Done By: Dr. Faisal Al-Thekair

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Presentation transcript:

Done By: Dr. Faisal Al-Thekair MRI Brain Done By: Dr. Faisal Al-Thekair

MRI Brain Basics of MRI Brian Brian Anatomy Clinical scenarios Conclusion

Basics of MRI brain

Brain Anatomy

Lateral view of L hem

Brain Anatomy

Blood supply to the brain

Circle of Willis The Circle of Willis join the anterior and posterior circulation – the carotid and vertebral-basilar circulations Important route of secondary or collateral circulation in the event of loss of circulation The Circle of Willis is the most common location for congenital aneurysm

Imaging in stroke Acute stroke Initial imaging CT without IV contrast -Rapid -Reliable to exclude hemorrhage -High sensitivity for acute blood -Acute blood appears bright on CT relative to brain tissue. -IV contrast only if suspicion of another etiology, e.g. tumor or AVM

Cont.. Imaging in stroke pt MRI : Acute stroke appears as -Normal to low signal on T1WI -High signal on T2WI -High signal on FLAIR -High signal on DWI -FLAIR and DWI most sensitive

Ischemic Stroke MRI -Abnormal area becomes bright on DWI within 30 minutes of onset of ischemia -High signal visible on T2WI in about 8 hours -T1WI image becomes abnormal after ~16 hours -Infarcted area remains bright on T2WI forever. -As encephalomalacia occurs, infarct becomes progressively darker on T1WI until it matches signal of CSF

Ischemic Stroke Diffusion Weighted Imaging -Super-sensitive -Not super-specific -False positives: Hemorrhage MS Abscess Lymphoma and other tumors -In uncertain situations, repeat in 2 weeks Infarct should normalize on DWI -Area of ischemia visible within 30 minutes