Medical Imaging Images Flashcards
Modality: PET-CT; 18-fluorodeoxyglucose (18F-FDG) radiotracer fused image (left); non-enhanced chest CT bone window, core biopsy (right)
Region: Chest, lung
Radiologic sign: Increased 18F-FDG uptake in the right apical mass; CT-guided core biopsy from the right apical mass
Diagnosis: Pancoast tumor, thoracic core biopsy
Modality: Pulmonary CT-angiography (contrast-enhanced series in pulmonary arterial phase), iv. iodine-based contrast agent
Region: Chest, axial views at the level of the pulmonary bifurcation
Radiologic sign: Large hypodense filling defects in the pulmonary arteries at both sides. Diagnosis: Bilateral pulmonary embolism
Modality: Bedside chest radiograph (AP radiograph)
Region: Chest, lung
Radiologic sign: Decreased tranparency (consolidation) in the right upper lobe with radiolucent aerobronchogram (red arrow) left-sided subclavian catheter, ECG electrodes
Diagnosis: Right-sided lobar pneumonia in the upper lobe
Modality: Non-enhanced CT, brain window setting
Region: Brain, axial view
Radiologic sign: Cortical-subcortical border disappeared/blurred due to oedema (blue area), Hyperdense Media-sign - acute thrombosis of the right middle cerebral artery (yellow arrow)
Diagnosis: Subacute ischaemia in the territory of the right MCA
Modality: left – Non-contrast CT, right – Contast-enhanced CT, iv. iodine-based contrast agent
Region: Upper abdomen
Radiologic sign: Enlarged pancreas with indistinct margins
- yellow arrow*: Enhancing head – living tissue
- red arrow* : Non-enhancing body – necrosis
Diagnosis: Acute necrotizing pancreatitis; fatty liver
Modality: Lower extremity venous ultrasound, linear probe (7,5-10 MHz), B-mode and Color-Doppler mode (right panel)
Region: V. femoral superficial and popliteal vein;
- Left image* – transverse section,
- right image* – transverse section
Radiologic sign: Veins are filled with hypoechoic thrombus, the lumen is non-compressible demonstrating no flow (lack of Doppler–signal); beneath the popliteal artery has normal flow signal (green arrow)
Diagnosis: Deep vein thrombosis (DVT)
Modality: Non-enhanced CT, brain window setting (window level: 40 HU; window width: 80 HU)
Region: Brain, axial view
Radiologic sign: Large hyperdense hemorrhage (density: 60-70 HU) extending into the ventricles, slight midline shift to the right, compressed right lateral ventricle due to the edema (yellow arrow)
Diagnosis: Acute cerebral apoplexy, most commonly caused by hypertension
Modality: Non-enhanced CT, brain window setting (window level: 40 HU; window width: 80 HU)
Region: Brain, axial view
Radiologic sign: Extensive hypodense (20-25 HU) brain parenchyma, concomitant dilatation of the right lateral ventricle (arrows); calcifications of the choroideal plexuses (common finding, green arrows)
Diagnosis: Chronic ischemic lesion in the territory of right MCA
Modality: FAST (Focused Assessment with Sonography for Trauma) scan
Region: Abdomen, pleural sinuses, pericardium, aorta
Radiologic sign: Free abdominal fluid in the hepatorenal fossa, around the spleen, among the bowel loops and in Douglas pouch. Patient sustained blunt trauma.
