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Training Collections
Library Memberships
On-demand course library with video lectures, expert case reviews, and more
Fellowship Certificate™ Programs
Practice-focused training programs designed to help you gain experience in a specific subspecialty area.
Ultimate Learning Pass
Unlock access to our full Course Library and all self-paced Fellowships.
Continuing Medical Education (State CME)
Complete all of your state CME requirements in one convenient place.
Noon Conference (Free)
Get access to free live lectures, every week, from top radiologists.
Case of the Week (Free)
Get a free weekly case delivered right to your inbox.
Case Crunch: Rapid Case Review (Free)
Register for free live board reviews.
Dr. Resnick's MSK Conference
Learn directly from the MSK Master himself.
Lower Extremities MRI Conference
Musculoskeletal Imaging
Emergency Imaging
PET Imaging
Pediatric Imaging
For Training Programs
Supplement your training program with case-based learning for residents, registrars, fellows, and more.
For Private Practices
Upskill in high growth, advanced imaging areas.
Compliance
NewTrack, fulfill, and report on all your radiologists' credentialing and licensing requirements.
Emergency Call Prep
Prepare trainees to be on call for the emergency department with this specialized training series.
60 topics, 3 hr. 18 min.
Introduction to the Carotid Space
3 m.Suprahyoid Spaces of the Head and Neck
4 m.Carotid Space Imaging Protocols
3 m.Contents of the Carotid Space
3 m.Carotid Space – Vitamin C&D
2 m.Vasculopathies and Variants
6 m.Carotid Fibromuscular Dysplasia with Dissection
8 m.Takayasu’s arteritis
3 m.Loeys-Dietz Syndrome
2 m.Marfan’s Syndrome
2 m.Carotid Space Infections
5 m.Causes of Internal Jugular Vein Thrombosis
5 m.Lemierre’s Syndrome
4 m.Internal Jugular Vein Thrombosis
3 m.Ludwig’s Angina (Carotid)
3 m.Internal Carotid Arteritis Secondary to Sialadenitis
3 m.Trauma in the Carotid Space
2 m.Penetrating Gunshot Wound of the Carotid Artery
4 m.Idiopathic Internal Carotid Artery Dissection
4 m.Internal Carotid Artery Dissection and Pseudoaneurysm
4 m.Horner Syndrome with Carotid Dissection
6 m.Carotid Blowout
3 m.Dissection and Strokes
6 m.Cervical Carotid Artery Dissection
4 m.Horner Syndrome
5 m.Value of Neurovascular Imaging for Seat Belt Injury
6 m.Right Internal Carotid Artery Pseudoaneurysm
3 m.Carotidynia – summary
4 m.Carotidynia
3 m.Carotid Space Neoplasms
2 m.Carotid Body Tumor
4 m.Carotid Body Tumor - Right Side
3 m.Bilateral Carotid Body Tumors
4 m.Carotid Body Tumor - Summary
5 m.Carotid Body Tumor Preoperative Imaging
3 m.Glomus Jugulare – summary
3 m.Glomus Jugulare with Tinnitis
4 m.Glomus Jugulare
3 m.Glomus Jugulare Tumor
2 m.Glomus Vagale – summary
3 m.Glomus Vagale
6 m.Hereditary Paragangliomas
3 m.Glomus Vagale, Carotid Body Tumor, Multiple Paragangliomas
4 m.Carotid Space Schwannomas
7 m.Vagal Schwannoma
4 m.Vagal Schwannoma, Growing in to Jugular Foramen
4 m.Carotid Space Neoplasms and Mass Effect
4 m.Sympathetic Trunk Neurofibroma in Neurofibromatosis
4 m.Carotid Space Meningioma
3 m.Carotid Invasion and Malignancy
3 m.Glottic Squamous Cell Carcinoma Invading the Carotid Space
4 m.Carotid Encasement from Metastatic Neuroblastoma
3 m.Characterizing Carotid Encasement
5 m.Lymph nodes by level of involvement
4 m.Tumors Impacting the Internal Jugular Vein
3 m.Papillary Thyroid Carcinoma Metastasis Mimicking Glomus
4 m.Pathology in the Carotid Space – Summary
6 m.The Cervical Sympathetic Chain
1 m.Vagus Nerve Anatomy
2 m.Deep Cervical Fascia of the Carotid Sheath
3 m.0:01
Let's take a look at these two examples of carotid
0:04
by tumors. Vis-à-vis the Shamblin classification.
0:08
On the left side, you see a lesion which
0:11
has involvement that is 360 degrees.
0:15
Circumferential involvement of the internal and
0:17
external carotid artery. Here we have our ICA,
0:21
here we have our ECA, and you can see that the tumor
0:26
involves 360 degrees around the carotid bifurcation.
