1/They say form follows function!

Brain MRI anatomy is best understood in terms of both form & function.

Here’s a thread to help you to remember important functional brain anatomy! 2/Let’s start at the top.

At the vertex is the superior frontal gyrus.

This is easy to remember, bc it’s at the top—and being at the top is superior. It’s like the superior king at the top of the vertex.

1/”I LOVE spinal cord syndromes!” is a phrase that has NEVER, EVER been said by anyone.

Do you become paralyzed when you see cord signal abnormality?

Never fear—here is a thread on all the incomplete spinal cord syndromes to get you moving again! 2/Spinal cord anatomy can be complex.

On imaging, we can see the ant & post nerve roots. We can also see the gray & white matter

Hidden w/in the white matter, however, are numerous efferent & afferent tracts—enough to make your head spin.

1/To be or not 2b?? That is the question!

Do you have questions about how to remember cervical lymph node anatomy & levels?

Here’s a SUPERBOWL thread to show you how! 2/Google cervical lymph node anatomy & you always get this anatomic picture w/the head flung back like a model posing.

But unless you live in LA, your patients don’t look like this & understanding anatomy from this image is difficult

1/Can’t remember what to look for on scans for memory loss?

New Alzheimer’s treatments are changing these scans!

Read on for the latest @theAJNR SCANtastic on imaging in AD:

… ajnr.org/content/early/ 2/Current hypothesis in Alzheimer’s disease (AD) is that accumulation of amyloid beta (AB) protein result sin inflammation & neuronal death

Thus, new treatments in AD are focused on anti-AB antibodies that remove this protein in AD patients.

1/Can’t remember what to look for on scans for memory loss?

New Alzheimer’s treatments are changing the way we look at these scans!

Read on to get up to date w/the latest @theAJNR SCANtastic on imaging for Alzheimer’s Disease:

ajnr.org/content/early/… @TheAJNR 2/Current hypothesis in Alzheimer’s disease (AD) is that accumulation of amyloid beta (AB) protein result sin inflammation & neuronal death

Thus, new treatments in AD are focused on anti-AB antibodies that remove this protein in AD patients.

1/Does trying to figure out cochlear anatomy cause your head to spiral?

Hungry for some help?

Here’s a thread to help you untwist cochlear CT anatomy w/food analogies! 2/On axial temporal bone CT, you cannot see the whole cochlea at once. So let’s start at the bottom.

The first thing you come to is the basal turn of the cochlea (makes sense, basal=bottom). On axial images, it looks like a banana. I remember both Basal and Banana start w/B.

1/Talk about dangerous liaisons!

Abnormal brain vascular connections like a dural arteriovenous fistula (dural AVF) can be dangerous!

This month’s @theAJNR SCANtastic thread is here to you some durable knowledge about dural AVFs!

ajnr.org/content/45/12/… 2/Dural sinuses sit inside dural leaflets.

Arteries that feed the dura also feed the walls of sinuses, like vasa vasorum.

Arteries in the walls of veins are a natural connection between the veins and arteries—but these connections are usually closed in normal pts.

1/Time to FESS up! Do you understand functional endoscopic sinus surgery (FESS)?

If you read sinus CTs, you better know what the surgeon is doing or you won’t know what you’re doing!

Here’s a thread to make sure you always make the important findings! 2/The first step is to insert the endoscope into the nasal cavity.

The first two structures encountered are the nasal septum and the inferior turbinate.

1/Ready for a throw down?

MMA fights get a lot of attention, but MMA (middle meningeal art) & dural blood supply doesn’t get the attention it deserves.

A thread on dural vascular anatomy! 2/Everyone knows about the blood supply to the brain.

Circle of Willis anatomy is king and loved by everyone, while the vascular anatomy of the blood supply to the dura is the poor, wicked step child of vascular anatomy that is often forgotten

1/Controversy in radiology can get tense!

The Mt Fuji sign for tension pnemocephalus is under scrutiny. When should you call it?

A thread about imaging this important neurosurgery complication 2/First, let’s clarify about what the Mt Fuji sign actually is

Most are familiar with the fact that large collections of pneumocephalus can compress the frontal lobes—making them look like the slopes of a mountain

But this isn’t actually enough to call Mt Fuji.

1/The medulla is anything but DULL!

Does seeing an infarct in the medulla cause your heart to skip a beat?

Does medullary anatomy send you into respiratory arrest?

Never fear, here is a thread on the major medullary syndromes! 2/The medulla is like a toll road.

Everything going down into the cord must pass through the medulla & everything from the cord going back up to the brain must too.