Diagnosis: Free abdominal fluid after blunt trauma, suspicious for internal hemorrhage
Modality: Digital subtraction angiography (DSA), intraarterial iodine-based contrast agent; noncontrast CT (inlet)
Region: Upper abdomen, liver
Radiologic sign: large hepatic mass in the righ lobe (hyperdense mass after embolization - inlet) selective catheterization of the right hepatic artery
Diagnosis: trans-catheter arterial embolization of a giant hepatic hemangioma with lipiodol; lipiodol appears hyperdense on the noncontrast CT
Modality: FDG PET-CT (right panel: noncontrast CT); 18(F)-fluorodeoxyglucose
Region: upper abdomen, axial view
Sign: increased focal uptake in the liver; physiological uptake in the right kidney
Diagnosis: Malignant tumor (colorectal cc. metastasis) in the liver
Modality: left - DWI MRI; middle - CE T1W SE with fat saturation MRI after iv. gadolinium administration; right - T2W fatsat MRI (axial view)
Region: Brain, axial views
Radiologic sign: bilateral enhancing intrabulbar masses, restricted diffusion
Diagnosis: bilateral retinoblastoma
Modality: Digital subtraction angiography (DSA), Catheter angiography, intraarterial iodine-based contrast agent
Region: Neck, carotid bifurcation
Radiologic sign:
- left image* – Significant internal carotid artery stenosis,
- center image* – balloon dilatation and stenting,
- right image* – Control angiography, normal flow
Diagnosis: Carotid angioplasty and stenting of a significant carotid stenosis
Modality: fluoroscopy, iv. iodine-based contrast agent
Region: upper abdomen, liver
Radiologic sign: Stent (yellow arrow) placement between the portal (red arrow) and hepatic vein (blue arrow) to create a lasting connection for the purpose of decreasing the portal pressure.
Diagnosis: TIPS (transjugular intrahepatic porto-systemic shunt) in liver fibrosis, proper contrast filling of the stent
Modality: Mammography of the right and left breast, mediolateral oblique view, soft-beam technique (30 kV)
Region: Craniocaudal (CC) views of the right and left breasts
Radiologic sign: Soft tissue mass with spiculated contour and microcalcifications in the right breast
Diagnosis: Right-sided breast cancer, Normal left breast
Modality: HRCT of the lung (noncontrast study), lung window
Region: Chest, lung, axial view
Radiologic sign: Bilateral dorsobasal honeycombing pattern (yellow arrow), traction bronchiectasis (green arrow)
Diagnosis: Pulmonary fibrosis
Modality: PET-CT, 18-fluorodeoxyglucose (18F-FDG) radiotracer; Hybrid imaging method: PET - Metabolic activity, CT - Morphology
Region: Whole-body, coronal view
Radiologic sign: Increased fluorodeoxyglucose (18F-FDG) uptake in liver and pubic bone, normal physiologic activity is shown in the bladder
Diagnosis: Multiple metastases (liver, pubic bone)
Modality: DWI MRI (left) and 3D TOF (time-of-flight) angiography, noncontrast sequences
Region: brain, axial view
Radiologic sign: significant hyperintensity (representing restricted diffusion) in the right parietal lobe with concomitant abrupt filling defect at the right middle cerebral artery
Diagnosis: large acute infarction, acute thrombosis of the right middle cerebral artery
Modailty: upper left: Non-enhanced CT, upper right and lower panels:
Multiphase contrast-enhanced CT (early arterial, portal and venous phase), iv. iodine- based contrast agent
Region: Abdomen, retroperitoneum
Radiologic sign: Aortic aneurysm with wall calcifications (yellow arrow), hyperdense retroperitoneal fluid collection (red arrow), aortic aneurysm leakage.
Diagnosis: Abdominal aortic aneurysm rupture
Modality: X-ray of the left knee in two projections (left), PD FS (proton density fatsat) and T1W postcontrast MRI (middle and right respectively)
Region: Left knee, lateral view (radiograph), coronal views (MRI)
Radiologic sign: Inhomogeneous destructive metaphyseal lesion of the left femur. Periosteal reaction, Codman triangle (red area) and invasion to the surrounding soft tissue is also present (radiograph). Inhomogenously enhancing metaphyseal mass infliltrating the surrounding soft tissue.
Diagnosis: Osteosarcoma of the femur
Modality: left image – PA chest radiograph (upright); right image – postcontrast chest CT; lung window setting, iodine-based contrast agent
Region: Chest, lung
Radiologic sign: Multiple soft tissue lesions showing different size and rounded shape (yellow arrows).
