.
This commit is contained in:
Ross
@@ -0,0 +1,52 @@
|
||||
[
|
||||
{
|
||||
"label": "'stroke' (exact)",
|
||||
"queries": [
|
||||
{
|
||||
"qval": "stroke",
|
||||
"mode": "exact",
|
||||
"targets": [
|
||||
"Title",
|
||||
"Breadcrumbs",
|
||||
"Keywords",
|
||||
"Category",
|
||||
"Type"
|
||||
]
|
||||
}
|
||||
]
|
||||
},
|
||||
{
|
||||
"label": "'polycystic live' (exact)",
|
||||
"queries": [
|
||||
{
|
||||
"qval": "polycystic live",
|
||||
"mode": "exact",
|
||||
"targets": [
|
||||
"Title",
|
||||
"Content",
|
||||
"Breadcrumbs",
|
||||
"Keywords",
|
||||
"Category",
|
||||
"Type"
|
||||
]
|
||||
}
|
||||
]
|
||||
},
|
||||
{
|
||||
"label": "'polycistic' (exact)",
|
||||
"queries": [
|
||||
{
|
||||
"qval": "polycistic",
|
||||
"mode": "exact",
|
||||
"targets": [
|
||||
"Title",
|
||||
"Content",
|
||||
"Breadcrumbs",
|
||||
"Keywords",
|
||||
"Category",
|
||||
"Type"
|
||||
]
|
||||
}
|
||||
]
|
||||
}
|
||||
]
|
||||
@@ -517,5 +517,23 @@
|
||||
"ac5f4ac213d7a5fdee2798f031ef6f8a46a08218178c10d33f6bcdca3092c1a3": "docs_md/articles/dysmorphic-liver-with-abnormal-bile-ducts_1cb8d652-5e83-4ee2-a762-bab56e2d107b.md",
|
||||
"0ae47dfb25774725d4674003765b6fda4428c490dd2c7a0ffaf4f29d5f4c65b5": "docs_md/articles/biliary-hamartoma_1b525344-ad66-4381-9ca9-3fb11172744f.md",
|
||||
"867463cc1316e7d2a185bc8ba323c0b88510ca00b996d3bf065610e3c605980d": "docs_md/articles/caroli-disease_acb4212f-766e-4766-bd10-1ebd525a467c.md",
|
||||
"aa4eab80f7ac1fbd5076c72743c5022ddf17437bc58c143d6b803bf4e2d3b882": "docs_md/articles/mucinous-cystic-neoplasm-of-liver_0aea34ce-3322-4284-a6f3-6c79e3359520.md"
|
||||
"aa4eab80f7ac1fbd5076c72743c5022ddf17437bc58c143d6b803bf4e2d3b882": "docs_md/articles/mucinous-cystic-neoplasm-of-liver_0aea34ce-3322-4284-a6f3-6c79e3359520.md",
|
||||
"e67b15e3fd32954f747fa69e89697ee5a801c0696ecebae2d1fbde91fe98b11f": "docs_md/articles/hepatic-cavernous-hemangioma_b6861694-7bb0-4730-860d-4c78c1cdb38b.md",
|
||||
"ebc5eae365d88cd48badef95aaf801aa5c9065487d6524a4ab4c8abe8ac6cff4": "docs_md/articles/enlarged-perivascular-spaces_24c4b347-098b-48a2-9ff9-2b4ed9563cf8.md",
|
||||
"5dfe4e1fefc6cdafc3a0451961dd140ad048b26427fdbefcf358f77081b18468": "docs_md/articles/gre-swi-venous-abnormalities_3404bc7b-0712-4f0d-bf16-34e619f93b06.md",
|
||||
"476f008168eadee26771a792c5704ab36ee38268ab13f739951b4ea540f93c83": "docs_md/articles/carotid-space_627bdee1-4bde-46f2-b93d-958882586337.md",
|
||||
"05d7cb33974472ff9f81008a7de1a9d3a1cc3f62baa1bd9f4ea45068690ee047": "docs_md/articles/status-epilepticus_bb0430ba-9933-40b4-a95b-97ca85070486.md",
|
||||
"b5877ece5c1b8cfb806a2592bdf205a515fe931a629930038e1ef30515f845d8": "docs_md/articles/dural-sinus-lesion-general_2fbd9762-23d0-40cb-868f-ff7ef3304264.md",
|
||||
"f0f25101c88fedbfd94c2ef0f2d5ab14e6293cc6e975a47d16c0364f3e30bdd1": "docs_md/articles/neurocysticercosis_fc7b01a2-45a4-432a-ad8e-c6bd999fa20a.md",
|
||||
"b6f51f3007381ed3af47f19be440c205d733974428918612646b57436645cc2e": "docs_md/articles/maple-syrup-urine-disease_3a260d42-504b-4e53-bb38-a0df76b3670b.md",
|
||||
"c078e00fa293764aaf7dc6d254c668747b264685cb950c7c02464651248a0d39": "docs_md/articles/moyamoya_a8059f6b-95e2-4fb2-82aa-5b51ee9dcd1a.md",
|
||||
"ebdc47ee73c9696f431024086bbff1c2197dd17971b25c83c601ffabaf9f5f20": "docs_md/articles/acute-subdural-hematoma_06930a44-3a5e-460c-84b3-6a0ea4468037.md",
|
||||
"f00c7095d213c401f6b2405bd4d41267b346d7a89ff2092cdc152666517739be": "docs_md/articles/homonymous-hemianopsia_1cdca8f4-95f8-4d19-b28a-19a433d1a624.md",
|
||||
"127cea8e1e7a2a85ca54b3d94537b64454910246d981e8cd026b9111d31df317": "docs_md/articles/porencephalic-cyst_132b5c61-f762-46ad-853c-615f4117d010.md",
|
||||
"8ecfa5369f21de83311a1dc416895157e138affdf8eda62bc2a4d6ea28503474": "docs_md/articles/neuroglial-cyst_496dec2d-7278-4398-95c3-40aa82da0bc6.md",
|
||||
"926f41ca0b3fbb5a68c9c0d1ea546a6bc1a837c9301547856a10a21d9d941eb0": "docs_md/articles/arachnoid-cyst_8a848a6c-ad10-4533-b48c-3e9969cee55c.md",
|
||||
"b0f36631a4a0371ece61d51a163ad8cffc1dbff0d90705b26665a214c6130fb8": "docs_md/articles/neurenteric-cyst_f2b33e5f-1d8a-4629-9f8d-8a1c106d79a0.md",
|
||||
"cb470a4bf66cb4c9add735cd0d47ec1c2b4de996da4d870e02a22716bae22134": "docs_md/articles/oligodendroglioma-idh-mutant-and-1p-19q-codeleted_650c343e-cca8-484f-a93c-3961b57a30c4.md",
|
||||
"4e0600afd635d76f7e5df90fd5a8e27bb0f095336466624d952a445050851a87": "docs_md/articles/kernicterus_1c0c7b6a-574a-4dcc-bfe9-9b0530b14386.md",
|
||||
"67b16a905c8c55626289b5a18b0f5879a96ddc0f8bcf5f5a83579347c989f5f4": "docs_md/articles/glioblastoma_45c3147e-3a1b-4fbf-a626-ed6e99a02ac2.md"
|
||||
}
|
||||
@@ -7135,5 +7135,416 @@
|
||||
"images/app.statdx.com_image_thumbnail_12516cdd-8c26-4911-bdf6-048dc444870e_annotated_true_size_900_quality_90_b76c90e750f249d72f584b4eeb0b87cd2f98e3c3.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_431af6c7-a6a4-42c7-8563-ed7ccc8acc8a_annotated_true_size_900_quality_90_a5d9961e308af7d422aa42b3e821d21909adb59d.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_f01d8b4f-ff0a-4886-baf9-112831588132_annotated_true_size_900_quality_90_fc08c7c6a0ceb9acc0f2695d042fd521755d8b18.jpg"
|
||||
],
|
||||
"docs_md/articles/hepatic-cavernous-hemangioma_b6861694-7bb0-4730-860d-4c78c1cdb38b.md": [
|
||||
"images/app.statdx.com_image_thumbnail_56bdb195-ae7a-4dfd-b253-de7741ea6050_annotated_true_size_900_quality_90_0ab338f602e714cf104b70c43b77b3b62273f7d0.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_14f86632-dca1-492f-bffa-acfde31fbc6f_annotated_true_size_900_quality_90_9be38491198a69366cc24f94ea677d26b04d5e6e.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_01f4837c-091b-4ce7-b00c-42ad9b1664f4_annotated_true_size_900_quality_90_3beb6481e062723edfcee806262fb571aa67cbfe.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_6aa72843-c36d-4a2e-ab9b-7007c7d39103_annotated_true_size_900_quality_90_81357d2dade3dd1f28df1535171becb6f93e9576.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_3ba8901a-9190-44ec-ba99-68f0b5a45922_annotated_true_size_900_quality_90_ce0cd309dee554e0123d0ea4420b5baf29209de3.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_461a4684-7ec6-4028-b0d2-1318eb729107_annotated_true_size_900_quality_90_bc590e49fad1b384fd3cccdbe631dbf7c641e32b.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_aa8c511f-e354-4bac-8cd1-4ecb4232f04f_annotated_true_size_900_quality_90_c04961ee2c2006f4b67cb6e0cd56b31a03e3634a.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_e29f119d-3119-4e47-a970-60e13e6c9d89_annotated_true_size_900_quality_90_0377c6e41ec3fabde2f2e5ee54434fc7eb309257.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_229a129d-b2e7-4b78-847b-7acb4828dc09_annotated_true_size_900_quality_90_91fddd4269a146ecd40cbd730ef04fbbc01c9c95.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_1e87300e-c216-42dc-93d2-9ff36695642a_annotated_true_size_900_quality_90_3a024313a155f554f8b630798ec897d1e5bdc56a.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_912eceec-9617-4c1e-a0a8-c0bebe0287f3_annotated_true_size_900_quality_90_c2784eba745c8358635d39d9e234f4ac278bb172.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_435370d8-d442-4f3b-99af-552dbf9382cd_annotated_true_size_900_quality_90_f23e18d3816967486bbbc52b6c8e9466f520547f.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_45b3247c-57f0-45e4-bd81-0e1b49940929_annotated_true_size_900_quality_90_e35b0f6605536aa46922d8e13b50fbdbf28695fa.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_1269e54b-edb5-4fb5-82a6-e4b36d10553f_annotated_true_size_900_quality_90_9b86a657aa7c700497eeeb99d948db88c3e1e85a.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_9dc229a9-e24b-4418-8930-3681d1dc088b_annotated_true_size_900_quality_90_bdde4e5534f74e0ccebea7ccf5d5b886892436d1.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_56a73022-ea37-41fa-b504-ee8ac5a8b500_annotated_true_size_900_quality_90_c7f176ca805a26eac28b4a9ee6ea6e5deb86ae59.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_d9743683-4eac-4393-a97f-62316c279cf1_annotated_true_size_900_quality_90_06778df2feb4317e34588225870a6ddd5147f74d.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_edcdc807-f362-4d91-9ca5-c8d07040a989_annotated_true_size_900_quality_90_7919851f1706276a027686fd0a8f0befa2454c81.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_90e34d3a-c7ab-40ed-a49f-cadfc600da87_annotated_true_size_900_quality_90_ee4d7f3617965999426baa7591d5d0b1045ca79d.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_29316b31-02dd-44d9-9303-82b266ac62a7_annotated_true_size_900_quality_90_b220a9abfa883e1cefdeee5e3b9bf11a49267ccf.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_806f615f-530e-44d4-a8e3-f64b11cdd61e_annotated_true_size_900_quality_90_bfeae95429e38327ee43dd5a9e735b8c2e4cfcc5.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_b1bd752f-acf6-470c-9393-356144e3ab80_annotated_true_size_900_quality_90_dd46577b5fee45b447e99bd08478b64c97861322.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_decdce44-70e2-48d6-9105-b7eec58480bd_annotated_true_size_900_quality_90_4085d867cf02c868e84a170813d331339a5a0600.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_150f160c-866c-4dfe-befd-198d438cc175_annotated_true_size_900_quality_90_ae55d7d980e4f152f776aae7d79b52b0754a57f5.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_4060197b-a880-45d0-8d1f-2e36ebb694cb_annotated_true_size_900_quality_90_cee115f6f48dfef42d93e1742ba3b67771e8e769.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_497cf367-cfd1-4b9b-a13f-4b628452f7ac_annotated_true_size_900_quality_90_854e778bb2e134d9901dfaeb85db961072e472de.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_d862bff6-8111-4c82-9482-9584e7db4837_annotated_true_size_900_quality_90_083e475b8318f3050f68f60c54aae823177f7480.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_bd1dbbd0-a8d3-4fc1-9a00-3d64ffd1db15_annotated_true_size_900_quality_90_6ac4d33d0576e773624784065b6bea4b63ca5848.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_98817dff-f202-4ae2-ae58-596d469ae9b5_annotated_true_size_900_quality_90_1f2cf0926b4d5be549d14fb874ce302f85a39496.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_cd7f54af-dbb0-4b6c-889b-f8b04369db6c_annotated_true_size_900_quality_90_1f79eea6657f4770da2dd45d08016ceabd2cb3e3.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_07e3745a-cf58-433b-8f35-074932a7daae_annotated_true_size_900_quality_90_84150176116f470487b9d66e2ce1ebc5c4c20c22.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_192dbfd5-c94d-44e2-b479-e37a58a4eec9_annotated_true_size_900_quality_90_4df9217c47c921bcfa710d0cc7837958803b6756.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_9b71892f-3559-4d97-83b3-7089f093675d_annotated_true_size_900_quality_90_8f8ec792293a811df5a42f2cc69cb22a73f32e0e.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_601a3850-a8bb-4f88-a55f-7be85029834f_annotated_true_size_900_quality_90_5faec61061b883c34ff984e660ae7bc38aaf7832.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_4e554bfe-cf73-4216-81b2-22dbf969e5ce_annotated_true_size_900_quality_90_6c9cd1cd142039b3137e1e0659ad26b71f2b0cf7.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_8029575e-41b0-47d0-82dc-4c69c964b94a_annotated_true_size_900_quality_90_a7c2df63db582993132cbe5574a4a6210558aba1.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_a5b2e77c-893b-4cec-ba4f-169185f60a7a_annotated_true_size_900_quality_90_4bc9252eb2d20085b21bcf9bbd91e47e046b58a7.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_8fa9b96c-594d-4601-a1c5-75d30efdf788_annotated_true_size_900_quality_90_0e8e709bc7a2ea6ef33a3f0f6281fb1bac3eee56.jpg"
|
||||
],
|
||||
"docs_md/articles/enlarged-perivascular-spaces_24c4b347-098b-48a2-9ff9-2b4ed9563cf8.md": [
|
||||
"images/app.statdx.com_image_thumbnail_e9ec07ed-336b-49fe-ac23-62044318c7c1_annotated_true_size_900_quality_90_a9360c2ae62ed045650dd891cf2e20dc96aaf215.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_870dc357-8185-4713-bcfe-1a0c4a8e41a1_annotated_true_size_900_quality_90_0085432c095c884aa8b9b453819f248c3221e093.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_822fcb94-07eb-4cd1-95fe-abbf74e6fec2_annotated_true_size_900_quality_90_301833cc5fc374019c5d50069b8e8fcf09b4a73b.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_9f1aca8f-0ebc-46c3-8bf4-9dd0a9b62460_annotated_true_size_900_quality_90_635407172b30f5920cc7a1bc0fac58b56c9386f3.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_905125e3-49e1-4492-919f-6e73430f82bd_annotated_true_size_900_quality_90_0805fa3e89b348704f25673ae7d96180d99aefaf.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_089e9ec0-01c4-4bd8-8c36-c37de164569e_annotated_true_size_900_quality_90_726285d416fa40899820eb9f7114bede105b4d72.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_1edea0ef-2c49-4765-a898-a0ca534aa13b_annotated_true_size_900_quality_90_0d4aa8c9759f089bfa35d089d441f513370de1ca.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_5a7331e5-c8ae-46af-9cac-bd576868bf4b_annotated_true_size_900_quality_90_cd705ef7a27fde2a11724c5918f451c7473d555b.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_4819de04-bbe9-4b9c-a103-3c2cd2b2ebac_annotated_true_size_900_quality_90_91485153a2ed76561fd1c876757630e72bf2a678.jpg"
|
||||
],
|
||||
"docs_md/articles/gre-swi-venous-abnormalities_3404bc7b-0712-4f0d-bf16-34e619f93b06.md": [
|
||||
"images/app.statdx.com_image_thumbnail_05bce021-37ca-42f4-9be5-4ac3533d5bff_annotated_true_size_900_quality_90_47f8443f3a9275c2ae74431da26e60ff5d83d3e1.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_05bce021-37ca-42f4-9be5-4ac3533d5bff_size_174_quality_85_91c15a2eb8bfd4a61d0f7b38a1f37c8df72f9975.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_8777c255-9e0d-453e-a7bb-9b4fe0d8c0b9_annotated_true_size_900_quality_90_ffa7e4059dba6e8f26d06d7b6d0a4a6c82de3da4.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_3fb84d43-75d0-4879-a88a-8da31d7b9fe6_annotated_true_size_900_quality_90_0409289eda75220108afec66e5be2f0ecbfbe3be.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_cee77eb6-932f-4950-9365-dcfbe40de68f_annotated_true_size_900_quality_90_3802df300bd6154fa4419c2138883bb1d049a6e6.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_383515a4-5dea-4657-873b-2cb7c328b0ff_annotated_true_size_900_quality_90_3409795d447970c3f610d28dbb657774ae37e250.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_a5eb49c0-5700-4744-ae94-bf34659c1e15_annotated_true_size_900_quality_90_e07dfaad4f9c935cdf60ef17a8b44ccc38f5b798.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_e5641338-713f-489a-b455-88deca834da6_annotated_true_size_900_quality_90_5bdde14ae6daa4f015dddbfc4d612bf4ce86545e.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_f09f788d-7616-4aa0-8a63-98d28236e448_annotated_true_size_900_quality_90_5a42d0d9a0d80448b8eb0ad11f4d51ef3a663745.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_8528f2c2-1757-4317-9113-d70964fc2aa4_annotated_true_size_900_quality_90_7c430f4a25bdc4d16fdeec786cf205dc454daf84.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_d46bc29f-6fc9-4ef3-9b51-0f806a726c65_annotated_true_size_900_quality_90_1dc2dab6d5837a675bf2f3d69fdb1f3f5c29b540.jpg"
|
||||
],
|
||||
"docs_md/articles/carotid-space_627bdee1-4bde-46f2-b93d-958882586337.md": [
|
||||
"images/app.statdx.com_image_thumbnail_bb2c12ca-6192-44c9-a99b-b7434b6ffe42_annotated_false_size_900_quality_90_6150ab3b964e9e997bd28b96019abf9deca0cab4.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_bb2c12ca-6192-44c9-a99b-b7434b6ffe42_size_174_quality_85_075ffac842e6add87b116e86ddcefcafceabfec2.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_ae2230ad-881a-4bff-90e2-2ddf10617210_annotated_false_size_900_quality_90_3d1a68a2330e33a3790b904525a3d87c743c1c7b.jpg"
|
||||
],
|
||||
"docs_md/articles/status-epilepticus_bb0430ba-9933-40b4-a95b-97ca85070486.md": [
|
||||
"images/app.statdx.com_image_thumbnail_3d7fda27-8825-4adc-912c-b39fdf04fd47_annotated_true_size_900_quality_90_dda61c8cbb5cd849fc70bbf8669503b730b4792d.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_37115527-e0b2-4ea0-81d0-ca5165696938_annotated_true_size_900_quality_90_35576a3a5e581039af7de459f27929141b0516e7.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_c76da990-4026-4aa1-a4e3-09cdbd322133_annotated_true_size_900_quality_90_e57ebcc7120da041b4c0f7802216ff3b8000bcfd.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_f5eef7fa-48e4-4ca0-a1ee-65f418e8e4a7_annotated_true_size_900_quality_90_934aef3fd78fdc8b556881f433de2ebdf5b9a0b1.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_66fa2b96-c7ae-4670-920c-ff2ebea28adc_annotated_true_size_900_quality_90_fea679f3818972a0d2b5e928cbd1fdf27b911b9c.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_0e87e11c-d73d-4fdf-99d4-3c4ff5463c83_annotated_true_size_900_quality_90_b8a64aa01b0380d5d6d5ce04875c8ab5766806c7.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_1f684aa4-baf7-4900-bb16-e516fbe2e56b_annotated_true_size_900_quality_90_7159fc0c652e34d2caed288569be2a804b3b353d.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_318b2440-4dfa-479e-bc5c-23ff4daddce2_annotated_true_size_900_quality_90_92f1605c2fd5a2157e97c727c44243cbd9c70399.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_bfd043a4-1e47-4b94-9f7d-5bbe194e1614_annotated_true_size_900_quality_90_9342a58c3e260cbc76f015d40397fa4fa968f409.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_88af9be9-75e5-43fc-aadb-5d78596282fb_annotated_true_size_900_quality_90_817a013f70a8802b4bfac8786b2bcccf9c36ca2a.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_267b8262-287c-4f80-b8cb-499061b224da_annotated_true_size_900_quality_90_099b2b6a78eb44ba461ec6a7e7a68afd90412e30.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_bcce5cb2-4706-467c-9033-9bacdaf01710_annotated_true_size_900_quality_90_c7b6574635046d977487f8fa84c38fd0aaf97352.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_1b70e2ec-9048-461a-b83b-51281d34415b_annotated_true_size_900_quality_90_1e4646af84af58af0372e9c0bef460f26859d1b3.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_e22a8e67-180a-4265-9d0f-26d2e9bbea19_annotated_true_size_900_quality_90_f89a39547fb829637805c711f346298305390b34.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_04b6aef1-cb2a-4c11-823e-3d28553381cd_annotated_true_size_900_quality_90_a1e31db2fb401b93abb04eefa0d316fdbfa436ea.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_f52f9c72-0a17-42f7-9e25-c5b6cd1da3e8_annotated_true_size_900_quality_90_eb7367047d3ea646dbf9efe78203ef133b7d8ee9.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_04376757-27ac-4c12-b668-4108e14ef911_annotated_true_size_900_quality_90_6e61440999f6ed3bef55c43dbafc76c5ef669721.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_0abc4021-a4ee-4508-9879-095ffb9e00b4_annotated_true_size_900_quality_90_8eafa96c26c576755c8d8831875bf4818fd30a69.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_0f940953-e102-4d40-982e-1c016d0af65d_annotated_true_size_900_quality_90_96286e9956c92034bcf8f944bde237b3f096b340.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_d02310f8-b555-405c-b26c-27ba385b15cf_annotated_true_size_900_quality_90_c15bbab5bbdde987cf4f2f1ef4fe9a778ae2d580.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_aa134b01-54db-42bd-b7e6-08b5b6da0efb_annotated_true_size_900_quality_90_e944fa7b2a274f80567e3500709754cbbba4ba64.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_c4bfdb2e-e9c9-490d-95d7-a4cea7116a7f_annotated_true_size_900_quality_90_f9c60408db92a7bc3d39718b52ddb5867bdd2558.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_19423958-c3f0-411b-8c29-c53fd3136421_annotated_true_size_900_quality_90_5642d5a49a2c64ce2fbefb69dbcb3bd51625705d.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_942263ce-26c1-40ab-a993-a151a02512bb_annotated_true_size_900_quality_90_1e390eafe1c280fe12e9c59ff758ef15904a40b7.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_ec4035a0-fa46-4dac-889b-c4e43bfa5b84_annotated_true_size_900_quality_90_29c0d08a90bf6605b1a6dab89174cc08cca9d2ed.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_8c9567a9-d61e-4872-b4e9-889425ef43c8_annotated_true_size_900_quality_90_ca9d2ede37e69f1c91b314549e4d000eb0ed1008.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_e75453df-8d10-4a57-ae12-dff697be271f_annotated_true_size_900_quality_90_72bd1362585677138e60414bbe0d194b7841e51e.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_99db7596-bfbc-4a18-9662-c6a3bbe6c87f_annotated_true_size_900_quality_90_39697dcc4641801e35d69fc84a9c1d188856113f.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_bd785e0f-f149-4a5d-9dd5-e783968fc903_annotated_true_size_900_quality_90_19c1f4fda4de72b5cc2116579f805d316d445faf.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_fe10836f-1b0d-4de8-adf3-48d7d004cdc8_annotated_true_size_900_quality_90_4c00e4a681474074b08a1e87f0b31eb9b9f551f4.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_15713ee2-55f4-45e8-9c5f-9a8958ff5282_annotated_true_size_900_quality_90_924333aab908dbb60b89939515c926b524622266.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_75ad1e33-b97d-43ed-9f2c-3a619d1d5422_annotated_true_size_900_quality_90_fb1e9954e62faad1ddc1fbc5373a763f26ce91ba.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_209c90d8-602f-4ec4-a539-3834930e4a28_annotated_true_size_900_quality_90_aca041741286ae18985435369ae35c3919e35a4c.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_68ff1522-063a-4c6f-9e42-959af0a0387e_annotated_true_size_900_quality_90_7bca9aacbed9e10ecedacdefaa6e3632f6f48ab6.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_74a2f0b4-2451-498b-9318-ec07ca6a18aa_annotated_true_size_900_quality_90_a68c3bc071655776ade365f87d41bb79229e608a.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_9278cb54-1fd7-4c1b-be08-46c64ae699b5_annotated_true_size_900_quality_90_62661b944bcd88ac202a15a303a877f4d837ee03.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_f38ec7fe-b05d-4bb6-93b1-c2061196cebf_annotated_true_size_900_quality_90_f9773a5abaf7c643d69526cc982330834352910c.jpg"
|
||||
],
|
||||
"docs_md/articles/dural-sinus-lesion-general_2fbd9762-23d0-40cb-868f-ff7ef3304264.md": [
|
||||
"images/app.statdx.com_image_thumbnail_a714dfeb-de22-48eb-8fad-18919d1b7be0_size_174_quality_85_6743f4f6c278789f7699564f190e3f84b07cacf6.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_a22a42bd-3576-4782-ba31-c03a56051a00_annotated_true_size_900_quality_90_b5159909d9089070996ca6069a1a0b56acbd3566.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_18a99d41-d9ab-4dad-943c-4f6fedd493e2_annotated_true_size_900_quality_90_4e4dbc2cd9f943be22c3a9779027f4472d800738.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_84553d57-67c6-45e9-8702-cd9e307236a5_annotated_true_size_900_quality_90_5dd687911570c0388338bac8fd2e79c4272c0638.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_c9162833-9643-456d-b3d2-a26e86f5e755_annotated_true_size_900_quality_90_bf890c18e04237a25cf258b70cf73485b6e16415.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_e59c9b44-b54b-4d5d-9f4d-759245741dcb_annotated_true_size_900_quality_90_07770a372b83a4b4198ae1797f1f2116b587a629.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_79e497f4-7df5-4638-895b-8326a1fabae4_annotated_true_size_900_quality_90_71ec3e9eb63ba6674bd5e3176b3502676d919e2e.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_660a9e95-8da8-4d46-b90d-8b25c7ba7f1b_annotated_true_size_900_quality_90_7ce524e8170905362a3fe12e6d0659bca2240b03.jpg"
