for stroke (ACEP Level B)		**Carotid US/CTA/MRA in patients with high short-term risk for stroke (ACEP Level B)
	***Carotid US is slightly less sensitive than MRA, but useful for carotid stenosis eval<ref>Nederkoorn PJ, Mali WP, Eikelboom BC, et al. Preoperative diagnosis of carotid artery stenosis. Accuracy of noninvasive testing. Stroke. 2002;33:2003-2008.</ref> (ACEP Level C)		***Carotid US is slightly less sensitive than MRA, but useful for carotid stenosis eval<ref>Nederkoorn PJ, Mali WP, Eikelboom BC, et al. Preoperative diagnosis of carotid artery stenosis. Accuracy of noninvasive testing. Stroke. 2002;33:2003-2008.</ref> (ACEP Level C)


	==MRI Modalities==		==MRI Modalities==

Rossdonaldson1 at 17:47, 18 February 2017

2017-02-18T17:47:55Z

← Older revision		Revision as of 17:47, 18 February 2017
Line 6:		Line 6:
	**Dark areas are hypointense		**Dark areas are hypointense
	**Bright areas are hyperintense		**Bright areas are hyperintense

			==Ordering Studies==
			===Ordering for Rule-Out [[CVA]] or [[TIA]]===
			*[[MRI Brain]] DWI and cervical vascular imaging predict short-term risk for stroke in patients presenting with suspected TIA<ref name="ACEP">ACEP Clinical Policy: Suspected Transient Ischemic Attack[https://www.acep.org/Physician-Resources/Policies/Clinical-policies/Clinical-Policy-Suspected-Transient-Ischemic-Attack/ full text]</ref>. When feasible, physicians should obtain:
			**MRI with DWI/MRA in patients with high short-term risk for stroke (ACEP Level B)
			**Carotid US/CTA/MRA in patients with high short-term risk for stroke (ACEP Level B)
			***Carotid US is slightly less sensitive than MRA, but useful for carotid stenosis eval<ref>Nederkoorn PJ, Mali WP, Eikelboom BC, et al. Preoperative diagnosis of carotid artery stenosis. Accuracy of noninvasive testing. Stroke. 2002;33:2003-2008.</ref> (ACEP Level C)


	==MRI Modalities==		==MRI Modalities==

Neil.m.young at 15:34, 16 May 2016

2016-05-16T15:34:24Z

← Older revision		Revision as of 15:34, 16 May 2016
Line 29:		Line 29:

	===Diffusion Weighted Imaging (DWI)===		===Diffusion Weighted Imaging (DWI)===
			[[File:DWI Brain.png\|150px]]
	*A method of measuring the Brownian motion of water molecules		*A method of measuring the Brownian motion of water molecules
	*Diffusion within the intracellular fluid, diffusion within extracellular fluid, and between these areas will differ depending on pathology		*Diffusion within the intracellular fluid, diffusion within extracellular fluid, and between these areas will differ depending on pathology

← Older revision		Revision as of 20:41, 18 February 2017
Line 57:		Line 57:
	==See Also==		==See Also==
	*[[MRI (main)]]		*[[MRI (main)]]

			==References==
			<references/>

	[[Category:Neurology]]		[[Category:Neurology]]
	[[Category:Radiology]]		[[Category:Radiology]]