Important Short Notes Flashcards
Imaging findings of pituitary hypoplasia
Small shallow sella torcica
Small adenohypophysis
Ectopic neurohypophysis
Midline facial& cranial anomalies
DDs of macroadenoma ( or suprasellar or sella torcica mass)
Lipoma
Pars intermedia cyst(rathk’s cleft cyst)
Meningioma
Arachnoid cyst
Aneurysm
Apoplexy
Craniopharyngioma
Sheehan’s syndrome
Localization of parathyroid gland:
Sonography and 99mTc-sestamibi scintigraphy are the dominant imaging techniques for preoperative location of parathyroid adenomaa
Differentiating benign from malignant adrenal mass by CT
Intracellular lipid content of adrenal mass represents the histological difference between adenomas and metastases.
Difference in vascular enhancement pattern represent the physiological difference.
(Adenomas vigorously anhance and exhibit early washout of contrast material compared with metastases
DDs of Adrenal gland mass
Pheochromocytoma
Adrenal hyperplasia
Adrenal hemorrhage
Adrenal cyst
Adrenal myelolipoma
DDs of dens vertebra
Metastases
Lymphoma
Paget’s disease
Healing fracture
Haemangioma
Radiological findings of tension pneumothorax:
• Air (black) in pleural space
• No lung markings in pleural space
• collapse lung at affected side
• mediastinal shifting to the opposite side
• lying diaphragm
• ++ density of the opposite lung
• ++ intercostal space
Next step : Chest tube
Types of bronchiectasis
Cylindrical (tubular)
Varicose
Cystic
Cuases of pleural effusion:
HF
Pneumonia
Malignancy
Pulmonary embolism
Types of emphysema
Centrilobular
Panlobular
Paraseptal
Cuases of Pneumoperitoneum (needing surgery)
Bowel perforation 90%
Duodenal ulcer
Colon diverticulum
Causes kf pneumoperitoneum (not needing surgery)
• Postoperative, (air can last up to 4wks)
• Thoracic - pneumothorax
• Abdominal - pneumatosis
• Gynecologic - transvaginal
Types of diaphragmatic hernia:
Morgagni hernia
Bochdalek hernia
Mention radiological difference between benign and malignant esophageal strictures:
Benign stricture has tapering ends with smooth outline
Malignant stricture has overhanging edges or shouldering with irregular outline
تقدر تفسوي من عندك زي اتقوله hx of weight loss والا الpeptic تلقاه في الlower esophagus وهكذا
Mention radiological difference between benign and malignant gastric ulcer
It’s going to be a long day.
Benign:
• Often along the lesser cuvature of stomach, in the gastric body and antrum region.
• Outpouching of ulcer crater beyond the gastric contour (exolumina)
• smooth rounded and deep ulcer crater
• smooth ulcer mound
• smooth gastric folds that reach the margin of the ulcer
• hampton’s line
Malignant:
• Doesn’t protrude beyond the gastric contour (endoluminal)
• irregular and shallow ulcer crater
• Nodular and angular ulcer mound
• Nodular gastric folds that don’t reach the ulcer margin
• Carman meniscus sign
• more often along the greater curvature of stomach
Summary
Crater, Mond, site, gastric contour,
Remember Hampton’s (Harmless = benign) and Carman (Carcinoma = malignant)
What are radiological signs of esophageal atresia:
• Non-progression of an orogastric catherter in the blind esophageal pouch with the presence of air in the stomach (with fistula)
• the radio-opaque tube jn the blind esophageal pouch and the absence of air in the stomach (without fistula)
•On barium study, the esophagus ends as blind pouch in the upper mediastinum
•
What are radiological signs of congenital hypertrophic pyloric stenosis:
Uss: target sign, cervix sign, antral nipple sign with Exaggerated peristalsis
Barium meal: shoulder sign, mushroom sign, mucosal nipple sign, and string sign