|
||||
],
|
||||
"docs_md/articles/neurocysticercosis_fc7b01a2-45a4-432a-ad8e-c6bd999fa20a.md": [
|
||||
"images/app.statdx.com_image_thumbnail_ab2676f5-82cf-4fa8-b377-13615cad2aa0_annotated_true_size_900_quality_90_046d16db99d926ea5fd670c10b9c9bf16a60ce27.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_4d9ae8ec-cda3-46bb-a827-3f14feb6c8ea_annotated_true_size_900_quality_90_96bee07d5cfed0678bbd92a54ce416dfce067001.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_b27e2904-6378-4928-80d0-05e1bc03a298_annotated_true_size_900_quality_90_0bdc3716e0eb9645b8146132ee6dbef15c6904ea.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_c1edffbe-1979-47cc-b844-8b135c865c08_annotated_true_size_900_quality_90_ecfb07fdd47ccbad1449edc0e8d42259a61ab3f2.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_04d6bfad-9347-4cfc-850b-4e4550788029_annotated_true_size_900_quality_90_03f5f6550d83d20a20ee709c320f3b614a9b1d73.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_80894fe9-5c80-41b0-bef9-c4fb92430f8f_annotated_true_size_900_quality_90_1628d8161faab6d478bf1cb307598f3b54025633.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_e7e5fc89-8ce7-4b68-8e38-97401718d72d_annotated_true_size_900_quality_90_3f59362d81f4427c554c32eb68c38973aa0f3351.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_a6ad59a7-e7a6-4965-9882-d22fbc8c1e05_annotated_true_size_900_quality_90_43a2a2866b1f0264b6eca97ef4dd3b5c279573ce.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_a960a855-8471-44ed-8e3a-db3909c38f9a_annotated_true_size_900_quality_90_06a9e2ffcbdb012cabeecd3abaaf7e41cd419c5d.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_adc1740e-20fd-4c08-83d8-7e24262e7e8d_annotated_true_size_900_quality_90_209845acee59b36927c9c90b54f1518810d722dc.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_2733313c-75ca-4672-a6ab-86fb4429a95c_annotated_true_size_900_quality_90_b31e697d8d597cd1a7b239d2bc637dbab4b98245.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_7b3df514-2a48-44b0-a413-66fe666f2b07_annotated_true_size_900_quality_90_2fdddedac3abb4908e96d01b0735fc9a381a71b1.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_fbb45be4-d6c1-4117-9971-7ebadc29ae38_annotated_true_size_900_quality_90_05de6953d409f1c3366358e88cf0b5a4cb786fb2.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_2bbfad27-6904-4865-821e-0bbb19de9112_annotated_true_size_900_quality_90_77854a7c8a7b3995eec520facd65b40b77387250.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_a16b98ab-3c48-4b28-8848-f25e83a7b4f7_annotated_true_size_900_quality_90_cf2082d4047b4ead4f583b2ab65d2f8f48eaae1e.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_4b7dfd2d-86bc-4dcd-a829-d2704f1a93a7_annotated_true_size_900_quality_90_2365e5f129edd03e3ff1788a565bcfca60a200fe.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_bdb676d5-1be7-4102-9efe-fd6185346eb2_annotated_true_size_900_quality_90_379b060e28fd0258784b97dc82b4100ef0ad6cf1.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_fcdee328-ed4a-407c-acd1-e6a84fc3f0a8_annotated_true_size_900_quality_90_c9c3ea2bfdf4ac6917e72b2a8e54b08545255688.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_4238284f-1ad0-4fe1-bf4f-2e104f126cd2_annotated_true_size_900_quality_90_4a2db05598a445ee691a9ab07ea960981c7f5135.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_2af49b09-d24d-4307-b072-73cd8173e374_annotated_true_size_900_quality_90_3d2d09f1ccba654fe98e0af344f3bba14057ad8d.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_2869a06f-cfa9-475f-bcf3-a2ec8ca17c54_annotated_true_size_900_quality_90_fa18df1855ce3506507b4fd60c9e5d2eb1293949.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_67b2cc1f-93f1-4c2e-be82-0e6161ec5ded_annotated_true_size_900_quality_90_048daa7c5ad55c94795e99ad19aa54989901045a.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_fa8f3cfe-bd5b-4d4b-9b78-b4247008dda6_annotated_true_size_900_quality_90_6409e4f3e67fad0845ca5f8b7b78b599b434d786.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_c69947a8-a934-49e8-9c52-8ac5d8c0efe5_annotated_true_size_900_quality_90_f2311093de91081a418f62a0a03650d739634493.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_324798eb-4b0e-4576-b6f8-419a92f28b1f_annotated_true_size_900_quality_90_58fd8d0458ac91dde0910ab35dfc51adbff16338.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_0cf57cae-98a5-4221-9e61-f8af064c8f3e_annotated_true_size_900_quality_90_3d8a9ad9a010bc1a059121157112adaa218416d9.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_0e311562-a641-4de3-b8a8-fb37571c5e10_annotated_true_size_900_quality_90_ca9985dfc0999a402a2b0a66e250721ccc508738.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_3a07bf70-6a16-423a-aa24-6835e5119d8d_annotated_true_size_900_quality_90_1c1039566f7e4e53db7063fd48e61b5b599cd269.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_2d07bfca-c4d5-4e2e-816d-d947d1836656_annotated_true_size_900_quality_90_6c0f70719498d0e21cfe3342e9c2ad65822026d6.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_141c9c02-6c16-4664-ba6c-6fd52579d4cc_annotated_true_size_900_quality_90_169b3989aa8b9b940dd56cdf812773ff7d9f9de2.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_a8117ae6-0519-46bb-a381-feb412bb8b2c_annotated_true_size_900_quality_90_29a295f7329f5193b4835b9c985f8b150a51d398.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_777c8f7e-b4fb-444f-a731-da32f0b9bee2_annotated_true_size_900_quality_90_d0c579615136ac3d78851b0dc49419bd3a6c3728.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_af36ec94-2baf-446c-9cfb-9ea192e0806b_annotated_true_size_900_quality_90_df818cc28eba48289402d0fbb79c68119ab66534.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_67d072b3-6330-4881-ba6e-8f1c9072b3f1_annotated_true_size_900_quality_90_c32d8eff341463fe9b2e1e0afaeecf634b4f4e2e.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_241afeb5-4055-41a3-a784-90665fd5adc9_annotated_true_size_900_quality_90_83edcff23974a2a11b8e0805912fc70a7d18f74c.jpg"
|
||||
],
|
||||
"docs_md/articles/maple-syrup-urine-disease_3a260d42-504b-4e53-bb38-a0df76b3670b.md": [
|
||||
"images/app.statdx.com_image_thumbnail_40b5d866-3449-4977-b13d-6af1c00828c3_annotated_true_size_900_quality_90_b0e1f4441aa2c7d9760da88781bc8d7ea858f1a4.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_40b5d866-3449-4977-b13d-6af1c00828c3_size_174_quality_85_d9d339effa7f7ee2b4373436c1ae1e5e89901b40.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_671d613f-40b1-4bb9-9c90-b296528868b4_annotated_true_size_900_quality_90_d85f06f870d77c68e4464f11f3e7670bc0c7d54a.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_39d4693d-ede6-4501-8976-80581c550911_annotated_true_size_900_quality_90_25a941b7b9b9bd8cafb5f432d572165978384223.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_a0ef9afb-2cbd-4034-90df-20e059d2b9df_annotated_true_size_900_quality_90_d891ff93593304fc0199b590cb28bafb652c6929.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_a5d9e172-014b-4ecf-b521-67e68cc57d8a_annotated_true_size_900_quality_90_5319c11eef677e03b8d8972d76edaa46e6e0f00c.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_8e294687-826f-4bbd-81a0-5fe53241c081_annotated_true_size_900_quality_90_217ef046aadffe224de4c8337339209dc0b5bbdb.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_59891d17-34f6-4120-8480-5347836fa7fa_annotated_true_size_900_quality_90_973349a93efe35c5078d7b202a529406bf80c1ff.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_face1773-c712-44ae-90cd-679d785267ab_annotated_true_size_900_quality_90_5bf1c2b97d1b8fc9ddcb091d2af012fd4eac8092.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_6c1fe88e-600a-41af-9bd6-1bc05a489bcf_annotated_true_size_900_quality_90_f215600162dd7bcfeef66d04e380d093e1b01eca.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_9df1bc33-9f31-45b7-907a-59dc43f574aa_annotated_true_size_900_quality_90_1b1d06f168689a929813b71e4d644cc5825f0a67.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_19f6f352-8dc7-4ab9-8358-fecd7e364c2a_annotated_true_size_900_quality_90_587b8d45b583f5397e6ec18b42e5528567ae6145.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_0d93ce24-67fb-4c6e-aedb-ff9d26626198_annotated_true_size_900_quality_90_f8d0adb341b66cc4fe5cd12554f09ec69dea7370.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_59e1d68d-5a98-42ad-80b3-d1c692ded869_annotated_true_size_900_quality_90_598ffdc5aa232fc1329a01c85ce51ce5b9baacf0.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_1bccf563-347d-432d-8006-6daa65d8d6b3_annotated_true_size_900_quality_90_b8607ffae464af3ad86df8277520664b194eccde.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_a7c440ba-63d9-4cee-8104-da6fd5d4d9ec_annotated_true_size_900_quality_90_0a04fc048aef23567bb4576f1cd8ea2a3b18ea74.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_2213477a-0611-4a8b-bad8-dff0c4c63c56_annotated_true_size_900_quality_90_ecd11195a91d6be21ad921ff76938d7d7c4dcca8.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_6d08de6e-e0f4-4c52-8967-3e0b2d825871_annotated_true_size_900_quality_90_d5164f5a1b521d3421b85de002832a337cd5b461.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_52d76510-b248-4891-aa03-ee74094dd928_annotated_true_size_900_quality_90_3abe5a04ef1a78ad5ab51e6364630e0a2d247992.jpg"
|
||||
],
|
||||
"docs_md/articles/moyamoya_a8059f6b-95e2-4fb2-82aa-5b51ee9dcd1a.md": [
|
||||
"images/app.statdx.com_image_thumbnail_c8078288-1a03-4b83-a032-44a1eb8e8820_annotated_true_size_900_quality_90_27837fe3723fbc371110af5310b071c54042de4d.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_c8078288-1a03-4b83-a032-44a1eb8e8820_size_174_quality_85_7f1ba71ed09110b13eb1476cf3ca27075f5c792e.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_5ad4ded7-618c-4c96-9db5-1e881501fe75_annotated_true_size_900_quality_90_a2afe14a553237b48680029356107bf03a1b6325.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_d5dac916-e5d4-4913-907a-008cbc6c948c_annotated_true_size_900_quality_90_568cfcc5f2715b5aea7b516c61349f1c5d0bd1ae.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_6f67233f-4857-42e7-8116-d0f206107e66_annotated_true_size_900_quality_90_48b643c9944df604e7c5597d22d8cfb136fa3db5.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_e1c4aa8b-8530-45ee-a5fc-4ccc471446a2_annotated_true_size_900_quality_90_f64c5bd500a573631c7bf03c0093b55c0007bcfa.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_401b3370-969f-44d6-a1b0-4071c94a93de_annotated_true_size_900_quality_90_e74f525765804d234462a2da3e2819dc14953929.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_acfed4fa-c63a-404f-ac49-21f9bb8d7283_annotated_true_size_900_quality_90_6b583842172e4759db193061faa0cbe756c3adeb.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_d7100e9e-f4f9-4749-ae17-30df8bc10e08_annotated_true_size_900_quality_90_84430edcb07e4c25f214ae333cd35cd1b2603b17.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_04ebdac9-a6a4-4558-a6db-342ece0e0ed5_annotated_true_size_900_quality_90_aa5a8e12e6ddb743ecf69948f91fbc7b12c138e8.jpg"
|
||||
],
|
||||
"docs_md/articles/acute-subdural-hematoma_06930a44-3a5e-460c-84b3-6a0ea4468037.md": [
|
||||
"images/app.statdx.com_image_thumbnail_b1318df9-52aa-4e35-8c87-5cc3c66e3e48_annotated_true_size_900_quality_90_41cd4f062aaac1586762dafd7330800f81751d7d.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_4fce1827-9ffd-4261-a957-dcf6ab36e282_annotated_true_size_900_quality_90_218dfa21addbbf2a86cd864536b5a7bdb24920bd.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_44df1b28-5178-422a-9fcf-2645648b0438_annotated_true_size_900_quality_90_d4a70703527e5e081949fd246439901a2efa7b72.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_f31555a5-af33-4332-b90f-66fded61da6a_annotated_true_size_900_quality_90_05d67d105b7bd54a25b37296788e356e0bd2110a.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_48bd7fa8-ae26-4841-b2a5-45c5485cab22_annotated_true_size_900_quality_90_58d02e6e7ca4d563d7f842e2482f227396b66970.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_a628c348-bb31-40a8-bb5a-46f73d80b34c_annotated_true_size_900_quality_90_eabe50a1e9d17d7c6da0e41a44d856253a6ee7a8.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_e93058d5-98a2-46ae-adbd-4e8a56fb1f1a_annotated_true_size_900_quality_90_2258b5afaba647ca609ed6f2b38a31cc614860b7.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_cb198ef2-04ab-4f94-b3eb-d25b3588e089_annotated_true_size_900_quality_90_08573d65dd0f0a19e86f5e23855a9d646cf4ea95.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_9d9bcaf2-52e8-4acd-82a1-af1933663894_annotated_true_size_900_quality_90_aaf75bceed37283e07594f6217e13344cff64633.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_4c30503f-5a4d-4b59-aa72-04e63d087d10_annotated_true_size_900_quality_90_5797e0e34ff6b12bf49f8d7d96d3f5c0ca1afed9.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_cd33e845-9869-4778-8e05-90c4195999f5_annotated_true_size_900_quality_90_9b0c03bb357106430536d7902cf2b8bf1272d767.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_81ec0fdb-6cbd-4db2-9d85-886f09b00f73_annotated_true_size_900_quality_90_1f601f739401000e6c9789ea9d445e0b3c4b7071.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_f5d901d8-2e24-4e07-842c-17b082e47476_annotated_true_size_900_quality_90_abb54524cdaa23a764d660a9085d117cdfdf209a.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_90bbf24b-bfb1-4e5a-bb0e-a6ba862c8f6a_annotated_true_size_900_quality_90_76d93818133550a1a30626c643dfdec67ce0331b.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_e71f8c2f-5693-4253-9ec1-33991b6a6cea_annotated_true_size_900_quality_90_5f2d03cf541a02eb794bed643dd92e6716ef529b.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_f9e29c72-78e5-4edd-85ee-bcc4eac72925_annotated_true_size_900_quality_90_5ecd224d2f73ba7d452b3001c37a833a2998cc21.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_b7b40995-2df0-4677-b295-714dc779374b_annotated_true_size_900_quality_90_e4e24056f72571482d81155ea1ad1924fb25d48e.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_3601f3d1-468f-4dce-97ba-89d603dfa269_annotated_true_size_900_quality_90_0a914ba50c12631c81f28d11dff84f2560bdb6e0.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_fdf3b276-9df0-43cd-9e7f-9ef776c3ab41_annotated_true_size_900_quality_90_570ac41077e35766e1a7018e1ebff5a6250a9d01.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_a36e677f-9604-481a-9ad3-330bf6f22e7f_annotated_true_size_900_quality_90_3b8fbe041bbce7012297e2d65f53bc818f496c8c.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_05cb4e38-dcfc-4b69-a8a3-210f5946a521_annotated_true_size_900_quality_90_9b7b4041d96c4925f582132d8e3615dd9d4718cd.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_6c764a6b-25ba-460e-a2e3-e24db60f5745_annotated_true_size_900_quality_90_3dbcb08d596d73bddc8b368f1d93626e0075180b.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_e49ac373-38e4-41b0-bbc0-098394645f32_annotated_true_size_900_quality_90_f34e04c372fa6f23166c2a564ac2c7e13d4867dd.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_b26ecef4-f6b5-4cbb-a92a-795f008b9ee3_annotated_true_size_900_quality_90_6c89824d873f07bf1f6ccb86af95dc6c2fdd8316.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_e88fbe18-5a97-4615-82e4-470e2956b482_annotated_true_size_900_quality_90_6cd1593f55e288b8a6c4f0ecf0476485b9074141.jpg"
|
||||
],
|
||||
"docs_md/articles/homonymous-hemianopsia_1cdca8f4-95f8-4d19-b28a-19a433d1a624.md": [
|
||||
"images/app.statdx.com_image_thumbnail_5da9b25a-8dd3-4882-9fce-516f31f8a4e7_annotated_true_size_900_quality_90_87e477c1dda16cef251cffdd4855768293412bd9.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_5da9b25a-8dd3-4882-9fce-516f31f8a4e7_size_174_quality_85_88e2e368_20251018T125015Z.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_5da9b25a-8dd3-4882-9fce-516f31f8a4e7_size_174_quality_85_a1badce960974fb636b7ac15c3e3503d9316cbe2.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_44cd07bb-511e-4807-ad52-f436e95f68d2_annotated_true_size_900_quality_90_7fc8534eb7e99ad86523c3939bc226b4ff2726b0.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_5466fef0-0fc5-402d-a452-4a5e6c12ffb8_annotated_true_size_900_quality_90_f707d21a56ebe625663ece98256ae19631130729.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_536dbe42-f24a-4be0-8c50-534f12f0d561_annotated_true_size_900_quality_90_1038057003877b4514ef4e93c8e216ac4197e2c7.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_36d9a0ba-a61a-4e2c-8758-c0b5c145fd0d_annotated_true_size_900_quality_90_a294359f47364fd568227f6177ccb92795181933.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_29610b98-7aef-4fb6-aaf4-48f8426644ac_annotated_true_size_900_quality_90_870aba2d5adfd13e2774151480c13dd733c799aa.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_654242c3-2837-4765-9e0b-b30cf84bdf8d_annotated_true_size_900_quality_90_880c5fb9619b0b48b73af5badeb81a44221ea556.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_63029fc3-ba66-4a42-8d76-4783a6fb3126_annotated_true_size_900_quality_90_1f86eb05117a06dcc5d9240b10eab4bfdfdd55c6.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_6a706cf3-3790-4a81-9058-10ac7d3d7cc9_annotated_true_size_900_quality_90_532786b4e3903a53b4a1fafea6af0cbe1376f925.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_0dd88f8c-d50a-448d-8258-507902feb89e_annotated_true_size_900_quality_90_e8a9e39501ae6f80d69befd72c5978afcb969343.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_5bb55c62-31a3-453a-a43d-9f36a1e38939_annotated_true_size_900_quality_90_ae50980c484f318ca1a9f88656f2d2b5ab0c7fd4.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_1ea810a7-afbf-4527-b380-6e0ff79f6564_annotated_true_size_900_quality_90_45765d8f1fc4b6fd33beaee145705bdf0bd8aba7.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_a0f32e72-802f-41bc-902e-255bb784fb59_annotated_true_size_900_quality_90_d80a459a498f01a53d685854deac7fb1b27162e6.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_ac80ad60-05ce-4c8d-a29b-a8209c435e68_annotated_true_size_900_quality_90_a5372aa149ca466fbd4fe32a86e9a5acfe957a5e.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_db0f0cd1-7391-4b12-8fa8-e56528a7b776_annotated_true_size_900_quality_90_6a57a1e4721902bb0c8d9eea9a8e539a71781759.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_312fa823-5990-42df-a1e8-8d7a26e382fc_annotated_true_size_900_quality_90_6f2cf0282d4a59254ec00543b0b5fffde2939127.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_cc6f6872-d636-4adc-bc52-c4632740d475_annotated_true_size_900_quality_90_651e215f16360cdd1e182153f04c320fc51fd269.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_aada1ae3-aad5-44d5-8eb5-be1f2480c3e4_annotated_true_size_900_quality_90_5bbc7d2d6665a715111a27b5210f6be8607d4cfe.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_ad641394-504a-4fbd-b9f4-119926e1ddd5_annotated_true_size_900_quality_90_f41c895ab4af07cca045a8098210bae368117014.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_318b67b7-6e01-4754-9849-b0d238f01099_annotated_true_size_900_quality_90_c9be0e69806f0a9d974308d9859c6c4ed38e83b6.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_8ac5ff4c-d896-4972-aea2-338462ff0218_annotated_true_size_900_quality_90_034eac4c1fb68988967e745e1b30c3bc20469b5a.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_166423fc-2f94-42e0-9cf7-d1618168178b_annotated_true_size_900_quality_90_35fff7ada6fee22936254369ffbd60974be16db6.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_815b7d37-f0a6-4152-8dfc-c71351b2518c_annotated_true_size_900_quality_90_cdda50a2f9ef3bcf5d21294b39ca973b2cf393ae.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_92f6a98a-aecd-42d5-aed4-f76f2ed1c00b_annotated_true_size_900_quality_90_b5a6f1646349cf2c1f5ba4d8c45c7d7b162a2b40.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_e463ddb3-9b77-4f94-b115-e69c35224656_annotated_true_size_900_quality_90_09efcbf85136df96ac29b72bf289f67a9959cd1c.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_07a9c1d9-a7ed-4845-8aaf-6702e86b8253_annotated_true_size_900_quality_90_f0db881eb2767e375e8ca3c1d878fca6352dd9af.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_6ef3b5ae-938c-4b78-ac28-87a1f3dc3d80_annotated_true_size_900_quality_90_67d8e5e91aa7f0c8328579609a07eaf2bb4b3ea8.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_82aa99da-5ebf-4935-bf9b-50f22fa4b123_annotated_true_size_900_quality_90_bfde95fde56860a56c490284f6448b41b8b6f0cf.jpg"
|
||||
],
|
||||
"docs_md/articles/porencephalic-cyst_132b5c61-f762-46ad-853c-615f4117d010.md": [
|
||||
"images/app.statdx.com_image_thumbnail_9c782163-f41f-457a-9444-3615942231a9_annotated_true_size_900_quality_90_3ffb7bb881cc9d90a2c71aae222d2321024c1fb3.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_c0976243-8a31-4d09-bc2a-824f7c4702f3_annotated_true_size_900_quality_90_5ee3c08008f00630f66c073f3175e1927bd20d59.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_5948509d-58a1-49da-8a4e-b8d18c60077f_annotated_true_size_900_quality_90_152a2b403a3c6a9ce4890b856e58a78085986073.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_a9919b20-0318-42c6-ad78-624f3f8f8edc_annotated_true_size_900_quality_90_a6ac2041e6d15c285d48b69aac133b9d131c80bb.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_863c045c-96a9-4860-af91-50dd99b212c5_annotated_true_size_900_quality_90_7ea0b6011774ec3ef7b13495827373b0a591e681.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_171e942b-236c-4cc3-b7f9-21f7de4e36c6_annotated_true_size_900_quality_90_f26f5a12be852443cd232689a11c74614e0f808b.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_887b3304-886d-428f-a81f-cdca566d0df3_annotated_true_size_900_quality_90_188e21848cf10fe89c39160b2772b6823c0e9972.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_0c54e8d7-19d8-4801-9c4c-4e2a5dae8363_annotated_true_size_900_quality_90_740beee3dc803270157cde0de0406967dd850f29.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_9ee56696-79d0-4bd7-9de0-304b18e955d8_annotated_true_size_900_quality_90_449b1ac2cf9b2adb01aeb95e7465b5c54890528f.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_00273f6f-dc0f-4fcd-bd57-ad1257d0db7f_annotated_true_size_900_quality_90_898ace9263c7273d8fa30fe8685558ee0392cff6.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_3f9bdb56-70e4-4807-9797-6b7d0bbad6b8_annotated_true_size_900_quality_90_5f171506e786cca73608309989d7afd6b911167b.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_92909ad9-0d0e-42d9-9f12-a425af8e3d43_annotated_true_size_900_quality_90_15884cfeff91e9cbd968b3b6eb91c6e53f055736.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_19e630b3-afc9-4b44-93ff-edf33095a6e6_annotated_true_size_900_quality_90_00168cbf62514d2166d0f4f41b7209141c17fd43.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_b8e09f4b-5de2-4e2b-b3fa-24120e130ece_annotated_true_size_900_quality_90_f7df3668f012bc997b38795d467df74fee2b09db.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_e9255964-9aaf-48a6-b9c4-2e5363726d70_annotated_true_size_900_quality_90_af2964883d3088e5f684b84a8399d2bda2394481.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_67135b82-63ee-4b0d-8d7c-0da6d04b62c6_annotated_true_size_900_quality_90_998b59f1d7e38aab7607924b194f8eb2a437f694.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_8bd458c5-c37f-421b-aa76-29f934c7ce9d_annotated_true_size_900_quality_90_534d7f8eaac566b7acf80129c48ae2653f412e97.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_4090773f-001f-40b9-9af5-8724b2b414da_annotated_true_size_900_quality_90_d29aa20fcf6f2c3c2b7a2a56bbf12536f2f03113.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_2acd1caa-536d-4a6f-92ad-8fac0e51bfbb_annotated_true_size_900_quality_90_2747da4dcc6aca1936a123d72d3265da7a3b241c.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_f3e2e615-bdb9-452e-addd-b9eced8d0542_annotated_true_size_900_quality_90_4b7edcbbd5f48ece7b99b9ac60cb525b86a60122.jpg"