History: Kidney cancer.
Diagnosis: Multiple lung metastases
Modality: left panels - Non-enhanced CT, right panels - CE T1WI MRI (upper - Sagittal view, lower - Axial view) after iv. gadolinium administration
Region: Brain, axial and sagittal views
Radiologic sign: Intraaxial parenchymal mass with rim-enhancement, which compresses the right lateral ventricle (arrow)
Diagnosis: Glioblastoma multiforme (GBM)
Modality: left image – Abdominal plain radiograph, standing posture; right image – Contrast-enhanced CT scan, iv. iodine-based contrast agent
Region: Abdomen and pelvis
Radiologic sign: Distended colon with air–fluid levels (yellow arrows). In the sigmoid colon an obstructing contrast-enhancing mass is shown (red arrow).
Diagnosis: Large-bowel obstruction caused by sigmoid cancer
Modality: Non-enhanced CT
Region: Brain, axial view
Radiologic sign: Hyperdense, spider-web-like hyperdensity in the basal cisterns and sulci
Diagnosis: Acute subarachnoid hemorrhage, most commonly due to aneurysm rupture
Modality: bone scintigraphy with 99mTc with methylene diphosphonate (MDP) radiotracer
Region: whole body, AP and PA views
Sign: multiple foci of increased radiopharmaceutical uptake in the bones
Diagnosis: multiplex osseal metastases, scoliosis
Modality: left - T1W fatsat postcontrast MRI after iv. gadolinium administration;
right - T2W fatsat MRI (sagittal view)
Region: thoracic spine
Radiologic sign: epidural enhancing mass at the level of Th 9-12th vertebras, no signal loss on fatsat image; non-enhancing fluid inside of the mass
Diagnosis: epidural abscess
Modality: DWI MR (left), dynamic mDIXON contrast-enhanced MR (middle) after iv. gadolinium, T2W MRI (right)
Region: pelvic MR study, axial view (left) and sagittal view (right)
Radiologic sign: thickened rectal wall/intraluminal mass with intensive contrast enhancement and concomitant restricted diffusion (red arrow)
Diagnosis: rectal adenocarcinoma
Modality: Contrast-enhanced chest CT, lung window setting (right panel); mediastinal window setting (left panel), iodine-based contrast agent
Region: Chest, axial views
Radiologic sign: Air-containing (red arrow) fluid collection with thick enhancing rim (yellow arrow)
Diagnosis: Left-sided lung abscess
Modality: aortic CT angiography;
Region: chest; left – coronal view, right – sagittal view, iv. iodine-based contrast agent
Radiologic sign: intima flap (yellow arrow), crescent-shaped false lumen (green arrow), oval true lumen (blue arrow)
Diagnosis: Stanford A aortic dissection, affecting the left subclavian artery (red arrow)
Modality: ankle X-ray – lateral view (left image), CT 3D reconstruction (right image)
Region: Left ankle
Radiologic sign: abrupt discontinuity of the cortex of the calcaneus, lucent fracture lines
Diagnosis: Comminuted fracture of the calcaneus.
