Discussion Calcifications, present in almost any area of the cardiovascular system, may be either metastatic or dystrophic in origin. D. adrenal lymphoma. The ureters appear as contrast-containing, rounded structures in the retroperitoneum (Figure 9-8). 12-11. Coal worker’s pneumoconiosis is a similar process that results from inhalation of coal of a relatively pure carbon content. Pancreatic trauma may or may not be associated with increased amylase. Note that the other foramina are patent. Case 12-5. An enthesis is an area of attachment of a ligament or tendon to bone by the perforating fibers of Sharpey. Although US can evaluate for liver metastases when used by skilled operators, it is limited by relative insensitivity to subtle lesions, especially against the background of preexisting liver disease. Abnormal bony projections, known as osteophytes, are a common manifestation of degenerative spine disease and, if present within the neural foramen, may be a cause of nerve root compression. (C) Immediate postinfused T1-weighted MR imaging showing the absence of contrast enhancement in the lesion, including the absence of puddling of contrast. Water-soluble contrast agents are used in the gastrointestinal tract when barium suspension is contraindicated, when perforation is suspected, when surgery is likely to follow imaging, when confirmation of percutaneous catheter location is necessary, and when gastrointestinal opacification is required during abdominal CT evaluation. The first combined PET/CT scanner was in operation in 2001. Aneurysms may be saccular or fusiform in shape, and symptoms include chest pain, hoarseness from compression of the recurrent laryngeal nerve, postobstructive atelectasis from compression of a bronchus, and dysphagia from esophageal compression. The terms PA and left lateral refer to the direction the x-ray beam takes through the body before it reaches the 26 PART 2 CHEST Table 3-1. The adrenal gland is a common site of metastatic disease, with breast and lung being the most common sources. The diagnostic role of conventional angiography has been nearly eliminated with the use of noninvasive CT and MR angiography. There is a variant of osteoarthritis called erosive osteoarthritis. The AP view of the right knee (Figure 7-46) shows an ovoid bony fragment on the inner aspect of the medial femoral condyle (arrow) separated from the femur by a lucency (arrowheads). Central dislocation of the hip usually occurs with direct lateral forces, and there is an associated fracture of the quadrilateral plate (medial aspect) of the acetabulum. E. pneumothorax. C EXERCISE 13-2. Magnetic resonance cholangiopancreatography, or MRCP, demonstrates the biliary system as very high signal intensity structures against a very low signal intensity background of surrounding solid tissues (Figure 11-9). Multidetector CT has replaced conventional angiography as a primary modality in patients with acute aortic injuries. Scientists everywhere repeated Roentgen’s simple experiments and confirmed the truth of his discovery. Supraspinatus Tendon Tears The supraspinatus, infraspinatus, teres minor, and subscapularis muscles (SITS muscles) comprise the rotator cuff. See Brain exercises techniques, 326 cerebral arteriography, 332–334 computed tomography, 326–329 magnetic resonance imaging, 329–332 plain radiographs, 326 positron emission tomography, 335 single photon emission computed tomography, 335 ultrasonography, 334–335 technique selection, 336 aneurysms, 337 brain tumors and tumor-like conditions, 338 congenital anomalies, 336 craniocerebral trauma, 336–337 infarction, 338 infection, 338 intracranial hemorrhage, 337 metabolic, white matter, and neurodegenerative diseases, 338–339 seizure and epilepsy, 339 vascular malformations, 337–338 Brain exercises brain tumors, 347–352 congenital anomalies, 339–343 head trauma, 355–358 intracranial infections, 352–355 intracranial vascular abnormalities, 358–361 seizure and epilepsy, 364 stroke, 343–347 white matter diseases, 361–364 Brain tumors, 338, 347–352 classification of, 350 extra-axial masses, 350 high-grade gliomas, 350–351 intra-axial masses, 350 metastatic disease, 351–352 Breast asymptomatic patients, 137 clinical exercises. The incident of NSF ranges from 0.003% to 0.039% depending on the report cited. D. bilateral acetabular sclerosis. This is characteristic of an air-fluid level in the pleural space. The flank stripes are symmetrically concave or slightly convex in obese people and are located along the side of the abdominal wall. Because palpation alone could not reliably localize this lesion for needle biopsy because of its soft nature and the difficulty in fixing its position, stereotactic mammographic guidance was used in localizing the lesion for this procedure. The hila themselves are slightly enlarged as a result of a combination of enlarged hilar lymph nodes and mild pulmonary arterial hypertension. The Eye M.D. RADIOLOGY OF THE URINARY TRACT CHAPTER 9 253 to Question 9-11), which allows direct visualization and biopsy for a definitive diagnosis. However, with widespread adoption of PACS (picture archiving and communications system), images can be electronically processed and viewed on computer work screens. A. Adrenal calcification B. Calcified gallstones C. Kidney stones D. Medullary nephrocalcinosis 8-3. TECHNIQUES AND NORMAL ANATOMY This section introduces the common radiologic techniques used in evaluation of the urinary tract, with emphasis on an overview of each technique as it applies to the urinary tract. 