|
||||
],
|
||||
"docs_md/articles/neuroglial-cyst_496dec2d-7278-4398-95c3-40aa82da0bc6.md": [
|
||||
"images/app.statdx.com_image_thumbnail_b1b1e3e4-14aa-45ff-845f-5dd5d759ed38_annotated_true_size_900_quality_90_7e8ce665dd6b95a9d3c6cb9305bb0d9dcb025cd6.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_d3bd7e9a-5085-43a6-bc47-ee316836a7e3_annotated_true_size_900_quality_90_37fc6b75ea1d45d535bb1cb7cc0e03b47a16a1ca.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_6c98cd5c-6d20-4a9c-bc80-abd9b6d05334_annotated_true_size_900_quality_90_96ee91c3b5c0db7d1d61d391484d6bac8a3d608c.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_20ca8bf5-cd3e-4052-a3dd-eb21c111c193_annotated_true_size_900_quality_90_1f93f18091d37e3767fec275bb383f57491b79a2.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_0b9effe3-91bf-479d-9267-67646ea0dc58_annotated_true_size_900_quality_90_357fdfb04b76d3500e68d8e8f09ba7ea989c3489.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_20457ca3-93b1-46f2-9956-06c764c87e27_annotated_true_size_900_quality_90_5c65b328f3107a02e5fabf432b29ac76c4c5af01.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_fd277745-cfe5-496f-8082-939850900d3b_annotated_true_size_900_quality_90_9daa4a0791b0df33a62aba0922f14c8944cb419d.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_bcd126f5-f857-4eb8-a29b-400e7651269e_annotated_true_size_900_quality_90_22916b391c446221655905c8be994c2f8f59a115.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_30efe154-eb9f-4a61-aa37-d55470c3d0c3_annotated_true_size_900_quality_90_173ed0edfc71d60f252d6ab1534609717d4a829b.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_4daf1178-4526-4aef-a838-c88fc9ade678_annotated_true_size_900_quality_90_77de3a0bc35f3423b184e15ea53706e6ddc8bb87.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_d149dbf9-e456-4db9-833a-4e39be93c5af_annotated_true_size_900_quality_90_00593644fd110a568296eba16185b01d8edf74d5.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_8c65d294-ce3f-408c-8443-1c17fbe2b958_annotated_true_size_900_quality_90_a639cd5bc3f80f75ee9f4e0fbab9577a27dbe745.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_72bf6bf1-9e62-44a6-9696-8d63e14c3733_annotated_true_size_900_quality_90_998a022a4c1ead20f5c4f01370e010f76a2c9bb5.jpg"
|
||||
],
|
||||
"docs_md/articles/arachnoid-cyst_8a848a6c-ad10-4533-b48c-3e9969cee55c.md": [
|
||||
"images/app.statdx.com_image_thumbnail_9dfe194d-9253-4c21-a1f9-fdeda1bc2840_annotated_true_size_900_quality_90_5e1f09fc939392178f2a624b892262bdd3519663.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_cee68e3a-5aba-466f-8895-09e0ead77d22_annotated_true_size_900_quality_90_bf169cc57239e646d0b3212b81ea64b47c960b76.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_5e48b890-6a9c-4f25-b966-cca5ec91dab2_annotated_true_size_900_quality_90_9385f8be4cb8ad2e3e524aaa532dc7dfd1157bc1.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_dc63c650-9563-46be-88e2-57016061b12c_annotated_true_size_900_quality_90_a26fe5c29f002d7182d1233002179a537df9cffd.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_388b2265-3533-444e-8687-adca83e2d926_annotated_true_size_900_quality_90_42039b3e10d5ac64efe286e6470511fe599e42e1.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_25c5eaa4-38fa-4286-b056-4cfe8a910279_annotated_true_size_900_quality_90_d65dfe13e484a18fcceb0d6a2c549247bd6af776.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_f16e1a5b-b25c-47ad-b251-199bfc6dccfb_annotated_true_size_900_quality_90_4573cb40f081625db4204016c044bff0cd113188.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_5122c171-670c-4827-9bb0-c0cfc6c57ee2_annotated_true_size_900_quality_90_19c1cf27e3710a150f694a5edf4190e96664206b.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_ac60a996-825e-474b-b532-83b82e6dfd7f_annotated_true_size_900_quality_90_c022e77fcc1e22a2ec29129d97bd8bba478b7eef.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_720fccf3-d32c-4744-b710-4d86f7762dad_annotated_true_size_900_quality_90_da7770d56a3742bb0ecfb092be6a5aebd07cbb7d.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_1c23acb8-7737-40ae-a83a-48940eb6c4a3_annotated_true_size_900_quality_90_4ab5346f698841c4c800a8fd01835b46013ad0fb.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_a7dc13d0-3455-46d4-a7ab-69c23c44474f_annotated_true_size_900_quality_90_beb03a3f8fcdd57c18057d094f13ce74fb5da856.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_090078a6-e8c8-4d27-b43c-a3ba54f0a38d_annotated_true_size_900_quality_90_9ee8f4430937bf00495e495058f73fef06d78cbc.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_ba3792ee-e902-4204-9756-97d057ec854f_annotated_true_size_900_quality_90_8725d696edbfcd9020bab94f9c42b2d3d5683905.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_62ef625f-e2ea-4db7-a224-d94c6455918e_annotated_true_size_900_quality_90_225a08913078988664682917cb6960a1b6f4a947.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_a7b8e765-5898-41df-8443-c1b93efb5460_annotated_true_size_900_quality_90_8f053c793b50ca1d7ac1275f1ef0fa0832f86b44.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_84fb053e-cf25-4ad7-b303-cab120edc845_annotated_true_size_900_quality_90_4fe8c30de52f6312cb0a0b745d4b7487cdb3de48.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_de5f304c-939a-42c1-80b0-4e9a131c3884_annotated_true_size_900_quality_90_bc95a50826abd27c72a10c77ae2e962049bcfc29.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_2ae21915-63d7-4ba9-8798-86c4489b7034_annotated_true_size_900_quality_90_97368299e6694978ac9492dbd6867c31d237e982.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_8810b5f6-cbda-43d7-9f0b-55148e522c55_annotated_true_size_900_quality_90_939fb05c25665f8cf6cf4c5ff89aef11375816e6.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_d5499cbd-dfd4-4e0d-8dd9-294d4aa064a8_annotated_true_size_900_quality_90_0848ba36aac45f012ce47ea2ed1c92f6c300a3e1.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_eef82935-8b84-4e63-9aad-9dce73e714fc_annotated_true_size_900_quality_90_95973231a38d257ba16ca9f1da711a1ecb9a1b25.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_b2ff6480-4bfb-4818-bbaf-5447da7a0ddb_annotated_true_size_900_quality_90_8d4816bfd3dda33357ac89c2e46e9beb24ec9f82.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_25224a10-f76f-45a8-97c8-f002a56298eb_annotated_true_size_900_quality_90_7dbf0d57631b6cc222fc1a755bf4903c1b5bc2f0.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_230311bf-1ad3-4bd5-9682-824ba7a3a051_annotated_true_size_900_quality_90_71d4ab9fd8f4949d75e20b4a7ae601c41df5aa8e.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_e81cf191-819e-427b-9e03-c487b83b45bd_annotated_true_size_900_quality_90_b9c465e41775eb5d24c4936d1400585895e23a4e.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_b66047ad-c755-4b47-a92a-730e87cff4ec_annotated_true_size_900_quality_90_289e1f7b154e12f760435f859b52f2e04c5959a8.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_47c1825a-5d98-4eb2-8a8c-3d23ab8aade5_annotated_true_size_900_quality_90_92f6249db03f4500941983db4febe80e338bf4bf.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_b53e0eba-3c64-4dfd-a36e-57a7624bb1eb_annotated_true_size_900_quality_90_e59f7423e77b747f4f42e6b80b1b8f7836a9fe27.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_31b5ebf6-57a1-4c3c-a260-e36ae8f23f48_annotated_true_size_900_quality_90_41f530a71653d13cf3d5a8b4e9b78a27f346902a.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_ce6f61f6-5184-45e4-a018-070576e2625f_annotated_true_size_900_quality_90_d0bd1a0c3252280057ecadf04f9403c906555b4e.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_b5cb1ff8-98d4-4a4f-8881-71858df85b49_annotated_true_size_900_quality_90_c7254ca1a5bdf079d55c3e78297bf7dd5fd8d700.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_d468219e-0105-4a96-833a-840ea3b68816_annotated_true_size_900_quality_90_fd6efc4747906e96581c0821f5678ac829fab6c5.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_6239c884-722e-416a-8644-ded543784cea_annotated_true_size_900_quality_90_248032541f53ee09ba72964205f12f8dd238bc14.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_5adc0900-390d-4f9d-be47-0ac801eabd0b_annotated_true_size_900_quality_90_3a0f31eb2eaba230faa41ac894ca0307679d45c6.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_57bfb390-b586-401a-bbb6-67a2634067ca_annotated_true_size_900_quality_90_f351569a655d355d6ad82bc7c0365c50ef3839bd.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_629e123e-15ac-4af3-9e7f-26581a551f89_annotated_true_size_900_quality_90_a19ddb20990e1fa20396639736279e92c56f4808.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_c8f85044-c04d-40af-8e81-7bbd756aa930_annotated_true_size_900_quality_90_49fc1d729ba897fbb8b7423cf1ad3525feed7e9b.jpg"
|
||||
],
|
||||
"docs_md/articles/neurenteric-cyst_f2b33e5f-1d8a-4629-9f8d-8a1c106d79a0.md": [
|
||||
"images/app.statdx.com_image_thumbnail_85a393f2-124a-43fd-98f6-a83e810fbb46_annotated_true_size_900_quality_90_4c6459bd7ac2199a9a5fd14e9cdc760507f759ee.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_12fbbfb4-9736-4fa9-933d-97dc496ced4c_annotated_true_size_900_quality_90_53998a3d9e9f01070330e87efc70248ce2caebe1.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_8de063cc-12a1-4de1-9ce6-7e3f21c85bc8_annotated_true_size_900_quality_90_cfd0fdfd26f25a139c6cb147f2c4d45f1beffc97.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_255611f6-49c7-45d1-8920-17d592bdc813_annotated_true_size_900_quality_90_bd9bffc91476e42fd53b85c714f73b7ceeba58b9.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_b4aa8f1d-cb79-4fcf-959e-c09ccb204abd_annotated_true_size_900_quality_90_29761406882fd744223c5cb318050f190696134e.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_a14e0f18-f221-47b6-9e25-566874669e7d_annotated_true_size_900_quality_90_f20fc46666a97b0903e95c2082442189da308901.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_c365bb4b-2e2c-47f6-bb6b-b0b1868a3d6a_annotated_true_size_900_quality_90_1b482e46d0da59da4615d6aa585ec5ba438b39ab.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_c9ca3101-1270-485e-94e1-26d0dc95f519_annotated_true_size_900_quality_90_c9fc95d42b7b49f399c71e363912875472b2ca26.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_3cc29a95-b265-4952-a59f-6900a740c2c5_annotated_true_size_900_quality_90_cb3f9c067f35f13f9c53a2d9511083c549ccb42a.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_869cc39a-f00b-49d0-bfed-43b8241a4308_annotated_true_size_900_quality_90_582d84f56d0d84e039034cefdd4abbe2b13c2c43.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_856c9eae-9079-422d-b4a0-d91587a79606_annotated_true_size_900_quality_90_89b27aac4befc88bd0c58338c3114916c75b598a.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_8c142026-ea13-404d-81ff-f6baf795a7fc_annotated_true_size_900_quality_90_7898055267c3f260e443e19e6f5ec7a8697d9cfe.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_fa597f06-74dc-440c-a9f5-bded22159ab9_annotated_true_size_900_quality_90_943e72136bcfdca433ed6c42baafc94c761ff7c0.jpg"
|
||||
],
|
||||
"docs_md/articles/oligodendroglioma-idh-mutant-and-1p-19q-codeleted_650c343e-cca8-484f-a93c-3961b57a30c4.md": [
|
||||
"images/app.statdx.com_image_thumbnail_10c20373-2d71-468b-8beb-e5af51306f21_annotated_true_size_900_quality_90_57b1ce674fa48984830649b261a7a32ca7ee91d5.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_6fca3e28-32d7-405d-a7af-588b27a7556d_annotated_true_size_900_quality_90_ef6075cbd58bd4408b86cd5b0350b4d386988b45.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_3554f094-9933-41a2-9b3f-5ae24d247ede_annotated_true_size_900_quality_90_8b57137ced22e29acb5b38c7614d6948b07b6223.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_5c3b9541-820e-4fc2-b2d5-978f1ba874bd_annotated_true_size_900_quality_90_070c031bb1518d1591dd4617b710d1dede6dc45c.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_f7c787e6-a0d5-4802-901e-61c0e2321efa_annotated_true_size_900_quality_90_ab991d0c97439ab2f38f0cca89acf0769add9558.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_47f0ed93-38ce-4be7-8b3e-fbbc1dfd861d_annotated_true_size_900_quality_90_5a45f735ddadab76bbdf631bf09e6398735e1e1a.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_40c4ea82-e715-4c93-83ce-2fdff2cefc0c_annotated_true_size_900_quality_90_3c2676a6672e060b0dbce2bcfd89f4511c2d7405.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_61abf7c2-68b8-406b-912d-9cfc16c4481c_annotated_true_size_900_quality_90_9d2d9ac927abbd958778ddf39a8ed7ccd0b3e366.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_396ff3f5-c69f-41c5-93ac-f56bf2940ca7_annotated_true_size_900_quality_90_445a0965866f30d863973c4dc30adbaa61a0dd30.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_1f730568-d175-48ac-9a3a-afa76f157ccc_annotated_true_size_900_quality_90_582ef36a991a48e976f1eed03c5fe70018badf88.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_18b7d3a8-b28f-4ccc-bbb9-71721dd7044e_annotated_true_size_900_quality_90_d349f2c4f6bdaf869ce52962a8a84e31327969bd.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_917cf089-d4d3-4f87-9d77-27af1752a98a_annotated_true_size_900_quality_90_9241a61243868f262237d28e497f1e0d4c4987e8.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_475e6410-9fd7-4f8b-9f10-618c2a345462_annotated_true_size_900_quality_90_bb7d087022da3ef37f3e38401c8ade5d65893821.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_39cfb3dd-70e7-4a58-a3a6-fba583cdf880_annotated_true_size_900_quality_90_185f269c2ef9a8f1e81372df62c4b3fc838f28e2.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_3a4c6003-bbf9-48e0-a287-87fea15322a6_annotated_true_size_900_quality_90_d89644df0ab30611663a0cd94bc5f9501215c366.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_7d9448cd-ecdb-405b-b77d-f6fab6163d0f_annotated_true_size_900_quality_90_b7cfd14d35ede54f5fd9903fe20e75776d1ab720.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_cfae62aa-d25b-470e-be4b-a9f3c5aa6cfa_annotated_true_size_900_quality_90_47b6690345158df009bedf22e102885dc1ac29f0.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_64a72e27-964f-4c05-bb04-6b73356fecf2_annotated_true_size_900_quality_90_2b4ab37dcb41466e17de528b0e8b2a0e3955becb.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_6dab36d8-d27f-427a-a891-45c9ba61b172_annotated_true_size_900_quality_90_06d596a0b097a900bf77941c63929a2a6c173789.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_78381441-1e52-49b3-a62b-3ffe2310c457_annotated_true_size_900_quality_90_a76dbfa3e4830911afae2ace12e5089bd7da3f38.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_1f5c4d43-ac11-4d8e-951b-b989888def38_annotated_true_size_900_quality_90_e12ae81c1874d6e1ef6f63ec53d12a45601ee067.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_98db6d0e-49c5-45db-b784-d30cfe811d9d_annotated_true_size_900_quality_90_e74b1f02b161173a998fa70743011e045920ee1e.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_0c749719-3977-4da3-9c5d-b8317e021296_annotated_true_size_900_quality_90_9eb0bbb32119ffe797b0793263ba93d1cdb5d6b6.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_46882603-f818-4c60-8372-9dcbdc5d64c3_annotated_true_size_900_quality_90_a5b557c41eb28966e9b7ce5a94a805f22d19d64a.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_8fa3d189-4eb2-47e3-9433-1a483b1a014d_annotated_true_size_900_quality_90_4551cb6d463ca87caacb644671873268c79ff190.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_418c292a-4984-416d-8c44-5ecbb52def46_annotated_true_size_900_quality_90_c97d045ef2168dd9fa5ca8734b264f5e8dec5354.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_8370fb58-3c6e-4be8-a926-12dc025d3bf8_annotated_true_size_900_quality_90_ed6e14c406aa3f30981d780cbb74493e9c2d58fc.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_a6cc73b4-ca6d-43a3-a2b1-a802a82990e3_annotated_true_size_900_quality_90_85570d262b3f5087a13f2cf182c939ef2925e7f4.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_91ca50e4-9652-4c13-8597-5d21452eca3f_annotated_true_size_900_quality_90_006b6b5b90a5502d05a1e993104ded6bdcd7f8ee.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_ac2b91eb-fe43-4a6a-a117-4a3acfe14475_annotated_true_size_900_quality_90_fff4a1de88e4f15865575871c0f63da5e00e1060.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_4862c7ff-c2b4-435e-bc9f-17ba7db7274a_annotated_true_size_900_quality_90_37fd04301f34ba9f118496b7c856893c0b447649.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_5f2275c5-e314-4360-82f4-5778ff452ec5_annotated_true_size_900_quality_90_f1ad941fb966366147f30997be80e0d525af2964.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_247ac1b8-b282-48a1-a93e-4517403dcb7c_annotated_true_size_900_quality_90_4207ef3306d13be10283eed5ca94bb1e2ab19a67.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_cde5fac9-fdc6-458b-8580-f4e86142bc9e_annotated_true_size_900_quality_90_0c2b0651a5896ebb89ad91b8969babde7a606dfe.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_465bd78a-b0b6-4d7a-b3bb-fff6c8309e18_annotated_true_size_900_quality_90_d0b6d4af1dd7333bf8908df2f204c3a0a292dfc6.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_96d8dc97-da54-428d-8d9a-4a3e3ecefde1_annotated_true_size_900_quality_90_ec0c99a4c56a86812e41639250fed69b95cc50d4.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_2ab52e21-aef1-49c6-9dd8-51970fe92b7e_annotated_true_size_900_quality_90_f2360c5f94b93cfccdd583a81c67c9bf38cd13ad.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_2b0d934e-43b7-4af7-ad0c-add5b64466f5_annotated_true_size_900_quality_90_9509b746f7fe1c1775aea4b17d9477265463ea75.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_7676f60d-c2c7-48a1-897e-da10d2cca88b_annotated_true_size_900_quality_90_ff15efb074390e29fe9a163ede54d2ab9f30574a.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_97661207-dc90-48fd-b7e7-a73c49673787_annotated_true_size_900_quality_90_4fe614c87ff2645db0650444a40c26cc9da19c72.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_e0e1802d-7b02-4f0b-ba0d-79b6fe68db48_annotated_true_size_900_quality_90_4ca7748e30835c706448986bc43bffc56e87d207.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_59480a4f-1c73-466c-b0d6-b9bd3f26f485_annotated_true_size_900_quality_90_00a45c52632bdb05ea0129081f669b5a9fa1721c.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_de6e1a58-a3b0-40fd-a3c8-98a54fee2733_annotated_true_size_900_quality_90_51f2489de52221c67e63881ed5c069a64c7d6fad.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_491a886f-b9af-4420-8f56-0c230cc864fb_annotated_true_size_900_quality_90_28d6d731e670063064602826b4ae5bd07c945a19.jpg"
|
||||
],
|
||||
"docs_md/articles/kernicterus_1c0c7b6a-574a-4dcc-bfe9-9b0530b14386.md": [
|
||||
"images/app.statdx.com_image_thumbnail_f0113108-dc0a-4f23-a83e-daf1db4e930c_annotated_true_size_900_quality_90_b6f09b4fab5cd7c4efd9921395b3447af10e5ff8.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_13489b0f-755a-443c-a881-56004ae3be4d_annotated_true_size_900_quality_90_e403807175c922a72a5cdd72168902daafd0ccd8.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_fd9afbd3-cfde-4751-a256-720bd859fcdb_annotated_true_size_900_quality_90_6982387130c46eb7d8d8ae3d44ec80eabe7560fd.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_db6d2e85-7db4-4728-8351-1064d87d7fcd_annotated_true_size_900_quality_90_27cc9c35618cd525fd3d385fc8e7cf59ffb89bed.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_25dba69a-26b2-4b74-a93f-b6f47819e1f6_annotated_true_size_900_quality_90_c19a0623933bf9cf94d4db5d5e6f7c51cf58a43e.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_9b837d5e-15b6-46aa-9c10-31d4531ba61c_annotated_true_size_900_quality_90_f7047e520935039810c185eda166b913ddb4ab9f.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_edd07154-09c2-4d8e-be0d-dd6e204d64e2_annotated_true_size_900_quality_90_5a2e8080630dec527549a6f571d6c4e367b34999.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_c9ebc216-a1d8-49fa-a2a5-6f8589a1c970_annotated_true_size_900_quality_90_510b71152ed82b5ccb3b549ab2bb81af19c8f112.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_5fc304f1-8e21-4244-9bf7-b39541149114_annotated_true_size_900_quality_90_23d8035a7d19d7bc1cd3d3826f9fbdc2e3ba1030.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_0f3bc9cc-97bc-46dd-bc61-c0475a776737_annotated_true_size_900_quality_90_e5f5d91b00fe9e98dbe05057cc94a88b286e81e4.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_0b9c9442-bb77-4aec-9804-970534b73ab1_annotated_true_size_900_quality_90_80c0d7e5a5ad05ec8ad4f6b4d03470c4d404a9bc.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_a4eade44-3036-4d06-9c54-45f05a320a15_annotated_true_size_900_quality_90_15c82eae39d30d40a3f5a8e2b3b289617124dde2.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_b031c599-9195-4c4b-bf17-bd6d93f3781e_annotated_true_size_900_quality_90_82118931bb6dc8b528a1c0ee6014d8b918296dba.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_1dbbfe3c-cacd-4c73-a5f3-3903078cf0f1_annotated_true_size_900_quality_90_50ba1408003064434ffb0d4280e1fda5c5bba1f3.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_afeaac8a-4414-41d0-a948-de559c5fd3c9_annotated_true_size_900_quality_90_f2b90bc3836b50ce8e9cfa7c995ad13ff5aa4bfe.jpg"
|
||||
],
|
||||
"docs_md/articles/glioblastoma_45c3147e-3a1b-4fbf-a626-ed6e99a02ac2.md": [
|
||||
"images/app.statdx.com_image_thumbnail_14224b78-81b1-4eda-aadd-36905cda472d_annotated_true_size_900_quality_90_2b1dee97d6eb023e4776e17d8f406c927117c1f4.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_2fdb92ab-dafc-4c65-8a83-8fb54e7206db_annotated_true_size_900_quality_90_4217bad74b86f0dd3406b249bc913818ed8bb0e3.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_fc5f03b0-96dc-4ea7-a5f4-302055e3c568_annotated_true_size_900_quality_90_dadb2bb4ee93fe296825e1dfdedbc21dd8328b32.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_944e920d-baf6-455a-8d7e-c519aacfcb3b_annotated_true_size_900_quality_90_48453f39297763459579495527221dbfb07066b6.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_e94e2200-1166-48c8-89da-89d1356a0089_annotated_true_size_900_quality_90_9c59deba889da4c4cb3b123f97e443de11c5c126.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_0a4226fe-e27f-4f61-9adc-b1b27d350957_annotated_true_size_900_quality_90_7ba37d13f190beb15ce103ba2780f353c8919d2a.jpg",
|
||||
"images/app.statdx.com_image_thumbnail_1ff073aa-7734-4c1e-a15d-a2e668e05373_annotated_true_size_900_quality_90_56123639051f89cd82e28232c185f73d5c65de27.jpg"
|
||||
]