0:32
This is a case of a paraganglioma, which is not
0:36
necessarily "spraying" the internal
0:38
and external carotid artery,
0:39
but is circumferentially involving it.
0:41
And this is a Shamblin Group Three involvement where
0:46
in very likely the carotid artery
0:49
will need to be sacrificed.
0:51
Contrast that with this example of a carotid body
0:54
tumor where we have the internal carotid
0:57
artery and the external carotid artery.
1:00
The tumor. And in addition,
1:02
we look at the circumferential involvement of the
1:05
internal carotid artery, and it is effectively
1:08
180 degrees or less. Now,
1:11
we'd have to look at multiple sections to make that
1:14
determination, but if it's less than 180 degrees,
1:17
it's a Group One and therefore readily resectable.
1:20
If it's group 2180 to 270 degrees,
1:25
then it still can be resected with difficulty.
1:29
So this is how we look at the carotid body tumors
1:33
and give them a grade and try to give the clinicians
1:36
a sense of the degree of circumferential
1:38
involvement by the tumor.
1:41
So carotid body tumor imaging bifurcation mass
1:45
Splays the internal and external carotid
1:47
artery shows contrast-enhanced mint,
1:50
often has flow voids associated with it.
1:53
We look at the ADC value on a head and
1:56
neck MRI scan. If the ADC value is...
2:00
It implies that this is an aggressive tumor and
2:03
more likely to have some malign potential.
2:06
By and large, these are benign tumors.
2:09
Low ADC may be a marker that this has
2:12
undergone malign transformation.
2:14
We then report the case as far as the degree to
2:17
which there is circumferential involvement
2:19
of the internal carotid artery.
2:21
To give a sense of the Shamblin classification,
2:24
the MIBG scan, nuclear medicine scan,
2:28
which is metaiodobenzylguanidine or octreotide, is a nuclear medicine
2:30
agent that is relatively specific for these types
2:35
of neuroendocrine tumors, the paragangliomas,
2:38
and it can help in identifying multiple
2:43
paragangliomas in the neck or elsewhere in the body.
Interactive Transcript
0:01
Let's take a look at these two examples of carotid
0:04
by tumors. Vis-à-vis the Shamblin classification.
0:08
On the left side, you see a lesion which
0:11
has involvement that is 360 degrees.
0:15
Circumferential involvement of the internal and
0:17
external carotid artery. Here we have our ICA,
0:21
here we have our ECA, and you can see that the tumor
0:26
involves 360 degrees around the carotid bifurcation.
0:32
This is a case of a paraganglioma, which is not
0:36
necessarily "spraying" the internal
0:38
and external carotid artery,
0:39
but is circumferentially involving it.
0:41
And this is a Shamblin Group Three involvement where
0:46
in very likely the carotid artery
0:49
will need to be sacrificed.
0:51
Contrast that with this example of a carotid body
0:54
tumor where we have the internal carotid
0:57
artery and the external carotid artery.
1:00
The tumor. And in addition,
1:02
we look at the circumferential involvement of the
1:05
internal carotid artery, and it is effectively
1:08
180 degrees or less. Now,
1:11
we'd have to look at multiple sections to make that
1:14
determination, but if it's less than 180 degrees,
1:17
it's a Group One and therefore readily resectable.
1:20
If it's group 2180 to 270 degrees,
1:25
then it still can be resected with difficulty.
1:29
So this is how we look at the carotid body tumors
1:33
and give them a grade and try to give the clinicians
1:36
a sense of the degree of circumferential
1:38
involvement by the tumor.
1:41
So carotid body tumor imaging bifurcation mass
1:45
Splays the internal and external carotid
1:47
artery shows contrast-enhanced mint,
1:50
often has flow voids associated with it.
1:53
We look at the ADC value on a head and
1:56
neck MRI scan. If the ADC value is...
2:00
It implies that this is an aggressive tumor and
2:03
more likely to have some malign potential.
2:06
By and large, these are benign tumors.
2:09
Low ADC may be a marker that this has
2:12
undergone malign transformation.
2:14
We then report the case as far as the degree to
2:17
which there is circumferential involvement
2:19
of the internal carotid artery.
2:21
To give a sense of the Shamblin classification,
2:24
the MIBG scan, nuclear medicine scan,
2:28
which is metaiodobenzylguanidine or octreotide, is a nuclear medicine
2:30
agent that is relatively specific for these types
2:35
of neuroendocrine tumors, the paragangliomas,
2:38
and it can help in identifying multiple
2:43
paragangliomas in the neck or elsewhere in the body.
Report
Description
Faculty
David M Yousem, MD, MBA
Professor of Radiology, Vice Chairman and Associate Dean
Johns Hopkins University
Tags
Neuroradiology
Neuro
Neoplastic
MRI
Head and Neck
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