Modality: T2W MRI and dynamic contrast-enhanced MRI of the prostate after iv. gadolinium contrast agent administration
Region: Pelvis, axial views
Radiologic sign: T2 hypointensity in the peripheral zone (left panel); intensive contrast-enhencing mass in the same area (signed with red); normal central zone (signed with blue)
Diagnosis: prostate adenocarcinoma
Modality: Low-dose non-enhanced CT scan
Region: abdomen, coronal view
Radiologic sign: Juxtavesical hyperdensity on the left side
Diagnosis: Juxtavesical stone
Modality: mDIXON dynamic contrast-enhanced MR after iv. gadolinium (noncontrast, arterial phase, portal phase, venous phase)
Region: upper abdominal MR study, axial view
Radiologic sign: large hepatic mass, intensive arterial enhancement, no „wash-out”, non-enhancing/hypointense central scar (red arrow)
Diagnosis: hepatic focal nodular hyperplasia (FNH)
Modality: Non-enhanced CT ; left - brain window setting (window level : 40 HU; window width: 80 HU), right - bone window setting (window level: 600 HU; window width: 2800 HU)
Region: Brain, axial views
Radiologic sign: Lens-shaped hyperdense bleeding and skull vault fracture (yellow arrow)
Diagnosis: Right-sided epidural hematoma
Modality: Radiograph of the left hallux in two projections
Region: Left foot, hallux
Radiologic sign: Marked ill-defined bone resorption in distal tuberosity (= ungual process). Ulcerous lesion is also shown.
Diagnosis: Acute osteomyelitis
Modality: Contrast-enhanced head-and-neck CT,
- left image* – axial view;
- right image* – coronal view, iv. iodine-based contrast agent
Region: Head and neck, axial (left) and coronal (right) view
Radiologic sign: Right-sided submandibular fluid collection with thick enhancing wall (red arrow). Fluid inside the abscess ha a density of 0-10 HU, and shows no enhancement. Patient had prior wisdom tooth extraction.
Diagnosis: Neck abscess
Modality: PA (left) and lateral (right) chest radiograph; hard-beam technique (120–140 kV)
Region: chest, pleura
Radiologic sign: Decreased transparency at the right lung base showing a meniscus-shaped contour on the right side. Diaphragm and lateral sinuses cannot be differentiated on the right. Left side is normal.
Diagnosis: Right-sided pleural effusion
Modality: Non-enhanced MRI (left: T1WI sagittal, center: T2WI sagittal, right: T2WI axial)
Region: Lumbar spine
Radiologic sign: Hypointense (dehydrated) discus protruding into the spinal canal (yellow arrow)
Diagnosis: Disc herniation between L2 and L3 level
Modality: Ultrasound of gallbladder with convex probe (3.5–5 MHz), B-mode
Region: Gallbladder, right subcostal view
Radiologic sign: Echodense structure in the lumen (yellow arrow) with acoustic shadowing; Thick, stratified, oedematous wall (red arrow)
Diagnosis: Acute cholecystitis with gallstone
Modality: Noncontrast CT
Region: Upper abdomen, axial views
Radiologic sign: Diffusely, homogenously decreased density (cca. - 20 HU) of the liver. The vessels (blue arrows) are more dense in comparison to the liver parenchyma
Diagnosis: Steatosis hepatis (Fatty liver)
Modality: Sonogram of the appendix (left: linear 7,5–10 MHz probe; right: convex 3,5-5 MHz probe), B-mode (inlet: power Doppler)
Region: Appendix, longitudinal and cross-sectional views
Radiologic sign: left image – Thickened (more than 6 mm), non-compressible tubular structure (green arrow) showing signs of edema and hypervascularisation (red arrow). Small amount of free abdominal fluid is also present (yellow arrow).