|
||||
}
|
||||
File diff suppressed because one or more lines are too long
File diff suppressed because one or more lines are too long
@@ -0,0 +1,251 @@
|
||||
---
|
||||
title: "Carotid Space"
|
||||
docid: "627bdee1-4bde-46f2-b93d-958882586337"
|
||||
authors:
|
||||
- key: "b2e6dabb-ee1c-42a4-a332-9f0814c1c607"
|
||||
value: "Surjith Vattoth, MD"
|
||||
- key: "33151213-01b2-4542-9105-342e006b3915"
|
||||
value: "H. Ric Harnsberger, MD"
|
||||
breadcrumbs:
|
||||
-
|
||||
name: "Head and Neck"
|
||||
slug: "head-and-neck"
|
||||
treeNodeId: "5c1f8e17-7acd-48d8-9d55-f9f8c2cad850"
|
||||
-
|
||||
name: "Anatomy"
|
||||
slug: "anatomy"
|
||||
treeNodeId: "5deb3a75-762a-49d7-8d1c-dffda4a1b190"
|
||||
-
|
||||
name: "Suprahyoid and Infrahyoid Neck"
|
||||
slug: "suprahyoid-and-infrahyoid-neck"
|
||||
treeNodeId: "af341e54-3d19-4091-8f8d-28281848e10b"
|
||||
-
|
||||
name: "Carotid Space"
|
||||
slug: "carotid-space"
|
||||
treeNodeId: null
|
||||
category: "Head and Neck"
|
||||
documentVersionId: "7eaaa374-19a6-4868-bd5a-a12af075096a"
|
||||
imageCount: 23
|
||||
lastUpdated: "12/20/23"
|
||||
pageDescription: "Carotid Space"
|
||||
pageKeywords: "Head and Neck, Anatomy, Suprahyoid and Infrahyoid Neck, Carotid Space"
|
||||
pageTitle: "Carotid Space | STATdx"
|
||||
enhancedTitle: "Carotid Space"
|
||||
type: "ANATOMY"
|
||||
breadcrumbs:
|
||||
- "Head and Neck"
|
||||
- "Anatomy"
|
||||
- "Suprahyoid and Infrahyoid Neck"
|
||||
- "Carotid Space"
|
||||
---
|
||||
## TERMINOLOGY
|
||||
|
||||
- ### Abbreviations
|
||||
|
||||
|
||||
- Carotid space (CS)
|
||||
- Suprahyoid neck (SHN); infrahyoid neck (IHN)
|
||||
- ### Synonyms
|
||||
|
||||
|
||||
- Poststyloid parapharyngeal space (PPS) in SHN
|
||||
- Real PPS, a.k.a. prestyloid PPS
|
||||
- ### Definitions
|
||||
|
||||
|
||||
- Paired, tubular spaces surrounded by carotid sheath that contain carotid arteries, internal jugular veins (IJVs), and **cranial nerves (CNs) IX-XII****(SHN) and** **CNX****(IHN)**
|
||||
|
||||
## IMAGING ANATOMY
|
||||
|
||||
- ### Overview
|
||||
|
||||
|
||||
- CS travels from inferior margins of jugular foramen-carotid canal above to aortic arch below
|
||||
- SHN CS contains CNIX-XII, internal carotid artery (ICA), and IJV
|
||||
- IHN CS contains CNX only, common carotid artery (CCA), IJV
|
||||
- IJ nodal chain closely associated with its outer surface
|
||||
- ### Extent
|
||||
|
||||
|
||||
- CS defined from skull base (carotid canal and jugular foramen) to aortic arch below
|
||||
- CS can be divided into its major segments
|
||||
- Nasopharyngeal, oropharyngeal, cervical, mediastinal
|
||||
- ### Anatomy Relationships
|
||||
|
||||
|
||||
- **SHN CS adjacent spaces**
|
||||
- Retropharyngeal space (RPS) medial; perivertebral space (PVS) posterior; PPS anterior; parotid space (PS) lateral
|
||||
- **Posterior belly of digastric (PBD)** muscle separates CS from deep lobe of parotid gland
|
||||
- **IHN CS adjacent spaces**
|
||||
- Visceral space and RPS medial; PVS posterior; anterior cervical space anterior; posterior cervical space lateral
|
||||
- ### Internal Contents
|
||||
|
||||
|
||||
- **SHN CS**
|
||||
- **Vessels: ICA and IJV**
|
||||
- **CNIX-XII in nasopharyngeal CS**
|
||||
- **Only CNX** in CS from oropharyngeal CS **inferiorly**
|
||||
- **CNX** in posterior notch formed by ICA and IJV **within CS**
|
||||
- Vagus nerve tumor: **Separates** carotid artery (pushed anteromedially) and IJV (pushed posterolaterally)
|
||||
- **Sympathetic trunk**lies **outside CS** posterior to it or between **medial**CS and lateral RPS
|
||||
- Plastered to prevertebral fascia
|
||||
- Sympathetic trunk tumor: **Displaces both** carotid artery and IJV **together** anteriorly/anterolaterally
|
||||
- **Postganglionic** sympathetic fibers pass **around** CCA, ICA, and ECA (within and outside CS) in both SHN and IHN
|
||||
- **I****HN CS**
|
||||
- **Vessels**:**CCA and IJV**
|
||||
- **Vagus nerve**(within CS between ICA and IJV) and**sympathetic trunk**(outside CS) **posteriorly**
|
||||
- **Ansa cervicalis**embedded in anterior wall of CS
|
||||
- **Superior root (descendens hypoglossi)**: Descends over**ICA and CCA**; continuation of descending branch of hypoglossal nerve; fibers from **C1** spinal nerve
|
||||
- Supplies **superior belly of omohyoid**
|
||||
- **Inferior root (descending cervical nerve)**: Descends winding around **IJV**; fibers from **C2**, **C3** spinal nerves
|
||||
- Supplies **inferior belly of omohyoid**
|
||||
- Joins superior root anteroinferiorly **in front of CCA** to form **ansa cervicalis**
|
||||
- Ansa cervicalis supplies **sternohyoid** and **sternothyroid**
|
||||
- Internal jugular nodes closely associated (but **not** in CS)
|
||||
- ### Fascia of CS
|
||||
|
||||
|
||||
- **Carotid sheath**made from components of **all 3 layers of deep cervical fascia (DCF)**
|
||||
- SHN CS: Carotid sheath incomplete or less substantial
|
||||
- IHN CS: Carotid sheath well-defined, tenacious fascia
|
||||
|
||||
## ANATOMY IMAGING ISSUES
|
||||
|
||||
- ### Questions
|
||||
|
||||
|
||||
- **Lesion in SHN CS**
|
||||
- Center of lesion within area of ICA-IJV, posterior to PPS
|
||||
- Lesion displaces PPS fat anteriorly; pushes PBD muscle anterolaterally; and nasopharyngeal CS lesion pushes styloid process anterolaterally
|
||||
- **Vagus nerve tumor** (schwannoma, neurofibroma, paraganglioma): **Separates** ICA and IJV
|
||||
- ICA pushed**anteromedially** and IJV **posterolaterally**
|
||||
- **Sympathetic schwannoma**: **D****isplaces**both ICA and IJV**together**anteriorly or anterolaterally
|
||||
- **Lesion in IHN CS**
|
||||
- May engulf CCA and IJV or push them apart
|
||||
- **Vagus nerve tumor**: **Separates** CCA and IJV
|
||||
- May **splay** **ECA** and **ICA** (**carotid body** paraganglioma)
|
||||
- **Sympathetic schwannoma**: **D****isplaces**both CCA and IJV**together**anteriorly or anterolaterally
|
||||
- ### Imaging Recommendations
|
||||
|
||||
|
||||
- CECT or MR easily identify normal CS anatomy and lesions
|
||||
- If using MR, remember to acquire unenhanced T1 (to look for high-velocity flow voids of paraganglioma)
|
||||
- MRA and MRV for defining normal and diseased vessels of CS (ICA dissection; pseudoaneurysm; IJV thrombosis)
|
||||
- ### Imaging Approaches
|
||||
|
||||
|
||||
- Remember that CS runs from jugular foramen-carotid canal of skull base above to aortic arch below
|
||||
- If imaging CS because of **left** vagal neuropathy, must reach aortopulmonic window inferiorly
|
||||
- ### Imaging Pitfalls
|
||||
|
||||
|
||||
- Normal vascular flow phenomenon of IJV may mimic schwannoma or thrombosis
|
||||
|
||||
## CLINICAL IMPLICATIONS
|
||||
|
||||
- ### Clinical Importance
|
||||
|
||||
|
||||
- **CNIX-XII**and**carotid artery**vital structures in CS
|
||||
- ### Function & Dysfunction
|
||||
|
||||
|
||||
- **Injury to nasopharyngeal CS** may result in complex cranial neuropathy involving some combination of **CNIX-XII**
|
||||
- **Vagus nerve injury**: Vocal cord paralysis
|
||||
- Look for extranodal extension of internal jugular nodal chain pathology around carotid artery
|
||||
|
||||
c4bdcb32-6fab-4ea1-9186-95d3fc2cdec8
|
||||
|
||||
|
||||
## Images
|
||||
|
||||
|
||||
### Graphics
|
||||
|
||||
|
||||
*Graphic shows the suprahyoid neck (SHN) at the level of C1 vertebral body with insert showing magnified carotid space (CS). SHN CS contains CNIX-XII, internal carotid artery (ICA), and internal jugular vein (IJV). Carotid sheath is made up of components of all 3 layers of deep cervical fascia (tricolor line around CS). In SHN, carotid sheath is less substantial than it is in infrahyoid neck (IHN). Sympathetic trunk runs posteromedial to CS.*
|
||||
|
||||
|
||||
*Graphic shows the suprahyoid neck (SHN) at the level of C1 vertebral body with insert showing magnified carotid space (CS). SHN CS contains CNIX-XII, internal carotid artery (ICA), and internal jugular vein (IJV). Carotid sheath is made up of components of all 3 layers of deep cervical fascia (tricolor line around CS). In SHN, carotid sheath is less substantial than it is in infrahyoid neck (IHN). Sympathetic trunk runs posteromedial to CS.*
|
||||
|
||||
|
||||
*In the IHN, the CS is tenacious throughout its length. IHN CS contains the common carotid artery (CCA), IJV, and only the vagus cranial nerve. Note sympathetic trunk lying outside the CS posterior to it, and ansa cervicalis embedded in the anterior wall of the carotid sheath. Postganglionic sympathetic fibers pass around CCA, ICA, and external carotid arteries and branches (within and outside CS) in both SHN and IHN. Postganglionic fibers from superior cervical sympathetic ganglion are distributed in the internal carotid nerve ascending with the ICA into the carotid canal entering the cranial cavity, and also in the lateral, medial, and anterior branches of the ganglion.*
|
||||
|
||||
|
||||
*Graphic shows the skull base viewed from below, illustrating the interaction between the CS and the skull base. The nasopharyngeal CS is an inferior continuation of the carotid canal, jugular foramen, and hypoglossal canal. The ICA, IJV, and CNIX-XII are found within the CS. The carotid sheath is depicted as a tricolor line because it is formed from all 3 layers of deep cervical fascia.*
|
||||
|
||||
|
||||
*Graphic of the neck shows the CS as a tube running from the skull base to the aortic arch. The CS is divided at the hyoid bone level into suprahyoid and infrahyoid portions. The suprahyoid CS has CNIX-XII within it, and the infrahyoid CS has only a vagus nerve inside.*
|
||||
|
||||
|
||||
*Graphic shows a generic CS mass. A SHN CS mass displaces the parapharyngeal space fat anteriorly as well as lifts the styloid process anterolaterally. SHN and IHN vagal nerve/sheath tumor separates the carotid artery (pushed anteromedially) and IJV (pushed posterolaterally). In contrast, a sympathetic trunk tumor will displace both carotid artery and IJV together anteriorly/anterolaterally as the sympathetic trunk lies outside the CS posteriorly/posteromedially.*
|
||||
|
||||
|
||||
### CECT and CTA of Carotid Space Vessels
|
||||
|
||||
|
||||
*Axial CECT of the IHN shows a right vagal nerve sheath tumor splaying the CCA anteromedially and IJV posterolaterally. Note the normal arrangement of the left CCA and IJV.*
|
||||
|
||||
|
||||
*Coronal MIP reconstruction of neck CTA shows the CS vessels, namely, CCA and IJV in IHN and ICA and IJV in SHN. CS nerves, which include CNIX-XII in nasopharyngeal CS and CNX from oropharyngeal CS inferiorly, cannot be visualized on routine CT/MR. ECA and vertebral artery, which are not part of the CS, are also marked.*
|
||||
|
||||
|
||||
*Lateral view of 3D reconstruction of neck CTA shows the contents of CS. Note that the hyoid bone is approximately at the level of carotid bifurcation with the ICA found in SHN CS and the CCA found in IHN CS. ECA originates from the carotid bulb, exits out of the CS and branches out in the neck, whereas the ICA within the CS has no branches in the neck. IJV runs within the CS in both SHN and IHN. SHN CS is also known as poststyloid parapharyngeal space (PPS) as it lies posterior to the styloid process, just behind the real PPS.*
|
||||
|
||||
|
||||
### Axial CECT
|
||||
|
||||
|
||||
*First of 6 axial CECT images presented from superior to inferior is shown. In this image at the level of C1 vertebral body, the nasopharyngeal CS contains the ICA, IJV, and CNIX-XII. Notice that the CS is posterior to the styloid process. At the level of the nasopharynx, a CS mass will push from posterior to anterior into the parapharyngeal space and displace the styloid process anterolaterally.*
|
||||
|
||||
|
||||
*In this image at the level of the midoropharynx, the posterior belly of the digastric (PBD) muscle is visible anterolateral to the CS. A CS mass here would push this muscle anterolaterally and the parapharyngeal space anteriorly. CS lies posteromedial to deep lobe of parotid gland in the parotid space and the PBD muscle separates upper CS from deep parotid space. Displacement of PBD muscle can be used to assess the epicenter of tumors in this location. Deep lobe of parotid tumor displaces PBD posteromedially, whereas CS mass here will displace PBD anterolaterally.*
|
||||
|
||||
|
||||
*At the level of the hyoid bone, the carotid bifurcation can be seen. At this level, only the vagus nerve is left within the CS.*
|
||||
|
||||
|
||||
*At the level of the hyoid bone, the CS has only the CCA, IJV, and vagus nerve within it. Notice that, despite the high-resolution nature of this CT image, it is not possible to see the vagus nerve or the carotid sheath.*
|
||||
|
||||
|
||||
*In this image through the infrahyoid aspect of the CS, the surrounding deep tissue anatomy can be seen. Posterolateral to the CS, the large fat-filled posterior cervical space is visible. Posteromedially, the perivertebral space is found. Medial to the CS are the visceral space and the retropharyngeal space. Anteriorly, the sternocleidomastoid muscle resides.*
|
||||
|
||||
|
||||
*At the level of the cricoid cartilage, the infrahyoid CS contains the CCA, IJV, and vagus nerve. Despite its large size, the vagal trunk cannot be visualized in its location between the CCA and IJV within the carotid sheath. The sympathetic chain lies outside the carotid sheath posterior to it, and the ansa cervicalis lies embedded in the anterior wall of carotid sheath. These are also not demonstrated (expected locations are marked).*
|
||||
|
||||
|
||||
### Common Carotid Artery Ultrasound
|
||||
|
||||
|
||||
*Transverse grayscale ultrasound shows the distal CCA at the level of the upper pole of the thyroid gland. Note that the artery wall in a normal individual is smooth with no intimal thickening or atherosclerotic plaque. The lumen is circular in cross section. There is no major named branch of the common carotid proximal to the bifurcation.*
|
||||
|
||||
|
||||
*Longitudinal grayscale ultrasound of the CCA shows the smooth outline of the intimal layer.*
|
||||
|
||||
|
||||
*Color Doppler ultrasound of the proximal CCA at the root of the neck in the longitudinal plane demonstrates the normal antegrade arterial flow in the cranial direction. Its origin, along with the subclavian artery from the right brachiocephalic artery, is also well demonstrated.*
|
||||
|
||||
|
||||
### Vagus Nerve Ultrasound
|
||||
|
||||
|
||||
*Transverse grayscale ultrasound of the lower cervical level at the thyroid gland level shows the vagus nerve as a small, round, hypoechoic structure that exhibits central echogenicity within the carotid sheath and is located between the CCA and the IJV.*
|
||||
|
||||
|
||||
*Power Doppler ultrasound of the midcervical level in the transverse plane demonstrates the avascular nature of the vagus nerve adjacent to the CCA and IJV. Note the presence of hilar vascularity in the adjacent normal deep cervical lymph node.*
|
||||
|
||||
|
||||
*Longitudinal grayscale ultrasound shows the vagus nerve, which appears as a long, thin, tubular, hypoechoic structure with a central echogenic fibrillary pattern. On ultrasound, the vagus nerve is readily seen from the carotid bifurcation to the lower cervical region.*
|
||||
|
||||
|
||||
### Additional Images
|
||||
|
||||
|
||||
*Lateral 3D-VRT CECT reconstruction shows the major vessels of the neck. The hyoid bone is approximately at the level of the carotid bifurcation with the ICA found in the suprahyoid CS and the CCA found within the infrahyoid CS.*
|
||||
|
||||
|
||||
*Lateral view of an extracranial MRA shows the carotid artery from the arch below to the supraclinoid area above. Remember that the carotid artery extends in the CS throughout this entire distance.*
|
||||
|
||||
|
||||
*Sagittal reformation of CECT of the extracranial head and neck shows the internal jugular vein from its emergence from the jugular foramen above to the clavicle level below. Thrombosis of this vessel can mimic infection (acute thrombophlebitis) or tumor (chronic thrombosis).*
|
||||
|
||||
@@ -0,0 +1,429 @@
|
||||
---
|
||||
title: "Dural Sinus Lesion, General"
|
||||
docid: "2fbd9762-23d0-40cb-868f-ff7ef3304264"
|
||||
authors:
|
||||
- key: "0672a616-96fb-43e8-809b-8be5d0b3b476"
|
||||
value: "Luke N. Ledbetter, MD"
|
||||
breadcrumbs:
|
||||
-
|
||||
name: "Head and Neck"
|
||||
slug: "head-and-neck"
|
||||
treeNodeId: "5c1f8e17-7acd-48d8-9d55-f9f8c2cad850"
|
||||
-
|
||||
name: "Differential Diagnosis"
|
||||
slug: "differential-diagnosis"
|
||||
treeNodeId: "deb55065-e1d6-4b6f-b3e3-181fafb4e218"
|
||||
-
|
||||
name: "Skull Base"
|
||||
slug: "skull-base"
|
||||
treeNodeId: "c64c7693-b8db-4b9f-aab5-d26fb08455f5"
|
||||
-
|
||||
name: "Anatomically Based Differentials"
|
||||
slug: "anatomically-based-differentials"
|
||||
treeNodeId: "1646983c-a8e8-4a00-8155-b1de0fc2ca45"
|
||||
-
|
||||
name: "Dural Sinus Lesion, General"
|
||||
slug: "dural-sinus-lesion-general"
|
||||
treeNodeId: null
|
||||
category: "Head and Neck"
|
||||
documentVersionId: "fc08ff69-359e-4705-bf67-18159ead5267"
|
||||
imageCount: 60
|
||||
lastUpdated: "08/15/18"
|
||||
pageDescription: "Dural Sinus Lesion, General"
|
||||
pageKeywords: "Head and Neck, Differential Diagnosis, Skull Base, Anatomically Based Differentials, Dural Sinus Lesion, General"
|
||||
pageTitle: "Dural Sinus Lesion, General | STATdx"
|
||||
enhancedTitle: "Dural Sinus Lesion, General"
|
||||
type: "DDX"
|
||||
references: true
|
||||
breadcrumbs:
|
||||
- "Head and Neck"
|
||||
- "Differential Diagnosis"
|
||||
- "Skull Base"
|
||||
- "Anatomically Based Differentials"
|
||||
- "Dural Sinus Lesion, General"
|
||||
---
|
||||
## ESSENTIAL INFORMATION
|
||||
|
||||
- ### Key Differential Diagnosis Issues
|
||||
|
||||
|
||||
- Includes generic lesions affecting **all**dural venous sinuses
|
||||
- Cavernous sinus (CS) unique because of contents, proximity to skull base
|
||||
- Has diagnoses (e.g., perineural metastasis, aneurysm, schwannoma) that do not affect other sinuses
|
||||
- Imaging challenge: Differentiate dural sinus thrombosis (DST) from potential mimics like stenosis & hypoplasia
|
||||
- CTV best
|
||||
- MRV shows anatomical narrowing/occlusion
|
||||
- T2* (GRE/SWI) shows thrombus
|
||||
- ### Helpful Clues for Common Diagnoses
|
||||
|
||||
|
||||
- **Arachnoid Granulations, Dural Sinuses**
|
||||
- Well-circumscribed, ovoid, filling defect in venous sinus ± calvarial remodeling
|
||||
- Occurs in any dural venous sinus
|
||||
- Most common location is transverse sinus
|
||||
- Normal anatomic variant in sinus despite some > 1 cm
|
||||
- May narrow but not occlude sinus
|
||||
- Nonenhancing; CSF signal on both CT & MR
|
||||
- **Dural Sinus Hypoplasia-Aplasia**
|
||||
- Unilateral in 33% of normal scans
|
||||
- Bilateral in up to 5% of scans
|
||||
- Transverse sinus most common site
|
||||
- Right side usually larger than left in hypoplasia-aplasia
|
||||
- Flow gaps on phase-contrast MRV can mimic DST
|
||||
- Confirm flow gaps on source data
|
||||
- No blooming thrombus on T2* when artifact
|
||||
- Thin 3D T1 C+ can help confirm lack of filling defect
|
||||
- Hypoplastic-aplastic side will have asymmetrically small draining foramen
|
||||
- Anterosuperior sagittal sinus commonly absent
|
||||
- **Thrombosis, Dural Sinus**
|
||||
- Symptoms vary with extent of thrombus, collaterals, cortical vein involvement
|
||||
- Headache common
|
||||
- Cortical/subcortical hemorrhages (bilateral parasagittal if superior sagittal sinus or temporal lobe if vein of Labbe)
|
||||
- ± edema (vasogenic > cytotoxic)
|
||||
- Thrombus elongated, not typically round like arachnoid granulations
|
||||
- NECT demonstrates hyperdense clot in sinus, typically >70 Hounsfield units
|
||||
- CECT/CTV findings
|
||||
- Lack of opacification in region of thrombus; if visualized in cross section of sinus = empty delta sign
|
||||
- Hyperdense clot may not be distinguishable from surrounding contrast; compare to NECT
|
||||
- MR findings
|
||||
- Conventional sequences vary: T1 & T2 signal changes with age of clot
|
||||
- Loss of normal central flow void
|
||||
- Clot elongated, fills sinus, shows susceptibility on T2*
|
||||
- Confirm with MRV ± thin 3D T1 C+
|
||||
- Chronic thrombosis difficult diagnosis
|
||||
- Progressive recanalization &/or granulation tissue forms
|
||||
- Chronic thrombus enhances, mimicking patent dural sinus
|
||||
- Dura also thickens, enhances; bizarre-appearing collaterals may mimic vascular malformation
|
||||
- May have clinical, imaging findings of intracranial hypertension (pseudotumor cerebri)
|
||||
- ### Helpful Clues for Less Common Diagnoses
|
||||
|
||||
|
||||
- **Dural****Arteriovenous****Fistula**
|
||||
- Acquired shunt between dural artery & dural sinus or cortical vein
|
||||
- Symptomatic from either venous hypertension (pulsatile tinnitus, exophthalmos, encephalopathy) or hemorrhage
|
||||
- Venous hypertension/congestion usually indolent; hemorrhage presents suddenly
|
||||
- Imaging
|
||||
- Flow voids within wall of thrombosed dural sinus common
|
||||
- Small web of vessels on collapsed MRA images may suggest diagnosis
|
||||
- Shunting of bright arterial blood into typically nonbright venous sinuses on MRA
|
||||
- Often difficult to identify on cross-sectional imaging necessitating DSA
|
||||
- Transverse sinus > CS
|
||||
- **Meningioma**
|
||||
- Enhancing dural-based mass ± tail
|
||||
- May invade, occlude, or compress dural sinuses
|
||||
- T2 flow void & 3D T1 C+ help assess
|
||||
- Parasagittal often involves superior sagittal sinus
|
||||
- Bony hyperostosis variable
|
||||
- **Metastasis**
|
||||
- Systemic primaries may compress or invade dural sinuses
|
||||
- Usually arise in skull with secondary dural involvement
|
||||
- **Lymphoma**
|
||||
- Dural-based mass(es) common in metastatic lymphoma
|
||||
- Primary central nervous system (CNS) lymphoma does not typically involve dural sinuses
|
||||
- **Depressed Skull Fracture**
|
||||
- May lacerate/compress/occlude dural sinus
|
||||
- ± venous epidural hematoma (EDH)
|
||||
- Venous EDH develops slowly, presents late
|
||||
- **Intracranial Hypotension**
|
||||
- Dural venous engorgement, diffuse enhancement
|
||||
- ± slumping midbrain, tonsillar descent, subdural hematoma
|
||||
- **Dural Venous Sinus Stenosis**
|
||||
- Focal short segmental narrowing on CTV, MRV, or DSA (venous phase)
|
||||
- Commonly in transverse sinus near junction with sigmoid sinus
|
||||
- Can be asymptomatic, but may be related to intracranial hypertension
|
||||
- Role in intracranial hypertension controversial; may be cause or result of elevated CSF pressure
|
||||
- Patients with suspected symptomatic venous outflow restriction, pressure gradient at venography may improve after stent
|
||||
- ### Helpful Clues for Rare Diagnoses
|
||||
|
||||
|
||||
- **Thrombophlebitis**
|
||||
- Complication of infection (meningitis, rhinosinusitis, or mastoiditis)
|
||||
- Infection spreads easily due to valveless nature of intracranial venous system
|
||||
