Brant and Helms' Fundamentals of Diagnostic Radiology, 5e by Jeffrey S. Klein, MD, FACR -- Read -- Imperial Library of Trantor

Index

Cover Section Editors Title Page Copyright Dedication Contributors Preface Contents List of Universal Abbreviations SECTION I. BASIC PRINCIPLES

1 DIAGNOSTIC IMAGING METHODS

CONVENTIONAL RADIOGRAPHY CROSS-SECTIONAL IMAGING TECHNIQUES

Computed Tomography Magnetic Resonance Imaging Ultrasonography

RADIOGRAPHIC CONTRAST AGENTS

Iodinated Contrast Agents Magnetic Resonance Imaging Intravascular Contrast Agents Gastrointestinal Contrast Agents Ultrasound Intravascular Contrast Agents

RADIATION RISK AND ENSURING PATIENT SAFETY RADIOLOGY REPORTING

Suggested Readings

SECTION II. NEURORADIOLOGY

2 INTRODUCTION TO BRAIN IMAGING

LOOKING AT THE BRAIN CURRENT NEUROIMAGING OPTIONS IMAGING STRATEGY FOR COMMON CLINICAL SYNDROMES ANALYSIS OF THE ABNORMALITY

Suggested Readings

3 CRANIOFACIAL TRAUMA

HEAD TRAUMA

Imaging Strategy Scalp Injury Skull Fractures Temporal Bone Fractures Head Injury Classification Primary Head Injury: Extra-Axial Primary Head Injury: Intra-Axial Secondary Head Injury Brainstem Injury Penetrating Trauma Predicting Outcome After Acute Head Trauma Child Abuse

FACIAL TRAUMA

Imaging Strategy Soft Tissue Findings Nasal Fractures Maxillary and Paranasal Sinus Fractures Orbital Trauma Fractures of the Zygoma Fractures of the Midface (Le Fort Fractures) Nasoethmoidal Fractures Mandibular Fractures References Suggested Readings

4 CEREBROVASCULAR DISEASE

ISCHEMIC STROKE

Pathophysiologic Basis for Imaging Changes Imaging Triage for Emergency Stroke Intervention Hemorrhagic Transformation of Infarction Use of Contrast in Ischemic Stroke Pattern Recognition in Ischemic Stroke Anterior (Carotid) Circulation Posterior (Vertebrobasilar) Circulation Watershed (Borderzone) Infarction Small Vessel Ischemia Venous Infarction

HEMORRHAGE

Imaging of Hemorrhage Subarachnoid Hemorrhage Parenchymal Hemorrhage Primary Hemorrhage Versus Hemorrhagic Neoplasm Suggested Readings

5 CENTRAL NERVOUS SYSTEM NEOPLASMS AND TUMOR-LIKE MASSES

TUMOR CLASSIFICATION CLINICAL PRESENTATION NEUROIMAGING PROTOCOL NEUROIMAGING ANALYSIS POSTOPERATIVE IMAGING FOLLOW-UP IMAGING SPECIFIC NEOPLASMS

Intra-Axial Tumors: Glial Intra-Axial Tumors: Nonglial Intra-Axial Tumors: Nonneuroepithelial Extra-Axial Tumors Pineal Region Masses Sellar Region Masses Masses of Developmental Origin Suggested Readings

6 CENTRAL NERVOUS SYSTEM INFECTIONS

CONGENITAL INFECTIONS EXTRA-AXIAL INFECTIONS

Subdural and Epidural Infections Meningitis

PARENCHYMAL INFECTIONS

Pyogenic Cerebritis and Abscess Mycobacterial Infections Fungal Infections Parasitic Infections Spirochete Infections Viral Infections Creutzfeldt–Jakob Disease

ACQUIRED IMMUNODEFICIENCY SYNDROME–RELATED INFECTIONS

Suggested Readings

7 WHITE MATTER AND NEURODEGENERATIVE DISEASES

DEMYELINATING DISEASES

Primary Demyelination Ischemic Demyelination Infection-Related Demyelination Toxic and Metabolic Demyelination

DYSMYELINATING DISEASES CEREBROSPINAL FLUID DYNAMICS NEURODEGENERATIVE DISORDERS

Suggested Readings

8 HEAD AND NECK IMAGING

PARANASAL SINUSES AND NASAL CAVITY SKULL BASE

Tumors of the Skull Base Temporal Bone

SUPRAHYOID HEAD AND NECK

Superficial Mucosal Space Parapharyngeal Space Carotid Space Parotid Space Masticator Space Retropharyngeal Space Prevertebral Space Trans-Spatial Diseases

LYMPH NODES ORBIT CONGENITAL LESIONS

Suggested Readings

9 SPINE IMAGING

COMMON CLINICAL SYNDROMES IMAGING METHODS INFLAMMATION INFECTION

Pyogenic Infections Nonpyogenic Infections

NEOPLASMS

Intramedullary Masses Intradural-Extramedullary Masses Extradural Masses

VASCULAR DISEASES TRAUMA DEGENERATIVE DISEASES OF THE SPINE

Imaging Methods Disc Disease Disc Herniation Location

SPINAL STENOSIS POSTOPERATIVE CHANGES

Bony Abnormalities Suggested Readings

SECTION III. CHEST

10 METHODS OF EXAMINATION, NORMAL ANATOMY, AND RADIOGRAPHIC FINDINGS OF CHEST DISEASE

IMAGING MODALITIES NORMAL CHEST ANATOMY

Frontal Chest Radiograph Lateral Chest Radiograph Anatomy of the Normal Mediastinum Normal Hilar Anatomy Pleural Anatomy Chest Wall Anatomy Diaphragmatic Anatomy

RADIOGRAPHIC FINDINGS IN CHEST DISEASE

Pulmonary Opacity Pulmonary Lucency Mediastinal Masses Mediastinal Widening Pneumomediastinum and Pneumopericardium Hilar Disease Pleural Effusion Pneumothorax Localized Pleural Thickening Diffuse Pleural Thickening Pleural and Extrapleural Lesions Chest Wall Lesions Diaphragmatic Abnormalities Suggested Readings

