ExpertDDx: Brain and Spine

SKULL AND BRAIN

Scalp, Skull

Anatomically Based Differentials

Skull Normal Variants

Scalp Mass, Child

Scalp Mass, Adult

Congenital Anomalies of Skull Base

Sellar/Parasellar Mass With Skull Base Invasion

Generic Imaging Patterns

Hair on End

Thick Skull, Generalized

Thick Skull, Localized

Thin Skull, Generalized

Thin Skull, Localized

Lytic Skull Lesion, Solitary

Multiple Lucent Skull Lesions

Sclerotic Skull Lesion, Solitary

Sclerotic Skull Lesions, Multiple

Clinically Based Differentials

Macrocephaly

Microcephaly

Meninges

Anatomically Based Differentials

Dural Calcification(s)

Dural-Based Mass, Solitary

Dural-Based Masses, Multiple

Falx Lesions

Generic Imaging Patterns

Thick Dura/Arachnoid, Generalized

Pial Enhancement

Dural Tail Sign

Ventricles, Periventricular Regions

Anatomically Based Differentials

Ventricles, Normal Variants

Choroid Plexus Lesions, Child

Choroid Plexus Lesions, Adult

Ependymal/Subependymal Lesions

Lateral Ventricle Mass

Thick Septum Pellucidum

Foramen of Monro Mass

3rd Ventricle Mass, Anterior

3rd Ventricle Mass, Body/Posterior

Cerebral Aqueduct/Periaqueductal Lesion

4th Ventricle Mass, Child

4th Ventricle Mass, Adult

Generic Imaging Patterns

Bubbly Appearing Intraventricular Mass

Ependymal Enhancement

Large Ventricles

Small Ventricles

Asymmetric Lateral Ventricles

Irregular Lateral Ventricles

Periventricular Enhancing Lesions

Modality-Specific Imaging Findings

Intraventricular Calcification(s)

Periventricular Calcification(s)

Periventricular T2/FLAIR Hyperintense Lesions

Extraaxial Spaces and Subarachnoid Cisterns

Anatomically Based Differentials

Cistern, Subarachnoid Space Normal Variants

Epidural Mass

Enlarged Sulci, Generalized

Effaced Sulci, Generalized

Interhemispheric Fissure Cysts

CPA Mass, Adult

Cystic CPA Mass

Prepontine Cistern Mass

Ventral Foramen Magnum Mass

Dorsal Foramen Magnum Mass

Generic Imaging Patterns

Solitary Enhancing Cranial Nerve

Multiple Enhancing Cranial Nerves

CSF-Like Extraaxial Fluid Collection

Convexal Subarachnoid Hemorrhage

CSF-Like Extraaxial Mass

Sulcal/Cisternal Enhancement

Fat in Sulci/Cisterns/Ventricles

Pneumocephalus

Modality-Specific Imaging Findings

Extraaxial Flow Voids

T1 Hyperintense CSF

FLAIR Hyperintense Sulci

T2 Hypointense Extraaxial Lesions

Hyperdense CSF

Hyperdense Extraaxial Mass(es)

Hypodense Extraaxial Mass(es)

Brain Parenchyma, General

Generic Imaging Patterns

Multiple Enhancing Lesions, General

Ring-Enhancing Lesion, Solitary

Ring-Enhancing Lesion, Multiple

Solitary Cystic Parenchymal Mass, General

CSF-Like Parenchymal Lesion(s)

Cyst With Nodule

Fat and Fat-Like Lesion(s)

Modality-Specific Imaging Findings

Solitary Parenchymal Calcification

Multiple Parenchymal Calcifications

Solitary Hyperdense Parenchymal Lesion

Multiple Hyperdense Parenchymal Lesions

Solitary Hypodense Parenchymal Lesion

Multiple Hypodense Parenchymal Lesions

Multiple Brain Hyperintensities (T2/FLAIR), Common

Multiple Brain Hyperintensities (T2/FLAIR), Less Common

Multiple Brain Hyperintensities (T2/FLAIR), Rare but Important

Multiple Hypointense Foci on T2

Multiple Hypointense Foci on GRE/SWI

T1/T2 Hyperintense Parenchymal Lesions

T1 Hypointense, T2 Hyperintense Parenchymal Lesions

T1/T2 Isointense Parenchymal Lesions

Restricted Diffusion, General

Restricted Diffusion, Cortex

Restricted Diffusion, Basal Ganglia

T1 Hyperintense Parenchymal Lesion(s)

