Shingo Omata

<Normal development in neonatal brain imaging>

✅ The anterior pituitary may show T1↑ like the posterior, mimicking hemorrhage.

✅ The subthalamic nucleus and globus pallidus show T1↑,

💡 A small subdural hematoma: Associated w/ vaginal delivery.

www.medicalk.net/jspr_journal...

<What's your diagnosis?>

A full-term infant, 5 days old

#Rdiag #RadSky #MedSky #NeuroRad #FOAMed

<Lipoma with osseous metaplasia>

CT:
✅ Well-defined mass
✅ Irregular linear ossified components
✅ Low-attenuation fatty background
✅ No continuity with adjacent bone

MRI:
✅ T1: ↑ (fat) + ↓ (bone)
✅ T2: ↑ (fat) + ↓ (bone) + focal ↑ (soft tissue)
✅ No contrast enhancement → Poor vascularity

<What's your diagnosis?>

Pt: 35 y/o Female
CC: Palpable mass in the right inguinal region

History:
Mass present for 1 year.
Incidentally palpated in the upper thigh, gradually increasing in size.
No history of trauma.
No tenderness.

#Rdiag #RadEd #MedEd #FOAMed

<Cavernous Hemangiomas in the Cavernous Sinus>

MRI
✅ Strong hyperintensity on T2WI
✅ Homogeneous
✅ Extension from intrasellar to suprasellar
✅ Dumbbell shape

💡 When all 4 findings are present
　⇨ sensitivity 87.5%, specificity 96.3%

PMID: 12812943

<What's your diagnosis?>

Pt: 36 y/o Female

CC: 7-month history of extraocular muscle limitation and visual disturbance

#Rdiag #RadEd #MedEd #NeuroRad #FOAMed

<Gorham-Stout Disease>

✅ Progressive bone resorption (outer skull resorbed, inner layer preserved)
✅ Vascular shaped contrast enhancement within the single lesion on MRI
✅ Asymptomatic, no signs of inflammation

#Rdiag #RadSky #MedSky #NeuroRad #FOAMed
PMID: 32117063

<What's your diagnosis?>

Pt: 24 y/o male
CC: Progressive Lt. parietal skull defect

Hx: First noticed at age 6, gradually enlarging, no trauma, no significant medical history

Symptoms: Asymptomatic

#Rdiag #RadSky #MedSky #FOAMed #FOAMRad

bsky.app/profile/shin...

Spinal dural arteriovenous fistula | Radiology Reference Article | Radiopaedia.org Spinal dural arteriovenous fistulas (SDAVF) are the most common type of spinal vascular malformation, accounting for ~70% of all such lesions. This article specifically relates to spinal dural arteriovenous fistulas. For a discussion of intracra...

<Spinal Dural Arteriovenous Fistula>

💡 MRI
✅ T2 diffuse hyperintensity - most sensitive
✅ Serpiginous flow voids - most specific
✅ Conus hyperintensity in 90% of cases
✅ Fistula location often distant from max MRI signal abnormality

#Rdiag #RadSky #MedSky #NeuroRad #FOAMed
doi.org/10.53347/rID...

<What's your diagnosis?>

Pt: 60 y/o Male

CC: Pain, weakness in bilateral lower limbs and urinary incontinence.

#Rdiag #RadSky #MedSky #FOAMed #FOAMRad

PMID: 32691295

<Horizontal Gaze Palsy with Progressive Scoliosis（HGPPS）>

✅ Pinhole pons appearance
- pontine hypoplasia, fourth ventricle floor depression
✅ Butterfly medulla
- absent cuneate/gracile nuclei, prominent olivary nuclei
✅ Absent pyramidal decussation and transverse pontine fibers on tractography

<What's your diagnosis?>

Pt：9 y/o Female
CC：Progressive scoliosis for 6 years

Height: -4 SD, Weight: -3 SD
Upper/lower body ratio: 0.64 (normal: 1.1)
Ophthalmologic Findings：Horizontal gaze palsy

#Rdiag #RadEd #MedEd #NeuroRad #FOAMRad

<Neuroferritinopathy>

💡 Basal ganglia cystic degeneration in advanced stages

🩻 MRI
T2∗WI: Earliest finding → Marked ↓ signal (iron deposition)
T2WI: ↓ Signal (iron) in early stage, ↑ Edema/Gliosis in middle stage
Atrophy: Frontal lobe, cerebellum

