Hello, thank you very much for the excellent informative lecture. Can we use DWI to fulfill dissemination in time if we have restrictive and non restrictive lessons?
First year radiology resident here, thank you so much for all your lectures, this is amazing stuff that a lot of us would be ready to pay a lot of money for, yet it’s free and accessible to everyone. I have a question : you mentioned that the time dissemination criterium can be fullfilled as long as we have some lesions that enhance and some that don’t no matter where they are, even including sub-cortical white matter lesions which don’t count for space dissemination. You also mentioned that optic neuritis doesn’t count for the criteria, but can it still give us time dissemination ? For example let’s say we have enough lesions for space dissemination elsewhere but none of them enhances, and there just happens to be a hyper-T2 on the optic nerve which enhances, do we have our time dissemination like we would if it was a sub-cortical lesion enhancing instead ?
That is such a specific (but completely justified) question that I had to look it up. Optic neuritis cannot be used as a DIS criterium, but a bit unsure about DIT, the McDonald criteria do not explicitely mention this specific situation as far as I can find out. I think not. The reason optic neuritis is not included as a diagnostic criterium is because optic neuritis can also be seen in several other demyelinating disorders, so including optic neuritis in the criteria would definitely improve the sensitivity of the criteria, but lower their specificity. There has been a lot of debate on whether or not optic nerves should be included in the McDonald criteria, however. A lot of people / experts believe it should, so I wouldn't be suprised if things were to change with the next update of the criteria.
@@theneuroradiologist Thanks a lot for your reply ! I asked this question to several neuroradiologists from my department and they all agreed with you that optic neuritis shouldn't count for DIT. Our way to make sense of it was that sub-cortical lesions are not used for DIS because there are a lot of aspecific sub-cortical lesions in a lot of patients whitout any particular underlying condition, but these normally aren't supposed to enhance so if one of them does then it sort of increases its specificity for MS. On the other hand, since optic neuritis is not used for DIS because it can happen in a lot of other demyelinating diseases then it doesn't really change anything wheter it enhances or not, it's an inflammatory lesion anyway. Not sure how often this situation will come up but it was definitely interesting from an intellectual point of view.
May I use screenshots from your (excellent!) videos to use them in my own RUclips videos (I have a German-language channel on multiple sclerosis)? Of course I would link the source = your video and refer to you. Kind regards!
Ich finde es sehr nett und auch sehr professionell von Ihnen, dass Sie mich überhaupt um Erlaubnis fragen (wir beide wissen, die Chancen sind gering, dass ich es jemals herausgefunden hätte, da es so viele RUclips-Videos gibt und nur so wenig Zeit am Tag). Also ja, Sie dürfen es unbedingt (und ich würde mich auf jeden Fall über eine Erwähnung freuen). Ihr Kanal sieht sehr interessant aus und ich schaue mich gerne deutsche Videos an (um meine Deutschkenntnisse aufrechtzuerhalten), also werde ich ihn mir in den nächsten Tagen vielleicht ein wenig ansehen :). Freundlichen GrüBen aus Belgien von einem ehemaligen MItarbeiter der UK RWTH Aachen, Sven.
right now I'm just uploading "old" presentations I've got lying around and giving them a second life online, don't have anything on middle ear or inner disease yet, so that won't be in the near future, but thanks for the idea, I will keep it in mind
Nice presentation! I will occasionally share it with some of my patients (as long as english is not a language barrier for them). My own channel (about MS) is German, unfortunately the RUclips generated automatic English subtitles are often translated incorrect...