Clinically Based Differentials

Brain Tumor in Newborn/Infant

Brain Tumor in Child > 1 Year

Epilepsy, Child

Epilepsy, Adult

Supratentorial Brain Parenchyma

Anatomically Based Differentials

Asymmetric Cerebral Hemispheres

Thick Cortex

Thin Cortex

Focal Cortical Mass

Cortical Hyperintensity T2/FLAIR

Cortical Enhancement

Solitary White Matter Lesion

Confluent White Matter Lesions

Thin Corpus Callosum

Abnormal Shape/Configuration of Corpus Callosum

Corpus Callosum Holes

Corpus Callosum Lesion Without Mass Effect

Corpus Callosum Mass

Corpus Callosum Splenium Lesion

Medial Temporal Lobe Lesion

Hippocampal Lesion

Basal Ganglia Calcification

Hyperdense Basal Ganglia

Hypodense Basal Ganglia

T1 Hyperintense Basal Ganglia

T2 Hyperintense Basal Ganglia

Enlarged Perivascular Spaces

Perivascular Space Enhancing Lesions

Bilateral Basal Ganglia Lesions

Putamen Lesion(s)

Globus Pallidus Lesion(s)

Unilateral Thalamic Lesion

Bithalamic Lesions

Pulvinar Sign

Tectal (Quadrigeminal Plate) Lesion

Infratentorial Brain Parenchyma

Anatomically Based Differentials

Large Brainstem

Small Brainstem

T2 Hyperintense Brainstem, Focal

T2 Hyperintense Brainstem, Diffuse

Midbrain Lesion

Pontine Lesion

Medulla Lesion

Middle Cerebellar Peduncle Lesion(s)

