5 typical image signs, waiting for you to challenge?

 

Without relevant medical history, the results of the cranial MRI examination are as follows: Figure 1 The cranial MRI examination revealed that the upper feet of the cerebellum were thickened and elongated, perpendicular to the brainstem, and the corresponding interfoot fossa was deepened, and the shape was similar to molars, called molars.
Bruxism sign
.
Cerebellar vermis hypoplasia, partial deletion of the visible vermis cerebellar hemispheres crack formation caused midlineDiagnosis: Joubert syndromeresolved: Joubert syndrome, also known as congenital cerebellar vermis hypoplasia, is a relatively rare congenital malformations chromosome , Mainly due to dysplasia of the cerebellar vermis plus other abnormalities, is considered to be an autosomal recessive genetic disease, its pathological features include partial or complete underdevelopment of the cerebellar vermis, deformation of the cerebellar dentate nucleus, development of the para-olive nucleus and the lower olive nucleus Malformation, abnormal development of the dorsal column nucleus, and vertebral crossover are almost completely absent
.
 Imaging: The diagnosis of the disease mainly relies on imaging findings
.
The typical manifestations are the "midline fissure" sign between the cerebellar hemispheres, the "bat wings" and "triangle" in the fourth ventricle, and the "brix sign" in the pons and midbrain
.

 

 

 

Without relevant medical history, the results of a cranial MRI examination are as follows: Figure 2 Sagittal T1WI image shows that the cerebellar tonsils herniated down into the lower cervical spinal canal, the inferior hernia is greater than 6 mm, and there is no syringomyelia.
Diagnosis: Chiari malformation type I, also known as Herniation of the cerebellar tonsil is a congenital malformation of the hindbrain
.
 Analysis: The root cause of Chiari malformation is due to congenital dysplasia and small volume of the posterior fossa, causing the lower cerebellar tonsils to herniate into the foramen magnum
.
 Type: The pathological feature is that the lower part of the cerebellar tonsils herniates into the spinal canal, and the pontine, medulla oblongata and fourth ventricle are elongated, twisted, and displaced into the spinal canal
.
Approximately 56% of this deformity is accompanied by syringomyelia
.
According to its pathological changes, it is divided into 4 types: Chiari malformation type I, Chiari malformation type II, Chiari malformation type III, and Chiari malformation type IV
.

 

 

Basic medical history: Male, 70 years old, with a history of Parkinson's disease for 2 years
.
Head MRI examination, the results are as follows: Figure 3 Sagittal T2WI image shows atrophy of the top of the midbrain, flat or sunken upper edge of the midbrain, showing the appearance of a hummingbird's beak, called the hummingbird sign
.
The midbrain-pontine ratio was measured to be 0.
15, which is significantly smaller than the lower limit of 0.
5, which is the lower limit of the normal range.
Diagnosis: Progressive supranuclear palsy (PSP)  .
, Vertical supranuclear palsy, pseudobulbar palsy, gait ataxia, and mild dementia are clinical features
.
 Image: In addition to the clinical symptoms, the diagnosis of PSP is particularly important.
The typical manifestations are: (1) Hummingbird sign, which is caused by the atrophy of the midbrain dorsal cover and the increase in the ratio of the toe fossa to the midbrain dorsal cover.
The base of the pons remains unchanged; (2) The midbrain-pons ratio is less than 1:2
.
In normal people, the ratio is about 2:3
.
Basic medical history: female, 35 years old, with headache, accompanied by ataxia symptoms
.
The results of the cranial MRI examination are as follows: Figure 4 The axial T2WI image shows the swelling of the right cerebellar hemisphere, and there are large patches of alternating abnormal signals with high signals, and the striped layered structure along the brain lobes, like tiger markings Structure, called tiger pattern  diagnosis: cerebellar dysplastic gangliocytoma  Analysis: This disease is a very rare benign cerebellar lesion, which is often accompanied by Cowden syndrome, and also has benign breast masses, skin, thyroid and other lesions , oral papilloma, gastrointestinal hamartomas, polyps
.
 Image: The image is extremely important in the diagnosis of this disease.
MR sulci gyrus shows clear signs of cerebellar space occupation.
Both T2 and FLAIR show high signal before and after enhancement, showing a "striated" shape
.

 

 

Basic medical history: No relevant medical history.

The results of a cranial MRI examination are as follows: Figure 5 Sagittal DWI image shows diffuse DWI high signal of the corpus callosum, suggesting the diagnosis of limited spread of the  corpus callosum: primary corpus callosum degeneration (Marchiafava-Bignami disease)  Analysis: The disease is a demyelinating lesion of the white matter of the brain, with corpus callosum involvement as the prominent manifestation.
The cause has not yet been fully elucidated

Figure 6 Degeneration of the corpus callosum in the chronic phase, showing a "sandwich cake" sign

 

 Source: Medical Imaging Service Center

 

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