PMID: 21808735

<What's your diagnosis?>

Pt: 42 y/o Male

CC: Hypotonia, joint hyperextensibility, aphonia, micrographia, hyperreflexia, facial dystonia, cognitive decline

Hx:Mid-teens: Hand tremor (onset)
35y: Gait disturbance (R foot drag)

FHx: Mother affected, deceased

#Rdiag #RadSky #MedSky #NeuroRad

PMID: 24218322

<Aceruloplasminemia>

✅ Symmetric iron deposition: basal ganglia, thalami, dentate nuclei, red nuclei, cortex.

🩻 Imaging
CT: Hyperattenuation
MRI: T1 ↑, T2 ↓, T2* ↓↓

🔑 Key: Deep gray hyperattenuation on CT is distinctive.
🩺 Clue: Early-onset diabetes.

#Rdiag #RadSky #MedSky #NeuroRad #FOAMRad

<What's your diagnosis?>

Pt: 55 y/o Male

- Diabetes (insulin-dependent), alcohol abuse
- DKA + 5-year cognitive decline (LTC placement)
- Pigmentary retinopathy

#Rdiag #RadSky #MedSky #NeuroRad #FOAMRad

<Meningioma & 3.8 ppm Peak>

💡 Accuracy:
✅ 3.8 ppm peak in top 3 → 96.9%
✅ 3.8 ppm/Cr ≥1.44 → 92.3%
✅ Lip-Lac/Cr ≥2.07 → 80.6%

💡 Alanine presence aids diagnosis

#Rdiag #RadSky #MedSky #NeuroRad #FOAMRad
PMID: 34211737

<What's your diagnosis?>

Pt: 73 y/o Male

#Rdiag #RadEd #MedEd #NeuroRad #FOAMRad

ijms.info/IJMS/article...

<Dyke-Davidoff-Masson Syndrome>

🩻 Imaging
- Hemiatrophy of the cerebrum w/ calvarial thickening
- Hyperpneumatization of sinuses ipsilateral to the hemiatrophy

💡 DDx of cerebral hemiatrophy
- Rasmussen encephalitis
- Sturge-Weber synd.
- basal ganglia germinoma

#Rdiag #RadEd #MedEd #FOAMRad

<What's your diagnosis?>

20 y/o Male w/ seizures since age 3, dx idiopathic generalized epilepsy at 17.

CC: multiple generalized seizures, LOC, & post-ictal confusion.

Other: Learning difficulties, left school early, no FHx.

#Rdiag #RadSky #MedSky #NeuroRad #FOAMed

Thanks!! Please check my answer post out, if you would like.

nsj.org.sa/content/26/3...

<Rosette-Forming Glioneural tumor> #Rdiag

✅ Young females, fourth ventricle.
✅ Solid or solid-cystic.
✅ Low cellularity, mucinous matrix → T2 ↑.
✅ 65% : "green bell pepper sign" (post-contrast).
✅ Cystic: 53%, Hydrocephalus: 43%, Calcification: 25%.

💡 WHO Grade I, but CSF dissemination isn't rare.

<What's your diagnosis?>

Pt: 18 y/o Female

CC: 4-month history of headache and dizziness and a 3-day-history of lethargy and vomiting.

Neurological exam: papilledema, impaired tandem gait, and right-sided dysmetria

#Rdiag #RadSky #MedSky #NeuroRad #FOAMrad

<Papillary renal neoplasm with reverse polarity(PRNRP)>

💡 WHO 5th: Newly Defined Papillary Renal Tumor Subtype

CT: Small, round, persistently enhancing lesion ("enhancing dot sign").
MRI: T2↓, mild diffusion restriction, pseudocapsule.
🔸 Some show internal heterogeneity.

#Rdiag
PMID: 37007143

<What's your diagnosis?>

Pt: 30 y/o Female, previously healthy .

An incidental renal mass was detected, leading to further evaluation.

MRI: Predominantly T2↓ w/ mild diffusion restriction.

#Rdiag #RadSky #MedSky