beautiful presentation, like all the other videos. I wanted to ask you why for the radiological DIT criteria we don’t care that the WM lesions are subcortical or in the deep white matter ( instead of being iuxtacortical, periventricular, infratentorial or spinal). I was thinking that maybe the reason could be that WM lesions as you said are so common and unspecific that you need stringent locations to confidently correlate one of them to MS, but when it comes to enhancing lesions if u have one of these, it’s surely going to be inflammatory/demyelinating and you can then assume that the other lesions, irrespective of where they are, could be related to MS. Keep up the good work
Vielen vielen Dank für die tollen Videos. Man lernt wirklich so viel, highly appreciated…. Eine Frage habe ich zu dem Beispielpatienten am Ende. Die Läsion links periventrikulär ist doch neu zu den Voruntersuchungen. Damit ist die DIT doch erfüllt oder? Ob Enhacement oder nicht (und somit ob simultane Läsionen vorliegen) ist dann doch nachrangig , oder? Vielen Dank und sorry, dass ich in deutsch schreibe (reine Bequemlichkeit 🙈🙈🙈)
Thanks so much for this exelent video, I’m a patient who doubts the diagnosis MS and after seeing your video I’m determined to get a second opinion before starting with my BT.
Good luck and I hope you will find the correct diagnosis and correct treatment. Radiology is just part of the puzzle, my advice would be to get a second opinion from a neurologist specialized in MS and inflammatory brain disorders, I'm sure they'll be able to put all the pieces together and provide you with the correct answers to all your questions. Best of luck and kind wishes, Sven
Current radiology resident….just want to say thank you for the excellent lectures, they are the best I’ve found online.
Excellent presentation, very clear and competent. Good examples and I like your speaking pace.
Great video! From start to finish!
Hello, thank you very much for the excellent informative lecture. Can we use DWI to fulfill dissemination in time if we have restrictive and non restrictive lessons?
First year radiology resident here, thank you so much for all your lectures, this is amazing stuff that a lot of us would be ready to pay a lot of money for, yet it’s free and accessible to everyone.
I have a question : you mentioned that the time dissemination criterium can be fullfilled as long as we have some lesions that enhance and some that don’t no matter where they are, even including sub-cortical white matter lesions which don’t count for space dissemination. You also mentioned that optic neuritis doesn’t count for the criteria, but can it still give us time dissemination ? For example let’s say we have enough lesions for space dissemination elsewhere but none of them enhances, and there just happens to be a hyper-T2 on the optic nerve which enhances, do we have our time dissemination like we would if it was a sub-cortical lesion enhancing instead ?
That is such a specific (but completely justified) question that I had to look it up. Optic neuritis cannot be used as a DIS criterium, but a bit unsure about DIT, the McDonald criteria do not explicitely mention this specific situation as far as I can find out. I think not. The reason optic neuritis is not included as a diagnostic criterium is because optic neuritis can also be seen in several other demyelinating disorders, so including optic neuritis in the criteria would definitely improve the sensitivity of the criteria, but lower their specificity. There has been a lot of debate on whether or not optic nerves should be included in the McDonald criteria, however. A lot of people / experts believe it should, so I wouldn't be suprised if things were to change with the next update of the criteria.
@@theneuroradiologist Thanks a lot for your reply ! I asked this question to several neuroradiologists from my department and they all agreed with you that optic neuritis shouldn't count for DIT.
Our way to make sense of it was that sub-cortical lesions are not used for DIS because there are a lot of aspecific sub-cortical lesions in a lot of patients whitout any particular underlying condition, but these normally aren't supposed to enhance so if one of them does then it sort of increases its specificity for MS. On the other hand, since optic neuritis is not used for DIS because it can happen in a lot of other demyelinating diseases then it doesn't really change anything wheter it enhances or not, it's an inflammatory lesion anyway. Not sure how often this situation will come up but it was definitely interesting from an intellectual point of view.
Top :-) thank you
May I use screenshots from your (excellent!) videos to use them in my own RUclips videos (I have a German-language channel on multiple sclerosis)? Of course I would link the source = your video and refer to you. Kind regards!