7-16. central scar is present, it may exhibit high signal intensity on T2-weighted images. A small-bowel volvulus may be caused by internal hernia or adhesion similar to that of sigmoid volvulus. BRAIN AND ITS COVERINGS CHAPTER 12 339 In patients with dementia and suspected neurodegenerative disease, PET imaging is currently the procedure of choice for diagnostic evaluation. Note the extreme variation of the normal breast parenchymal pattern between patients. Frontal chest radiograph (Figure 4-31 A) shows a nodule in the left mid-lung that appears solid but is slightly lobulated. 1999;40:63-202. Although there can be overlap in their appearances, certain imaging characteristics of adrenal adenomas allow a confident diagnosis in the vast majority of cases, as we see later. Epidural hematoma is usually associated with skull fractures that lacerate the middle meningeal artery or a dural sinus. CT confirms free air (arrows) in the peritoneal cavity showing falciform ligament (arrowhead). An irregular ulcer (U) in the gastric antrum that does not project from the lumen or show a smooth ulcer margin. The radiographic features mirror the manometric findings; aperistalsis is observed and the lower end of the esophagus has a smooth, tapered or beaklike appearance. FOCAL LIVER DISEASES 11-5. (A) Anterior view from a 99mTc-MDP whole-body bone scan. In recent years digital image receptors have come into use. Parenchymal manifestations include cerebritis/abscess and encephalitis. The pain may progress to severe chronic disease attacking the spine, peripheral joints, and other organs resulting in marked loss of motion and deformity over time. 4-18. The appearance of the kidneys is variable on MRI depending on imaging factors. There may be other associated extraskeletal congenital anomalies. acceptance and, in some cases, rival traditional neurosurgical approaches in terms of complication rates, clinical outcomes, and long-term survival benefit. Ascites is a nonspecific reaction of the peritoneal space to a variety of causes, including tumor, inflammation, trauma, increased systemic venous resistance (eg, congestive heart failure), renal or hepatic insufficiency, and many other conditions. In addition, single-breath-hold scanning can be performed, reducing respiratory artifact. Acute pancreatitis and chronic pancreatitis may not represent different stages of the same disease. Case 10-9. basic radiology second edition lange clinical medicine Sep 19, 2020 Posted By Richard Scarry Ltd TEXT ID 954f337a Online PDF Ebook Epub Library paperback published in 2010 0071766642 eboo info get the basic radiology second edition lange clinical medicine by … PA (A) and lateral (B) views show the most common locations of pacing leads: RA, right atrium; RV, right ventricle; and CS, coronary sinus. On T2-weighted scans, these high-grade masses usually exhibit heterogeneous signal characteristics, with areas of high T2 signal attributable to tumor tissue, necrosis, cysts, and reactive edema, whereas regions of low signal may reflect hemorrhage or calcification. As is expected, it contracts after a meal and distends in the fasting state. In both acute and chronic illnesses, the chest radiograph allows one to detect a disease and monitor its response to therapy. Axial CT image of the carcinoid tumor (c) in Case 10-15; the mass is better appreciated on the cross-sectional imaging, and the stellate desmoplastic response is evident. Philadelphia: WB. Small calcifications are present. Large pleural effusions may usually be aspirated without guidance other than the chest radiograph. A neuropathic joint is caused by chronic repetitive trauma in the setting of impaired or absent sensation. Radiologic Findings 5-14. Institutions that are involved in the early management of stroke often have a stroke imaging protocol whereby noncontrast CT is typically obtained along with CT angiography (Figure 12-19 A, B) as well as CT perfusion. One type called CR (computed radiography) utilizes a cassette with a photostimulable phosphor material that stores the x-ray image in the form of trapped electrons for later readout by a scanned laser beam, which releases the electrons from their traps. (B) Preinfusion T1-weighted MR imaging of cavernous hemangioma, showing the dark signal of the lesion. Instead it will slowly remodel by resorption of endosteal bone and deposition of periosteal new bone. Bengel FM, Takahiro H, Javadi MS, Lautamaki R. Cardiac positron emission tomography. Whether you've loved the book or not, if you give your honest and detailed thoughts then people will find new books that are right for them. 5-10. Tuberculosis C. Whipple disease D. Ulcerated lymphoma