11 MEDIASTINUM AND HILA

MEDIASTINAL MASSES

Anterior (Prevascular) Mediastinal Masses (Table 11.2) Middle (Visceral) Mediastinal Masses (Table 11.3) Posterior (Paravertebral) Mediastinal Masses (Table 11.5)

DIFFUSE MEDIASTINAL DISEASE (TABLE 11.6) THE HILA

Unilateral Hilar Enlargement/Increased Density (Table 11.8) Bilateral Hilar Enlargement Small Hila Suggested Readings

12 PULMONARY VASCULAR DISEASE

PULMONARY EDEMA PULMONARY HEMORRHAGE AND VASCULITIS PULMONARY EMBOLISM PULMONARY ARTERIAL HYPERTENSION

Suggested Readings

13 PULMONARY NEOPLASMS AND NEOPLASTIC-LIKE CONDITIONS

THE SOLITARY PULMONARY NODULE

Lesions Presenting as SPNs

LUNG TUMORS

Lung Cancer

NONEPITHELIAL LUNG TUMORS AND TUMOR-LIKE CONDITIONS TRACHEAL AND BRONCHIAL MASSES METASTATIC DISEASE TO THE THORAX

Suggested Readings

14 PULMONARY INFECTION

INFECTION IN THE NORMAL HOST

Bacterial Pneumonia Viral Pneumonia Fungal Pneumonia Parasitic Infection

COMPLICATIONS OF PULMONARY INFECTION INFECTION IN THE IMMUNOCOMPROMISED HOST

Suggested Readings

15 DIFFUSE LUNG DISEASE

THIN-SECTION CT OF THE PULMONARY INTERSTITIUM

Thin-Section CT Signs of Disease

CHRONIC INTERSTITIAL LUNG DISEASE

Chronic Interstitial Pulmonary Edema Connective Tissue Disease Idiopathic Chronic Interstitial Pneumonias Chronic Fibrosing Idiopathic Interstitial Pneumonias Smoking-Related Idiopathic Interstitial Pneumonias Acute or Subacute Idiopathic Interstitial Pneumonias Rare Idiopathic Interstitial Pneumonias Unclassifiable Idiopathic Interstitial Pneumonia Other Chronic Interstitial Lung Diseases

INHALATIONAL DISEASE

Pneumoconiosis Hypersensitivity Pneumonitis

GRANULOMATOUS DISEASES

Sarcoidosis Berylliosis Langerhans Cell Histiocytosis of Lung Granulomatosis With Polyangiitis

EOSINOPHILIC LUNG DISEASE

Idiopathic Eosinophilic Lung Disease Eosinophilic Lung Disease of Identifiable Etiology Eosinophilic Lung Disease Associated With Autoimmune Diseases

DRUG-INDUCED LUNG DISEASE

Specific Agents (Table 15.11)

MISCELLANEOUS DISORDERS

References and Suggested Readings

16 AIRWAYS DISEASE AND EMPHYSEMA

INTRODUCTION TRACHEA AND CENTRAL BRONCHI

Congenital Tracheal and Bronchial Anomalies Focal Tracheal Disease Diffuse Tracheal Disease Tracheal and Bronchial Injury Broncholithiasis

CHRONIC OBSTRUCTIVE PULMONARY DISEASE

Asthma and Chronic Bronchitis Bronchiectasis Emphysema

BULLOUS LUNG DISEASE SMALL AIRWAYS DISEASE

Suggested Readings

17 PLEURA, CHEST WALL, DIAPHRAGM, AND MISCELLANEOUS CHEST DISORDERS

PLEURA

Anatomy, Physiology, and Pathophysiology Pleural Effusion Bronchopleural Fistula Pneumothorax Focal Pleural Disease Diffuse Pleural Disease Asbestos-Related Pleural Disease

CHEST WALL

Soft Tissues The Bony Thorax

DIAPHRAGM CONGENITAL LUNG DISEASE IN ADULTS TRAUMATIC LUNG DISEASE ASPIRATION RADIATION-INDUCED LUNG DISEASE

Suggested Readings

SECTION IV. BREAST RADIOLOGY

18 NORMAL ANATOMY AND HISTOPATHOLOGY

OVERVIEW SKIN NIPPLE–AREOLAR COMPLEX SUBCUTANEOUS TISSUE MILK DUCTS AND LOBULES STROMA CHEST WALL MALE BREAST LYMPHATICS BLOOD SUPPLY EMBRYOLOGY AND DEVELOPMENT CHANGES OVER TIME: PREGNANCY, LACTATION, AND MENOPAUSE PATHOPHYSIOLOGY OF BREAST CANCER

Suggested Readings

19 IMAGING THE SCREENING PATIENT

INTRODUCTION SCREENING FOR BREAST CANCER

Support for Screening Screening Guidelines

TECHNICAL FACTORS IN SCREENING

Mammography Physics Radiation Risk Positioning of Screening Mammography Image Quality

BREAST IMPLANTS

Implant Types Implant Rupture

TOMOSYNTHESIS INTERPRETING THE MAMMOGRAM

Maximizing Your Interpretation Breast Density

THE USE OF OTHER IMAGING MODALITIES FOR BREAST CANCER SCREENING

Screening Breast Ultrasound Functional Imaging

CONCLUSION

Suggested Readings

20 IMAGING THE DIAGNOSTIC PATIENT

INTRODUCTION DIAGNOSTIC MAMMOGRAPHY

Spot Compression Views Magnification Views True Lateral and Rolled CC Views Tomosynthesis Ultrasound

EVALUATION OF THE SYMPTOMATIC PATIENT

Palpable Breast Mass Breast Pain Nipple Discharge Inflammation of the Breast Paget Disease Axillary Adenopathy