Ich finde es sehr nett und auch sehr professionell von Ihnen, dass Sie mich überhaupt um Erlaubnis fragen (wir beide wissen, die Chancen sind gering, dass ich es jemals herausgefunden hätte, da es so viele RUclips-Videos gibt und nur so wenig Zeit am Tag). Also ja, Sie dürfen es unbedingt (und ich würde mich auf jeden Fall über eine Erwähnung freuen). Ihr Kanal sieht sehr interessant aus und ich schaue mich gerne deutsche Videos an (um meine Deutschkenntnisse aufrechtzuerhalten), also werde ich ihn mir in den nächsten Tagen vielleicht ein wenig ansehen :). Freundlichen GrüBen aus Belgien von einem ehemaligen MItarbeiter der UK RWTH Aachen, Sven.
@@theneuroradiologist Danke für die schnelle und sehr freundliche Antwort!!!
❤ excellent work
👍👍👍👍
Ty 💓
Thank you so much for this... such excellent lectures, easy to understand. Please keep the lectures coming.
Fantastic Videos....could you do a video on the middle/inner ear anatomy and it's diseases. It's a confusing area for many trainees
right now I'm just uploading "old" presentations I've got lying around and giving them a second life online, don't have anything on middle ear or inner disease yet, so that won't be in the near future, but thanks for the idea, I will keep it in mind
@neuroradiologist Thanks, that would be awesome if you did get to it.
Nice presentation! I will occasionally share it with some of my patients (as long as english is not a language barrier for them).
My own channel (about MS) is German, unfortunately the RUclips generated automatic English subtitles are often translated incorrect...
Danke Ihnen!
This was incredibly helpful. I finally understand my MRI results clearly. Thank you!
Second year Internal Medicine , Mexico, thank you
beautiful presentation, like all the other videos.
I wanted to ask you why for the radiological DIT criteria we don’t care that the WM lesions are subcortical or in the deep white matter ( instead of being iuxtacortical, periventricular, infratentorial or spinal).
I was thinking that maybe the reason could be that WM lesions as you said are so common and unspecific that you need stringent locations to confidently correlate one of them to MS, but when it comes to enhancing lesions if u have one of these, it’s surely going to be inflammatory/demyelinating and you can then assume that the other lesions, irrespective of where they are, could be related to MS.
Keep up the good work
Great job, may you always be blessed. Great collegue!
as always genius presentation, logical, clear, easy to understand, better than any medical school
Vielen vielen Dank für die tollen Videos. Man lernt wirklich so viel, highly appreciated….
Eine Frage habe ich zu dem Beispielpatienten am Ende. Die Läsion links periventrikulär ist doch neu zu den Voruntersuchungen. Damit ist die DIT doch erfüllt oder? Ob Enhacement oder nicht (und somit ob simultane Läsionen vorliegen) ist dann doch nachrangig , oder?
Vielen Dank und sorry, dass ich in deutsch schreibe (reine Bequemlichkeit 🙈🙈🙈)
Ja, Sie haben Recht! Für das Kriterium DIT ist es egal ob eine neue Läsion auf eine Verlaufskontrolle anreichert oder nicht!
Excellence !
Thank you …….one stop for my neuroradiology learning
Radiology resident
Very detailed and clear presentation 👌🙏🏻
Thanks so much for this exelent video, I’m a patient who doubts the diagnosis MS and after seeing your video I’m determined to get a second opinion before starting with my BT.
Good luck and I hope you will find the correct diagnosis and correct treatment. Radiology is just part of the puzzle, my advice would be to get a second opinion from a neurologist specialized in MS and inflammatory brain disorders, I'm sure they'll be able to put all the pieces together and provide you with the correct answers to all your questions. Best of luck and kind wishes, Sven
Thank you very much
This is a lot better than paid courses! Thanks a million!
thank you !
Dankeschön 👍👍👍
thank you so much
thanks
perfect again
very nice
❤❤ incredible
why no 1080p quality?
because I'm not very technical :/, going to see what I can do to increase video quality in the future, thanks for the remark
Thank you 👍
you're welcome!
Spellcheck
oh well :)