تبي تفسوي زيادة تذكر القياسات : 3mm, 14mm, 17mm
Radiological signs of duodenal atresia
US: double bubble sign
Pain CAXR: larger double is air in dilated stomach, and smaller bouble is air in dilated proximal duodenum
There is little or no air distal to the obstruction
Radiological signs of **Malrotation with a midgut volvulus
Pain x-ray: double bubble sign
Barium meal: corkscrew sign
US: whirlpool sign
Radiological signs of Hirschprung’s disease HSD (Congenital megacolon)
Contrast enema: abrupt transition zone from the small distal aganglionic segment to dilated normally innervated bowel
Write short notes about pneumoperitoneum radiology:
Erect CXR: sub diaphragmatic air (crescent sign)
Supine AXR: the rigler sign (double wall sign): the gas is outlining both sides of the bowel wall
The football sign: in case of massive pneumoperitoneum (inflant with necrotizing enterocolitis)
Causes of small bowel obstruction
congenital:
Jejubal atresia
Midgut volvulus
Meconium ileus
Meckel diverticulum
Aquired:
Adhesions
Hernia
Tumor
Gallstone ileus
Intussusception
Causes of large bowel obstruction :
Carcinoma (60%)
Diverticulitis (20%)
Volvulus
Stricture, such as from crohn’s d
Faecal impact
Hernia
Imperforate anus kr meconium ileus in paediatric population
CT acute appendicitis:
> 8-9 mm outer-to-outer
Wall thickening (>3mm), enhancement and stratification if no gangrene
Thickening of the cecal apex
Periappendiceal inflammation fat stranding.
Extraluminal fluid
Phegmon (inflammatory mass) or abscess
Large bowel obstruction vs. Small bowel obstruction, fight !
Large bowel:
• Peripheral
• Haustral markings don’t extend from wall to wall
• Max diameter 6cm (9cm cecum)
Small bowel:
• Central
• Plica extends across lumen
• Maximum diameter of 3cm
Classification of splenic injury
I - Capsular disruption, subcapsular hematoma
II - Peripheral laceration, hematoma < 3cm
III - Fracture extending to the hilum, hematoma > 3cm
IV - Shattered spleen, vascular disruption
DDs of multiple liver lesions:
Multiple abscess
Regenerating nodules in cirrhosis
Multiple cysts
Multiple hemangioma
Metastases
What are the radiological feature of pulmonary fibrosis??
Irregular interlobular septal thickening.
Interlobular reticular opacity
Irregular pleural thickening
-
honeycombing
traction bronchiectasis
lung architectural distortion
What are the CT finding of empyema?
Typically appears as a fluid density collection in the pleural space (pleural effusion) with locules of gas , that shows thick enhancing pleural lining with typical split pleura sign
What are the x-ray findings of a collapsed lung?
displacement of a fissure/s occurs towards the collapsing lobe.
a significant amount of volume loss is required to cause air space opacification.
the collapsed lobe is triangular or pyramidal in shape, with the apex pointing to the hilum
mention radiological modalities used in GIT imaging.
Plain X-ray.
Ultrasound.
Contrast studies (Barium, water-soluble).
Computed tomography (CT).
Magnetic resonance imaging (MRI).
Scintigraphy.
give short not about normal constriction of the esophagus
Esophagus has four constrictions
1st constriction
At the beginning of esophagus, at the level of C6 vertebra (15 cm from incisor teeth).
2nd constriction
Where the arch of aorta crosses it, at the level of T3
vertebra ( 22.5 cm from incisor teeth)
3rd constriction
Where the left bronchus crosses it, at the level of T6
vertebra ( 27.5 cm from incisor teeth )
4th constriction
Where it passes through the diaphragm, at the level of
T10 vertebra ( 40 cm from incisor teeth)
short note about Esophageal atresia.