THE MALE BREAST ASSESSMENT AND RECOMMENDATION BREAST CANCER STAGING POSTOPERATIVE SURVEILLANCE CONCLUSION

Suggested Readings

21 BREAST IMAGING REPORTING AND DATA SYSTEM

INTRODUCTION MAMMOGRAPHY LEXICON

Breast Composition Masses Calcifications Architectural Distortion Asymmetries Associated Features

ULTRASOUND LEXICON MRI LEXICON REPORTING FOLLOW-UP AND OUTCOME MONITORING

Statistical Terms Medical Audit Suggested Readings

22 BREAST MAGNETIC RESONANCE IMAGING

INTRODUCTION TO MRI INDICATIONS

Screening Extent of Disease Metastatic Disease With Suspected Breast Primary Nipple Discharge Biopsy Planning Implant Evaluation

TECHNIQUE

Imaging Parameters Kinetics Artifacts

INTERPRETATION

Background Parenchymal Enhancement and Fibroglandular Tissue Findings

WORKUP OF ABNORMAL MRI RISKS OF MRI FUTURE OF MR IMAGING CONCLUSION

Suggested Readings

23 IMAGE-GUIDED BREAST PROCEDURES

INTRODUCTION TO BREAST BIOPSIES BREAST BIOPSY

Indications Needle Types Guidance Biopsy Markers Complications Radiology–Pathology Concordance Follow-Up After Benign Biopsy

LOCALIZATION

Indications Localization Devices Guidance Specimen Radiograph

GALACTOGRAPHY CONCLUSION

Suggested Readings

SECTION V. CARDIAC RADIOLOGY

24 INTRODUCTION TO CARDIAC ANATOMY, PHYSIOLOGY, AND IMAGING TECHNIQUES

INTRODUCTION CARDIAC ANATOMY CARDIAC PHYSIOLOGY IMAGING TECHNIQUES

Chest Radiography Echocardiography Nuclear Imaging Cardiac CT Cardiac MRI Suggested Readings

25 CORONARY ARTERY ANOMALIES AND DISEASE

CORONARY ARTERY ANATOMY

Left Main Coronary Artery Left Anterior Descending Coronary Artery Left Circumflex Coronary Artery Ramus Intermedius Right Coronary Artery Posterior Descending Artery Posterior Left Ventricular Branch Conus Branch Sinoatrial Nodal Branch Atrioventricular Nodal Branch

CORONARY ARTERY ANOMALIES ABNORMALITIES IN ORIGIN

Abnormalities in Origin, Benign Abnormalities in Origin, Possibly Malignant

ABNORMALITIES IN COURSE

Myocardial Bridging Intracavitary Course Split (Double) Coronary Artery

ABNORMALITIES IN TERMINATION

Coronary Fistula

CORONARY ARTERY DISEASE

Coronary Artery Calcification Coronary Plaque and Remodeling

MRI IN CORONARY ARTERY DISEASE

MR Imaging of the Coronary Arteries MR Assessment of the Myocardium in Coronary Artery Disease

TREATMENT OF CORONARY ARTERY DISEASE

Coronary Stents Coronary Artery Bypass Grafts

CORONARY ARTERY ANEURYSM AND PSEUDOANEURYSM CORONARY ARTERY DISSECTION MECHANICAL COMPLICATIONS OF MYOCARDIAL INFARCTION ADDITIONAL CONSIDERATIONS

Suggested Readings

26 CARDIAC MASSES

INTRODUCTION IMAGING TECHNIQUES AND PROTOCOLS

Echocardiography Cross-Sectional Imaging

BENIGN CARDIAC TUMORS MALIGNANT CARDIAC TUMORS

Metastatic Disease Tumorlike Lesions Suggested Readings

27 VALVULAR DISEASE

VALVE STRUCTURE AND FUNCTION IMAGING EVALUATION OF VALVE DISEASE

Echocardiography Radiography and CT Cardiac MRI Phase-Contrast MRI Quantification of Ventricular Stroke Volume

AORTIC VALVE

Congenital Aortic Valve Disease Acquired Aortic Valve Disease Aortic Stenosis Aortic Regurgitation

MITRAL VALVE

Congenital Mitral Valve Disease Acquired Mitral Valve Disease

TRICUSPID VALVE

Congenital Tricuspid Valve Disease

PULMONARY VALVE

Pulmonary Stenosis Pulmonary Regurgitation

ACQUIRED DISEASES OF MULTIPLE VALVES

Infective Endocarditis Nonbacterial Endocarditis Rheumatic Heart Disease Carcinoid Valve Disease

POSTOPERATIVE COMPLICATIONS FOLLOWING VALVE SURGERY

Suggested Readings

28 NONISCHEMIC CARDIOMYOPATHIES

HYPERTROPHIC CARDIOMYOPATHY FABRY DISEASE CARDIAC AMYLOIDOSIS LOEFFLER ENDOCARDITIS DILATED CARDIOMYOPATHIES ARRHYTHMOGENIC RIGHT VENTRICULAR CARDIOMYOPATHY MYOCARDITIS CARDIAC SARCOIDOSIS LEFT VENTRICULAR NONCOMPACTION STRESS-INDUCED (TAKOTSUBO) CARDIOMYOPATHY IRON OVERLOAD CARDIOMYOPATHY

Suggested Readings

29 IMAGING OF THE PERICARDIUM

ANATOMY AND NORMAL APPEARANCE ON IMAGING

Pericardial Sinuses and Recesses

CONGENITAL ANOMALIES OF THE PERICARDIUM

Pericardial Cyst Pericardial Defect

ACQUIRED PERICARDIAL DISEASES

Pericardial Effusion Pericardial Tamponade

INFLAMMATION OF THE PERICARDIUM

Acute Pericarditis Fibrous Pericarditis Constrictive Pericarditis Epipericardial Fat Pad Necrosis

PERICARDIAL TUMORS

Suggested Readings

30 THORACIC AORTA

AORTIC ROOT ANATOMY AND VARIANTS

Aortic Valve

ASCENDING AORTA AORTIC ARCH ANATOMY AND VARIANTS

Left Arch Variants Right Arch Variants Double Aortic Arch Cervical Aortic Arch Interrupted Aortic Arch Circumflex Aorta Descending Thoracic Aorta

