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Shingo Omata @shingoomata.bsky.social · Mar 6

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

✅ The subthalamic nucleus and globus pallidus show T1↑,

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

www.medicalk.net/jspr_journal...

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Shingo Omata @shingoomata.bsky.social · Mar 6

A full-term infant, 5 days old

#Rdiag #RadSky #MedSky #NeuroRad #FOAMed

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Shingo Omata @shingoomata.bsky.social · Mar 5

<Lipoma with osseous metaplasia>

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

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

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Shingo Omata @shingoomata.bsky.social · Mar 5

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

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

#Rdiag #RadEd #MedEd #FOAMed

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Shingo Omata @shingoomata.bsky.social · Mar 4

<Cavernous Hemangiomas in the Cavernous Sinus>

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

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

PMID: 12812943

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Shingo Omata @shingoomata.bsky.social · Mar 4

Pt: 36 y/o Female

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

#Rdiag #RadEd #MedEd #NeuroRad #FOAMed

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Shingo Omata @shingoomata.bsky.social · Mar 2

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

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

Shingo Omata @shingoomata.bsky.social · Mar 2

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

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

Symptoms: Asymptomatic

#Rdiag #RadSky #MedSky #FOAMed #FOAMRad

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Shingo Omata @shingoomata.bsky.social · Mar 1

bsky.app/profile/shin...

Shingo Omata @shingoomata.bsky.social · Mar 1

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

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

Spinal dural arteriovenous fistula | Radiology Reference Article | Radiopaedia.org

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

doi.org

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Shingo Omata @shingoomata.bsky.social · Mar 1

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

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

Spinal dural arteriovenous fistula | Radiology Reference Article | Radiopaedia.org

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

doi.org

1

Shingo Omata @shingoomata.bsky.social · Feb 28

Pt: 60 y/o Male

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

#Rdiag #RadSky #MedSky #FOAMed #FOAMRad

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Shingo Omata @shingoomata.bsky.social · Feb 28

PMID: 32691295

Shingo Omata @shingoomata.bsky.social · Feb 28

<Horizontal Gaze Palsy with Progressive Scoliosis（HGPPS）>

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

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Shingo Omata @shingoomata.bsky.social · Feb 28

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

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

#Rdiag #RadEd #MedEd #NeuroRad #FOAMRad

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Shingo Omata @shingoomata.bsky.social · Feb 27

<Neuroferritinopathy>

💡 Basal ganglia cystic degeneration in advanced stages

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

PMID: 21808735

Shingo Omata @shingoomata.bsky.social · Feb 27

Pt: 42 y/o Male

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

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

FHx: Mother affected, deceased

#Rdiag #RadSky #MedSky #NeuroRad

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Shingo Omata @shingoomata.bsky.social · Feb 26

PMID: 24218322

Shingo Omata @shingoomata.bsky.social · Feb 26

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

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

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

#Rdiag #RadSky #MedSky #NeuroRad #FOAMRad

Shingo Omata @shingoomata.bsky.social · Feb 26

Pt: 55 y/o Male

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

#Rdiag #RadSky #MedSky #NeuroRad #FOAMRad

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Shingo Omata @shingoomata.bsky.social · Feb 26

Pt: 55 y/o Male

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

#Rdiag #RadSky #MedSky #NeuroRad #FOAMRad

Shingo Omata @shingoomata.bsky.social · Feb 25

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

💡 Alanine presence aids diagnosis

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

Shingo Omata @shingoomata.bsky.social · Feb 25

Pt: 73 y/o Male

#Rdiag #RadEd #MedEd #NeuroRad #FOAMRad

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Shingo Omata @shingoomata.bsky.social · Feb 25

Pt: 73 y/o Male

#Rdiag #RadEd #MedEd #NeuroRad #FOAMRad

Shingo Omata @shingoomata.bsky.social · Feb 24

ijms.info/IJMS/article...

Shingo Omata @shingoomata.bsky.social · Feb 24

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

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

#Rdiag #RadEd #MedEd #FOAMRad

Shingo Omata @shingoomata.bsky.social · Feb 23

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

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

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

#Rdiag #RadSky #MedSky #NeuroRad #FOAMed

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Shingo Omata @shingoomata.bsky.social · Feb 23

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

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

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

#Rdiag #RadSky #MedSky #NeuroRad #FOAMed

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Shingo Omata @shingoomata.bsky.social · Feb 23

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

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