Question on Diffuse MRI

[Kaustikos]

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Looking at diffuse MRI of the brain and I saw some bright white streaks in the temporal lobe of the images and I can't figure out what they mean. I can't find any explanation about it... They just say there's hypersensitivity vs hyposensitivity... but not saying which is dark and which is white... I'd appreciate any input.

Pic for reference -

 

[45408]

The white streaks are hyperintense.

 

[Kaustikos]

The white streaks are hyperintense.

So what are causative agent(s)?

 

[Kaustikos]

Or what does it mean for the temporal lobe? Damage?

 

[Bangersandmash]

Curious to see what someone with more expertise has to say, but from my time working in a neuropsych lab T2 hyperintensities can be present in temporal lobe epileptics and patients with cognitive issues (dementia/MCI/Alzheimer's). Maybe it's implicated in other things as well? I don't know about the physiological causes if that's what you were looking for.

 

[Kaustikos]

Curious to see what someone with more expertise has to say, but from my time working in a neuropsych lab T2 hyperintensities can be present in temporal lobe epileptics and patients with cognitive issues (dementia/MCI/Alzheimer's). Maybe it's implicated in other things as well? I don't know about the physiological causes if that's what you were looking for.

Alterations in cognition were also seen....

 

[ijn]

Diffuse? Do you mean diffusion weighted MRI?

Usually you use that to diagnose an ischemic stroke or MS plaque.

 

[Kaustikos]

Diffuse? Do you mean diffusion weighted MRI?

Usually you use that to diagnose an ischemic stroke or MS plaque.

Yes, diffusion. I was lazy. Well, research papers showed it's something seen in epileptics..

 

[Bangersandmash]

Alterations in cognition were also seen....

You know what the patient has? If it's a TLE patient with cognitive deficits that fits right in with a lot of the data I've worked with.

 

[SciencePlus]

Just a med student, not a radiologist: I think it might just be artifacts. DWI gets weird as you get to the inferior temporal, especially around the poles. The close proximity of the MCA might have something to do with it?

 

[greatnt249]

Alterations in cognition were also seen....

Dude's got the herpes.

Without more info, other things on my DDx would be stroke, epilepsy, demyelinating disorders like MS, and possibly trauma. There's probably more, but that's just what I came up with in the 10 seconds I felt like thinking about it.

 

[Kaustikos]

Just a med student, not a radiologist: I think it might just be artifacts. DWI gets weird as you get to the inferior temporal, especially around the poles. The close proximity of the MCA might have something to do with it?

Yeah, true. I read up on it and artifacts are seen in the inferior pole. But the dude was freaking out and I'm not a radiologist either.

Dude's got the herpes.

Without more info, other things on my DDx would be stroke, epilepsy, demyelinating disorders like MS, and possibly trauma. There's probably more, but that's just what I came up with in the 10 seconds I felt like thinking about it.

It's related to epilepsy for sure. And not herpes... esp considering the lack of symptoms It just seemed to fit the bill with the cognition issue.

 

[cowme]

Radiology resident here.

It is susceptibility artifact caused by the air and bone interface at the level of the temporal bone.

You see it on most studies, and it is normal.

 

[Kaustikos]

Radiology resident here.

It is susceptibility artifact caused by the air and bone interface at the level of the temporal bone.

You see it on most studies, and it is normal.

Thanks