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NS > Diagnostic Imaging > Flashcards

Diagnostic Imaging Flashcards

1
Q

Common locations for arachnoid cysts.

A
  1. Middle cranial fossa.
  2. CPA.
  3. Suprasellar.
  4. Miscellaneous (convexity, quadrigeminal).
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2
Q

Diagnostic checklist for arachnoid cysts.

A
  1. Follow CSF on all sequences.
  2. Suppresses completely on FLAIR.
  3. Shows no restriction on DWI.
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3
Q

Classic imaging findings of Dandy-Walker malformation.

A
  1. Cystic dilatation of 4th ventricle – enlarged posterior fossa, superiorly rotated hypoplastic vermis.
  2. Torcular-lambdoid inversion.
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4
Q

Findings of persistent Blake’s pouch cyst.

A
  1. Tetraventricular hydrocephalus, communicating 4th ventricle and posterior fossa cyst, with or without hypoplasia of both the cerebellar vermis and the medial aspects of the cerebellar hemispheres.
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5
Q

Characteristics of Joubert’s anomaly.

A
  1. Episodic hyperpnea, oculomotor apraxia, retinal dystrophy, +/- renal cysts, hepatic fibrosis.
  2. Split vermis, bat wing 4th ventricle, mesencephalon is shaped like a molar tooth.
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6
Q

Characteristic imaging findings of aqueductal stenosis.

A
  1. Ventriculomegaly of lateral and 3rd ventricles.
  2. Corpus callosum thinned, stretched upward.
  3. Fornix, internal cerebral veins, 3rd ventricular floor displaced downward.
  4. Enlarged rounded optic and infundibular recesses of 3rd ventricle.
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7
Q

What are some characteristics of rhombencephalosynapsis?

A
  1. Developmental midline anomaly.
  2. Continuity of cerebellar hemispheres with partial or complete absence of vermis.
  3. Other midline anomalies include: fusion of inferior/superior colliculi, aqueductal stenosis, absence of septum pellucidum.
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8
Q

What does the acronym CRASH syndrome stand for?

A

CRASH

  • callosal hypoplasia
  • mental retardation
  • adducted thumbs
  • spastic paraplegia
  • X-linked hydrocephalus
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9
Q

What are some abnormalities associated with CRASH syndrome?

A
  1. Absence/diminution of corticospinal tracts, thalamic fusion, collicular fusion, absence of septum pellucidum, corpus callosum dysgenesis.
  2. Thin cerebral mantle, malformations of cortical development, hypoplastic white matter.
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10
Q

What are some features of Walker-Warburg syndrome?

A
  1. Severe tectal dysgenesis.
  2. Aqueductal stenosis.
  3. Marked enlargement of lateral > 3rd ventricles.
  4. Zigzag brainstem.
  5. Small cerebellum.
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11
Q

What are some imaging features of callosal dysegnesis or callosal agenesis?

A
  1. On axial CT, lateral ventricles are parallel and separate.
  2. Atrium and occipital horns dilated (colpocephaly).
  3. ACAs course directly upward in interhemispheric fissure.
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12
Q

What is another term for septo-optic dysplasia?

A
  1. Morsier syndrome.
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13
Q

What is the pathophysiology of septo-optic dysplasia?

A
  1. Incomplete early morphogenesis of anterior midline structures producing hypoplasia of the optic nerves and possibly optic chiasm and pituitary infundibulum.
  2. Septum pellucidum is absent in about half the cases.
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14
Q

What are some characteristic imaging features of septo-optic dysplasia?

A
  1. Absent septum pellucidum.
  2. Small optic chiasm.
  3. Flat-roofed ventricles.
  4. Downward-pointing anterior horns.
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15
Q

What is Kallman syndrome?

A
  1. Absent olfactory nerves.

2. +/- visual, septal, pituitary abnormalities.

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16
Q

Characteristic imaging features of intracranial lipomas?

A
  1. Hyperintense on T1.

2. Hypointense on fat suppression.

17
Q

Common locations of intracranial lipomas?

