Dear Experts,

Occasionally, we have patients with clear cortical or subcort. gray matter infarcts. If the infarct is large enough, in some cases the pial line bends in away from the outer boundary of viable gray matter and in toward the infarct (i.e., area of decreased contrast). In the attached power point, I show a case where there is a left (radiologic convention) rostral insula infarct and the pial line dives in toward the infarct, but the adjacent main surface line looks like it is only very slightly underestimating the white matter boundary. This occurs on six contiguous slices, but the infarct is only apparent of three. This individual was run on a 1.5T scanner and processed with FS v4.5. The area of attenuation is apparent on his raw MPR and is bright on T2, so this is not an artifact in FS. I'm reluctant to use control points or change the WM boundary because it appears to be overall correct. Is there any way to fix this? Thanks a lot. - Tim

Timothy C. Durazzo, PhD Assistant Professor Department of Radiology and Biomedical Imaging University of California, San Francisco Center for Imaging of Neurodegenerative Diseases San Francisco VA Medical Center (415) 221-4810 x4157