MIMICS OF HEMORRHAGE ON MRI

Mimics of Hemorrhage: Hyperintensity on T1W Images

Fat (biological or oil-based contrast agents) Very high nonparamagnetic protein content Paramagnetic or iodinated contrast agents Calcification Paramagnetic ions (associated with liver disease, hyperalimentation, calcification, necrosis) Mucinous material Intratumoral melanin Hypermyelination Ferromagnetic artifact Slow flow

Mimics of Hemorrhage: Hypointensity on T2W Images

Iron without hemorrhage Calcification or bone Air Very high nonparamagnetic protein content Deoxyhemoglobin in patent veins Mucinous material Rapid or turbulent flow Ferromagnetic artifact

FRCR MCQ --NEURO MODULE

58. 35 yrs old male suffered from RTA.He was subjected to MRI of brain which shows  a lesion in right frontal lobe with mass effect .The lesion is slightly hypointense to brain on T1-weighted images and slightly hyperintense to brain on T2-weighted images with no contrast enhancement.There is restriction on diffusion weighted image . The lesion also shows a thin, irregular rim of marked hypointensity at the periphery of the lesion on T2-weighted images The lesion  becomes more evident in 3-T than lower-field systems and more obvious on GRE images.What is the most likely diagnosis

a. Hyperacute hematoma

b. Acute hematoma

c. Early subacute

d. Subacute to chronic

e.infarction

FRCR MCQ ---NEUR0 MODULE

56.All are true except

a. Spin echo imaging minimizes the effects of field inhomogeneities

b. gradient echo imaging is extremely sensitive to field inhomogeneities

c. air–tissue interfaces produce signal loss in GRE

d. higher magnetic field strengths enhance susceptibility 

e. Number of unpaired electrons in Oxyhemoglobin is 4

FRCR MCQ ----Diffusion imaging

Q.All are true regarding diffusion imaging in stroke except

a. DWI changes have been observed at less than 1 hour after the onset of ischemia

b. the ADC map shows hyperintensity beyond 10 days of stroke

c.Infarcts with greater percentages of low ADC values  have higher rates of hemorrhagic transformation

d. Enhancement and restricted diffusion often coexist in arterial infarction.

e. DWI of lesion volumes  enlarge over time after the acute stroke.

ANS---d

Enhancement and restricted diffusion are not generally found 

coexisting in arterial infarction.

ADC values is seen low within hours after the stroke and continue

 to decline for the next few days. They remain reduced through the

 first 4 to 5 days after stroke and then undergo pseudonormalization

 between 4 and 10 days . After this the ADC subsequently has been

 found to rise in the lesion (i.e., the ADC map shows 

hyperintensity) beyond 10 days.

DWI has been shown to improve lesion localization and detect the age of the infarction more accurately, DWI has also been shown more accurately to detect and size ischemic lesions. 

Wallerian degeneration

Q.Which MR imaging  is used to detect longitudinal changes due to Wallerian degeneration?

a.Spin –echo imaging

b.Gradient-echo imaging

c.Diffuion-tensor imaging

d.FLAIR

e.Inversion recovery imaging

ANS----C

Tractography image of corona radiata in healthy subject

The Rose Criterion

The Rose criterion

From a radiologic standpoint, the contrast-to-noise ratio (CNR) should be on the order of 4:1 or greater for the images to have sufficient contrast and be easily interpretable. 

This is known as the Rose criterion

Nobel prize for MRI

3. Who were jointly awarded the Nobel Prize in Physiology or Medicine (2003) “for their discoveries concerning magnetic resonance imaging”

a. Lauterbur and Sir Peter Mansfield

b. Bloch and Purcell

c. Ernst and Anderson

d. Jackson and  Damadian

e. Aberdeen and Nottingham

ANS -----a--Lauterbur and Sir Peter Mansfield

Look Ahead: The Next 100 Years of Radiology Education

“Who, what, when, where, how, and why” of education 

Renowned radiology educator Richard Gunderman, M.D., Ph.D.,view 

Who is Educating

• I anticipate that the locus of authority over radiology education will shift away from the people who compose and administer tests and accredit educational programs and toward the learners and educators actually doing the work. 
• Attention will focus more on the distinctive interests, abilities and resources of individual learners and educators, asking them less to conform to a monolithic standard and instead contribute distinctively to the educational enterprise.

What Education Is

• In the future, we will be interested less in memorization and more on whether learners pose good questions and show the potential to solve puzzles that their teachers have not yet imagined.

When Education Occurs

• William Osler’s ideal that medical education should begin, continue and end with the patient.
• 
  
• In short, we will recognize that learners gain more when they are actively inquiring—and especially when they are teaching—than when they are watching and listening to someone else

Where Education Occurs

• A corollary transition takes shape as we begin to recognize that the only truly meaningful locus of education is the minds and hearts of learners, not boardrooms where people design curricula, develop new instructional technologies and produce new educational assessment methods. 
• Osler’s advice: great education must begin, continue and end with the learner.
• In the future, we will grasp that in order to teach effectively, educators must get to know their learners. 

How Education Happens

• One of the most counterintuitive future developments in education will be a growing understanding of the limitations of technology as the solution to the challenges faced by learners and educators. I expect our successors will look back condescendingly on our current excitement over the transformative power of smartphones, tablets and computers to change education, much as we smile when we contemplate the raptures that accompanied the introduction of the carousel slide projector.

Why We Educate

Most importantly, the next 100 years will bring into focus the most critical educational interrogative of all: Why?

 Antoine de Saint-Exupéry, “When you want to build a ship, do not begin by gathering wood, cutting boards and distributing work, but awaken within the heart of human beings the desire for the vast and endless sea.” 

Whatever response we offer to the ultimate question concerning education’s purpose, we must never fail to attend to the hopes and dreams of learners and educators, around whom the entire educational apparatus should revolve.

LINK FOR MY NEW MCQ BOOK

LINK FOR MY NEW MCQ BOOK

FRCR Part 2A, MCQs on Thoracic & Cardiac Radiology

The book FRCR Part 2A ,MCQs on Thoracic & Cardiac Radiology contains 14 TEST PAPERS .Each test paper consists of 50 questions and so this book contains 700 MCQs (14 x50 =700).Each test paper is designed to cover the different topics of thoracic and cardiac radiolgy.The each test paper is followed by answer with detailed explanations with references .Most of MCQs are based on Adam: Grainger & Allison's Diagnostic Radiology, 5th ed.

https://www.createspace.com/5441503?ref=1147694&utm_id=6026

WHO WIN ARGUMENT ---FEMALE OR MALE AND WHY

Magnetic Resonance Imaging brain scans (MRI) clearly show why women have far greater capacity for communicating with and evaluating people than men do. 

Women have between fourteen and sixteen areas of the brain to evaluate others' behaviour versus a man's four to six areas.

The female brain is organised for multitracking — the average woman can juggle between two and four unrelated topics at the same time.

 She can watch a television programme while talking on the telephone plus listen to a second conversation behind her, while drinking a cup of coffee. She can talk about several unrelated topics in the one conversation and uses five vocal tones to change the subject or emphasise points. Unfortunately, most men can only identify three of these tones. As a result, men often lose the plot when women are trying to communicate with them