AORTIC COARCTATION

Pseudocoarctation

ATHEROMA ANEURYSM

Sinus of Valsalva Aneurysm Ascending Thoracic Aorta and Aortic Arch Aneurysms Descending Thoracic Aortic Aneurysms

ACUTE AORTIC SYNDROME

Aortic Dissection Intramural Hematoma Penetrating Atherosclerotic Ulcer

AORTIC PSEUDOANEURYSM AORTIC FISTULAS ACUTE TRAUMATIC AORTIC INJURY POSTOPERATIVE AORTA

Complications Thoracic Endovascular Aortic Repair

AORTITIS AORTIC TUMORS CONCLUSION

Suggested Readings

SECTION VI. VASCULAR AND INTERVENTIONAL RADIOLOGY

31 MEDICATIONS IN INTERVENTIONAL RADIOLOGY

INTRODUCTION MODERATE SEDATION (TABLE 31.1)

Benzodiazepines Opioids

ANTIBIOTICS (TABLE 31.4) VASODILATORS AND VASOCONSTRICTORS (TABLE 31.6)

Vasodilators Vasoconstrictors

ANTICOAGULANTS (TABLE 31.7)

Heparin Warfarin (Coumadin®) New Direct Oral Anticoagulants (NOACs)

ANTIPLATELETS (TABLE 31.8)

Cyclooxygenase Inhibitors (NSAIDs) Thienopyridines Glycoprotein IIb/IIIa Inhibitors

THROMBOLYTICS (TABLE 31.9)

Alteplase (Activase®) Reteplase (Retavase®) Tenecteplase (TNKase®)

PROTHROMBOTICS (TABLE 31.10) ADJUNCT MEDICATIONS (TABLE 31.11)

Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) Ondansetron (Zofran®) Diphenhydramine (Benadryl®, Dramin®) Glucagon Meperidine (Demerol®) Lidocaine Suggested Readings

32A BASICS OF ANGIOGRAPHY AND ARTERIAL DISEASE – (ANGIOGRAPHY)

HISTORY OF ANGIOGRAPHY THE X-RAY PHOTON ANGIOGRAPHIC CONTRAST AGENTS THE CONTRAST INJECTOR GUIDEWIRE USE AND CONSTRUCTION SELECTING THE “RIGHT” CATHETER CATHETER-BASED ARTERIOGRAPHY

Suggested Readings

32B PERIPHERAL ARTERIAL DISEASE

INTRODUCTION RISK FACTORS PATHOGENESIS CLINICAL PRESENTATION

History Physical Examination

IMAGING WORKUP

Vascular Doppler Ultrasound Ankle–Brachial Index and Pulse Volume Recording Computed Tomography Angiography Magnetic Resonance Angiography Digital Subtraction Angiography

CLASSIFICATION OF PAD AND MEDICAL DECISION MAKING INTERVENTIONS OTHER PERIPHERAL VASCULAR DISORDERS

Acute Limb Ischemia Vasospasm Cystic Adventitial Disease Mönckeberg Medial Sclerosis (MMS) Buerger Disease Impingement Syndromes Inherited Disorders of the Vessel Wall Acquired Disorders of the Arterial Wall AVF/Pseudoaneurysm

SUMMARY

Suggested Readings

33 CENTRAL VENOUS CATHETERS

BACKGROUND ELUCIDATING THE TYPES OF CENTRAL VENOUS CATHETERS

Nontunneled Central Venous Catheter Tunneled Central Venous Catheter Totally Implantable Central Venous Catheters (Ports) Peripherally Inserted Central Catheter

VENIPUNCTURE TECHNIQUE AND RELEVANT ANATOMY

Internal Jugular Vein Approach Subclavian Vein Approach Femoral Vein Approach

POTENTIAL COMPLICATIONS

Mechanical Complications Infection Occlusion

DEVICE SELECTION

Suggested Readings

34 CHRONIC VENOUS DISEASE AND DEEP VEIN THROMBOSIS

LOWER EXTREMITY VENOUS DISEASE

Introduction Anatomy

SUPERFICIAL VENOUS DISEASE

Pathophysiology Clinical Evaluation and Patient Selection Imaging Evaluation Treatment

DEEP VENOUS THROMBOSIS

Pathophysiology Clinical Evaluation and Patient Selection Imaging Evaluation Treatment

CHRONIC VENOUS DISEASE

Pathophysiology Clinical Evaluation and Patient Selection Imaging Evaluation Treatment Suggested Readings

35 PULMONARY EMBOLISM

INTRODUCTION PATIENT EVALUATION AND RISK STRATIFICATION MANAGEMENT OF ACUTE PULMONARY EMBOLISM

Management of Acute Low-Risk PE Management of Acute Massive (High-Risk) PE Management of Acute Submassive (Intermediate-Risk) PE

CATHETER-DIRECTED THERAPY FOR ACUTE PE

Contraindications Procedure Preparation Percutaneous Catheter-Directed Therapy for Massive PE Percutaneous Catheter-Directed Therapy for Submassive PE Postprocedural Management and Follow-Up Care

IVC FILTERS

Indications for IVC Filter Placement Contraindications Technique Complications Follow-Up Care Filter Retrieval

SUMMARY

Suggested Readings

36C GASTROINTESTINAL INTERVENTIONS

MESENTERIC ANGIOGRAPHY AND INTERVENTION

Anatomy GI Hemorrhage Upper GI Hemorrhage Lower GI Hemorrhage Mesenteric Ischemia Mesenteric Aneurysms Mesenteric Trauma

