MRS for non-radiologist Part 2:

Goal: Learn how different disease processes have unique spectrogram followed by a few cases.

Most of the images are from personal collection; others have appropriate source credited in pubmed#

Before we move on, let’s review part 1 to refresh.

https://twitter.com/JayKinariwala/status/1530350707538284548

👉🏻👀history & MRI 1st before looking at MRS
👉🏻Mindful of TE,🧲strength, location of Voxel & adequate H2O suppression
👉🏻When needed, compare w/ contralateral side
👉🏻👀NAA & Choline 1st, then the rest
👉🏻Learn metabolites & significance➡️derive D/D of tissue➡️Diagnosis
👉🏻⚠️pitfalls

Ever wondered how MR Spectroscopy (MRS) is acquired & how to interpret it? Have you ever come across funky looking zigzag graph with MRI & scratched your head?

If interested in learning BASICS of MRS, follow this 🧵

MRS for non-radiologists
#EmoryNCCTweetorials @MedTweetorials First available since 1980, 1H-MRS is noninvasive technique uses proton signals to determine relative concentrations of tissue metabolites & thereby acquiring data about chemical composition of a tissue.
13C MRS
23Na MRS(neurocognitive,brain tumor research)
31P MRS(🫀&💪🏻research)

When was the last time you saw a pt with hepatic encephalopathy or lost a pt to cerebral edema from it?

Ever wondered why liver failure causes HE & Cerebral edema? What if conventional Rx fail?

If interested in journey to MARS, keep reading.
Bringing awareness to #neurologists. Pt w/ MVA,G5 liver lac,hepatic art sacrificed,LFT 5k,NH3 250,GCS 4
Pt w/🍺cirrhosis,found down,severe rhabdo,CK📈,NH3 400s,renal shutdown,GCS 5
Pt w/ colon Ca on @KEYTRUDA w/jaundice DILI
Pt w/ liver transplant, p/w intractable pruritus

You got the gist-MARS aka Albumin dialysis

Humanity has but three great enemies: fever, famine and war; of these, by far the greatest, by far the most terrible, is fever. -Sir William Osler

That’s why temperature is one of the “vital signs” (not pain🤨) So if you have ever wondered how body controls🌡 & never got an answer beyond - somewhere in 🧠hypothalamus; here’s an explanation.
🤕 is admitted H&H 4 SAH + IVH. This is the temp📈-shows, patient started spiking 🌡@ 24hrs & peaked ~72hrs. Cultures ⏲ ABX started on admission.

1/ Antiepileptic drugs: a constantly evolving frontier- like many other fields in #Neurology. It’s hard to know about every single medication in-depth. Here, I attempted to make AEDs simple, easy to understand and a handy layout of important facts to know about #AED #epilepsy. 2/ Let’s begin with understanding what is synapse and how it works, then only we can understand how the AEDs work. Look at the cartoon I created from references (acknowledged at the end) with help of an amazing app #Procreate. I’m a fan of @PeterMLawrence1 great art work !!