WIDI - CA0609-MR Diffusion

MR Diffusion

Claim CME Credit

0.5 CME Credit available on completion

POINT 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.

CA0609-MR Diffusion

Exam

MR diffusion

Prior Study

Noncontrast head
CT Acute thrombosis is evident within the posterior (parietal/occipital) segments of the superior sagittal sinus extending into the torcular herophile and the straight sinus. There is no apparent cortical or deep central vein CVT

CT perfusion: No CT perfusion is available

CTV of the neck: No CTV neck is available

CTV of the head
There is evidence of partial recanalization of dural sinus thromboses, which include the parietal-occipital segments of the SSS, the torcular herophile, the initial segment of the transverse sinuses, and the straight sinus. Multiple effective routes of collateral venous egress are present, as listed above. There is also some antegrade venous blood flow after partial recanalization.

Delayed post contrast CT
Dural sinus thrombosis is evident affecting the distal SSS, the straight sinus, the torcula, and both mesial segments transverse sinuses proximal to the lateral tentorial venous confluences.

There is moderate venous congestion in the deep central venous system. The venous congestion accounts for the size effacement of the upper third ventricle. There is no evidence of venous stroke nor hemorrhagic conversion.

Pre contrast T1 MR
There is evidence of recent thrombus within the distal SSS, straight sinus, torcula, and mesial segments transverse sinuses. The age of the thrombus is acute, since the clot evolution has not yet change into the met-hemoglobin phase (which would appear hyperintense).

There is evidence of deep central venous congestion now affecting the deep medullary veins indicating at least moderate venous congestion. There is no hemorrhagic conversion nor acute hydrocephalus nor clear evidence of optic hydrops.