MR diffusion
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.
CB1193-MR diffusion
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CB1193-MR diffusion
Case ReportHistory
Exam
Prior Study
1. There are minimal changes of leptomeningeal reaction or leptomeningeal infection (possibly viral). The patient has been treated with antibiotics making CSF cultures negative. Differential includes immune overshoot response to the documented GI adenoviral infections (cytokine storm/SIRS) versus actual infectious leptomeningitis.
MR T1-w post contrast
1. Negative post contrast T1-w head MR coronal
Findings
MR diffusion
The MR diffusion is positive on DWI and negative ADC consistent with T2 shine-through involving the parietal lobes bilaterally and posterior frontal high convexity on the left. There is no involvement of the basal ganglia, thalamus, brain stem or central cerebellum to suggest hypoxia, hypoglycemia or HIE. There is no hippocampal abnormality to suggest effects of status epilepticus.
There are three sites of small focal subcortical lesions that display actual tissue restriction (cytogenic injury).
Impression
Three small subcortical sites of positive MR diffusion are present consistent with cytogenic injury; basis is indeterminate.
Recommendations
No recommendation
