Tag Archive | MRI

MAGIC DR – a handy mnemonic used to remember…

MAGIC DR – a handy mnemonic used to remember the potential causes of a cerebral ring enhancing lesion.

M – Metastasis

A – Abscess

G – Glioblastoma multiforme

I – Infarct (subacute phase)

C – Contusion

D – Demyelinating disease (eg. tumefactive MS)

R – Radiation necrosis

An alternative is DR MAGIC of course, which is what you may like to call yourself if you can remember the list! Although you can’t possibly know by looking at the single images, for what it is worth, the above cases are; A = metastasis, B = abscess, C = radiation necrosis, D = GBM, E = demyelination, F = contusion.

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Hypertensive haemorrhage – high blood pressure is the most…

Hypertensive haemorrhage – high blood pressure is the most common cause of primary intracerebral haemorrhage (also known as haemorrhagic stroke). Typical locations include:

This short educational video comes to you courtesy of Dr Frank Gaillard and the RadiologyChannel.

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Arcuate sign – a subtle but important avulsion fracture of the…

Arcuate sign – a subtle but important avulsion fracture of the proximal fibula at the site of arcuate ligament complex insertion. It is associated with cruciate ligament injury in around 90% of cases and represents an unstable posterolateral corner injury. When detected, the arcuate sign should prompt further evaluation with MRI and referral to an orthopaedic surgeon. 

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CLASSIC CASE: Post contrast MRI demonstrating an enhancing mass…

CLASSIC CASE: Post contrast MRI demonstrating an enhancing mass within the left lobe of liver with a central “scar”. Try out the BRAND NEW RADIOPAEDIA.ORG QUIZ MODE to work through this case and learn about the diagnosis. Click to enter QUIZ MODE

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Haemosiderin cap sign – a spinal tumour appearance where a cap…

Haemosiderin cap sign – a spinal tumour appearance where a cap of hypointense haemosiderin is seen on T2 weighed imaging above and / or below the tumour due to previous haemorrhage. It is most often associated with spinal ependymomas, being seen in 20-33% of these cases.  The sign however may also be seen in hemangioblastomas and paragangliomas and therefore while it is highly suggestive of ependymoma it is not pathognomonic. 

See our YouTube video tutorial on ‘Spinal Ependymoma’ here.

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Acoustic neuroma – a relatively common type…

Acoustic neuroma – a relatively common type of schwannoma arising from the vestibulocochlear nerve (CN VIII). It typically presents with sensorineural hearing loss or tinnitus and accounts for 75 – 90% of cerebellopontine angle masses. Extension into the internal acoustic canal is a major differentiating feature and results in a trumpeted appearance of the canal and a classic ice-cream cone appearance with the portion outside the canal representing the ice-cream. When seen bilaterally, acoustic neuromas are strongly suggestive of neurofibromatosis type 2.   

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Butterfly glioma – name given to a high grade astrocytoma,…

Butterfly glioma – name given to a high grade astrocytoma, usually a glioblastoma multiforme, which crosses the corpus callosum. The often symmetric projections extending out from the midline simulate butterfly wings. These tumors most frequently occur in the frontal lobes and like all high grade gliomas the prognosis is poor. Rarely cerebral metastasestumefactive demyelination, lymphoma or cerebral toxoplasmosis may mimic this appearance.

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Comb sign – seen in active Crohn’s disease. It describes…

Comb sign – seen in active Crohn’s disease. It describes prominent mesenteric vessels extending towards inflamed segments of small bowel like the teeth of a comb. The appearance is due to a combination of vascular distension and mesenteric fibrofatty proliferation. It can be seen on both CT and MRI.

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QUIZ: What does the bone contusion pattern on this knee MRI…

QUIZ: What does the bone contusion pattern on this knee MRI indicate? Click for ANSWER

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Black turbinate sign – an important MRI sign of mucormycosis; a…

Black turbinate sign – an important MRI sign of mucormycosis; a deadly form of acute invasive fungal sinusitis seen in diabetic and immunocompromised patients. Fungal spores germinate to produce angioinvasive hyphae that cause infarction as they invade the nasal mucosa. This results in a ‘black’ area of non-enhancing mucosa which stands out against the normal enhancing mucosa. The sign may be critical to early detection and treatment of mucormycosis which when untreated can result in blindness and death within 2 weeks.

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