Presentation on theme: "PATTERNS OF EDEMA James G. Smirniotopoulos, M.D. Professor of Radiology and Neurology Chairman, Department of Radiology and Nuclear Medicine Uniformed."— Presentation transcript:
PATTERNS OF EDEMA James G. Smirniotopoulos, M.D. Professor of Radiology and Neurology Chairman, Department of Radiology and Nuclear Medicine Uniformed Services University of the Health Sciences 4301 Jones Bridge Road Bethesda, MD USA Voice: FAX: Visit us on the WEB:
DISCLAIMER: The opinions expressed herein are those of the author(s), and are not necessarily representative of the Uniformed Services University of the Health Sciences (USUHS), the Department of Defense (DOD); or the World Health Organization (WHO). Medicine is a constantly changing field, and medical information is subject to frequent correction and revision. Therefore the reader is entirely responsible for verifying the accuracy and relevance of the information contained herein. Portions herein copyright 2000 James G. Smirniotopoulos, M.D.
EDEMA Definitions Increase In Tissue Water Intracellular - Cytotoxic Extracellular (Interstitial, Extra Cellular Fluid ‑ Ecf) - Vasogenic - Hydrostatic (Hydrocephalic)
EDEMA: INCREASED TISSUE WATER CT: Decreased SPECIFIC GRAVITY -Decreased Attenuation MR: Prolongs BOTH T1/T2 T1W ‑ Decreased Signal Intensity T2W ‑ Bright
EDEMA: PD ‑ INCREASED SIGNAL usually > CSF except Macrocystic Encephalomalacia T2W ‑ INCREASED SIGNAL (Often <>CSF, depends on the windows and pulse sequence)
Interstitial Edema –Abnl. Or Absent Bbb –Plasma Ultrafiltrate (Ions, Small Proteins) Spreads From Neovascularity - Abscess - Neoplasm Localized In Infarct - No "Pump"
WHITE MATTER (Accepts Interstitial Edema) Relatively Loose Organized Tracts (Natural Conduits For Edema) Larger ECF More Compliant (To Increased Size Of ECF) Spreads Until Production = Absorption (Over Large Area)
GRAY MATTER (Resistant To Interstitial Edema): More Dense And Compact Small ECF (Almost Non ‑ Existent) Non ‑ Compliant (To Increased Size Of ECF)
EDEMA DAMS (Effectively Block Spread): –INTERNAL CAPSULE (Projection) –CORPUS CALLOSUM (Commissure) –GRAY MATTER - Both Deep And Cortex
EDEMA LOCATION White Only Peri ‑ Tumoral (Peri ‑ Lesional) White Only Periventricular White And Gray (Also Gray Only) – Vascular Territory
PATTERNS OF EDEMA Hydrocephalic (Hydrostatic) Edema –Extracellular (Interstitial) Edema –Distention of Ventricle –Ependymal lining rips open CSF pours into brain parenchyma Edema spreads from ventricle through white matter Chronic edema => demyelination
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