- May cause septic venous thrombosis or distant infectious emboli
|
||||
- **Polycythemia**
|
||||
- High hematocrit → "dense" dural sinus
|
||||
- MR + MRV helpful in distinguishing patent sinuses
|
||||
- **Dural Sinus Venous Malformation**
|
||||
- Historically called hemangioma
|
||||
- Convexity dura or venous sinus (CS most common)
|
||||
- May present with mass effect or intracranial hypertension
|
||||
- Progressive centripetal enhancement in larger lesions
|
||||
- **Leukemia**
|
||||
- Dural-based enhancing masses
|
||||
- May compress/invade dural sinuses
|
||||
- **Rosai-Dorfman Disease**
|
||||
- a.k.a. sinus histiocytosis
|
||||
- Younger patients with massive bilateral lymphadenopathy
|
||||
- Extranodal involvement: Skin, sinonasal mucosa, orbit, bone, salivary glands, & dura
|
||||
- Lymphadenopathy usually coexists if CNS disease is present
|
||||
- Solitary/multiple dural-based enhancing masses
|
||||
- **Extramedullary Hematopoiesis**
|
||||
- Smooth juxtacranial homogeneously enhancing masses due to decreased medullary hematopoiesis
|
||||
- Dural sinus compression/invasion rare
|
||||
- **Lipoma**
|
||||
- Fat in dural sinus rare; CS most common
|
||||
- **Intravascular Papillary Endothelial Hyperplasia**
|
||||
- a.k.a. Masson vegetant intravascular hemangioendothelioma
|
||||
- Benign tumor with endothelial hyperplasia of veins
|
||||
- Can mimic meningioma
|
||||
|
||||
## References
|
||||
|
||||
## Selected References
|
||||
|
||||
1. [Lansley JA et al: Sigmoid sinus diverticulum, dehiscence, and venous sinus stenosis: potential causes of pulsatile tinnitus in patients with idiopathic intracranial hypertension? AJNR Am J Neuroradiol. 38(9):1783-1788, 2017](http://www.ncbi.nlm.nih.gov/pubmed/?term=28705815%5Bpmid%5D)
|
||||
1. [Durst CR et al: Prevalence of dural venous sinus stenosis and hypoplasia in a generalized population. J Neurointerv Surg. ePub, 2016](http://www.ncbi.nlm.nih.gov/pubmed/?term=26747875%5Bpmid%5D)
|
||||
1. [Bonneville F: Imaging of cerebral venous thrombosis. Diagn Interv Imaging. 95(12):1145-50, 2014](http://www.ncbi.nlm.nih.gov/pubmed/?term=25465119%5Bpmid%5D)
|
||||
1. [Horsburgh A: Incidental fat in the dural sinuses. Neuroradiology. 51(11):787-8, 2009](http://www.ncbi.nlm.nih.gov/pubmed/?term=19543888%5Bpmid%5D)
|
||||
1. [Wasay M et al: Neuroimaging of cerebral venous thrombosis. J Neuroimaging. 15(2):118-28, 2005](http://www.ncbi.nlm.nih.gov/pubmed/?term=15746223%5Bpmid%5D)
|
||||
1. [Liang L et al: Normal structures in the intracranial dural sinuses: delineation with 3D contrast-enhanced magnetization prepared rapid acquisition gradient-echo imaging sequence. AJNR Am J Neuroradiol. 23(10):1739-46, 2002](http://www.ncbi.nlm.nih.gov/pubmed/?term=12427634%5Bpmid%5D)
|
||||
|
||||
|
||||
## Images
|
||||
|
||||
|
||||
### Selected Images
|
||||
|
||||
|
||||
**Arachnoid Granulations, Dural Sinuses**
|
||||
*Axial CT venography shows an arachnoid granulation within the left transverse sinus <img src='img/arrows/WS.png' alt='white solid arrow'/>, a common incidental finding on imaging studies. This has cerebrospinal fluid (CSF) density, is ovoid, and is well circumscribed. Venous contrast opacifies around the granulation <img src='img/arrows/WO.png' alt='white open arrow'/>.*
|
||||
|
||||
|
||||
**Arachnoid Granulations, Dural Sinuses**
|
||||
*Axial T2W MR in the same patient shows the arachnoid granulation with T2 hyperintensity similar to CSF. Again, the arachnoid granulation is well circumscribed and ovoid.*
|
||||
|
||||
|
||||
**Arachnoid Granulations, Dural Sinuses**
|
||||
*Axial CT venography shows a well-defined area of multilobulated bony erosion of the inner table of the occiput <img src='img/arrows/WS.png' alt='white solid arrow'/> below the right transverse sinus <img src='img/arrows/WO.png' alt='white open arrow'/>, consistent with an arachnoid granulation. The arachnoid granulation is low density, similar to CSF.*
|
||||
|
||||
|
||||
**Arachnoid Granulations, Dural Sinuses**
|
||||
*Sagittal T2W MR in the same patient shows the relationship of the T2 hyperintense arachnoid granulation <img src='img/arrows/WS.png' alt='white solid arrow'/> to the dural sinus above <img src='img/arrows/WO.png' alt='white open arrow'/> as well as the benign multilobulated erosion into the inner table of the occiput.*
|
||||
|
||||
|
||||
**Arachnoid Granulations, Dural Sinuses**
|
||||
*Time-of-flight MRV demonstrates a well-circumscribed, low signal intensity, ovoid lesion within the superior sagittal sinus compatible with an arachnoid granulation <img src='img/arrows/WS.png' alt='white solid arrow'/>.*
|
||||
|
||||
|
||||
**Arachnoid Granulations, Dural Sinuses**
|
||||
*Conventional venogram with a catheter and injection of contrast into the torcular Herophili demonstrates dominate drainage into the right transverse sinus <img src='img/arrows/BS.png' alt='black solid arrow'/>. There is a round, nonocclusive filling defect in the mid transverse sinus, consistent with an arachnoid granulation <img src='img/arrows/BO.png' alt='black open arrow'/>.*
|
||||
|
||||
|
||||
**Dural Sinus Hypoplasia-Aplasia**
|
||||
*Time-of-flight MRV shows an asymmetrically small left transverse <img src='img/arrows/WS.png' alt='white solid arrow'/> and sigmoid sinus <img src='img/arrows/WO.png' alt='white open arrow'/> with preferential flow into the larger right transverse sinus <img src='img/arrows/WC.png' alt='white curved arrow'/>. Notice the asymmetric small size of the left internal jugular vein <img src='img/arrows/BO.png' alt='black open arrow'/>.*
|
||||
|
||||
|
||||
**Dural Sinus Hypoplasia-Aplasia**
|
||||
*Conventional venogram with the catheter in the superior sagittal sinus shows there is preferential flow into the right transverse sinus <img src='img/arrows/BS.png' alt='black solid arrow'/> with only trace flow into the hypoplastic left transverse sinus <img src='img/arrows/BO.png' alt='black open arrow'/>.*
|
||||
|
||||
|
||||
**Thrombosis, Dural Sinus**
|
||||
*Axial CT venography shows the empty delta sign of a nearly occlusive dural sinus thrombosis <img src='img/arrows/WS.png' alt='white solid arrow'/>. The clot in the superior sagittal vein is hypodense relative to the surrounding contrast, leading to the appearance of an empty sinus.*
|
||||
|
||||
|
||||
**Thrombosis, Dural Sinus**
|
||||
*Coronal T1 C+ MR shows large T1 hypointense filling defects in both transverse sinuses <img src='img/arrows/WS.png' alt='white solid arrow'/> as well as the superior sagittal sinus <img src='img/arrows/WO.png' alt='white open arrow'/>. This extensive clot resulted in leptomeningeal venous congestion demonstrated by the increased prominence of sulcal enhancing vascularity <img src='img/arrows/WC.png' alt='white curved arrow'/>.*
|
||||
|
||||
|
||||
**Thrombosis, Dural Sinus**
|
||||
*Axial T1 MR demonstrates bright subacute thrombus within the bilateral transverse sinuses <img src='img/arrows/WS.png' alt='white solid arrow'/>. A T1 hyperintense clot may have a pseudopatent appearance on contrast-enhanced MR imaging, and correlation with unenhanced images is key.*
|
||||
|
||||
|
||||
**Thrombosis, Dural Sinus**
|
||||
*Axial T1 C+ MR obtained immediately after mastoidectomy shows an elongated filling defect in the left sigmoid sinus <img src='img/arrows/WS.png' alt='white solid arrow'/> as well as separate thrombus in the jugular vein <img src='img/arrows/WO.png' alt='white open arrow'/>.*
|
||||
|
||||
|
||||
**Dural Arteriovenous Fistula**
|
||||
*Axial time-of-flight MRA shows abnormal shunting of arterial bright blood into the right sigmoid sinus <img src='img/arrows/WS.png' alt='white solid arrow'/> due to a dural arteriovenous fistula. The left sigmoid sinus contains the expected dark venous blood <img src='img/arrows/WO.png' alt='white open arrow'/> due to suppression of venous inflow.*
|
||||
|
||||
|
||||
**Dural Arteriovenous Fistula**
|
||||
*Right external carotid angiogram (same patient) shows the area of abnormal communication between branches of external carotid artery <img src='img/arrows/WS.png' alt='white solid arrow'/> and sigmoid sinus <img src='img/arrows/WO.png' alt='white open arrow'/>, consistent with a dural arteriovenous fistula. Lack of retrograde venous opacification carries lower risk for intracranial hemorrhage.*
|
||||
|
||||
|
||||
**Meningioma**
|
||||
*Axial T1 C+ demonstrates a posterior parasagittal cystic meningioma <img src='img/arrows/WS.png' alt='white solid arrow'/> with invasion into the superior sagittal sinus <img src='img/arrows/WO.png' alt='white open arrow'/>. Brighter T1 intensity corresponds to the residual lumen opacified with venous contrast <img src='img/arrows/WC.png' alt='white curved arrow'/>.*
|
||||
|
||||
|
||||
**Metastasis**
|
||||
*Coronal T1 C+ MR in a patient with pachymeningeal seminoma metastatic disease <img src='img/arrows/WS.png' alt='white solid arrow'/> shows vertex dural metastasis invades into and obliterates the superior sagittal sinus <img src='img/arrows/WO.png' alt='white open arrow'/>.*
|
||||
|
||||
|
||||
**Lymphoma**
|
||||
*Axial T1 C+ FS MR demonstrates homogeneous enhancing lymphoma centered in the right cavernous sinus <img src='img/arrows/WS.png' alt='white solid arrow'/> and extending into the orbital apex <img src='img/arrows/WO.png' alt='white open arrow'/>.*
|
||||
|
||||
|
||||
**Depressed Skull Fracture**
|
||||
*Sagittal T1 MR in a patient with traumatic head injury and multiple skull fractures (not shown) shows that a fracture lacerated the dural venous sinus <img src='img/arrows/WO.png' alt='white open arrow'/>, resulting in a transvenous epidural hematoma <img src='img/arrows/WS.png' alt='white solid arrow'/>. Since hemorrhage is venous in nature, venous hematomas can be managed conservatively.*
|
||||
|
||||
|
||||
**Intracranial Hypotension**
|
||||
*Coronal T1 C+ MR demonstrates multiple findings of intracranial hypotension. These include prominence of the dural venous sinuses <img src='img/arrows/WS.png' alt='white solid arrow'/>, smooth pachymeningeal thickening and enhancement <img src='img/arrows/WO.png' alt='white open arrow'/>, and convexity subdural hematomas <img src='img/arrows/WC.png' alt='white curved arrow'/>.*
|
||||
|
||||
|
||||
**Dural Venous Sinus Stenosis**
|
||||
*Conventional angiogram shows focal narrowing <img src='img/arrows/BS.png' alt='black solid arrow'/> at the junction of the transverse sinus <img src='img/arrows/BO.png' alt='black open arrow'/> and the sigmoid sinus <img src='img/arrows/BC.png' alt='black curved arrow'/>, a common site of narrowing. Stenoses can be associated with intracranial hypertension.*
|
||||
|
||||
|
||||
**Thrombophlebitis**
|
||||
*Axial T1 C+ MR in a patient with bilateral mastoiditis <img src='img/arrows/WS.png' alt='white solid arrow'/> and associated bone destruction <img src='img/arrows/WO.png' alt='white open arrow'/> is shown. Low T1 signal expansile filling defect in the adjacent sigmoid sinus <img src='img/arrows/WC.png' alt='white curved arrow'/> and jugular foramen <img src='img/arrows/BS.png' alt='black solid arrow'/> is compatible with thrombophlebitis.*
|
||||
|
||||
|
||||
**Polycythemia**
|
||||
*Axial NECT shows hyperdense appearance of the superior sagittal sinus <img src='img/arrows/BS.png' alt='black solid arrow'/> and cortical veins <img src='img/arrows/BO.png' alt='black open arrow'/>, mimicking the CECT for this 22-year-old patient (not shown) with chronic right-to-left cardiac shunt with a hematocrit of 67.*
|
||||
|
||||
|
||||
**Dural Sinus Venous Malformation**
|
||||
*Coronal T1 C+ MR in this 13 year old shows a strongly enhancing <img src='img/arrows/WS.png' alt='white solid arrow'/> left cavernous sinus mass encasing the left internal carotid artery <img src='img/arrows/BC.png' alt='black curved arrow'/> without narrowing it and extending into the sella and middle cranial fossa.*
|
||||
|
||||
|
||||
**Leukemia**
|
||||
*Sagittal T1 C+ MR in a patient with multiple areas of dural involvement with leukemia shows an irregular, dural-based leukemic mass <img src='img/arrows/WS.png' alt='white solid arrow'/> along the tentorium that invades or narrows the adjacent transverse sinus <img src='img/arrows/WO.png' alt='white open arrow'/>.*
|
||||
|
||||
|
||||
**Extramedullary Hematopoiesis**
|
||||
*Coronal T1 C+ MR shows several dural-based masses <img src='img/arrows/WS.png' alt='white solid arrow'/>, including one along the falx cerebri <img src='img/arrows/WO.png' alt='white open arrow'/> adjacent to the anterior aspect of the superior sagittal sinus. These lesions represent extensive extramedullary hematopoiesis.*
|
||||
|
||||
|
||||
**Intravascular Papillary Endothelial Hyperplasia**
|
||||
*Axial T2 MR of left cavernous sinus intravascular papillary endothelial hyperplasia (IPEH) is shown. IPEH can present with a cystic T2 hyperintense <img src='img/arrows/WS.png' alt='white solid arrow'/> component with an associated T2 hypointense nodule <img src='img/arrows/WO.png' alt='white open arrow'/>, as seen here.*
|
||||
|
||||
|
||||
### Additional Images
|
||||
|
||||
|
||||
**Arachnoid Granulations, Dural Sinuses**
|
||||
*Axial T2WI FS MR shows a large ovoid CSF-signal mass <img src='img/arrows/WO.png' alt='white open arrow'/> in the right transverse sinus with internal flow void <img src='img/arrows/WC.png' alt='white curved arrow'/>, probably representing a vein.*
|
||||
|
||||
|
||||
**Arachnoid Granulations, Dural Sinuses**
|
||||
*Axial T1 C+ FS MR in the same patient shows that the lesion <img src='img/arrows/WO.png' alt='white open arrow'/> does not enhance and is the same signal as CSF. The small vein <img src='img/arrows/WC.png' alt='white curved arrow'/> enhances. This was an incidental finding in an asymptomatic patient.*
|
||||
|
||||
|
||||
**Arachnoid Granulations, Dural Sinuses**
|
||||
*Axial CECT shows hypodense CSF-like lobulated filling defect in the right transverse sinus <img src='img/arrows/WS.png' alt='white solid arrow'/>. Note adjacent calvarial scalloping <img src='img/arrows/BO.png' alt='black open arrow'/>.*
|
||||
|
||||
|
||||
**Arachnoid Granulations, Dural Sinuses**
|
||||
*Axial bone CT in the same patient shows smooth, well-delineated erosion <img src='img/arrows/BS.png' alt='black solid arrow'/> of the calvarium caused by arachnoid granulation.*
|
||||
|
||||
|
||||
**Arachnoid Granulations, Dural Sinuses**
|
||||
*Sagittal T1WI MR shows a round, fluid signal cystic lesion within the superior sagittal sinus <img src='img/arrows/WS.png' alt='white solid arrow'/> that followed CSF on all sequences. This is a variant case because of the atypical size and location of the lesion.*
|
||||
|
||||
|
||||
**Arachnoid Granulations, Dural Sinuses**
|
||||
*Coronal oblique angiography shows a large filling defect <img src='img/arrows/WS.png' alt='white solid arrow'/> in the superior sagittal sinus caused by giant arachnoid granulation.*
|
||||
|
||||
|
||||
**Arachnoid Granulations, Dural Sinuses**
|
||||
*Axial NECT shows a well-circumscribed water attenuation cyst within the superior sagittal sinus <img src='img/arrows/WS.png' alt='white solid arrow'/>. Arachnoid granulations should follow water signal or density on all sequences.*
|
||||
|
||||
|
||||
**Thrombosis, Dural Sinus**
|
||||
*Axial T1WI MR shows faint high T1 signal in the left transverse sinus <img src='img/arrows/WS.png' alt='white solid arrow'/> compared to peripheral low and central high signal from laminar flow in the right transverse sinus <img src='img/arrows/WO.png' alt='white open arrow'/>.*
|
||||
|
||||
|
||||
**Thrombosis, Dural Sinus**
|
||||
*Anteroposterior MRV MIP in the same patient shows an occluded left sigmoid sinus and left internal jugular vein <img src='img/arrows/WS.png' alt='white solid arrow'/>. Faint signal on MIPs in the left transverse sinus <img src='img/arrows/WO.png' alt='white open arrow'/> is due to "T1 shine through" from methemoglobin.*
|
||||
|
||||
|
||||
**Thrombosis, Dural Sinus**
|
||||
*Anteroposterior MRV shows lack of flow-related enhancement in the left transverse sigmoid sinuses and left internal jugular vein <img src='img/arrows/WC.png' alt='white curved arrow'/> (confirmed on source images).*
|
||||
|
||||
|
||||
**Thrombosis, Dural Sinus**
|
||||
*Axial NECT in the same patient shows a typical location of left posterior temporal hemorrhage <img src='img/arrows/WS.png' alt='white solid arrow'/> and surrounding vasogenic edema in the acute left vein of Labbe and transverse sinus thrombosis. While a dural clot can be asymptomatic due to collaterals, cortical vein extension causes hemorrhage &/or ischemia.*
|
||||
|
||||
|
||||
**Thrombosis, Dural Sinus**
|
||||
*Axial CECT shows a filling defect in the left transverse sinus <img src='img/arrows/WS.png' alt='white solid arrow'/>, consistent with acute thrombosis.*
|
||||
|
||||
|
||||
**Thrombosis, Dural Sinus**
|
||||
*Axial T1 C+ MR shows dural sinus thrombophlebitis and thrombosis associated with suppurative otomastoiditis. Enhancing thrombus is present within the right sigmoid sinus <img src='img/arrows/WO.png' alt='white open arrow'/>.*
|
||||
|
||||
|
||||
**Meningioma**
|
||||
*Coronal T1 C+ MR shows an unusual cystic meningioma that has invaded the superior sagittal sinus <img src='img/arrows/BO.png' alt='black open arrow'/>.*
|
||||
|
||||
|
||||
**Dural Sinus Hypoplasia-Aplasia**
|
||||
*Coronal MRV shows no flow-related signal within the left transverse or sigmoid sinuses on the MRV MIP projection. Compare to normal dominant right transverse <img src='img/arrows/WS.png' alt='white solid arrow'/> and sigmoid <img src='img/arrows/WC.png' alt='white curved arrow'/> sinuses.*
|
||||
|
||||
|
||||
**Dural Sinus Hypoplasia-Aplasia**
|
||||
*Coronal MRV in the same patient shows small flow-related signal within an asymmetrically smaller left transverse sinus <img src='img/arrows/WS.png' alt='white solid arrow'/>; it is important to review the source images before concluding that lack of flow on MIPs is genuine.*
|
||||
|
||||
|
||||
**Thrombosis, Dural Sinus**
|
||||
*Sagittal CTA shows that the anterior 1/3 of the superior sagittal sinus is patent <img src='img/arrows/WO.png' alt='white open arrow'/>. The posterior 2/3 are filled with nonenhancing clot <img src='img/arrows/WS.png' alt='white solid arrow'/>.*
|
||||
|
||||
|
||||
**Thrombosis, Dural Sinus**
|
||||
*Axial T2* GRE MR in the same patient shows blooming of the clot in the superior sagittal sinus <img src='img/arrows/BS.png' alt='black solid arrow'/>. Note extension into adjacent cortical veins <img src='img/arrows/BO.png' alt='black open arrow'/>.*
|
||||
|
||||
|
||||
**Thrombosis, Dural Sinus**
|
||||
*Lateral MRV shows lack of flow-related enhancement in the expected location of the superior sagittal sinus <img src='img/arrows/WS.png' alt='white solid arrow'/>, consistent with acute thrombosis.*
|
||||
|
||||
|
||||
**Thrombosis, Dural Sinus**
|
||||
*Axial T2WI MR shows bilateral parenchymal foci of swelling and high T2 signal in areas of associated cortical venous ischemia <img src='img/arrows/WS.png' alt='white solid arrow'/> in the same patient as the prior image. These findings are due to associated cortical venous occlusion.*
|
||||
|
||||
|
||||
**Dural Arteriovenous Fistula**
|
||||
*Lateral angiography shows thrombosis at the junction of the transverse sigmoid sinus <img src='img/arrows/BO.png' alt='black open arrow'/> with retrograde filling of the transverse and contralateral dural sinuses. Several enlarged transosseous perforating branches from occipital artery supply the dural arteriovenous fistula <img src='img/arrows/BS.png' alt='black solid arrow'/>.*
|
||||
|
||||
|
||||
**Dural Arteriovenous Fistula**
|
||||
*Axial T2WI MR shows normal right flow void <img src='img/arrows/BO.png' alt='black open arrow'/>. The left side is hyperintense and contains numerous tiny flow voids <img src='img/arrows/WS.png' alt='white solid arrow'/>. Dural arteriovenous fistula developed in the chronically occluded left transverse sinus.*
|
||||
|
||||
|
||||
**Meningioma**
|
||||
*Axial NECT shows a densely calcified meningioma that originated within and mildly expands superior sagittal sinus <img src='img/arrows/WS.png' alt='white solid arrow'/>.*
|
||||
|
||||
|
||||
**Metastasis**
|
||||
*Coronal T1 C+ MR shows dural-based metastasis <img src='img/arrows/WS.png' alt='white solid arrow'/> on both sides of the superior sagittal sinus, which is invaded and thrombosed by the tumor <img src='img/arrows/WO.png' alt='white open arrow'/>.*
|
||||
|
||||
|
||||
**Lymphoma**
|
||||
*Sagittal T1 C+ MR shows an enhancing dural-based mass <img src='img/arrows/WS.png' alt='white solid arrow'/> in the region of cisterna magna that is encroaching into the region of the torcular herophili <img src='img/arrows/WO.png' alt='white open arrow'/> in a patient with systemic lymphoma.*
|
||||
|
||||
|
||||
**Depressed Skull Fracture**
|
||||
*Axial NECT shows a large acute epidural hematoma <img src='img/arrows/WS.png' alt='white solid arrow'/> due to a depressed skull fracture through the torcular and transverse sinus (not shown), resulting in dural sinus laceration and bleeding.*
|
||||
|
||||
|
||||
**Intracranial Hypotension**
|
||||
*Coronal T1 C+ MR in this patient with intracranial hypotension shows engorged dural venous sinuses <img src='img/arrows/BS.png' alt='black solid arrow'/> and thickened enhancing dura <img src='img/arrows/BO.png' alt='black open arrow'/>. The pituitary gland (not shown) also appeared enlarged.*
|
||||
|
||||
|
||||
**Dural Venous Sinus Stenosis**
|
||||
*Axial MR venography shows small caliber of both transverse-sigmoid sinus junctions, with focal stenosis in the left transverse sinus <img src='img/arrows/WS.png' alt='white solid arrow'/> in a patient with papilledema and headaches.*
|
||||
|
||||
|
||||
**Thrombophlebitis**
|
||||
*Axial CECT shows bilateral proptosis. The cavernous sinuses are enlarged with a lack of contrast opacification due to thrombosis <img src='img/arrows/WC.png' alt='white curved arrow'/>. Mucosal disease and fluid levels consistent with acute rhinosinusitis can be seen in multiple paranasal sinuses.*
|
||||
|
||||
|
||||
**Leukemia**
|
||||
*Sagittal T1 C+ MR in a 13 year old with frontal soft tissue swelling shows a dural, calvarial enhancing mass that occludes the anterior superior sagittal sinus <img src='img/arrows/WC.png' alt='white curved arrow'/>. Acute lymphoblastic leukemia was found.*
|
||||
|
||||
|
||||
**Rosai-Dorfman Disease**
|
||||
*Coronal T1 C+ MR shows bilateral dural-based masses <img src='img/arrows/WS.png' alt='white solid arrow'/> along the falx with involvement of the superior sagittal sinus <img src='img/arrows/WC.png' alt='white curved arrow'/>.*
|
||||
|
||||
|
||||
**Extramedullary Hematopoiesis**
|
||||
*Axial NECT shows several dural-based masses <img src='img/arrows/WS.png' alt='white solid arrow'/>, including one along the falx <img src='img/arrows/WO.png' alt='white open arrow'/>, adjacent to the anterior aspect of the superior sagittal sinus.*
|
||||
|