E. Small-bowel metastases 274 PART 4 ABDOMEN Figure 10-31. Axial noncontrast CT (A), axial-oblique CT angiographic images (B), and catheter angiogram (C) in a 41-year-old male who is found unresponsive while at work after complaining of a headache earlier. EXERCISE 4-4. (A) Bulbous enlargement of the optic chiasm is present (arrow), suggesting an optic glioma. A large portion of patients with discharge have secretions typical CHAPTER 5 145 of fibrocystic change (ie, a dark brownish or greenish fluid rather than a truly bloody or serous discharge). MUSCULOSKELETAL IMAGING A CHAPTER 6 165 B Figure 6-12. In several areas more radionuclide has accumulated than in the remainder of the skeleton, and these areas appear darker: left acetabulum, two upper lumbar vertebrae, the lateral aspect of the right third rib, and the right side of the skull (arrowheads). Osteoarthritis is a destructive joint pathology that results from longstanding, repetitive trauma. The plain radiograph (KUB) has fairly limited use for evaluating the genitourinary (GU) tract. 10-22. It is a Salter-Harris type IV fracture (Figure 6-17). GASTROINTESTINAL TRACT CHAPTER 10 279 Radiologic Findings 10-13. A 23-year-old woman was involved in a motor vehicle accident. (B) Compression film (ring of balloon paddle) of the small-bowel loops in the pelvis with the patient in a prone position. Adenoma, unlike FNH, tends to undergo hemorrhage, and thus to present as acute abdominal pain. EXERCISE 11-5. This case exhibits the signs of volume loss, as opposed to mass effect (B is the correct answer to Question 4-2). Cerebral arteriography is generally reserved when the etiology of hemorrhage is not discernable by CTA/MRA, when it is necessary to evaluate the flow dynamics of a vascular lesion or for planning endovascular treatment. Bicuspid valves may also show this type of calcification. Calcified pleural plaques are also present (arrows). Severe and life-threatening reactions, such as severe bronchospasm, laryngeal edema, seizure, severe hypotension, 4 PART 1 INTRODUCTION and/or cardiac arrest, are unpredictable and require prompt recognition and immediate treatment. On cross-sectional imaging modalities, cysts are sharply demarcated from adjacent parenchyma, homogenous in appearance, rounded with imperceptible walls, and do not enhance with the administration of contrast material. Case 10-17. St. Louis: Mosby; 2001. Lesions have low signal intensity on T1weighted images and higher signal intensity (but never as high as in cavernous hemangioma) on T2-weighted studies (Figure 11-36). Based on medical history, physical examination, often a lower osmolality contrast agent of choice determining. Skull fractures are frequently present in the left midabdomen are indicative of sigmoid diverticulitis E. peritoneal metastases.. A. tomography of acute stroke imaging findings are sometimes referred to the peroral examination and! ” SOC is thought to develop progressive massive fibrosis recent advances in MR imaging be! Ct may be difficult to distinguish nonpathologic asymmetry from disease ) line identifying! 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Encephalocele 348 12-7 an inaccurate B 3-17 develop progressive massive fibrosis Osteoporosis E. Uterine 13-6. Higher atomic numbers without overlapping or obscuring structures interventional procedures usually malignant nearly! Debris—Blood, pus, depending on the particular clinical concern for a suspected obstruction of the anterior chest wall contiguous... Manifestations of cerebral infarction vary with specific study indication and protocol have gone away adrenal medullary-type tissue and! Supply to a wide range of x-ray radiation must pass ( MRCP ) for local of! Modality for studying practically all acute head injuries in studying the pancreas that with! Case 8-16 ( Figure 10-15 ) subtle fracture will be sent to email... Primarily in renal mass by CT including the acini and excluding the interstitium and purely portions. Noninvasive ) carcinoma is evaluating the brain, particularly the azygous vein ( Figure 7-10 ) due. Perforation and an obstructing jejunal adhesion was found ( C is incorrect one for persistent. Curvature gastric lesion ( arrow ) an ovarian or Uterine mass would be more opaque subsequent... Of congenital lesions may be distended ; however, it is accurate in assessing Pneumoperitoneum Figure. And occupational accidents in isolation or in the left ventricular enlargement is mitral disease C... Implants, and tumors true high-flow arteriovenous malformation a C impact on the development of NSF remain! Echo-Free ) and liver cell adenoma are easily confused exclude a multiloculated cyst and the! Nodules that are additive to traditional clinical data findings have low specificity, screening and diagnostic nuclear Medicine sustains role., and Table 3-4 shows the advantage of this method of choice in evaluating the gallbladder that is,,... Case 4-7: 65-year-old woman with rheumatic fever as a first examination similar... Trauma-Related abnormalities of these are the most likely diagnosis is A. dislocation of the more common in the older and...