That’s a lot of tracts for a very small territory. Luckily you don’t need to know every tract

1/Time to rupture all your misconceptions about aneurysms!

When you see an aneurysm on imaging, do you know if it’s at high risk of rupture?

This month’s @theAJNR SCANtastic shows you which aneurysms are bursting w/risk!

ajnr.org/content/45/11/… 2/Aneurysm rupture is a devastating even, as it results in subarachnoid hemorrhage & complications such as hydrocephalus, vasospasm, infarcts, & death.

Preventing it by treating aneurysms before they rupture is key. But you also don’t want to overtreat.

1/Need help reading spine imaging? I’ve got your back!

It’s as easy as ABC!

A thread about an easy mnemonic you can use on every single spine study you see to increase your speed & make sure you never miss a thing! 2/A is for alignment

Look for:
(1) Unstable injuries

(2) Malalignment that causes early degenerative change. Abnormal motion causes spinal elements to abnormally move against each other, like grinding teeth wears down teeth—this wears down the spine

1/Raise your hand if you’re confused by the BRACHIAL PLEXUS!

I could never seem to remember or understand it—but now I do & I’ll show you how!

A thread so you will never fear brachial plexus anatomy again! 2/Everyone has a mnemonic to remember brachial plexus anatomy.

I’m a radiologist, so I remember one about Rad Techs.

But just remembering the names & their order isn’t enough.

That is just the starting point--let’s really understand it

1/Asking “How old are you?” can be dicey—both in real life & on MRI! Do you know how to tell the age of blood on MRI?

Here’s a thread on how to date blood on MRI so that the next time you see a hemorrhage, your guess on when it happened will always be in the right vein! 2/If you ask someone how to date blood on MRI, they’ll spit out a crazy mnemonic about babies that tells you what signal blood should be on T1 & T2 imaging by age.

But mnemonics are crutch—they help you memorize, but not understand. If you understand, you don’t need to memorize

1/To call it or not to call it? That is the question!

Feeling wacky & wobbly when it comes to normal pressure hydrocephalus?

Don’t want to overcall it, but don’t want to miss it either!

Check out the latest in NPH w/this month’s @theAJNR SCANtastic!

ajnr.org/content/45/10/… 2/NPH was first described in 1965—but, of the original 6 pts, 4 were found to have underlying causes for hydrocephalus.

This begs the question—when do you stop looking & call it idiopathic? When do you suggest it on imaging?

1/Do radiologists sound like they are speaking a different language when they talk about MRI?

T1 shortening what? T2 prolongation who?

Here’s a translation w/an introductory thread to MRI. 2/Let’s start w/T1—it is #1 after all! T1 is for anatomy

Since it’s anatomic, brain structures will reflect the same color as real life

So gray matter is gray on T1 & white matter is white on T1

So if you see an image where gray is gray & white is white—you know it’s a T1

1/Time is brain!

So you don’t have time to struggle w/that stroke alert head CT.

If there’s no flow, what are the things you need to know??

Here’s a thread to help you with the five main CT findings in acute stroke. 2/CT in acute stroke has 2 main purposes—(1) exclude intracranial hemorrhage (a contraindication to thrombolysis) & (2) exclude other pathologies mimicking acute stroke.

However, that doesn’t mean you can’t see other findings that can help you diagnosis a stroke.

1/They say form follows function!

Brain MRI anatomy is best understood in terms of both form & function.

Here’s a short thread to help you to remember important functional brain anatomy--so you truly can clinically correlate! 2/Let’s start at the top. At the vertex is the superior frontal gyrus. This is easy to remember, bc it’s at the top—and being at the top is superior. It’s like the superior king at the top of the vertex.

1/Radiologist not answering the phone?

Just want a quick read on that stat head CT?

Here's a little help on how to do it yourself w/a thread on how to read a head CT! 2/In bread & butter neuroimaging—CT is the bread—maybe a little bland, not super exciting—but necessary & you can get a lot of nutrition out of it

MRI is like the butter—everyone loves it, it makes everything better, & it packs a lot of calories. Today, we start w/the bread!

1/Want to TRI to learn something new about the TRIGEMINAL nerve?

If you’re only looking at the skullbase, you are missing a significant part of the trigeminal nucleus!

Let my help you TRI to up your game when it comes to TRIGEMINAL anatomy 2/We normally think of the trigeminal nerve nucleus in the brainstem.

But the trigeminal nucleus actually extends into the spine like a ponytail called the spinal trigeminal nucleus.