||||
|
||||
**Lipoma**
|
||||
*Axial CECT shows a very low-density filling defect in the dural sinuses <img src='img/arrows/WS.png' alt='white solid arrow'/>. Reviewing bone windows is important to distinguish air from fat.*
|
||||
|
||||
|
||||
**Lipoma**
|
||||
*Axial CECT in the same patient shows that the low-density intrasinus lesion <img src='img/arrows/WS.png' alt='white solid arrow'/> is due to fat.*
|
||||
|
||||
+484
@@ -0,0 +1,484 @@
|
||||
---
|
||||
title: "Enlarged Perivascular Spaces"
|
||||
docid: "24c4b347-098b-48a2-9ff9-2b4ed9563cf8"
|
||||
authors:
|
||||
- key: "a25c450b-3d34-4f64-bba3-cc0834813df6"
|
||||
value: "Miral D. Jhaveri, MD, MBA"
|
||||
- key: "5cff4116-3654-4b3a-bb75-5ebe0b8c9850"
|
||||
value: "Anne G. Osborn, MD, FACR"
|
||||
breadcrumbs:
|
||||
-
|
||||
name: "Brain"
|
||||
slug: "brain"
|
||||
treeNodeId: "0361042c-9c90-48e4-864e-a2e6428ee9c9"
|
||||
-
|
||||
name: "Diagnosis"
|
||||
slug: "diagnosis"
|
||||
treeNodeId: "948c6f1e-8e18-45f3-bd9d-7a04ab0b8708"
|
||||
-
|
||||
name: "Pathology-Based Diagnoses"
|
||||
slug: "pathology-based-diagnoses"
|
||||
treeNodeId: "d60fe914-7897-46a0-9cd2-f88ffb322f16"
|
||||
-
|
||||
name: "Primary Nonneoplastic Cysts"
|
||||
slug: "primary-nonneoplastic-cysts"
|
||||
treeNodeId: "50546b5d-ff01-44c6-a465-0efe78299306"
|
||||
-
|
||||
name: "Enlarged Perivascular Spaces"
|
||||
slug: "enlarged-perivascular-spaces"
|
||||
treeNodeId: null
|
||||
category: "Brain"
|
||||
documentVersionId: "6df68138-1984-481e-b165-1f834fcddd24"
|
||||
imageCount: 31
|
||||
lastUpdated: "08/23/25"
|
||||
pageDescription: "Enlarged Perivascular Spaces"
|
||||
pageKeywords: "Brain, Diagnosis, Pathology-Based Diagnoses, Primary Nonneoplastic Cysts, Enlarged Perivascular Spaces"
|
||||
pageTitle: "Enlarged Perivascular Spaces | STATdx"
|
||||
enhancedTitle: "Enlarged Perivascular Spaces"
|
||||
type: "DX"
|
||||
references: true
|
||||
breadcrumbs:
|
||||
- "Brain"
|
||||
- "Diagnosis"
|
||||
- "Pathology-Based Diagnoses"
|
||||
- "Primary Nonneoplastic Cysts"
|
||||
- "Enlarged Perivascular Spaces"
|
||||
---
|
||||
## KEY FACTS
|
||||
|
||||
- ### Terminology
|
||||
|
||||
|
||||
- Perivascular spaces (PVSs): Pial-lined, interstitial fluid (ISF)-filled structures
|
||||
- Accompany penetrating arteries, draining veins
|
||||
- Can occur anywhere ,but most common = basal ganglia (BG)
|
||||
- Other = midbrain, thalami, subcortical white matter (WM), dentate nuclei
|
||||
- ### Imaging
|
||||
|
||||
|
||||
- Clusters of variable-sized, well-delineated, nonenhancing cysts
|
||||
- PVSs occur in all locations, at all ages; easily seen in most patients on 3/7T imaging
|
||||
- Most common site for normal PVSs = BG (clustered around anterior commissure)
|
||||
- Midbrain, thalami
|
||||
- Deep white matter (including corpus callosum, subinsular cortex, extreme capsule)
|
||||
- Almost never involve cortex
|
||||
- PVSs invisible as they pass through cortex, expand within subcortical white matter
|
||||
- PVSs usually ≤ 5 mm
|
||||
- Occasionally expand, attain large size
|
||||
- Most common location for expanded ("giant" or "tumefactive") PVSs = midbrain
|
||||
- May cause mass effect, obstructive hydrocephalus
|
||||
- Isodense/isointense with cerebrospinal fluid (CSF)
|
||||
- ### Top Differential Diagnoses
|
||||
|
||||
|
||||
- Lacunar infarcts
|
||||
- Multinodular and vacuolating neuronal tumor (MVNT)
|
||||
- Cystic neoplasm (e.g., DNET, cystic astrocytoma)
|
||||
- Infectious/inflammatory cysts
|
||||
- ### Clinical Issues
|
||||
|
||||
|
||||
- Should not be mistaken for serious disease
|
||||
- Usually remain stable in size over years
|
||||
|
||||
## TERMINOLOGY
|
||||
|
||||
- ### Abbreviations
|
||||
|
||||
|
||||
- Perivascular spaces (PVSs)
|
||||
- Interstitial fluid (ISF)
|
||||
- ### Synonyms
|
||||
|
||||
|
||||
- Virchow-Robin spaces
|
||||
- ### Definitions
|
||||
|
||||
|
||||
- Pial-lined, ISF-filled structures
|
||||
- Accompany penetrating arteries, draining veins
|
||||
|
||||
## IMAGING
|
||||
|
||||
- ### General Features
|
||||
|
||||
|
||||
- #### Best diagnostic clue
|
||||
|
||||
|
||||
- Clusters of variable-sized, fluid-filled spaces resembling cerebrospinal fluid (CSF)
|
||||
- Can be seen throughout brain wherever vessels are present
|
||||
- Found in virtually all locations, in patients of all ages
|
||||
- #### Location
|
||||
|
||||
|
||||
- **Type I (most common)**
|
||||
- Along lenticulostriate arteries into basal ganglia (BG) through anterior perforated substance
|
||||
- Cluster around anterior commissure
|
||||
- **Type II**
|
||||
- Along perforating medullary arteries through cortex
|
||||
- Subcortical/deep white matter (WM)
|
||||
- **Type III**
|
||||
- Along penetrating collicular arteries
|
||||
- Pontomesencephalic junction
|
||||
- Midbrain, thalami
|
||||
- **Type IV**
|
||||
- Opercular, subinsular cortex
|
||||
- Anterior temporal lobe WM
|
||||
- Less common sites
|
||||
- Dentate nuclei
|
||||
- Corpus callosum, cingulate gyrus
|
||||
- Expanded ("giant" or "tumefactive") PVSs
|
||||
- Can be found almost anywhere
|
||||
- Most common = midbrain, thalamus
|
||||
- Almost never involve cortex
|
||||
- PVSs expand within subcortical WM
|
||||
- #### Size
|
||||
|
||||
|
||||
- PVSs usually ≤ 5 mm
|
||||
- Occasionally expand, attain large size (up to several cm)
|
||||
- May cause focal mass effect, hydrocephalus
|
||||
- Widespread dilatation of PVSs may look very bizarre
|
||||
- #### Morphology
|
||||
|
||||
|
||||
- Clusters of well-demarcated, variable-sized parenchymal cysts
|
||||
- Multiple > solitary cysts
|
||||
- ### CT Findings
|
||||
|
||||
|
||||
- Clusters of round/ovoid/linear/punctate fluid-like lesions
|
||||
- Low density (attenuation = CSF)
|
||||
- Do not enhance on CECT
|
||||
- ### MR Findings
|
||||
|
||||
|
||||
- #### T1WI
|
||||
|
||||
|
||||
- Multiple well-delineated cysts isointense with CSF
|
||||
- Focal mass effect common
|
||||
- Expand overlying gyri
|
||||
- Thalamomesencephalic enlarged PVSs may compress aqueduct/3rd ventricle, cause hydrocephalus
|
||||
- #### T2WI
|
||||
|
||||
|
||||
- Appear isointense with CSF
|
||||
- Signal intensity within PVSs actually measures slightly < CSF
|
||||
- No perilesional edema
|
||||
- #### FLAIR
|
||||
|
||||
|
||||
- Suppress completely
|
||||
- 25% have minimal ↑ signal in surrounding brain
|
||||
- Anterior temporal lobe PVSs often have mild to extensive surrounding edema
|
||||
- #### T2* GRE
|
||||
|
||||
|
||||
- No blooming
|
||||
- #### DWI
|
||||
|
||||
|
||||
- No restricted diffusion
|
||||
- #### T1WI C+
|
||||
|
||||
|
||||
- No enhancement
|
||||
- ± visualization of penetrating arteries with contrast
|
||||
- #### MRS
|
||||
|
||||
|
||||
- Spectra in adjacent brain typically normal
|
||||
- ### Imaging Recommendations
|
||||
|
||||
|
||||
- #### Best imaging tool
|
||||
|
||||
|
||||
- T2 SPACE, FLAIR, DWI MR
|
||||
- Contrast optional
|
||||
|
||||
## DIFFERENTIAL DIAGNOSIS
|
||||
|
||||
- [Lacunar Infarcts](/document/lacunar-infarction/03672bd8-67c2-4d2c-96fd-c21347f28cce)
|
||||
- Older patients (état lacunaire)
|
||||
- Common in BG, WM
|
||||
- Adjacent parenchymal hyperintensity
|
||||
- ### Multinodular and Vacuolating Neuronal Tumor
|
||||
|
||||
|
||||
- Clusters of variable-sized cysts (usually small)
|
||||
- Along inner margin of cortex, subcortical WM
|
||||
- Very prominent on DWI
|
||||
- Do not suppress on FLAIR
|
||||
- [Cystic Neoplasm](/document/pilocytic-astrocytoma/55946978-4764-4b29-acbb-c6bd805caee9)
|
||||
- Usually in pons, cerebellum, thalamus/hypothalamus
|
||||
- Single > multiple cysts
|
||||
- Signal not quite like CSF
|
||||
- Parenchymal signal abnormalities common
|
||||
- May enhance
|
||||
- ### Infectious/Inflammatory Cysts
|
||||
|
||||
|
||||
- [Neurocysticercosis](/document/neurocysticercosis/fc7b01a2-45a4-432a-ad8e-c6bd999fa20a)
|
||||
- Cysts often have scolex
|
||||
- Most are < 1 cm
|
||||
- Can be multiple but do not typically occur in clusters
|
||||
- Cyst walls often enhance
|
||||
- Surrounding edema often present
|
||||
- [Cryptococcosis](/document/hivaids-miscellaneous-manifestatio-/083d69de-cf29-4bf4-a491-80e2a562a53c)
|
||||
- HIV/AIDs common
|
||||
- Gelatinous "pseudocysts" in BG
|
||||
- Do not suppress on FLAIR
|
||||
- Other parasites
|
||||
- [Hydatid cysts often unilocular, almost all in children](/document/miscellaneous-parasites-/0af9a9f4-d45c-428b-bdf4-9534f84268e8)
|
||||
- Multilocular parasitic cysts typically enhance, mimic neoplasm more than PVSs
|
||||
- [Neuroglial Cyst](/document/neuroglial-cyst/496dec2d-7278-4398-95c3-40aa82da0bc6)
|
||||
- Usually unilocular, WM > BG
|
||||
|
||||
## PATHOLOGY
|
||||
|
||||
- ### General Features
|
||||
|
||||
|
||||
- #### Etiology
|
||||
|
||||
|
||||
- Part of brain "glymphatic" (glia + lymphatic) system
|
||||
- CSF-ISF exchange occurs within brain parenchyma
|
||||
- Bulk flow of CSF
|
||||
- Enters brain through periarterial space to ISF
|
||||
- Mediated by AQP4 channels expressed in astrocyte endfeet
|
||||
- ISF drains through perivenous space into subarachnoid spaces (SASs)
|
||||
- Clears interstitial solutes
|
||||
- ISF eliminated via meningeal to extracranial lymphatics
|
||||
- Possible etiology of enlarged PVSs
|
||||
- Hypothesis of ISF circulation impairment
|
||||
- Locally impaired ISF dynamics
|
||||
- Insufficient clearance of ISF via PVSs
|
||||
- Hypothesis on spiral elongation of vessels/tortuous vessels
|
||||
- Increasing space requirements &/or vascular pulsations of tortuous arteries: Dilation of PVS
|
||||
- Hypothesis on brain atrophy and perivascular myelin loss
|
||||
- Could be sign of focal ex vacuo atrophy &/or demyelination of adjacent brain tissue
|
||||
- Hypothesis on immune cell accumulation in PVS
|
||||
- #### Genetics
|
||||
|
||||
|
||||
- Usually normal unless PVSs expanded by undegraded mucopolysaccharides (Hurler, Hunter disease)
|
||||
- PVSs expand in some congenital muscular dystrophies
|
||||
- #### Associated abnormalities
|
||||
|
||||
|
||||
- Hydrocephalus (midbrain expanding PVSs can obstruct aqueduct)
|
||||
- "Cysts" caused by enlarged/obstructed PVSs reported with pituitary adenoma/pituitary neuroendocrine tumor, large aneurysms
|
||||
- PVSs provide entry site into CNS in inflammatory, neoplastic disorders
|
||||
- Transmigration across capillaries, venules into PVSs
|
||||
- Progress across glia limitans into parenchyma
|
||||
- Controversial
|
||||
- Enlarged BG PVSs may be associated with small vessel disease
|
||||
- May be associated with mild cognitive impairment, early Alzheimer disease
|
||||
- Enlarged juxtacortical PVSs colocalize with microbleeds, amyloid angiopathy
|
||||
- ### Gross Pathologic & Surgical Features
|
||||
|
||||
|
||||
- Smoothly demarcated, fluid-filled cyst(s)
|
||||
- ### Microscopic Features
|
||||
|
||||
|
||||
- Single or double layer of invaginated pia
|
||||
- Pia becomes fenestrated, disappears at capillary level
|
||||
- PVSs usually very small in cortex, often enlarge in subcortical WM
|
||||
- Surrounding brain usually lacks gliosis
|
||||
|
||||
## CLINICAL ISSUES
|
||||
|
||||
- ### Presentation
|
||||
|
||||
|
||||
- #### Most common signs/symptoms
|
||||
|
||||
|
||||
- Often normal, discovered incidentally at imaging/autopsy
|
||||
- Nonspecific symptoms (e.g., headache)
|
||||
- Reported association with increased risk of hypertensive hemorrhages, cerebral small vessel disease
|
||||
- #### Clinical profile
|
||||
|
||||
|
||||
- Patient with nonspecific, nonlocalizing symptoms and bizarre, alarming, multicystic-appearing brain mass initially diagnosed as "cystic neoplasm"
|
||||
- ### Demographics
|
||||
|
||||
|
||||
- #### Age
|
||||
|
||||
|
||||
- Occur in all locations, at all ages
|
||||
- Easily seen on 3T imaging
|
||||
- At 7T, PVSs not visualized as they pass through cortex; only visible in subcortical WM
|
||||
- Present in 25-30% of children (benign normal variant)
|
||||
- Enlarged PVSs
|
||||
- Mean age = mid 40s
|
||||
- May occur in children
|
||||
- #### Sex
|
||||
|
||||
|
||||
- Giant PVSs: M:F = 1.8:1
|
||||
- #### Epidemiology
|
||||
|
||||
|
||||
- Common nonneoplastic brain "cyst"
|
||||
- Common cause of multifocal hyperintensities on T2WI
|
||||
- ### Natural History & Prognosis
|
||||
|
||||
|
||||
- Usually remain stable in size over many years
|
||||
- Rarely continue to expand
|
||||
- Rare spontaneous regression of "tumefactive" PVS reported
|
||||
- ### Treatment
|
||||
|
||||
|
||||
- "Leave alone" lesion that should not be mistaken for serious disease
|
||||
- Shunt ventricles if midbrain lesions cause obstructive hydrocephalus
|
||||
- Cystoventriculoperitoneal shunt has been reported as alleviating symptoms
|
||||
|
||||
## DIAGNOSTIC CHECKLIST
|
||||
|
||||
- ### Consider
|
||||
|
||||
|
||||
- Could multicystic, nonenhancing mass on MR or CT be cluster of enlarged PVSs
|
||||
- ### Image Interpretation Pearls
|
||||
|
||||
|
||||
- Prominent, but normal, PVSs are identified in nearly all patients, in virtually every location at 3T imaging
|
||||
|
||||
e5f20f24-28c8-4dba-b92a-26673be64b29
|
||||
|
||||
## References
|
||||
|
||||
## Selected References
|
||||
|
||||
1. [Benson JC et al: Radiology-pathology correlation: giant tumefactive perivascular spaces. Neuroradiol J. 19714009241247459, 2024](http://www.ncbi.nlm.nih.gov/pubmed/?term=38613202%5Bpmid%5D)
|
||||
1. [Oltmer J et al: Enlarged perivascular spaces in the basal ganglia are associated with arteries not veins. J Cereb Blood Flow Metab. 44(11):1362-77, 2024](http://www.ncbi.nlm.nih.gov/pubmed/?term=38863151%5Bpmid%5D)
|
||||
1. [Cavallari M et al: Editorial: enlarged perivascular spaces: etiology and significance. Front Neurosci. 17:1321691, 2023](http://www.ncbi.nlm.nih.gov/pubmed/?term=38161800%5Bpmid%5D)
|
||||
1. [Dredla BK et al: Sleep and perivascular spaces. Curr Neurol Neurosci Rep. 23(10):607-15, 2023](http://www.ncbi.nlm.nih.gov/pubmed/?term=37572227%5Bpmid%5D)
|
||||
1. [Okar SV et al: The etiology and evolution of magnetic resonance imaging-visible perivascular spaces: systematic review and meta-analysis. Front Neurosci. 17:1038011, 2023](http://www.ncbi.nlm.nih.gov/pubmed/?term=37065926%5Bpmid%5D)
|
||||
1. [Yang Y et al: Enlarged perivascular spaces and age-related clinical diseases. Clin Interv Aging. 18:855-67, 2023](http://www.ncbi.nlm.nih.gov/pubmed/?term=37274869%5Bpmid%5D)
|
||||
1. [Ineichen BV et al: Perivascular spaces and their role in neuroinflammation. Neuron. 110(21):3566-81, 2022](http://www.ncbi.nlm.nih.gov/pubmed/?term=36327898%5Bpmid%5D)
|
||||
1. [Bouvy WH et al: Microbleeds colocalize with enlarged juxtacortical perivascular spaces in amnestic mild cognitive impairment and early Alzheimer's disease: a 7 Tesla MRI study. J Cereb Blood Flow Metab. 40(4):739-46, 2020](http://www.ncbi.nlm.nih.gov/pubmed/?term=30890076%5Bpmid%5D)
|
||||
1. [Du H et al: Association between steno-occlusive middle cerebral artery and basal ganglia perivascular spaces. Front Neurol. 11:293, 2020](http://www.ncbi.nlm.nih.gov/pubmed/?term=32390930%5Bpmid%5D)
|
||||
1. [Mestre H et al: Cerebrospinal fluid influx drives acute ischemic tissue swelling. Science. 367(6483), 2020](http://www.ncbi.nlm.nih.gov/pubmed/?term=32001524%5Bpmid%5D)
|
||||
1. [Shen M et al: Association between enlarged perivascular spaces and internal carotid artery stenosis: a study in patients diagnosed by digital subtraction angiography. J Stroke Cerebrovasc Dis. 29(4):104635, 2020](http://www.ncbi.nlm.nih.gov/pubmed/?term=31959503%5Bpmid%5D)
|
||||
1. [Troili F et al: Perivascular unit: this must be the place. the anatomical crossroad between the immune, vascular and nervous system. Front Neuroanat. 14:17, 2020](http://www.ncbi.nlm.nih.gov/pubmed/?term=32372921%5Bpmid%5D)
|
||||
1. [Wardlaw JM et al: Perivascular spaces in the brain: anatomy, physiology and pathology. Nat Rev Neurol. 16(3):137-53, 2020](http://www.ncbi.nlm.nih.gov/pubmed/?term=32094487%5Bpmid%5D)
|
||||
1. [Kwee RM et al: Tumefactive Virchow-Robin spaces. Eur J Radiol. 111:21-33, 2019](http://www.ncbi.nlm.nih.gov/pubmed/?term=30691661%5Bpmid%5D)
|
||||
1. [Smeijer D et al: Enlarged perivascular spaces and dementia: a systematic review. J Alzheimers Dis. 72(1):247-56, 2019](http://www.ncbi.nlm.nih.gov/pubmed/?term=31561362%5Bpmid%5D)
|
||||
1. [Al Abdulsalam H et al: Giant tumefactive perivascular spaces: a case report and literature review. World Neurosurg. 112:201-4, 2018](http://www.ncbi.nlm.nih.gov/pubmed/?term=29382614%5Bpmid%5D)
|
||||
1. [Hilal S et al: Enlarged perivascular spaces and cognition: a meta-analysis of 5 population-based studies. Neurology. 91(9):e832-42, 2018](http://www.ncbi.nlm.nih.gov/pubmed/?term=30068634%5Bpmid%5D)
|
||||
1. [Niazi M et al: Quantitative MRI of perivascular spaces at 3T for early diagnosis of mild cognitive impairment. AJNR Am J Neuroradiol. 39(9):1622-8, 2018](http://www.ncbi.nlm.nih.gov/pubmed/?term=30093484%5Bpmid%5D)
|
||||
1. [Rudie JD et al: Neuroimaging of dilated perivascular spaces: from benign and pathologic causes to mimics. J Neuroimaging. 28(2):139-49, 2018](http://www.ncbi.nlm.nih.gov/pubmed/?term=29280227%5Bpmid%5D)
|
||||
1. [Saylisoy S et al: Is there a connection between perivascular space and subarachnoid space? J Comput Assist Tomogr. 38(1):33-5, 2014](http://www.ncbi.nlm.nih.gov/pubmed/?term=24424554%5Bpmid%5D)
|
||||
1. [Salzman KL et al: Giant tumefactive perivascular spaces. AJNR Am J Neuroradiol. 26(2):298-305, 2005](http://www.ncbi.nlm.nih.gov/pubmed/?term=15709127%5Bpmid%5D)
|
||||
|
||||
|
||||
## Images
|
||||
|
||||
|
||||
### Selected Images
|
||||
|
||||
|
||||
*Coronal graphic shows normal perivascular spaces (PVSs) as they accompany penetrating arteries into the basal ganglia (BG) and subcortical white matter (WM). Normal PVSs cluster around the anterior commissure but occur in all areas.*
|
||||
|
||||
|
||||
*Axial T2 3T MR with thin sections shows multiple small PVSs <img src='img/arrows/CO.png' alt='cyan open arrow'/> clustered around the anterior commissure <img src='img/arrows/CS.png' alt='cyan solid arrow'/> in the inferior 1/3 of the BG. These are normal findings.*
|
||||
|
||||
|
||||
*Close-up view of coronal T2 7T MR shows normal PVSs in the subcortical <img src='img/arrows/CS.png' alt='cyan solid arrow'/> and deep WM <img src='img/arrows/CC.png' alt='cyan curved arrow'/>. Notice the PVSs are not visible as they pass through the cortex. (Courtesy M. Law, MD and G. Barisano, MD.)*
|
||||
|
||||
|
||||
*Axial T2 MR in an 64-year-old man with headaches and no cognitive issues show multiple enlarged PVSs <img src='img/arrows/CC.png' alt='cyan curved arrow'/> in the subcortical WM and centrum semiovale, more pronounced on the right.*
|
||||
|
||||
|
||||
*Coronal graphic shows enlarged PVSs in the midbrain and thalami causing mass effect on the 3rd ventricle and aqueduct with resulting hydrocephalus.*
|
||||
|
||||
|
||||
*Sagittal T1 MR in a 41-year-old man with severe headaches shows a multicystic mass <img src='img/arrows/CS.png' alt='cyan solid arrow'/> expanding the thalamus and midbrain. The lateral ventricles are enlarged.*
|
||||
|
||||
|
||||
*Axial T2 MR in the same patient shows a cluster of multiple various-sized, CSF-like cysts <img src='img/arrows/CS.png' alt='cyan solid arrow'/> in the left thalamus. The cysts suppressed completely on FLAIR (not shown).*
|
||||
|
||||
|
||||
*Axial T2 MR (left) and axial FLAIR (right) show an enlarged PVS <img src='img/arrows/CC.png' alt='cyan curved arrow'/> in the left anterior temporal lobe with <img src='img/arrows/CS.png' alt='cyan solid arrow'/> surrounding edema, a variant of tumefactive/giant PVSs, which can mimic cystic tumors. Anterior temporal lobe PVSs often have mild to extensive surrounding edema.*
|
||||
|
||||
|
||||
*Axial T2 MR in a 69-year-old man with moderate dementia and no focal neurologic findings shows multiple bilateral cystic lesions in the WM of both cerebral hemispheres.*
|
||||
|
||||
|
||||
*More cephalad T2 MR in the same patient shows the gyri are markedly expanded by the cysts. The overlying cortex is spared. The findings are most consistent with "giant" or "tumefactive" PVSs. (Courtesy M. Warmuth-Metz, MD.)*
|
||||
|
||||
|
||||
### Additional Images
|
||||
|
||||
|
||||
*Axial T2 MR shows an enormous, CSF-like cyst in the left insula and BG <img src='img/arrows/WS.png' alt='white solid arrow'/>. Note the numerous tiny cysts <img src='img/arrows/WO.png' alt='white open arrow'/>. The neurosurgeons operated on this patient despite the biopsy-proven diagnosis of enlarged PVSs. The cyst was drained but reaccumulated fluid within 2 weeks and has remained stable over several years.*
|
||||
|
||||
|
||||
*Composite imaging in a 15-year-old boy with longstanding shunted hydrocephalus caused by "cystic brain mass" is shown. These are multiple enlarged PVSs that expand the midbrain, causing hydrocephalus. The PVSs are of variable size and follow CSF on all sequences.*
|
||||
|
||||
|
||||
*Axial graphic shows enlarged PVSs in the WM of the occipital lobe, centrum semiovale, corpus callosum, and cingulate gyrus. Note focal expansion of overlying cortex.*
|
||||
|
||||
|
||||
*Sagittal T1 MR shows CSF-like cysts in the corpus callosum, cingulate gyrus, and occipital lobe. Note the mass effect with gyral expansion but striking sparing of the overlying gray matter.*
|
||||
|
||||
|
||||
*Axial T2 MR in the same patient shows clusters of variable-sized, CSF-intensity cysts with minimal surrounding gliosis and expansion of overlying gyri <img src='img/arrows/WS.png' alt='white solid arrow'/>.*
|
||||
|
||||
|
||||
*Axial FLAIR MR in the same patient shows the CSF-intensity cysts suppress with minimal surrounding gliosis. The diagnosis was enlarged PVSs. (Courtesy L. Valanne, MD.)*
|
||||
|
||||
|
||||
*Axial T1 MR shows a multicystic mass <img src='img/arrows/WS.png' alt='white solid arrow'/> expanding the midbrain.*
|
||||
|
||||
|
||||
*Axial T2 MR in the same case shows the midbrain cysts <img src='img/arrows/WS.png' alt='white solid arrow'/> are identical to CSF signal in the mildly enlarged lateral ventricles. Note additional cysts in the left medial temporal lobe <img src='img/arrows/WC.png' alt='white curved arrow'/>.*
|
||||
|
||||
|
||||
*Axial FLAIR MR in the same patient shows the midbrain <img src='img/arrows/WS.png' alt='white solid arrow'/> and medial temporal lobe <img src='img/arrows/WC.png' alt='white curved arrow'/> cysts suppress completely.*
|
||||
|
||||
|
||||
*Axial T1 C+ FS MR shows the midbrain and medial temporal lobe cysts do not enhance. Giant "tumefactive" PVSs.*
|
||||
|
||||
|
||||
*Coronal T2 MR in a child with headaches referred for overread with a diagnosis of "cystic brain tumor" shows dilated PVSs in the left dentate nucleus <img src='img/arrows/WS.png' alt='white solid arrow'/>.*
|
||||
|
||||
|
||||
*Coronal T1 C+ MR in a 7-year-old boy shows a cluster of cysts in the dentate nuclei. The cysts are similar to CSF in signal and do not enhance. Note the focal mass effect on the 4th ventricle. The diagnosis was enlarged PVSs.*