Cerebellar Atrophy

Cerebellar Hemisphere Mass

Vermis Mass

Low Cerebellar Tonsils

Generic Imaging Patterns

Cystic-Appearing Posterior Fossa Lesion

Clinically Based Differentials

Posterior Fossa Neoplasm, Adult

Posterior Fossa Neoplasm, Pediatric

Sella/Juxtasellar, Pineal Region

Anatomically Based Differentials

Pineal Region Mass, General

Pineal Gland Mass

Quadrigeminal Cistern Mass

Pineal + Suprasellar Lesions

Sella/Pituitary Normal Variants

Sellar/Juxtasellar Calcification

Enlarged Pituitary Gland

Intrasellar Lesion

Cystic Intrasellar Mass

Suprasellar Mass, Child

Suprasellar Mass, Adult

Suprasellar Cystic Mass

Calcified Suprasellar Mass

Enhancing Suprasellar Mass

Absent/Thin Infundibular Stalk

Thick Infundibular Stalk

Hypothalamus Lesion

Modality-Specific Imaging Findings

Hyperdense Suprasellar Mass

T1 Hyperintense Suprasellar Mass

Arteries

Anatomically Based Differentials

Multifocal Arterial Narrowing

Vessel Wall Abnormalities

Fusiform Arterial Enlargement

Modality-Specific Imaging Findings

Hyperattenuating (Dense) Artery

Veins, Venous Sinuses

Anatomically Based Differentials

Dural Sinus Lesion, General

Enlarged Cortical Veins

Enlarged Deep (Medullary/Ependymal) Veins

Unilateral Cavernous Sinus Mass

Bilateral Cavernous Sinus Lesions

Meckel Cave Lesion

Modality-Specific Imaging Findings

Hyperdense Dural Sinus

GRE/SWI Venous Abnormalities

Cranial Nerves

Clinically Based Differentials

Hemifacial Spasm

Sensorineural Hearing Loss in Adult

Sensorineural Hearing Loss in Child

Monocular Vision Loss

Bitemporal Heteronymous Hemianopsia

Homonymous Hemianopsia

Oculomotor, Trochlear, or Abducens Neuropathy

Trigeminal Neuralgia

Complex Cranial Nerve IX-XII Neuropathy

Horner Syndrome

SPINE

Transspatial

Anatomically Based Differentials

Cervical, Chronic Posttraumatic Abnormality

Cervical, Lower, Posttraumatic Bony Abnormality

Thoracic Bony Trauma

Lumbar Bony Trauma

Generic Imaging Patterns

Scoliosis

Kyphosis

Kyphoscoliosis, Child

Platyspondyly, Diffuse

Sacral Mass, Adult

Sacrococcygeal Mass, Pediatric

Sacral Deformity

Clinically Based Differentials

Acute Back Pain/Radiculopathy, Postoperative

Chronic Back Pain/Radiculopathy, Postoperative

Acute Upper Extremity Pain/Weakness

Lower Extremity Pain

Back Pain, Adult

Back Pain, Pediatric

Craniovertebral Junction

Anatomically Based Differentials

Craniocervical Junction Acute Injury

CVJ Abnormality, General

Craniovertebral Junction Soft Tissue Abnormality

Generic Imaging Patterns

C1-C2 Instability

Odontoid Deformity

Vertebral Body, Posterior Elements

Anatomically Based Differentials

Congenital Vertebral Anomalies

Cervical Bony Fusion

Generic Imaging Patterns

Flattened Vertebral Body, Solitary

Flattened Vertebral Body, Multiple

Dysmorphic Vertebral Body

Enlarged Vertebral Body/Posterior Element

Enlarged Neural Foramen

Vertebral Body Scalloping/Widened Canal

Spondylolisthesis

Bony Lesion, Aggressive

Fracture, Vertebral Body

Facet Abnormality, Nontraumatic

Fracture, Posterior Element

Pedicle Abnormality

Modality-Specific Imaging Findings

Enlarged Vertebral Body, Soap Bubble Expansion

Vertebral Body Sclerosis, Focal

Vertebral Body Sclerosis, Diffuse

Vertebral Body Thickened Bony Trabeculae

Vertebral Body, T1 Hyperintense Signal, Diffuse

Vertebral Body, T1 Hyperintense Signal, Focal

Vertebral Body, T1 Hypointense Signal, Diffuse

Vertebral Body, T1 Hypointense Signal, Focal

Intervertebral Disc, Endplate

Generic Imaging Patterns

Disc Contour Abnormality

Intervertebral Disc/Endplate Irregularity

Vertebral Endplate Contour Abnormality

Modality-Specific Imaging Findings

Intervertebral Disc, T1 Hypointense

Intervertebral Disc, T2 Hyperintense

Vertebral Endplate Signal Abnormality

Extradural

Anatomically Based Differentials

Epidural Mass, Spine

Ventral/Lateral Paraspinal Mass

Generic Imaging Patterns

Paraspinal Muscle Abnormality

Extradural Lesions, Multiple

Extradural Lesion, No Enhancement

Extradural Lesion, Solid Enhancement

Modality-Specific Imaging Findings

Soft Tissue Calcification, Paraspinal

Extradural, Normal Marrow Signal

Extradural, Abnormal Marrow Signal

Extradural Lesion, T1 Hyperintense

Extradural Lesion, T1 Hypointense

Extradural Lesion, T2 Hyperintense, T1 Isointense

Extradural Lesion, T2 Hypointense, T1 Hypointense

Clinically Based Differentials

Lumbar Soft Tissue Mass, Pediatric

Intradural Extramedullary

Anatomically Based Differentials

Cauda Equina Enhancement, Diffuse

Subarachnoid Space Narrowing

Intradural Extramedullary, Leptomeningeal Enhancement

Generic Imaging Patterns

Intradural Extramedullary Lesion, No Enhancement

Intradural Extramedullary Lesion, Solid Enhancement

Intradural Lesion, Serpentine

Intradural Extramedullary Lesion, Multiple

Modality-Specific Imaging Findings

Intradural Extramedullary Lesion, Ring/Peripheral Enhancement

Intradural Extramedullary Lesion, T1 Hyperintense

Intradural Extramedullary Lesion, T1 Hypointense

Intradural Extramedullary Lesion, T1 Hypointense, T2 Hypointense

Intradural Extramedullary Lesion, T2 Hyperintense, T1 Isointense

Clinically Based Differentials

Cauda Equina Syndrome

Intramedullary

Anatomically Based Differentials

Intramedullary Mass

Conus Abnormality

Generic Imaging Patterns

Cord, Small/Atrophic

Intramedullary Lesions, Multiple

Intramedullary Lesion, Solid Enhancement

Intramedullary Lesion, No Enhancement

Intramedullary Lesion, Diffuse/Ill-Defined Enhancement

Intramedullary Lesion, Ring/Peripheral Enhancement

Modality-Specific Imaging Findings

Intramedullary Lesion, T1 Hypointense, T2 Hypointense

Intramedullary Lesion, T1 Hypointense

Intramedullary Lesion, T2 Hyperintense, T1 Isointense

Intramedullary Lesion, T1 Hyperintense

Cord Lesion, T2 Hyperintense, Ventral

Cord Lesion, T2 Hyperintense, Dorsal

Cord Lesion, T2 Hyperintense, Central

Clinically Based Differentials

Myelopathy