Hemorrhage - Case 6 MR SWI
Claim CME CreditPOINT OF CARE INFORMATION
This CME activity consists of the student reviewing the video of the professor reviewing the case as well as the associated DICOM image set related to the case in question.
Learning Objectives
As a result of participation in this activity, participants should be able to:
- Provide improved patient care.
- Greater knowledge of the imaging characteristics of the patient's disease.
- Understand a better approach to interpretation of studies.
Faculty Disclosure
Mehmet Albayram, MD, Ivan Davis, MD, Mariam Hanna, MD, Anthony Mancuso, MD, Ronald Quisling, MD, Dhanashree Rajderkar, MD, Priya Sharma, MD, Roberta Slater, MD and Joann Stamm, MBA have disclosed that they have no relevant financial relationships. No one else is a position to control content have any financial relationship to disclose.
CME Advisory Committee Disclosure:
Conflict of interest information for the CME Advisory Committee members can be found on the following website: https://cme.ufl.edu/disclosure/.
Continuing Medical Education Credit
Accreditation: The University of Florida College of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
Credit: The University of Florida College of Medicine designates this enduring material for a maximum of 0.5 AMA PRA Category 1 Credits. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
CB1707-Hemorrhage - Case 6 MR SWI
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CB1707-Hemorrhage - Case 6 MR SWI
Case ReportHistory
Exam
Prior Study
1. There is a single mass lesion (consistent with low grade tumor based on history) that has undergone recent hemorrhage necrosis the blood products evident in the dorsal anterior aspect of the tumor, which has released a small amount of blood into the ventricles. There is no secondary hydrocephalus.
2. The mass causes only local mass-effects with effacement of the left frontal horn but not the left cerebral aqueduct.
3. There is age-related ex vacuo ventriculomegaly and frontotemporal atrophic changes.
T1-w MR pre and post contrast
1. The left basifrontal intraaxial mass has contrast enhancement throughout. It has very distinct tumoral margin. The features are those of a low grade paraventricular brain tumor most consistent with low grade ependymoma.
2. There is evidence of some internal hemorrhagic necrosis, which is the source of the minimal intraventricular blood products.
T2-w spin echo
1. The spin echo T2-w sequence confirms the low grade nature of the left basifrontal mass and also indicates there has been intratumoral hemorrhagic necrosis.
MR flair
1. The MR flair also demonstrate changes of internal tumoral hemorrhagic necrosis with minimal intraventricular bleeding.
2. There is no transependymal fluid migration to suggest there is secondary hydrocephalus.
Findings
MR susceptibility (SWI)
The MR susceptibility sequence (SWI) demonstrates the full extent of the internal hemorrhagic necrosis within the tumor. It also clearly delineates blood within the occipital horns of the lateral ventricles and also in the caudal 4th ventricle.
The MR susceptibility sequence (SWI) demonstrates blood within the occipital horns of the lateral ventricles and also in the caudal 4th ventricle.