|
||||
|
||||
|
||||
*Coronal T2 MR in a 15-year-old boy with headaches shows a cluster of variable-sized cysts <img src='img/arrows/WS.png' alt='white solid arrow'/> in the parietal subcortical WM. Note the sparing of the overlying gray matter, which distinguishes this condition from DNET.*
|
||||
|
||||
|
||||
*Axial T2 MR in an 88-year-old woman with mild cognitive decline shows innumerable tiny, CSF-like cysts in both BG <img src='img/arrows/WO.png' alt='white open arrow'/>.*
|
||||
|
||||
|
||||
*Axial FLAIR MR in the same patient shows almost all the BG cysts <img src='img/arrows/WO.png' alt='white open arrow'/> suppress, indicating they are filled with fluid similar to CSF. The symmetry of the cysts and absence of FLAIR hyperintensity indicate these are enlarged PVSs, sometimes called "état criblé" (cribriform state), and not lacunar infarcts.*
|
||||
|
||||
|
||||
*Sagittal T1 MR in a 39-year-old man with increasing gait abnormality, diplopia, and facial pain shows a multicystic mass <img src='img/arrows/WS.png' alt='white solid arrow'/> expanding the pons.*
|
||||
|
||||
|
||||
*Axial T2 MR in the same patient shows multiple CSF-like cysts of varying size ranging from multiple tiny cysts <img src='img/arrows/WS.png' alt='white solid arrow'/> to a large unilocular cyst that extends into the cerebellopontine angle cistern <img src='img/arrows/WO.png' alt='white open arrow'/>.*
|
||||
|
||||
|
||||
*Axial FLAIR MR in the same patient shows the cysts suppress completely.*
|
||||
|
||||
|
||||
*Coronal T1 C+ MR in the same patient shows no enhancement. The imaging diagnosis of giant "tumefactive" PVSs was confirmed at surgery.*
|
||||
|
||||
|
||||
*Coronal T1 C+ MR shows the cluster of cerebrospinal fluid (CSF)-like cysts does not enhance ("giant" or "tumefactive" PVSs). The patient was successfully treated with ventricular shunting.*
|
||||
|
||||
|
||||
*Axial T2 MR in an 80-year-old cognitively and neurologically normal man with headaches shows mildly prominent sulci, multiple enlarged PVSs throughout the corona radiata of both hemispheres.*
|
||||
|
||||
File diff suppressed because one or more lines are too long
+163
@@ -0,0 +1,163 @@
|
||||
---
|
||||
title: "GRE/SWI Venous Abnormalities"
|
||||
docid: "3404bc7b-0712-4f0d-bf16-34e619f93b06"
|
||||
authors:
|
||||
- key: "318f80ab-6abb-4067-a809-2ebdaa5a30c9"
|
||||
value: "Kalen Riley, MD, MBA"
|
||||
- key: "fdb5a7ec-f06b-4450-967c-3bde5f4ce5b7"
|
||||
value: "Miriam E. Peckham, MD"
|
||||
breadcrumbs:
|
||||
-
|
||||
name: "Brain"
|
||||
slug: "brain"
|
||||
treeNodeId: "0361042c-9c90-48e4-864e-a2e6428ee9c9"
|
||||
-
|
||||
name: "Differential Diagnosis"
|
||||
slug: "differential-diagnosis"
|
||||
treeNodeId: "0de9c040-6d20-4d13-a2bb-35101f8d7945"
|
||||
-
|
||||
name: "Veins, Venous Sinuses"
|
||||
slug: "veins-venous-sinuses"
|
||||
treeNodeId: "8d8007eb-126f-4270-a5ea-efe4225e4dee"
|
||||
-
|
||||
name: "Modality-Specific Imaging Findings"
|
||||
slug: "modality-specific-imaging-findings"
|
||||
treeNodeId: "5970c0c7-7621-4682-8a67-a62169935b03"
|
||||
-
|
||||
name: "GRE/SWI Venous Abnormalities"
|
||||
slug: "greswi-venous-abnormalities"
|
||||
treeNodeId: null
|
||||
category: "Brain"
|
||||
cmeTopicId: "27e4de6d-9ffa-45f2-9700-898f8290748e"
|
||||
documentVersionId: "dba48923-bcef-47b4-914f-b95169293352"
|
||||
imageCount: 10
|
||||
lastUpdated: "02/02/23"
|
||||
pageDescription: "GRE/SWI Venous Abnormalities"
|
||||
pageKeywords: "Brain, Differential Diagnosis, Veins, Venous Sinuses, Modality-Specific Imaging Findings, GRE/SWI Venous Abnormalities"
|
||||
pageTitle: "GRE/SWI Venous Abnormalities | STATdx"
|
||||
enhancedTitle: "GRE/SWI Venous Abnormalities"
|
||||
type: "DDX"
|
||||
references: true
|
||||
breadcrumbs:
|
||||
- "Brain"
|
||||
- "Differential Diagnosis"
|
||||
- "Veins, Venous Sinuses"
|
||||
- "Modality-Specific Imaging Findings"
|
||||
- "GRE/SWI Venous Abnormalities"
|
||||
---
|
||||
## ESSENTIAL INFORMATION
|
||||
|
||||
- ### Helpful Clues for Common Diagnoses
|
||||
|
||||
|
||||
- **Developmental Venous Anomaly**
|
||||
- Collection of enlarged medullary veins (Medusa head appearance)
|
||||
- GRE/SWI shows slow-flowing, deoxygenated blood as hypointense blooming
|
||||
- May be missed on conventional imaging secondary to attenuated flow
|
||||
- **Dural Sinus Thrombosis**
|
||||
- High deoxyhemoglobin within thrombus causes susceptibility shift
|
||||
- Susceptibility shift causes hypointense thrombus to bloom on GRE/SWI
|
||||
- Susceptibility effect of thrombus is most prominent within 7 days of onset; this effect ↓ over time
|
||||
- ↑ hypointensity of deep medullary veins in setting of thrombosis signifies congestion/slow drainage
|
||||
- Susceptibility in deep vessels ↓ with treatment response, serving as useful prognostic marker
|
||||
- SWI/GRE further aids in diagnosing developing hemorrhagic venous infarct
|
||||
- **Capillary Telangiectasia**
|
||||
- Slow-flow vascular malformation
|
||||
- May be occult, not well seen on other MR sequences
|
||||
- Apparent on GRE & SWI sequences; SWI is most sensitive
|
||||
- ↓ SWI corresponds with paintbrush-like enhancement
|
||||
- Sporadic, syndromic (i.e., hereditary hemorrhagic telangiectasia), or radiation induced
|
||||
- **Acute Infarct (Indirect)**
|
||||
- May see ↑ susceptibility of deep medullary veins
|
||||
- Likely related to higher oxygen extraction from red blood cells in regions of impaired flow
|
||||
- Prominent cortical & medullary veins in infarcts associated with imaging biomarkers for poor outcome
|
||||
- Useful predictors for early infarct growth
|
||||
- These prominent vessels could be surrogate for determining areas of ↑ oxygen extraction within penumbra
|
||||
- ### Helpful Clues for Less Common Diagnoses
|
||||
|
||||
|
||||
- **Deep Cerebral Venous Thrombosis**
|
||||
- Stasis of deep veins leads to ↑ deoxygenated intravascular hemoglobin
|
||||
- Blooming of deoxygenated hemoglobin makes occluded vessels conspicuous
|
||||
- SWI/GRE helps diagnose developing hemorrhagic venous infarct
|
||||
- **Cortical Venous Thrombosis**
|
||||
- SWI is most sensitive modality for detecting
|
||||
- Often see parenchymal susceptibility change adjacent to occluded cortical vein due to venous congestion
|
||||
- ### Helpful Clues for Rare Diagnoses
|
||||
|
||||
|
||||
- **Sturge-Weber Syndrome**
|
||||
- Persistent primitive venous plexus results in abnormal deep venous drainage
|
||||
- Deep medullary veins best evaluated with SWI
|
||||
- May be earliest imaging indicator of disease
|
||||
- GRE/SWI can evaluate abnormal medullary veins & cortical tram-track calcification in later stage of disease
|
||||
|
||||
## References
|
||||
|
||||
## Selected References
|
||||
|
||||
1. [Boukerche F et al: High-resolution susceptibility-weighted imaging of clots in cerebral venous thrombosis. Neuroradiology. 64(12):2267-75, 2022](http://www.ncbi.nlm.nih.gov/pubmed/?term=35821529%5Bpmid%5D)
|
||||
1. [Rubin A et al: Application of susceptibility weighted imaging (SWI) in diagnostic imaging of brain pathologies - a practical approach. Clin Neurol Neurosurg. 221:107368, 2022](http://www.ncbi.nlm.nih.gov/pubmed/?term=35933968%5Bpmid%5D)
|
||||
1. [Dempfle AK et al: Longitudinal volume quantification of deep medullary veins in patients with cerebral venous sinus thrombosis : venous volume assessment in cerebral venous sinus thrombosis using SWI. Clin Neuroradiol. 28(4):493-9, 2018](http://www.ncbi.nlm.nih.gov/pubmed/?term=28589484%5Bpmid%5D)
|
||||
1. [Hsu CC et al: Susceptibility weighted imaging in acute cerebral ischemia: review of emerging technical concepts and clinical applications. Neuroradiol J. 30(2):109-19, 2017](http://www.ncbi.nlm.nih.gov/pubmed/?term=28424015%5Bpmid%5D)
|
||||
1. [Payabvash S et al: Prominent cortical and medullary veins on susceptibility-weighted images of acute ischaemic stroke. Br J Radiol. 89(1068):20160714, 2016](http://www.ncbi.nlm.nih.gov/pubmed/?term=27805839%5Bpmid%5D)
|
||||
1. [Chen CY et al: Prominent vessel sign on susceptibility-weighted imaging in acute stroke: prediction of infarct growth and clinical outcome. PLoS One. 10(6):e0131118, 2015](http://www.ncbi.nlm.nih.gov/pubmed/?term=26110628%5Bpmid%5D)
|
||||
1. [Chaudhry US et al: Susceptibility-weighted MR imaging: a better technique in the detection of capillary telangiectasia compared with T2* gradient-echo. AJNR Am J Neuroradiol. 35(12):2302-5, 2014](http://www.ncbi.nlm.nih.gov/pubmed/?term=25147196%5Bpmid%5D)
|
||||
1. [Park MG et al: Multiple hypointense vessels on susceptibility-weighted imaging in acute ischemic stroke: surrogate marker of oxygen extraction fraction in penumbra? Cerebrovasc Dis. 38(4):254-61, 2014](http://www.ncbi.nlm.nih.gov/pubmed/?term=17925363%5Bpmid%5D)
|
||||
1. [El-Koussy M et al: Susceptibility-weighted MR imaging for diagnosis of capillary telangiectasia of the brain. AJNR Am J Neuroradiol. 33(4):715-20, 2012](http://www.ncbi.nlm.nih.gov/pubmed/?term=22194370%5Bpmid%5D)
|
||||
1. [Tong KA et al: Susceptibility-weighted MR imaging: a review of clinical applications in children. AJNR Am J Neuroradiol. 29(1):9-17, 2008](http://www.ncbi.nlm.nih.gov/pubmed/?term=25401484%5Bpmid%5D)
|
||||
1. [Leach JL et al: Cerebral venous thrombus signal intensity and susceptibility effects on gradient recalled-echo MR imaging. AJNR Am J Neuroradiol. 28(5):940-5, 2007](http://www.ncbi.nlm.nih.gov/pubmed/?term=17494675%5Bpmid%5D)
|
||||
|
||||
|
||||
## Images
|
||||
|
||||
|
||||
### Selected Images
|
||||
|
||||
|
||||
**Developmental Venous Anomaly**
|
||||
*Axial SWI MR shows the typical Medusa head appearance of a developmental venous anomaly in the right cerebellum <img src='img/arrows/CC.png' alt='cyan curved arrow'/>. This lesion is highly conspicuous on SWI due to the slow flow of intravascular deoxygenated blood.*
|
||||
|
||||
|
||||
**Developmental Venous Anomaly**
|
||||
*Axial SWI MR shows the typical Medusa head appearance of a developmental venous anomaly in the right cerebellum <img src='img/arrows/CC.png' alt='cyan curved arrow'/>. This lesion is highly conspicuous on SWI due to the slow flow of intravascular deoxygenated blood.*
|
||||
|
||||
|
||||
**Dural Sinus Thrombosis**
|
||||
*Axial GRE MR shows blooming hypointensity <img src='img/arrows/CS.png' alt='cyan solid arrow'/> related to superior sagittal sinus thrombosis. Prominent deep medullary veins are present, signifying venous congestion from poor venous drainage <img src='img/arrows/CC.png' alt='cyan curved arrow'/>.*
|
||||
|
||||
|
||||
**Capillary Telangiectasia**
|
||||
*Axial SWI MR shows a faint dark signal within the pons <img src='img/arrows/CS.png' alt='cyan solid arrow'/>, a common location for capillary telangiectasias. Capillary telangiectasias are benign clusters of enlarged, dilated capillaries interspersed with normal brain parenchyma.*
|
||||
|
||||
|
||||
**Capillary Telangiectasia**
|
||||
*Axial T1 C+ MR in the same patient shows faint, brush-like enhancement <img src='img/arrows/CS.png' alt='cyan solid arrow'/> associated with the capillary telangiectasia. These benign vascular lesions may be associated with other vascular malformations, including cavernous or venous malformations.*
|
||||
|
||||
|
||||
**Acute Infarct (Indirect)**
|
||||
*Axial GRE MR shows prominent cortical and medullary veins at the site of a large right middle cerebral artery territory infarct <img src='img/arrows/CS.png' alt='cyan solid arrow'/>. This reflects increased oxygen extraction of red blood cells in the region of impaired flow.*
|
||||
|
||||
|
||||
**Cortical Venous Thrombosis**
|
||||
*Axial GRE MR shows a hypointense blooming thrombus within a left cortical vein <img src='img/arrows/CS.png' alt='cyan solid arrow'/>. Parenchymal susceptibility artifact seen as hypointensity <img src='img/arrows/CO.png' alt='cyan open arrow'/> is noted adjacent to the thrombosed vessel, reflecting venous congestion.*
|
||||
|
||||
|
||||
**Sturge-Weber Syndrome**
|
||||
*Axial SWI MR demonstrates abnormal prominence of deep medullary veins in the left cerebral hemisphere in a patient with Sturge-Weber syndrome (SWS) <img src='img/arrows/CS.png' alt='cyan solid arrow'/>. Early in this disease, the appearance of abnormal venous drainage may be one of the only imaging clues for diagnosis.*
|
||||
|
||||
|
||||
**Sturge-Weber Syndrome**
|
||||
*Axial SWI MR shows dystrophic cortical calcification in a patient with more advanced SWS <img src='img/arrows/CO.png' alt='cyan open arrow'/>. There are also prominent deep medullary veins present in this region <img src='img/arrows/CS.png' alt='cyan solid arrow'/>.*
|
||||
|
||||
|
||||
### Additional Images
|
||||
|
||||
|
||||
**Developmental Venous Anomaly**
|
||||
*Axial SWI MR shows a large left cerebellar developmental venous anomaly (DVA) with prominent medullary veins <img src='img/arrows/CS.png' alt='cyan solid arrow'/> draining into a larger "collector" vein.*
|
||||
|
||||
|
||||
**Developmental Venous Anomaly**
|
||||
*Coronal T1 C+ MR shows the DVA with multiple smaller veins draining into a larger collector vein <img src='img/arrows/CO.png' alt='cyan open arrow'/>. This appearance has been described as a Medusa head.*
|
||||
|
||||
+584
File diff suppressed because one or more lines are too long
@@ -0,0 +1,284 @@
|
||||
---
|
||||
title: "Homonymous Hemianopsia"
|
||||
docid: "1cdca8f4-95f8-4d19-b28a-19a433d1a624"
|
||||
authors:
|
||||
- key: "e61f84c0-fe96-48cc-8bd4-294dd3bb3ae6"
|
||||
value: "Kristine M. Mosier, DMD, PhD"
|
||||
breadcrumbs:
|
||||
-
|
||||
name: "Head and Neck"
|
||||
slug: "head-and-neck"
|
||||
treeNodeId: "5c1f8e17-7acd-48d8-9d55-f9f8c2cad850"
|
||||
-
|
||||
name: "Differential Diagnosis"
|
||||
slug: "differential-diagnosis"
|
||||
treeNodeId: "deb55065-e1d6-4b6f-b3e3-181fafb4e218"
|
||||
-
|
||||
name: "Cranial Nerves and Brainstem"
|
||||
slug: "cranial-nerves-and-brainstem"
|
||||
treeNodeId: "385449a2-5859-451c-bed3-584babc08f0c"
|
||||
-
|
||||
name: "Clinically Based Differentials"
|
||||
slug: "clinically-based-differentials"
|
||||
treeNodeId: "f0574381-a384-4486-8fb9-e90591e4f9be"
|
||||
-
|
||||
name: "Homonymous Hemianopsia"
|
||||
slug: "homonymous-hemianopsia"
|
||||
treeNodeId: null
|
||||
category: "Head and Neck"
|
||||
documentVersionId: "a79413fb-2c59-47aa-955c-1de3b06e0f33"
|
||||
imageCount: 29
|
||||
lastUpdated: "10/09/18"
|
||||
pageDescription: "Homonymous Hemianopsia"
|
||||
pageKeywords: "Head and Neck, Differential Diagnosis, Cranial Nerves and Brainstem, Clinically Based Differentials, Homonymous Hemianopsia"
|
||||
pageTitle: "Homonymous Hemianopsia | STATdx"
|
||||
enhancedTitle: "Homonymous Hemianopsia"
|
||||
type: "DDX"
|
||||
references: true
|
||||
breadcrumbs:
|
||||
- "Head and Neck"
|
||||
- "Differential Diagnosis"
|
||||
- "Cranial Nerves and Brainstem"
|
||||
- "Clinically Based Differentials"
|
||||
- "Homonymous Hemianopsia"
|
||||
---
|
||||
## ESSENTIAL INFORMATION
|
||||
|
||||
- ### Key Differential Diagnosis Issues
|
||||
|
||||
|
||||
- Clinical terminology
|
||||
- Homonymous hemianopsia (HH) = blindness in ipsilateral 1/2 of visual field
|
||||
- Sectoranopia = loss of vision in sector of visual field
|
||||
- Incongruous HH = incomplete or asymmetric HH
|
||||
- Type of hemianopsia pinpoints relative location along visual pathway
|
||||
- HH with afferent pupillary defect and band or bow tie pattern of optic atrophy = lesion in contralateral optic tract
|
||||
- Homonymous sectoranopia = characteristic of lesions involving lateral geniculate nucleus
|
||||
- Homonymous upper quadrant defect ("pie in sky" vision loss) = damage to inferior optic radiations (Meyer loop) in contralateral anterior temporal lobe
|
||||
- Homonymous defect, denser more inferiorly = lesion in parietal lobe
|
||||
- Complete HH = lesion in temporoparietal ± occipital
|
||||
- Homonymous upper quadrantanopsia with macular sparing = lesion in lower bank of occipital lobe
|
||||
- Homonymous lower quadrantanopsia, macular sparing = lesion in upper bank of occipital lobe
|
||||
- Isolated homonymous defect (macular sparing) without other neurological findings = lesion in occipital lobe
|
||||
- ### Helpful Clues for Common Diagnoses
|
||||
|
||||
|
||||
- **Posterior Cerebral Artery Ischemia**
|
||||
- Posterior cerebral artery (PCA) distribution infarct is most common cause of HH (40-90%)
|
||||
- Occipital or inferior temporal lobes common
|
||||
- Also includes thalamus, hypothalamus, geniculate bodies, internal capsule posterior limb, upper midbrain, and choroid plexus
|
||||
- Significant association with hypertension, diabetes, and renal impairment
|
||||
- MR findings
|
||||
- Acute PCA CVA: Diffusion restriction and ADC map correlate in PCA territory
|
||||
- Subacute: Wedge-shaped area in PCA distribution with edema on T1, T2, FLAIR; gyral enhancement on T1 C+; ↑ diffusion restriction and ↓ ADC with reversal through subacute stage
|
||||
- Chronic: Nonenhancing, hypointense, or CSF isointense area with gliosis along margin; no diffusion restriction
|
||||
- **Glioblastoma**
|
||||
- Many primary and metastatic CNS neoplasms affect temporal-occipital brain or retrochiasmatic optic pathway
|
||||
- Most are gliomas; most gliomas are glioblastoma
|
||||
- Pilocytic astrocytoma: ± enhancing and enlarged optic chiasm or optic tract; pediatric population; ~ 30% neurofibromatosis type 1
|
||||
- Parenchymal metastasis: Often multiple C+ masses at gray-white junction
|
||||
- MR findings
|
||||
- Temporal, parietal, or occipital focal or diffuse C- or C+ white matter or cortical mass involving retrochiasmatic optic pathway or optic radiations
|
||||
- Diffusion tensor imaging: FA maps ± fiber tracts may show infiltration or compression of optic radiation ± inferior occipitofrontal fasciculus
|
||||
- Look for lack of diffusion restriction to differentiate from ischemia/infarction
|
||||
- **Multiple Sclerosis**
|
||||
- Polyphasic illness
|
||||
- MR findings: Look for multiple lesions involving callososeptal interface; optic neuritis
|
||||
- Transient enhancement during active demyelination
|
||||
- **ADEM**
|
||||
- Monophasic illness, autoimmune mediated, frequently follows infection or vaccination
|
||||
- MR findings: Multifocal white matter and deep gray matter lesions; variable contrast enhancement
|
||||
- Typically does not involve callososeptal interface
|
||||
- ± spinal cord lesions
|
||||
- **Subdural Hematoma, Acute**
|
||||
- Mass effect may affect temporal-occipital region or retrochiasmatic optic pathway
|
||||
- Specific visual field testing usually not performed in emergent or acute setting
|
||||
- CT findings: Shows hyper- to hypodense extraaxial fluid collection
|
||||
- Enhancement of bridging veins
|
||||
- Compression and displacement of underlying brain
|
||||
- **Cerebral Contusion**
|
||||
- May affect temporal-occipital region or retrochiasmatic optic pathway
|
||||
- Has reported association with encephalomalacia following traumatic subdural hematoma
|
||||
- CT findings: Look for multiple patchy, ill-defined punctate or linear areas of gyral hemorrhage and surrounding edema
|
||||
- Look for subarachnoid hemorrhage and associated skull fracture
|
||||
- ### Helpful Clues for Less Common Diagnoses
|
||||
|
||||
|
||||
- **Fusiform Aneurysm, ASVD, PCA****,****or MCA**
|
||||
- Chronically enlarging posterior or middle cerebral artery fusiform aneurysms cause HH from mass effect
|
||||
- MR findings: Fusiform arterial enlargement with variable complex signal; depends on presence/age of intramural clot
|
||||
- May or may not be related to atherosclerotic vascular disease
|
||||
- **Abscess, Temporal-Occipital Brain**
|
||||
- Headaches, seizures, altered mental status, focal neurologic deficit, nausea &/or vomiting
|
||||
- Fever in only 50% of patients with brain abscess
|
||||
- Bacterial > > fungal and parasitic organisms
|
||||
- MR findings: Frank abscess, hemispheric parenchymal ring-enhancing mass with restricted diffusion
|
||||
- Progress from early to late cerebritis followed by early capsule and then late capsule formation
|
||||
- **Cavernous Malformation, Temporal-Occipital Brain**
|
||||
- Benign vascular hamartoma prone to intralesional hemorrhages of varying ages
|
||||
- MR findings: Popcorn ball appearance with mixed signal intensity locules with blood products in varying stages of evolution and complete hypointense hemosiderin rim + prominent susceptibility effect on with GRE
|
||||
- ### Helpful Clues for Rare Diagnoses
|
||||
|
||||
|
||||
- **Opportunistic Infection, AIDS,****Progressive Multifocal Leukoencephalopathy**
|
||||
- Immunocompromised patients, subacute opportunistic infection caused by JC polyomavirus
|
||||
- Majority of patients present with HH
|
||||
- Altered mental status, progressive neurological symptoms, lethargy, and headache
|
||||
- MR findings: Multiple frontal and parietooccipital subcortical white matter patchy high T2 signal without enhancement
|
||||
- Extend to deep white matter: Gray matter often spared until late stage
|
||||
- Peripherally located lesions in contrast to periventricular lesions in multiple sclerosis
|
||||
- **Creutzfeldt-Jakob Disease, Heidenhain Variant**
|
||||
- Rapidly progressive, fatal dementia caused by prion
|
||||
- Heidenhain variant: Isolated visual symptoms from predominantly occipital lobe degeneration
|
||||
- MR findings: Progressive T2/FLAIR hyperintensity of basal ganglia, thalamus, and cerebral cortex
|
||||
- **Posterior Cortical Atrophy (Benson Syndrome)**
|
||||
- Rare neurodegenerative condition presenting with visual agnosia, visual apraxia, less commonly hemianopsia
|
||||
- Do not have significant memory loss or cognitive decline until later in disease process
|
||||
- Unknown etiology: Most are believed to be variant of Alzheimer disease but some caused by corticobasal degeneration or Creutzfeldt-Jakob disease
|
||||
- MR findings: Significant gray and white matter atrophy in 1/both occipital lobes + parietal lobes
|
||||
|
||||
## References
|
||||
|
||||
## Selected References
|
||||
|
||||
1. [Crutch SJ et al: Consensus classification of posterior cortical atrophy. Alzheimers Dement. 13(8):870-884, 2017](http://www.ncbi.nlm.nih.gov/pubmed/?term=28259709%5Bpmid%5D)
|
||||
1. [Kowal KM et al: Spectrum of magnetic resonance imaging features in unilateral optic tract dysfunction. J Neuroophthalmol. 37(1):17-23, 2017](http://www.ncbi.nlm.nih.gov/pubmed/?term=28192386%5Bpmid%5D)
|
||||
1. [Tantiwongkosi B et al: Imaging of retrochiasmal and higher cortical visual disorders. Neuroimaging Clin N Am. 25(3):411-24, 2015](http://www.ncbi.nlm.nih.gov/pubmed/?term=26208417%5Bpmid%5D)
|
||||
1. [Sawaya R et al: Reversible homonymous hemianopia secondary to occipital lobe seizures. Seizure. 23(10):915-7, 2014](http://www.ncbi.nlm.nih.gov/pubmed/?term=25053154%5Bpmid%5D)
|
||||
1. Suski J et al: Demyelinating lesion isolated to the lateral geniculate nucleus. J. Neurol Neurophysiol. S12: S14, 2014.