BILIARY INTERVENTIONS

Percutaneous Biliary Drainage Percutaneous Cholecystostomy

PERCUTANEOUS ABSCESS DRAINAGE ENTERIC ACCESS

Gastrostomy Tube Placement Gastrojejunostomy Suggested Readings

36B GENITOURINARY INTERVENTIONS

UTERINE ARTERY EMBOLIZATION

Adenomyosis

RENAL INTERVENTIONS—PERCUTANEOUS

Nephroureterostomy and Ureteral Stent

RENAL INTERVENTIONS—VASCULAR

Renal Artery Stenosis Renal Angiomyolipoma

PROSTATE ARTERY EMBOLIZATION

Suggested Readings

37A PORTAL HYPERTENSION

PORTAL HYPERTENSION BACKGROUND

Definition of Portal Hypertension Etiology of Portal Hypertension and Cirrhosis Complications of Portal Hypertension

PORTAL VENOUS AND PORTOSYSTEMIC COLLATERAL ANATOMY

Portal Venous Anatomy Gastroesophageal Varices Gastric Varices

MANAGEMENT OF PORTAL HYPERTENSION AND COMPLICATIONS

Portosystemic Shunt Creation TIPS Technique and Surveillance TIPS Outcomes Venous Recanalization Variceal Occlusion BRTO Technique BRTO Outcomes Ascites Drainage Partial Splenic Embolization Suggested Readings

37B INTERVENTIONAL RADIOLOGY IN THE DIAGNOSIS AND MANAGEMENT OF POST LIVER AND KIDNEY TRANSPLANT COMPLICATIONS

INTRODUCTION OVERVIEW OF LIVER AND KIDNEY TRANSPLANT SURGICAL TECHNIQUES

Liver Transplantation Kidney Transplantation

VASCULAR COMPLICATIONS

Hepatic Inflow Renal Inflow Hepatic Outflow Renal Outflow

BILIARY COMPLICATIONS

Biliary Leak Biliary Obstruction

URINARY COMPLICATIONS

Urine Leak Urinary Obstruction

EXTRINSIC COMPLICATIONS

Abdominal Fluid Collections

INTRINSIC COMPLICATIONS CONCLUSION

Suggested Readings

38 IMAGE-GUIDED NEEDLE BIOPSIES AND PERSONALIZED MEDICINE

INTRODUCTION IMAGE-GUIDED NEEDLE BIOPSIES: MODALITIES AND EQUIPMENT PREPROCEDURE CLINICAL EVALUATION TECHNIQUE

Ultrasound-Guided Needle Biopsy Computed Tomography–Guided Needle Biopsy Sampling

ORGAN-BASED CONSIDERATIONS

Thyroid Lung, Pleural and Anterior Mediastinal Biopsy Abdomen and Pelvis Musculoskeletal System

SAMPLE ADEQUACY AND ANALYSIS CURRENT APPLICATIONS OF BIOMARKERS ETHICAL CONSIDERATIONS FUTURE TRENDS AND CONCEPTS

References

39 INTERVENTIONAL MANAGEMENT OF HEPATIC MALIGNANCIES: GENERAL CONCEPTS FROM ANATOMY TO PRACTICE

INTRODUCTION VASCULAR ANATOMY OF THE LIVER

Segmental Liver Anatomy Hepatic Arterial Anatomy and Special Considerations for Intra-Arterial Therapy

INTRA-ARTERIAL THERAPIES

Transarterial Chemoembolization Transarterial Radioembolization (TARE) or Selective Internal Radiation Therapy (SIRT)

PERCUTANEOUS THERAPIES (TABLE 39.4)

Chemical Ablation Energy-Based Ablation

PRINCIPLES OF ASSESSING TREATMENT RESPONSE CONCLUSION

Suggested Readings

SECTION VII. GASTROINTESTINAL TRACT

40 ABDOMEN AND PELVIS

IMAGING METHODS COMPARTMENTAL ANATOMY OF THE ABDOMEN AND PELVIS FLUID IN THE PERITONEAL CAVITY PNEUMOPERITONEUM ABDOMINAL CALCIFICATIONS ACUTE ABDOMEN SMALL BOWEL OBSTRUCTION LARGE BOWEL OBSTRUCTION BOWEL ISCHEMIA AND INFARCTION ABDOMINAL TRAUMA LYMPHADENOPATHY ABDOMINOPELVIC TUMORS AND MASSES HERNIAS OF THE ABDOMINAL WALL HIV AND AIDS IN THE ABDOMEN

Suggested Readings

41 LIVER, BILIARY TREE, AND GALLBLADDER

LIVER

Anatomy Diffuse Liver Disease Liver Masses

BILIARY TREE

Biliary Dilatation Gas in the Biliary Tract

GALLBLADDER

Suggested Readings

42 PANCREAS AND SPLEEN

PANCREAS

Imaging Techniques Anatomy Pancreatitis Solid Lesions of the Pancreas Cystic Lesions of the Pancreas

SPLEEN

Imaging Techniques Anatomy Solid Lesions of the Spleen Cystic Lesions of the Spleen Suggested Readings

43 PHARYNX AND ESOPHAGUS

IMAGING METHODS ANATOMY NORMAL SWALLOWING AND MOTILITY MOTILITY DISORDERS OUTPOUCHINGS ESOPHAGITIS ESOPHAGEAL STRICTURE ENLARGED ESOPHAGEAL FOLDS MASS LESIONS/FILLING DEFECTS ESOPHAGEAL PERFORATION AND TRAUMA

Suggested Readings

44 STOMACH AND DUODENUM

IMAGING METHODS ANATOMY STOMACH

Helicobacter pylori Infection Gastric Mass Lesions/Filling Defects Thickened Gastric Folds/Thickened Wall Gastric Ulcers

DUODENUM

Duodenal Mass Lesions/Filling Defects Thickened Duodenal Folds Duodenal Ulcers and Diverticuli Duodenal Narrowing Upper Gastrointestinal Hemorrhage Suggested Readings

45 MESENTERIC SMALL BOWEL

IMAGING METHODS ANATOMY SMALL BOWEL FILLING DEFECTS/MASS LESIONS MESENTERIC MASSES DIFFUSE SMALL BOWEL DISEASE SMALL BOWEL EROSIONS AND ULCERATIONS SMALL BOWEL DIVERTICULA