A
  1. 80% supratentorial, most often in the midline.
  2. 40-50% interhemispheric fissure.
  3. 15-20% suprasellar.
  4. 10-15% tectal region.
18
Q

What can an intracranial lipoma mimic on non-con CT?

A
  1. Intracranial air.
19
Q

Presentation of hypothalamic hamartomas?

A
  1. Precocious puberty.
  2. Gelastic seizures (unprovoked laughter).
  3. Developmental delay.
20
Q

What is Klippel-Feil syndrome?

A
  1. Congenital fusion of two or more cervical vertebrae.
21
Q

What is the classic triad of Klippel-Feil syndrome?

A
  1. Low posterior hairline.
  2. Shortened neck (brevicollis).
  3. Limitation of neck motion.
22
Q

What locations are most commonly affected in Klippel-Feil syndrome?

A
  1. C2-3 (50%).

2. C5-6 (33%).

23
Q

What are some associated abnormalities with Klippel-Feil syndrome?

A
  1. Sensorineural hearing loss (30%).
  2. GU tract abnormalities (35%).
  3. Congenital heart disease (14%).
24
Q

Clinical features of tethered cord syndrome?

A
  1. LE weakness.
  2. Sensory deficit.
  3. Bladder dysfunction.
  4. Cutaneous findings (hypertrichosis, sub-q lipoma).
  5. Posterior spina bifida.
  6. Muscle atrophy, short limb, ankle deformity.
25
Q

Characteristic imaging features of tethered cord syndrome?

A
  1. Low lying conus (terminating below L2-3 always abnormal at any age).
  2. Filum thickened (> 2mm at L5-S1 on axial slice).
26
Q

What is a type 1 split-cord malformation?

A
  1. Two hemicords, each with its own central canal and surrounding pia, each within a separate dural tube separated by a dural-sheathed rigid osseocartilaginous median septum.
27
Q

What is a type 2 split-cord malformation?

A
  1. Two hemicords within a single dural tube, separated by a non-rigid fibrous median septum.
28
Q

Characteristic imaging features of Chiari O?

A
  1. Syringomyelia with low obex position.
  2. NO cerebellar tonsillar ectopia.
  3. Increased AP diameter of foramen magnum.
29
Q

Diagnostic criteria for Chiari I malformations?

A
  1. Herniation of at least 1 cerebellar tonsil > 5mm or herniation of both tonsils > 3-5 mm below a line connecting the basion with opisthion.
30
Q

Other imaging features of Chiari I malformations?

A
  1. +/- syringomyelia.
  2. Pointed tonsils with oblique vertical sulci.
  3. Elongated but normally located 4th ventricle.
31
Q

Characteristic imaging features of complex Chiari (aka Chiari 1.5)?

A
  1. Cerebellar tonsillar herniation with low obex.
  2. Medullary “bump”.
  3. +/- syringohydromyelia, ventral cervicomedullary compression.
  4. +/- odontoid retroflexion, small posterior fossa, clival anomalies, platybasia.
32
Q

Imaging features of Chiari II malformations?

A
  1. Cerebellum “wraps” around medulla and “towers” through incisura.
  2. Beaked tectum.
  3. Heart shaped midbrain.
  4. Low lying torcula.
  5. Cervicomedullary kink.
33
Q

What are some associated anomalies seen with Chiari II?

A
  1. Myelomeningocele (almost 100%).
  2. Posterior C1 arch anomalies.
  3. Syringohydromyelia.
  4. Corpus callosum dysgenesis.
  5. Lacunar skull (Luckenschadel).
34
Q

Diagnostic checklist for Chiari III?

A
  1. Occipitocervical encephalocele containing cerebellar +/- brainstem in conjunction with C1-C2 spina bifida.
35
Q

What is a Modic type 1 change?

A
  1. Hypointense on T1.

2. Hyperintense on T2.

36
Q

What is a Modic type 2 change?

A
  1. Hyperintense on T1.

2. Isointense on T2.

37
Q

What is a Modic type 3 change?

A
  1. Hypointense on T1 and T2.

NS (25 decks)

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