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Pitfalls in Diagnostic Radiology

Abstract

False-negative perceptual pitfalls are important in neuroradiology, with commonly missed lesions lurking in anatomical blind spots such as the cerebral sulci, dural sinuses, cavernous sinuses, orbits, and the skull base. These review areas should be kept in mind, as should the differential diagnosis gamuts for bilaterally symmetrical brain lesions. Similarly, false-positive pitfalls from technical artifacts should be considered, including understanding the basic physics principles and limitations of magnetic resonance imaging (MRI), computed tomography (CT) and MR angiography, diffusion-weighted imaging (DWI), MR spectroscopy, and perfusion CT and MRI. Examples such as the complex T2 effects on DWI, the overlapping appearances of blood products on MRI, and atypical appearance in all diseases should be taken into account. Spinal cord imaging and pediatric neuroimaging have their own characteristics and pitfalls, and knowledge of disease patterns, non-accidental injury, and their mimics is essential.

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Abbreviations

2D:

Two-dimensional

3D:

Three-dimensional

ADC:

Apparent diffusion coefficient

CBF:

Cerebral blood flow

CBV:

Cerebral blood volume

CSF:

Cerebrospinal fluid

CT:

Computed tomography

CTA:

Computed tomography angiography

CTV:

Computed tomography venography

CVT:

Cerebral venous thrombosis

DSA:

Digital subtraction angiography

DTI:

Diffusion tensor imaging

DWI:

Diffusion-weighted imaging

EPI:

Echo-planar imaging

FLAIR:

Fluid-attenuated inversion recovery

GRE:

Gradient-recalled echo

MIP:

Maximum intensity projection

MPR:

Multi-planar reconstruction

MRA:

Magnetic resonance angiography

MRI:

Magnetic resonance imaging

MRS:

Magnetic resonance spectroscopy

MRV:

Magnetic resonance venography

MTT:

Mean transit time

PCT:

Perfusion CT

PWI:

Perfusion-weighted imaging

SAH:

Subarachnoid hemorrhage

TOF:

Time of flight

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Authors and Affiliations

  1. Department of Neuroradiology, National Neuroscience Institute, 11 Jalan Tan Tock Seng, Singapore, 308533, Republic of Singapore

    C. C. Tchoyoson Lim MBBS, MMed, FRCR & Mahendran Nadarajah BSc, MBBS, FRCR

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  1. C. C. Tchoyoson Lim MBBS, MMed, FRCR
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  2. Mahendran Nadarajah BSc, MBBS, FRCR
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Correspondence to C. C. Tchoyoson Lim MBBS, MMed, FRCR .

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  1. Department of Diagnostic Radiology, Khoo Teck Puat Hospital, Alexandra Health, Singapore, Singapore

    Wilfred C. G. Peh

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Lim, C.C.T., Nadarajah, M. (2015). Brain. In: Peh, W. (eds) Pitfalls in Diagnostic Radiology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-44169-5_10

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