Suggested Readings

46 COLON AND APPENDIX

COLON

Imaging Methods Anatomy Colon Polyps and Mass Lesions Colon Inflammatory Disease Diverticular Disease Lower Gastrointestinal Hemorrhage

APPENDIX

Imaging Methods Anatomy Acute Appendicitis Mucocele of the Appendix Appendiceal Tumors Suggested Readings

SECTION VIII. GENITOURINARY TRACT

47 ADRENAL GLANDS AND KIDNEYS

ADRENAL GLANDS

Imaging Methods Anatomy The Incidental Adrenal Mass Adrenal Endocrine Syndromes Benign Adrenal Lesions Malignant Adrenal Lesions

KIDNEYS

Imaging Methods Anatomy Congenital Renal Anomalies Solid Renal Masses Cystic Renal Masses Renal Cystic Disease Renal Vascular Diseases Renal Infections Renal Parenchymal Disease Nephrocalcinosis Suggested Readings

48 PELVICALYCEAL SYSTEM, URETERS, BLADDER, AND URETHRA

PELVICALYCEAL SYSTEM AND URETER

Imaging Methods Anatomy Congenital Anomalies Renal Stone Disease Hydronephrosis Mass or Filling Defect in Pelvicalyceal System or Ureter Stricture of Pelvicalyceal System or Ureter Papillary Cavities

BLADDER

Imaging Methods Anatomy and Anomalies Thickened Bladder Wall/Small Bladder Capacity Calcified Bladder Wall Bladder Wall Mass or Filling Defect Bladder Outpouchings and Fistulas Bladder Trauma

URETHRA

Imaging Methods Anatomy Pathology Suggested Readings

49 GENITAL TRACT—CT, MR, AND RADIOGRAPHIC IMAGING

FEMALE GENITAL TRACT

Anatomy Congenital Anomalies Benign Conditions Gynecologic Malignancy

MALE GENITAL TRACT

Testes and Scrotum Prostate Seminal Vesicles Penis Suggested Readings

SECTION IX. ULTRASONOGRAPHY

50 ABDOMEN ULTRASOUND

PERITONEAL CAVITY RETROPERITONEUM LIVER BILE DUCTS GALLBLADDER SPLEEN PANCREAS GASTROINTESTINAL TRACT ADRENAL GLANDS KIDNEYS

Suggested Readings

51 GENITAL TRACT AND BLADDER ULTRASOUND

FEMALE GENITAL TRACT

Uterus Ovaries and Adnexa

MALE GENITAL TRACT

Testes and Scrotum Prostate

BLADDER

Suggested Readings

52 OBSTETRIC ULTRASOUND

FIRST TRIMESTER

Normal Early Pregnancy Problematic Early Pregnancy Gestational Trophoblastic Disease

FETAL MEASUREMENTS AND GROWTH THE FETAL ENVIRONMENT

Uterus and Adnexa in Pregnancy Placenta and Membranes Amniotic Fluid Multiple Pregnancy

FETAL ANOMALIES

General Central Nervous System, Face, and Neck Chest and Heart Abdomen Skeleton Suggested Readings

53 CHEST, THYROID, PARATHYROID, AND NEONATAL BRAIN ULTRASOUND

CHEST

Pleural Space Lung Parenchyma Mediastinum

THYROID

Thyroid Nodules Benign Thyroid Nodules Malignant Thyroid Nodules Diffuse Thyroid Disease

PARATHYROID

Hyperparathyroidism

NEONATAL NEUROSONOGRAPHY

Hypoxic–Ischemic Brain Injury Infection Congenital Brain Abnormalities Suggested Readings

54 VASCULAR ULTRASOUND

DOPPLER BASICS CAROTID ULTRASOUND ABDOMINAL VESSELS

Anatomy Pathology

PERIPHERAL ARTERIES VENOUS ULTRASOUND

Lower Extremity Upper Extremity Suggested Readings

SECTION X. MUSCULOSKELETAL RADIOLOGY

55 BENIGN LUCENT BONE LESIONS

FEGNOMASHIC FIBROUS DYSPLASIA ENCHONDROMA EOSINOPHILIC GRANULOMA GIANT CELL TUMOR NONOSSIFYING FIBROMA OSTEOBLASTOMA METASTATIC DISEASE AND MYELOMA ANEURYSMAL BONE CYST SOLITARY BONE CYST HYPERPARATHYROIDISM (BROWN TUMORS) HEMANGIOMAS INFECTION CHONDROBLASTOMA CHONDROMYXOID FIBROMA SUMMARY DIFFERENTIAL DIAGNOSIS OF A SCLEROTIC LESION

Suggested Readings

56 MALIGNANT BONE AND SOFT TISSUE TUMORS

RADIOGRAPHIC FINDINGS

Cortical Destruction Periostitis Orientation or Axis of the Lesion Zone of Transition Magnetic Resonance Imaging

TUMORS

Osteosarcoma Parosteal Osteosarcoma Ewing Sarcoma Chondrosarcoma Malignant Giant Cell Tumor Malignant Fibrous Histiocytoma—Formerly Called Fibrosarcoma Desmoid Tumor Primary Lymphoma of Bone (Formerly Called Reticulum Cell Sarcoma) Metastatic Disease Myeloma Soft Tissue Tumors Suggested Readings

57 SKELETAL TRAUMA

SPINE HAND AND WRIST ARM PELVIS LEG

Suggested Readings

58 ARTHRITIS

OSTEOARTHRITIS RHEUMATOID ARTHRITIS HLA-B27 SPONDYLOARTHROPATHIES CRYSTAL-INDUCED ARTHRITIS

Gout Pseudogout (Calcium Pyrophosphate Dihydrate Crystal Deposition Disease—CPPD)

COLLAGEN VASCULAR DISEASES SARCOIDOSIS HEMOCHROMATOSIS NEUROPATHIC OR CHARCOT JOINT HEMOPHILIA, JUVENILE RHEUMATOID ARTHRITIS, AND PARALYSIS SYNOVIAL CHONDROMATOSIS PIGMENTED VILLONODULAR SYNOVITIS SUDECK ATROPHY JOINT EFFUSIONS AVASCULAR NECROSIS

