Black Spots and White Dots in the Brain
In der diesjährigen Röntgenvorlesung referierte die renommierte Neuroradiologin Prof. Anne Osborn eindrucksvoll über die Differentialdiagnostik im MRT und die Aussagekraft der schwarzen und weißen Flecken auf Schichtbildern des Gehirns.
Hier ein Abstract Ihres Vortrages:
„White Spots“, defined as multifold hyperdensities of markedly elevated Hounsfield units, are essentially the differential diagnosis of multiple intraparenchymal calcifications. Black dots, defined as multifocal lesions, are confined to two substances: air and fat.
The differential diagnosis of white spots on MR imaging depends on imaging sequence. First, she focused on T1 white spots in the brain, focusing on the common, less common, and rare but important causes of multifocal hyperintensities on T1-weighted MR images. These include mineral deposition, artifacts, subacute blood, proteinaceous substances, melanin, congenital lesions in NF 1 and TSC, and fat.
Black spots on MR imaging is defined as multifocal hypointensities on T2* (GRE/SWI imaging). This differential diagnosis is much broader and spans the spectrum from common lesions, such as diffuse brain „purpura“ caused by amyloid angiopathy or chronic hypertension microbleeds and diffuse vascular injury, to rare causes such as fat emboli with hemorrhages, thrombatic microangiopathies, intravascular lymphoma, and complications of devises such as emboli metallic heart valves
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