Isolated DWI restriction in acute ischemia — useful window?

Diffusion restriction appears in minutes to hours and persists for days to weeks. ADC pseudonormalizes around 7–10 days — always correlate with FLAIR (DWI/FLAIR mismatch can estimate window).

Multiple sclerosis — current criteria?

McDonald 2017 criteria: dissemination in space (lesions in ≥ 2 of 4 typical regions) and time (enhancing + non-enhancing lesions simultaneously, or new lesion on follow-up MRI).

When to order perfusion / spectroscopy?

For brain tumor characterization (glioma grading), differentiation of recurrence vs radionecrosis and suspected metabolic disease.

Report template — MRI of flow CSF

When to use

Brain MRI is the most sensitive method for acute ischemia (DWI), demyelinating lesions (multiple sclerosis), epilepsy, dementia, tumors, CNS infections and vascular malformations. In emergencies, CT remains first-line due to speed; MRI completes the workup.

What to evaluate

Diffusion (DWI/ADC): acute restrictions and vascular distribution pattern.
FLAIR: white matter lesions, MS distribution pattern (McDonald criteria).
Post-gadolinium T1: focal enhancement, pattern (ring, solid, leptomeningeal).
Susceptibility-weighted (SWI/SWAN): microhemorrhages, deposits.
Deep structures, posterior fossa, sella, skull base.

Interactive template

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Técnica: Sequências multiplanares T1, T2, difusão (DWI), FLAIR. Realizada a sequência sagital FIESTA para o estudo do aqueduto cerebral. Obtidas também sequências phase contrast nos planos sagital e axial, para a avaliação do fluxo liquórico através do aqueduto cerebral. Análise: A sequência sagital FIESTA demonstra aqueduto cerebral pérvio. As sequências phase contrast não evidenciam sinais de fluxo liquórico hiperdinâmico através do aqueduto cerebral, cuja velocidade máxima foi de cm/s . O IV ventrículo apresenta morfologia e dimensões preservadas.

Template in Brazilian Portuguese (clinical reporting language). Adapt to your service protocol. Not medical advice — the physician reviews, edits and signs.

How to use

Replace each [...] with the exam's measurement or descriptor.
Adapt the conclusion to your service protocol before signing.
Use the template as a starting point — not a replacement for physician review.
In Laudos.AI, dictate findings in natural speech and the AI structures text in this format for review.

Frequently asked

Isolated DWI restriction in acute ischemia — useful window?: Diffusion restriction appears in minutes to hours and persists for days to weeks. ADC pseudonormalizes around 7–10 days — always correlate with FLAIR (DWI/FLAIR mismatch can estimate window).
Multiple sclerosis — current criteria?: McDonald 2017 criteria: dissemination in space (lesions in ≥ 2 of 4 typical regions) and time (enhancing + non-enhancing lesions simultaneously, or new lesion on follow-up MRI).
When to order perfusion / spectroscopy?: For brain tumor characterization (glioma grading), differentiation of recurrence vs radionecrosis and suspected metabolic disease.

References

Thompson AJ et al., Lancet Neurol 2018 (McDonald 2017).
Powers WJ et al., Stroke 2019.