Suggested Readings

59 METABOLIC BONE DISEASE

OSTEOPOROSIS OSTEOMALACIA HYPERPARATHYROIDISM HYPOPARATHYROIDISM PSEUDOHYPOPARATHYROIDISM AND PSEUDOPSEUDOHYPOPARATHYROIDISM PITUITARY GLAND HYPERFUNCTION THYROID GLAND HYPERFUNCTION THYROID GLAND HYPOFUNCTION OSTEOSCLEROSIS

Renal Osteodystrophy Sickle Cell Disease Myelofibrosis Osteopetrosis Pyknodysostosis Metastatic Carcinoma Mastocytosis Paget’s Disease Athletes Fluorosis

SUMMARY

Suggested Readings

60 SKELETAL “DON’T TOUCH” LESIONS

POSTTRAUMATIC LESIONS NORMAL VARIANTS OBVIOUSLY BENIGN LESIONS CONCLUSION

Suggested Readings

61 MISCELLANEOUS BONE LESIONS

ACHONDROPLASIA AVASCULAR NECROSIS (OSTEONECROSIS) HYPERTROPHIC PULMONARY OSTEOARTHROPATHY MELORHEOSTOSIS MUCOPOLYSACCHARIDOSES (MORQUIO, HURLER, AND HUNTER SYNDROMES) MULTIPLE HEREDITARY EXOSTOSES OSTEOID OSTEOMA OSTEOPATHIA STRIATA OSTEOPOIKILOSIS PACHYDERMOPERIOSTOSIS SARCOIDOSIS TRANSIENT OSTEOPOROSIS OF THE HIP

Suggested Readings

62 MAGNETIC RESONANCE IMAGING OF THE KNEE

TECHNIQUE MENISCI CRUCIATE LIGAMENTS COLLATERAL LIGAMENTS PATELLA BONY ABNORMALITIES BURSAE

Suggested Readings

63 MAGNETIC RESONANCE IMAGING OF THE SHOULDER

ANATOMY ROTATOR CUFF BONY ABNORMALITIES GLENOID LABRUM BICEPS TENDON SUPRASCAPULAR NERVE ENTRAPMENT QUADRILATERAL SPACE SYNDROME PARSONAGE–TURNER SYNDROME

References and Suggested Readings

64 MAGNETIC RESONANCE IMAGING OF THE FOOT AND ANKLE

TENDONS

Achilles Tendon Posterior Tibial Tendon Flexor Hallucis Longus Tendon Peroneal Tendons

AVASCULAR NECROSIS TUMORS LIGAMENTS BONY ABNORMALITIES

References and Suggested Readings

SECTION XI. PEDIATRIC RADIOLOGY

65 IMAGING CHILDREN—WHAT YOU NEED TO KNOW

WORKING WITH CHILDREN IN THE RADIOLOGY DEPARTMENT RADIATION RISK SEDATION AND ANESTHESIA CONTRAST MATERIAL CONSIDERATIONS MODALITY-SPECIFIC SPECIAL CONSIDERATIONS FOR PEDIATRIC IMAGING

Radiographs Fluoroscopy Ultrasound Nuclear Medicine MRI CT Suggested Readings

66 PEDIATRIC NEURORADIOLOGY

INTRODUCTION NORMAL DEVELOPMENT ABNORMALITIES OF MIDLINE DEVELOPMENT POSTERIOR FOSSA MALFORMATIONS

Dandy–Walker Continuum

MALFORMATIONS OF CORTICAL DEVELOPMENT NEONATAL ENCEPHALOPATHY

Malformations Periventricular Leukomalacia Deep Nuclear Injury Diffuse and Peripheral Injury

THE PHAKOMATOSES PEDIATRIC SPINE

Congenital Spinal Malformations Myelomeningocele and Myelocele Lipomyelomeningocele, Lipomyelocele, and Intradural Lipoma Dorsal Dermal Sinus Caudal Regression Syndrome Myelocystocele Split Cord Malformations Tethered Cord Syndrome Syringomyelia Scoliosis Suggested Readings

67 PEDIATRIC CHEST

INTRODUCTION THE PEDIATRIC CHEST RADIOGRAPH

The Heart The Thymus The Lungs The Trachea

THE NEONATAL CHEST

Neonatal Lung Disease Airleak Support Equipment in Neonates

CONGENITAL LUNG MALFORMATIONS

Congenital Pulmonary Airway Malformation Sequestration Foregut Duplication Cysts Congenital Lobar Overinflation Other Congenital Parenchymal Abnormalities Congenital Anomalies of the Trachea and Bronchi

PULMONARY INFECTION

Pneumonia in Children Specific Etiologies of Pneumonia in Children Mycobacterium Tuberculosis

LUNG MASSES

Lung Nodules and Cysts Mediastinal Lesions

CHEST WALL DIFFUSE (INTERSTITIAL) LUNG DISEASE SYSTEMIC CONDITIONS AFFECTING THE LUNG

Immunodeficiencies Cystic Fibrosis Sickle Cell Disease Rheumatoid/Collagen Vascular Disease

LUNG TRAUMA

Pneumomediastinum Blunt Force Trauma

THE UPPER AIRWAY

Evaluating the Upper Airway Upper Airway Infection Bacterial Tracheitis Epiglottitis Retropharyngeal Abscess Laryngomalacia Obstructive Sleep Apnea Suggested Readings

68 CONGENITAL AND PEDIATRIC HEART DISEASE

PULMONARY VASCULARITY

Cardiac and Mediastinal Contours

ACYANOTIC HEART DISEASE WITH INCREASED PULMONARY VASCULARITY CYANOTIC HEART DISEASE WITH INCREASED PULMONARY VASCULARITY DECREASED PULMONARY VASCULARITY NORMAL PULMONARY VASCULARITY CARDIAC MALPOSITIONS SUMMARY