An absence in the continuity of the esophagus due to an inappropriate division of the primitive foregut into the trachea and esophagus
This is the most common congenital anomaly of the esophagus.
May associated with duodenal atresia or pyloric stenosis.
radilogical finding of congenital hypertrophic pyloric stenosis by ultrasound
Pyloric muscle wall thickness >3 mm
Pyloric transverse diameter >14 mm with pyloric channel closed
Elongated pyloric canal >17 mm in length
Exaggerated peristaltic waves
short notes about gastric ulcer
An infection with Helicobacter pylori (H. pylori) bacteria
Taking non-steroidal anti-inflammatory drugs (NSAIDs)
Complications: POB
Perforation
Gastric Obstruction
Bleeding
Ulcer location
90-95% of gastric ulcers are located on the lesser curvature and posterior stomach wall in the gastric body and antrum
They are uncommonly seen on the greater curvature (~5%)
What are the anatomical classification of fractures?
Fractures are classified by their complexity, location, and other features. Common types of fractures are transverse, oblique, spiral, comminuted, impacted, greenstick, open (or compound), and closed (or simple).
What are the radiological signs of rickets?
1) metaphyseal cupping and fraying
2) poor mineralization of epiphyseal centers,
3) splaying (widening of the metaphyseal ends
D/D of dense vertebrae
• Metastases
• Lymphoma
• Paget’s disease
• Haemangioma
• Healing fracture
What are the main radiological modalities used in obstetrics imaging , and the role of each modality
1 -Ultrasound: The primary imaging modality, Trans abdominal , endo vaginal, Doppler , 3D,4D
utilizing sound waves to visualize the fetus, uterus, and ovaries without ionizing radiation. It is essential for monitoring fetal development, assessing congenital abnormalities, and determining gestational age.
2 - Magnetic Resonance Imaging (MRI): Used for detailed imaging of the fetus and placenta, particularly in high-risk pregnancies. MRI is considered safe throughout pregnancy and provides valuable information regarding fetal and maternal conditions.–
What are the key features that indicate a malignant lesion in mammography
1- Shape: Malignant lesions typically present as irregular shapes, while benign lesions are often round or oval14.
2- Margins: Spiculated or indistinct margins are highly suggestive of malignancy. benign lesions usually have well-defined, circumscribed margins25.
3- Density: Malignant lesions often appear as high-density masses compared to surrounding breast tissue. Low-density lesions are more likely to be benign.
4- Calcifications: Microcalcifications associated with malignancy tend to be small, Pleomorphic, or clustered, whereas benign calcifications are larger and more uniform in appearance
What are the difference in sonographic imaging feature between benign and malignant ovarian cysts? mention at least 3 differences
Benign Ovarian Cysts:
1 - unilocular, Regular multilocular, .
2- thin septation ,
3-Solid components are usually less than 7 mm in diameter.
4- Vascularity: No detectable Doppler signal.
Malignant Ovarian Cysts:
1- Shape: Often irregular and multilocular.
2- thick septation Solid components (nodules) .
3- Ascites: Presence of ascites is common.
4- Vascularity within the : High Doppler signal indicating increased blood flow.
Imaging modality for pulmonary embolism and which is best
- chest computed tomography pulmonary angiography (CTPA)
- echocardiography
- MRI
- nuclear imaging
causes of enlarged cardiac silhouette
- cardiomegaly (most common cause by far)
- pericardial effusion
- anterior mediastinal mass
- prominent epicardial fat pad
- expiratory radiograph
توا تلقى تفاصيل و mcq ع الموضوع هذا
https://radiopaedia.org/articles/enlargement-of-the-cardiac-silhouette
DD of Single liver nodule
?
I know DDs of multiple liver nodules
Radiologic signs of arthritis
Narrowing + erosion + bone formation
1. joint space narrowing
2. subchondral sclerosis
3. osteophytosis
4. joint erosions
5. subchondral cysts
6. bone marrow lesions
7. synovitis