|
||||
1. [Alves J et al: Posterior cortical atrophy and Alzheimer's disease: a meta-analytic review of neuropsychological and brain morphometry studies. Brain Imaging Behav. 7(3):353-61, 2013](http://www.ncbi.nlm.nih.gov/pubmed/?term=23690254%5Bpmid%5D)
|
||||
1. [Rowe FJ et al: A prospective profile of visual field loss following stroke: prevalence, type, rehabilitation, and outcome. Biomed Res Int. 2013:719096, 2013](http://www.ncbi.nlm.nih.gov/pubmed/?term=24089687%5Bpmid%5D)
|
||||
|
||||
|
||||
## Images
|
||||
|
||||
|
||||
### Selected Images
|
||||
|
||||
|
||||
**Posterior Cerebral Artery Ischemia**
|
||||
*Axial NECT of a patient with an acute onset of left binocular visual field defect shows a hypodense area in the right occipital lobe <img src='img/arrows/WS.png' alt='white solid arrow'/>.*
|
||||
|
||||
|
||||
**Posterior Cerebral Artery Ischemia**
|
||||
*Axial NECT of a patient with an acute onset of left binocular visual field defect shows a hypodense area in the right occipital lobe <img src='img/arrows/WS.png' alt='white solid arrow'/>.*
|
||||
|
||||
|
||||
**Posterior Cerebral Artery Ischemia**
|
||||
*Axial NECT of a patient with an acute onset of left binocular visual field defect shows a hypodense area in the right occipital lobe <img src='img/arrows/WS.png' alt='white solid arrow'/>.*
|
||||
|
||||
|
||||
**Posterior Cerebral Artery Ischemia**
|
||||
*Axial DWI MR shows ↑ diffusion-weighted signal <img src='img/arrows/WS.png' alt='white solid arrow'/> in the right occipital lobe, which showed restricted diffusion on ADC maps. On examination, the patient had a left superior homonymous quadrantanopsia.*
|
||||
|
||||
|
||||
**Glioblastoma**
|
||||
*Axial FLAIR MR reveals extensive confluent hyperintensity involving the white matter of the right temporal lobe <img src='img/arrows/WS.png' alt='white solid arrow'/> and thalamus <img src='img/arrows/WO.png' alt='white open arrow'/>.*
|
||||
|
||||
|
||||
**Multiple Sclerosis**
|
||||
*Axial T1WI C+ MR demonstrates peripherally enhancing <img src='img/arrows/WS.png' alt='white solid arrow'/> tumefactive multiple sclerosis plaque in the region of the left optic radiations.*
|
||||
|
||||
|
||||
**ADEM**
|
||||
*Axial T2WI MR shows confluent regions of high signal in the white matter of the cerebral hemispheres <img src='img/arrows/WO.png' alt='white open arrow'/> in this patient with acute disseminated encephalomyelitis. Note the additional regions of T2-hyperintense signal seen in the thalami <img src='img/arrows/WS.png' alt='white solid arrow'/>.*
|
||||
|
||||
|
||||
**Subdural Hematoma, Acute**
|
||||
*Axial NECT shows crescentic hyperdense extraaxial hemorrhage along right occipital lobe <img src='img/arrows/WS.png' alt='white solid arrow'/>, parietal, and temporal lobes <img src='img/arrows/WO.png' alt='white open arrow'/>. Acute onset homonymous hemianopsia with severe headache were the presenting symptoms.*
|
||||
|
||||
|
||||
**Cerebral Contusion**
|
||||
*Axial NECT shows traumatic contrecoup hemorrhagic contusion of the right temporal lobe <img src='img/arrows/WO.png' alt='white open arrow'/>. Also notice the subdural blood layering along the right tentorium <img src='img/arrows/WC.png' alt='white curved arrow'/>. A large, left subcutaneous hematoma <img src='img/arrows/WS.png' alt='white solid arrow'/> is also noted.*
|
||||
|
||||
|
||||
**Fusiform Aneurysm, ASVD, PCA, or MCA**
|
||||
*Axial contrast-enhanced MRA source image delineates the residual lumen <img src='img/arrows/WS.png' alt='white solid arrow'/> and rim-enhancing clot.*
|
||||
|
||||
|
||||
**Abscess, Temporal-Occipital Brain**
|
||||
*Axial FLAIR MR shows extensive confluent high signal intensity in the temporal lobe, midbrain, basal ganglia, and deep white matter. Note involvement of the retrochiasmatic pathway <img src='img/arrows/WS.png' alt='white solid arrow'/>.*
|
||||
|
||||
|
||||
**Cavernous Malformation, Temporal-Occipital Brain**
|
||||
*Axial T2WI MR demonstrates classic "popcorn ball" mixed signal intensity with multiple fluid-fluid levels <img src='img/arrows/WO.png' alt='white open arrow'/> contained within a low-signal hemosiderin ring. Edema is present in the right temporal lobe adjacent to the malformation <img src='img/arrows/WS.png' alt='white solid arrow'/>.*
|
||||
|
||||
|
||||
**Cavernous Malformation, Temporal-Occipital Brain**
|
||||
*Axial T2* GRE MR reveals blooming <img src='img/arrows/WS.png' alt='white solid arrow'/> blood products from a previous hemorrhage in a medial temporal lobe cavernous malformation. Note the extension of the blooming blood products anteromedially along the optic tract <img src='img/arrows/WO.png' alt='white open arrow'/>.*
|
||||
|
||||
|
||||
**Opportunistic Infection, AIDS, Progressive Multifocal Leukoencephalopathy**
|
||||
*Axial T2WI MR reveals the typical appearance of PML with patchy increased signal in the white matter bilaterally <img src='img/arrows/WS.png' alt='white solid arrow'/>. Progressive multifocal leukoencephalopathy typically causes a subacute demyelination.*
|
||||
|
||||
|
||||
**Creutzfeldt-Jakob Disease, Heidenhain Variant**
|
||||
*Axial T2WI MR shows occipital lobe white matter confluent high signal <img src='img/arrows/WS.png' alt='white solid arrow'/> without mass effect. The Heidenhain variant of Creutzfeldt-Jakob disease is characterized by early isolated visual symptoms and signs.*
|
||||
|
||||
|
||||
**Posterior Cortical Atrophy (Benson Syndrome)**
|
||||
*Axial FLAIR MR demonstrates ex vacuo dilatation of the occipital horn of the left lateral ventricle <img src='img/arrows/WS.png' alt='white solid arrow'/> in this 60-year-old patient presenting with homonymous hemianopsia. Note the severe white matter atrophy of the occipital lobe <img src='img/arrows/WO.png' alt='white open arrow'/> and lack of abnormality in the residual parenchyma.*
|
||||
|
||||
|
||||
### Additional Images
|
||||
|
||||
|
||||
**Posterior Cerebral Artery Ischemia**
|
||||
*Axial FLAIR MR demonstrates a confluent high-signal abnormality in the left occipital lobe <img src='img/arrows/WS.png' alt='white solid arrow'/> with the appearance of encephalomalacia.*
|
||||
|
||||
|
||||
**Posterior Cerebral Artery Ischemia**
|
||||
*Axial DWI shows a relatively large area of restricted diffusion in the left occipital lobe white matter and splenium of the corpus callosum <img src='img/arrows/WS.png' alt='white solid arrow'/> in this patient with an acute posterior cerebral artery distribution infarct. The patient presented with a right homonymous hemianopia.*
|
||||
|
||||
|
||||
**Posterior Cerebral Artery Ischemia**
|
||||
*Axial DWI in a 54-year-old patient with acute onset of homonymous hemianopsia following a motor vehicle accident 24 hours prior. The area of restricted diffusion in the right parietooccipital junction demonstrates a wedge shape <img src='img/arrows/WS.png' alt='white solid arrow'/>, suggesting a thromboembolic etiology in this acute posterior cerebral artery distribution infarct. Note the chronic infarct in the left occipital lobe <img src='img/arrows/WO.png' alt='white open arrow'/>.*
|
||||
|
||||
|
||||
**Posterior Cerebral Artery Ischemia**
|
||||
*This 48-year-old man presented with a macula-sparing left homonymous hemianopia. Axial T2WI MR shows cystic-appearing encephalomalacia in the right cuneus <img src='img/arrows/WS.png' alt='white solid arrow'/> secondary to chronic infarct.*
|
||||
|
||||
|
||||
**Glioblastoma**
|
||||
*Axial T1 C+ SPGR shows an infiltrative centrally necrotic and peripherally enhancing intraaxial mass in the right temporoparietal lobe <img src='img/arrows/WS.png' alt='white solid arrow'/> that extends into the right occipital lobe <img src='img/arrows/WO.png' alt='white open arrow'/>. The mass extends along the trajectory of the inferior longitudinal fasciculus and optic radiations.*
|
||||
|
||||
|
||||
**Glioblastoma**
|
||||
*Axial DTI in the same patient with right temporal-parietal-occipital glioblastoma shows loss of signal in the posterior inferior longitudinal fasciculus and optic radiations <img src='img/arrows/CS.png' alt='cyan solid arrow'/> that represents destruction of the axons. There is also absence of signal from the right lateral geniculate nucleus <img src='img/arrows/WO.png' alt='white open arrow'/> without destruction due to transsynaptic degeneration. Compare this to the normal contralateral lateral geniculate nucleus and optic radiation <img src='img/arrows/WC.png' alt='white curved arrow'/>. The right inferior fronto-occipital fasciculus shows mixed reduction in caliber and more diffuse areas representing infiltration <img src='img/arrows/WS.png' alt='white solid arrow'/>.*
|
||||
|
||||
|
||||
**Glioblastoma**
|
||||
*Axial fMRI visual cortex mapping in a patient with a right temporal lobe glioblastoma shows activation in the bilateral primary and association visual cortices <img src='img/arrows/WS.png' alt='white solid arrow'/> and activation in the left lateral geniculate nucleus <img src='img/arrows/WO.png' alt='white open arrow'/>. Note that although the tumor does not directly involve the right lateral geniculate nucleus, there is substantially reduced activation <img src='img/arrows/WC.png' alt='white curved arrow'/>.*
|
||||
|
||||
|
||||
**Demyelinating Diseases**
|
||||
*Axial FLAIR MR in a 36-year-old female patient with vision loss and headaches reveals a single area of hyperintensity in the left geniculate nucleus <img src='img/arrows/WS.png' alt='white solid arrow'/>. This did not show diffusion restriction or enhancement and proved to be the initial lesion in multiple sclerosis. Lesions of the lateral geniculate nucleus usually result in a homonymous sectoranopia.*
|
||||
|
||||
|
||||
**Multiple Sclerosis**
|
||||
*Sagittal T1WI MR shows variant tumefactive multiple sclerosis plaque with the diagnosis proven in biopsy. The hypointense mass-like lesion <img src='img/arrows/WS.png' alt='white solid arrow'/> involves the parietal-occipital visual association areas and sits where the body or 2nd segment of the optic radiations turns toward the 3rd or dorsal segment.*
|
||||
|
||||
|
||||
**Multiple Sclerosis**
|
||||
*Axial FLAIR in an 18-year-old patient with acute B-cell ALL presenting with acute loss of color vision is shown. There is a conspicuous hyperintense lesion on the left lateral geniculate nucleus <img src='img/arrows/WS.png' alt='white solid arrow'/> and numerous other scattered hyperintense foci <img src='img/arrows/WO.png' alt='white open arrow'/>, which proved to be septic emboli. Although lateral geniculate nucleus lesions typically cause a homonymous sectoranopia, the lateral geniculate nucleus relays color representation, particularly red-green.*
|
||||
|
||||
|
||||
**ADEM**
|
||||
*Axial T2WI MR shows a case of extensive confluent ADEM. Note the large confluent regions of hyperintense signal in the white matter along the course of the optic radiations <img src='img/arrows/WO.png' alt='white open arrow'/>. Of note is the T2-hyperintense signal seen in the thalami <img src='img/arrows/WS.png' alt='white solid arrow'/> and putamina <img src='img/arrows/WC.png' alt='white curved arrow'/>.*
|
||||
|
||||
|
||||
**ADEM**
|
||||
*Coronal T2WI MR in the same patient shows T2-hyperintense signal in the thalamus and putamen <img src='img/arrows/WS.png' alt='white solid arrow'/> and region of Meyer loop in the temporal stem <img src='img/arrows/WO.png' alt='white open arrow'/>.*
|
||||
|
||||
|
||||
**Abscess, Temporal-Occipital Brain**
|
||||
*Axial T1WI C+ MR demonstrates irregular ring enhancement <img src='img/arrows/WS.png' alt='white solid arrow'/> as well as some more focal nodules of solid enhancement <img src='img/arrows/WO.png' alt='white open arrow'/> in this patient with toxoplasmosis brain abscess.*
|
||||
|
||||
|
||||
**Cavernous Malformation, Temporal-Occipital Brain**
|
||||
*3D rendering of DTI fiber tracking illustrates the optic radiations <img src='img/arrows/CS.png' alt='cyan solid arrow'/> that run posteriorly from the lateral geniculate nucleus <img src='img/arrows/CC.png' alt='cyan curved arrow'/> (horizontally oriented fibers in red). Fibers from the inferior frontooccipital fasciculus <img src='img/arrows/WC.png' alt='white curved arrow'/> run along the superior aspect of the inferior longitudinal fasciculus <img src='img/arrows/CO.png' alt='cyan open arrow'/>, which runs inferior to and merges with the optic radiations. Splenial fibers <img src='img/arrows/WS.png' alt='white solid arrow'/> merge into the occipital projections. Note the dense U fibers <img src='img/arrows/WO.png' alt='white open arrow'/> (blue, purple) that make up the occipital-temporal projection system.*
|
||||
|
||||
|
||||
**Creutzfeldt-Jakob Disease, Heidenhain Variant**
|
||||
*Axial graphic shows a lesion (black line) in the left optic tracts. Infarct or any other destructive lesion that involves this pathway can result homonymous hemianopsia (ipsilateral 1/2 visual field blindness) <img src='img/arrows/WS.png' alt='white solid arrow'/>.*
|
||||
|
||||
BIN
Binary file not shown.
|
After Width: | Height: | Size: 83 KiB |
BIN
Binary file not shown.
|
After Width: | Height: | Size: 105 KiB |
BIN
Binary file not shown.
|
After Width: | Height: | Size: 110 KiB |
BIN
Binary file not shown.
|
After Width: | Height: | Size: 100 KiB |
BIN
Binary file not shown.
|
After Width: | Height: | Size: 102 KiB |
BIN
Binary file not shown.
|
After Width: | Height: | Size: 89 KiB |
BIN
Binary file not shown.
|
After Width: | Height: | Size: 105 KiB |
BIN
Binary file not shown.
|
After Width: | Height: | Size: 7.7 KiB |
BIN
Binary file not shown.
|
After Width: | Height: | Size: 112 KiB |
BIN
Binary file not shown.
|
After Width: | Height: | Size: 122 KiB |
BIN
Binary file not shown.
|
After Width: | Height: | Size: 148 KiB |
BIN
Binary file not shown.
|
After Width: | Height: | Size: 125 KiB |
BIN
Binary file not shown.
|
After Width: | Height: | Size: 115 KiB |
BIN
Binary file not shown.
|
After Width: | Height: | Size: 89 KiB |
BIN
Binary file not shown.
|
After Width: | Height: | Size: 110 KiB |
BIN
Binary file not shown.
|
After Width: | Height: | Size: 111 KiB |
BIN
Binary file not shown.
|
After Width: | Height: | Size: 118 KiB |
BIN
Binary file not shown.
|
After Width: | Height: | Size: 106 KiB |
BIN
Binary file not shown.
|
After Width: | Height: | Size: 99 KiB |
BIN
Binary file not shown.
|
After Width: | Height: | Size: 113 KiB |
BIN
Binary file not shown.
|
After Width: | Height: | Size: 60 KiB |
BIN
Binary file not shown.
|
After Width: | Height: | Size: 100 KiB |
BIN
Binary file not shown.
|
After Width: | Height: | Size: 119 KiB |
BIN
Binary file not shown.
|
After Width: | Height: | Size: 107 KiB |
BIN
Binary file not shown.
|
After Width: | Height: | Size: 92 KiB |
BIN
Binary file not shown.
|
After Width: | Height: | Size: 115 KiB |
BIN
Binary file not shown.
|
After Width: | Height: | Size: 105 KiB |
BIN
Binary file not shown.
|
After Width: | Height: | Size: 116 KiB |
BIN
Binary file not shown.
|
After Width: | Height: | Size: 105 KiB |
BIN
Binary file not shown.
|
After Width: | Height: | Size: 89 KiB |
BIN
Binary file not shown.
|
After Width: | Height: | Size: 91 KiB |
BIN
Binary file not shown.
|
After Width: | Height: | Size: 77 KiB |
BIN
Binary file not shown.
|
After Width: | Height: | Size: 294 KiB |
BIN
Binary file not shown.
|
After Width: | Height: | Size: 176 KiB |
BIN
Binary file not shown.
|
After Width: | Height: | Size: 72 KiB |
BIN
Binary file not shown.
|
After Width: | Height: | Size: 113 KiB |
BIN
Binary file not shown.
|
After Width: | Height: | Size: 104 KiB |
BIN
Binary file not shown.
|
After Width: | Height: | Size: 88 KiB |
BIN
Binary file not shown.
|
After Width: | Height: | Size: 103 KiB |
BIN
Binary file not shown.
|
After Width: | Height: | Size: 99 KiB |
BIN
Binary file not shown.
|
After Width: | Height: | Size: 111 KiB |
BIN
Binary file not shown.
|
After Width: | Height: | Size: 122 KiB |
BIN
Binary file not shown.
|
After Width: | Height: | Size: 68 KiB |
BIN
Binary file not shown.
|
After Width: | Height: | Size: 97 KiB |
BIN
Binary file not shown.
|
After Width: | Height: | Size: 91 KiB |
BIN
Binary file not shown.
|
After Width: | Height: | Size: 120 KiB |
BIN
Binary file not shown.
|
After Width: | Height: | Size: 92 KiB |
BIN
Binary file not shown.
|
After Width: | Height: | Size: 107 KiB |
BIN
Binary file not shown.
|
After Width: | Height: | Size: 94 KiB |
BIN
Binary file not shown.
|
After Width: | Height: | Size: 108 KiB |
BIN
Binary file not shown.
|
After Width: | Height: | Size: 88 KiB |
BIN
Binary file not shown.
|
After Width: | Height: | Size: 129 KiB |
BIN
Binary file not shown.
|
After Width: | Height: | Size: 90 KiB |
BIN
Binary file not shown.
|
After Width: | Height: | Size: 114 KiB |
BIN
Binary file not shown.
|
After Width: | Height: | Size: 102 KiB |
BIN
Binary file not shown.
|
After Width: | Height: | Size: 107 KiB |
BIN
Binary file not shown.
|
After Width: | Height: | Size: 133 KiB |
BIN
Binary file not shown.
|
After Width: | Height: | Size: 87 KiB |
BIN
Binary file not shown.
|
After Width: | Height: | Size: 88 KiB |
BIN
Binary file not shown.
|
After Width: | Height: | Size: 110 KiB |
BIN
Binary file not shown.
|
After Width: | Height: | Size: 115 KiB |
BIN
Binary file not shown.
|
After Width: | Height: | Size: 71 KiB |
BIN
Binary file not shown.
|
After Width: | Height: | Size: 115 KiB |
BIN
Binary file not shown.
|
After Width: | Height: | Size: 165 KiB |
BIN
Binary file not shown.
|
After Width: | Height: | Size: 103 KiB |
BIN
Binary file not shown.
|
After Width: | Height: | Size: 74 KiB |
BIN
Binary file not shown.
|
After Width: | Height: | Size: 97 KiB |
BIN
Binary file not shown.
|
After Width: | Height: | Size: 99 KiB |
BIN
Binary file not shown.
|
After Width: | Height: | Size: 88 KiB |
BIN
Binary file not shown.
|
After Width: | Height: | Size: 141 KiB |
BIN
Binary file not shown.
|
After Width: | Height: | Size: 96 KiB |
BIN
Binary file not shown.
|
After Width: | Height: | Size: 102 KiB |
BIN
Binary file not shown.
|
After Width: | Height: | Size: 98 KiB |
BIN
Binary file not shown.
|
After Width: | Height: | Size: 136 KiB |
BIN
Binary file not shown.
|
After Width: | Height: | Size: 271 KiB |
BIN
Binary file not shown.
|
After Width: | Height: | Size: 102 KiB |
BIN
Binary file not shown.
|
After Width: | Height: | Size: 124 KiB |
BIN
Binary file not shown.
|
After Width: | Height: | Size: 109 KiB |
BIN
Binary file not shown.
|
After Width: | Height: | Size: 105 KiB |
BIN
Binary file not shown.
|
After Width: | Height: | Size: 125 KiB |
BIN
Binary file not shown.
|
After Width: | Height: | Size: 68 KiB |
BIN
Binary file not shown.
|
After Width: | Height: | Size: 130 KiB |
BIN
Binary file not shown.
|
After Width: | Height: | Size: 113 KiB |
BIN
Binary file not shown.
|
After Width: | Height: | Size: 105 KiB |
BIN
Binary file not shown.
|
After Width: | Height: | Size: 102 KiB |
BIN
Binary file not shown.
|
After Width: | Height: | Size: 127 KiB |
BIN
Binary file not shown.
|
After Width: | Height: | Size: 105 KiB |
BIN
Binary file not shown.
|
After Width: | Height: | Size: 98 KiB |
Some files were not shown because too many files have changed in this diff Show More
Reference in New Issue
Block a user