Suggested Readings

69 ABDOMEN

OBSTRUCTION—GENERAL OBSTRUCTION—CONGENITAL

Esophageal Atresia and Tracheoesophageal Fistula Duodenal Obstruction Small Bowel Obstruction Colonic Obstruction

OBSTRUCTION—ACQUIRED

Esophageal Obstruction Hypertrophic Pyloric Stenosis Small Bowel Obstruction

INFECTION AND INFLAMMATION

Necrotizing Enterocolitis Appendicitis Inflammatory Bowel Disease

HEPATOBILIARY

Congenital Hepatobiliary Disorders

GENITOURINARY

Renal Fusion and Migration Anomalies Multicystic Dysplastic Kidney Duplex Kidney and Collecting System Duplication Antenatal/Perinatal Hydronephrosis Febrile Urinary Tract Infection Posterior Urethral Valves Gonadal Torsion

ABDOMINOPELVIC TUMORS

Neuroblastoma Renal Tumors Liver Tumors Lymphoma Suggested Readings

70 PEDIATRIC MSK

INTRODUCTION GROWTH AND DEVELOPMENT OF THE IMMATURE SKELETON

Bone Composition MR Appearance of Bone

ACCIDENTAL TRAUMA

Fractures Fractures Unique to Children Osteochondral Injuries Osteochondroses

NONACCIDENTAL TRAUMA INFECTION

Acute Osteomyelitis Septic Arthritis and Toxic Synovitis

BONE LESIONS

Benign Bone Lesions Malignant Bone Tumors

SOFT TISSUE LESIONS

Hemangiomas Fibromatosis Colli

CONSTITUTIONAL DISORDERS OF BONE

Skeletal Dysplasias Caffey Disease Neurofibromatosis

METABOLIC BONE DISEASE

Rickets Scurvy Lead Poisoning

CONGENITAL AND DEVELOPMENTAL BONE AND JOINT DISORDERS

Lower Limb Upper Limb Amniotic Band Syndrome

INFLAMMATORY CONDITIONS

Juvenile Idiopathic Arthritis Hemophilic Arthropathy Chronic Recurrent Multifocal Osteomyelitis

HEMOGLOBINOPATHIES

Sickle Cell Disease β-Thalassemia Suggested Readings

SECTION XII. NUCLEAR RADIOLOGY

71A INTRODUCTION TO NUCLEAR MEDICINE

INTRODUCTION IMAGING PRINCIPLES RADIOTHERAPY AN APPROACH TO IMAGE INTERPRETATION SECTION OVERVIEW

71B ESSENTIAL SCIENCE OF NUCLEAR MEDICINE

RELEVANT ASPECTS OF RADIATION PHYSICS RADIATION SAFETY RADIOPHARMACEUTICALS IMAGING SYSTEMS AND RADIATION DETECTORS

Gamma Camera Quality Control PET Scanner Quality Control Nonimaging Detector Systems Suggested Readings

72A GASTROINTESTINAL, LIVER–SPLEEN, AND HEPATOBILIARY SCINTIGRAPHY

GASTROINTESTINAL STUDIES ESOPHAGEAL IMAGING GASTROESOPHAGEAL REFLUX GASTRIC EMPTYING GASTROINTESTINAL BLEEDING SCINTIGRAPHY MECKEL SCAN LIVER AND SPLEEN STUDIES

Liver/Spleen Scan Heat-Damaged Red Blood Cell Scan for Splenic Tissue

HEPATOBILIARY IMAGING HEPATIC BLOOD POOL SCINTIGRAPHY

Suggested Readings

72B PULMONARY SCINTIGRAPHY

ANATOMY AND PHYSIOLOGY VENTILATION LUNG SCAN

Radiopharmaceuticals Ventilation Scan Technique

PERFUSION LUNG SCAN

Radiopharmaceuticals Perfusion Scan Technique

V/Q SCANS PULMONARY EMBOLISM

V/Q Scan Interpretation Nonthromboembolic Pulmonary Disease Suggested Readings

72C SKELETAL SYSTEM SCINTIGRAPHY

TECHNIQUE INTERPRETATION F-18 NaF PET-CT SYSTEMIC RADIONUCLIDE PALLIATIVE PAIN THERAPY BONE MINERAL DENSITOMETRY

Suggested Readings

72D ENDOCRINE GLAND SCINTIGRAPHY

THYROID

Thyroid Nodules Thyroid Cancer

PARATHYROID ADRENAL NEUROENDOCRINE

Suggested Readings

73 CARDIOVASCULAR SYSTEM SCINTIGRAPHY

MYOCARDIAL PERFUSION SCANS

Technique Radiopharmaceuticals Interpretation Positron Emission Tomography (PET)

GATED BLOOD POOL SCANS

Technique Interpretation

RIGHT VENTRICULAR STUDIES

First-Pass Function Studies First-Pass Flow Studies Suggested Readings

74 NUCLEAR BRAIN IMAGING

POSITRON EMISSION TOMOGRAPHY AND SINGLE-PHOTON EMISSION COMPUTED TOMOGRAPHY

Radiopharmaceuticals: Tc-99m HMPAO, Tc-99m ECD, and F-18 FDG Interpretation

CEREBRAL PERFUSION IMAGING PLANAR BRAIN IMAGING CEREBROSPINAL FLUID STUDIES

Radiopharmaceuticals: In-111 DTPA, Tc-99m DTPA, and Tc-99m Pertechnetate Suggested Readings

75 SCINTIGRAPHIC DIAGNOSIS OF INFLAMMATION AND INFECTION

GALLIUM-67 RADIOLABELED LEUKOCYTES SPECT-CT FLUORINE-18-FLUORODEOXYGLUCOSE POSITRON EMISSION TOMOGRAPHY CONCLUSION

Suggested Readings

76 POSITRON EMISSION TOMOGRAPHY

INTRODUCTION ONCOLOGIC PET IMAGING PET IMAGING IN INFLAMMATION AND INFECTION PITFALLS IN PET CT EMERGING TRACERS

Suggested Readings

Index

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