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Page 1: IRM de diffusion IRM de perfusion - AFIIM.COM I do NeuroRx.pdfIRM de diffusion IRM de perfusion Author: Julien Savatovsky Created Date: 6/9/2015 12:22:02 AM

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Page 2: IRM de diffusion IRM de perfusion - AFIIM.COM I do NeuroRx.pdfIRM de diffusion IRM de perfusion Author: Julien Savatovsky Created Date: 6/9/2015 12:22:02 AM

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Page 3: IRM de diffusion IRM de perfusion - AFIIM.COM I do NeuroRx.pdfIRM de diffusion IRM de perfusion Author: Julien Savatovsky Created Date: 6/9/2015 12:22:02 AM

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Page 4: IRM de diffusion IRM de perfusion - AFIIM.COM I do NeuroRx.pdfIRM de diffusion IRM de perfusion Author: Julien Savatovsky Created Date: 6/9/2015 12:22:02 AM

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Page 6: IRM de diffusion IRM de perfusion - AFIIM.COM I do NeuroRx.pdfIRM de diffusion IRM de perfusion Author: Julien Savatovsky Created Date: 6/9/2015 12:22:02 AM

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Page 8: IRM de diffusion IRM de perfusion - AFIIM.COM I do NeuroRx.pdfIRM de diffusion IRM de perfusion Author: Julien Savatovsky Created Date: 6/9/2015 12:22:02 AM

Impossible to put the head coil due to scoliosis => 2 Flex coils around the head

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Page 9: IRM de diffusion IRM de perfusion - AFIIM.COM I do NeuroRx.pdfIRM de diffusion IRM de perfusion Author: Julien Savatovsky Created Date: 6/9/2015 12:22:02 AM

Image quality could still be decent without a head coil

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Page 10: IRM de diffusion IRM de perfusion - AFIIM.COM I do NeuroRx.pdfIRM de diffusion IRM de perfusion Author: Julien Savatovsky Created Date: 6/9/2015 12:22:02 AM

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Page 11: IRM de diffusion IRM de perfusion - AFIIM.COM I do NeuroRx.pdfIRM de diffusion IRM de perfusion Author: Julien Savatovsky Created Date: 6/9/2015 12:22:02 AM

More lateral coverage for Sag 3D acquisitions. Cover the entire ears as parallelimaging may induce foldover artifact inside the brain

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Page 12: IRM de diffusion IRM de perfusion - AFIIM.COM I do NeuroRx.pdfIRM de diffusion IRM de perfusion Author: Julien Savatovsky Created Date: 6/9/2015 12:22:02 AM

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Like a construction game. Chose pieces

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Thrombus appears as a filling defect on CE-mra and is strongly hypointense on T2*

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Page 36: IRM de diffusion IRM de perfusion - AFIIM.COM I do NeuroRx.pdfIRM de diffusion IRM de perfusion Author: Julien Savatovsky Created Date: 6/9/2015 12:22:02 AM

Small & cortical DVT may be better seen on SWI or raw images from CEmra

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Page 37: IRM de diffusion IRM de perfusion - AFIIM.COM I do NeuroRx.pdfIRM de diffusion IRM de perfusion Author: Julien Savatovsky Created Date: 6/9/2015 12:22:02 AM

Flow related techniques such as PC may falsely lead to a diagnosis of venousthrombosis in case of slow flow such as in th left lateral sinus

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Up : high grade glioma

Down, left : colloid cyst in the 3rd ventricule associated with hydrocephalus

Down, righ : cavernoma

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Diffuse and regular (without nodules) dural thickening

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Page 43: IRM de diffusion IRM de perfusion - AFIIM.COM I do NeuroRx.pdfIRM de diffusion IRM de perfusion Author: Julien Savatovsky Created Date: 6/9/2015 12:22:02 AM

Sphenoidal sinusitis

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Apoplexy

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Upper images : 2 broad-based dural fully enhancing lesions : meningiomas

Lower images : non enhancing lesion in T2 high-SI but not exactly the same signal as CSF on FLAIR and cisternographic T2 sequence : epidermoid cyst

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Page 58: IRM de diffusion IRM de perfusion - AFIIM.COM I do NeuroRx.pdfIRM de diffusion IRM de perfusion Author: Julien Savatovsky Created Date: 6/9/2015 12:22:02 AM

Multiple sclerosis with pontine and cerebellar peduncles active lesions.

Note that some of the supra-tentorial lesions are centered by venules on SWI imaging

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Page 59: IRM de diffusion IRM de perfusion - AFIIM.COM I do NeuroRx.pdfIRM de diffusion IRM de perfusion Author: Julien Savatovsky Created Date: 6/9/2015 12:22:02 AM

Postero-lateral medulla infarction with cervical vertebral artery dissection

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Positionning in the sagittal plane : 2 anatomical landmarks

- Median sagittal slice : pons-medulla junction

- Slightly more lateral slice : IAC is cut perpendicularly and appears as a gray disc within the black petrous bone

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Adjust the lateral obliquity in coronal plane

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Small intralabyrinthine schwannoma, very difficult to depict on cisternographicimages alone, easier to see on T1 post-gad sequence

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Atrophy with ventricular enlargment but no hippocampal involvement if small vesseldisease is isolated

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Up : old lacunar infarction

Down : microbleeds on T2* sequence. If several peripherical microbleeds present, amyloïd angiopthy may be discussed

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Hippocampus atrophy

Precuneus atrophy visible on sagittal plane

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Frontal meninioma

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Subdural hematoma

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Up : Acute stroke < 6hrs : usually no FLAIR abnomality except slow vessels in high-SI

Down : Stroke in diffusion high SI with low ADC and high FLAIR SI – usually more than6 hrs and less than 1 week

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Better vessel assessment including thrombus site, lenght with CE-MRA and SWI

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Cemra : simultaneous assessment of supraaortic arteries : useful if endovascularprocedure is done after the mri

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