Diagnosis: Acute appendicitis
Modality: left - SWI axial MRI (magnitude image); middle - T2WI axial MRI; right - T1W sagittal MRI, noncontrast sequences
Region: Brain, axial and sagittal views
Radiologic sign: crescent-shaped hyperintense area on all sequences in the subdural space
Diagnosis: left-sided subdural hematoma, most commonly caused by the rupture of the bridge veins
Modality: Thyroid gland scintigram, Technetium-99m (99m Tc)-pertechnetate scintigraphy
Region: Thyroid
Radiologic sign: Enlarged right lobe with focal lesion showing decreased tracer activity (yellow arrow)
Diagnosis: Cold nodule
Modality: left - Barium enema study, double-contrast method (barium and air); right – contrast-enhanced CT, venous phase, iv. iodine-based contrast agent
Region: Abdomen, axial view
Radiologic sign: Annular irregular stenosis (apple-core sign), tumorous infiltration of the surrounding fat (increased density)
Diagnosis: Colon adenocarcinoma
Modality: Digital subtraction angiography (DSA), Catheter angiography, intraarterial iodine-based contrast agent
Region: Lower extremity, popliteal artery
Radiologic sign:
- left image* – Significant right popliteal artery stenosis (yellow arrow), collateral circulation;
- right image* – Control angiography after balloon dilatation (NO stents were used), collateral circulation is diminished
Diagnosis: Chronic popliteal artery stenosis, balloon angioplasty (PTA)
Modality: FLAIR (left) and DWI (right) MRI, noncontrast sequences
Region: brain, axial view
Radiologic sign: hypertensive lesion representing edema and restricted diffusion in the territory of the right basal ganglions
Diagnosis: small acute infarction
Modality: left – PA chest radiograph, frontal projection (upright position); right – noncontrast CT, axial view
Region: Chest, upper abdomen
Radiologic sign: Crescents of radiolucency under the hemidiaphragms (red arrow), free air accumulation at the convexity of the liver and at the liver hilum (yellow arows)
Diagnosis: Free abdominal air (due to perforation of luminal abdominal organ)
Modality: Barium swallow test, fluoroscopy
Region: Esophagus
Radiologic sign: Outpouching (red arrow) filled with contrast material near the pharyngo-esophageal junction. An air-fluid level is also seen (yellow arrow). Dilated, sclerotic aorta (blue arrow)
Diagnosis: Zenker diverticulum
Modality: Breast sonography with linear probe (7.5–10 MHz), B-mode
Region: Breast, axilla
Radiologic sign:
- left image* – well-defined anechoic lesion with posterior acoustic enhancement (btw yellow lines);
- right image* – ill-defined hypoechogenic lesion with partial acoustic shadowing (btw red olines): solid structure, suspicious of cancer
Diagnosis: cyst (left) and breast carcinoma (right)
Modality: T2W MRI and 3D TOF angiography (non-contrast)
Region: brain, axial view
Radiologic sign: circumscribed dilatation of the right internal carotid artery
Diagnosis: aneurysm of the right internal carotid artery (cavernous part)
Modality:
- left image* – X-ray of the sinuses;
- right image* – noncontrast CT of the sinuses, low-dose, bone window
Region: Maxillary region, paranasal sinuses
Radiologic sign: Right maxillary sinus shows homogenous decreased transparency, the left one has rounded mucous thickening
Diagnosis: Bilateral sinusitis
Modality: T2W MRI, axial plane (left); 3D MRCP, coronal plane (heavily T2-weighted sequence) (right), noncontrast study
Region: upper abdominal MR study, axial (left) and coronal (right) views
Radiologic sign: filling defect in the common bile duct
Diagnosis: choledocholithiasis
Modality: Expiratory chest radiograph in frontal projection
Region: Chest, pleura
Radiologic sign: Peripheral space is radiolucent with no lung markings (yellow arrow), visible visceral pleural line (blue arrow), partially collapsed left lung, slight mediastinal shift to the right.
Diagnosis: Left-sided pneumothorax (PTX)
Modality: left - contrast-enhanced ultrasonography (CEUS) after iv. microbubble administration, arterial phase; right - CEUS, late phase
Region: liver, right subcostal view
Radiologic sign: hepatic mass showing peripheral nodular enhancement in the arterial phase and complete filling in the late phase
Diagnosis: hepatic hemangioma
Modality: linear probe (7,5–10 MHz),
- left* - B-mode US,
- middle* – Color Doppler US, right – B-mode US
Region: neck, thyroid gland
Radiologic sign: well-circumscribed Isoechoic vascularized nodule, right - FNAB (fine-needle aspiration biopsy) (yellow arrow)
Diagnosis: Suspicious thyroid nodule, cytology proves benignity
Modality: thyroid scintigraphy; Technetium-99m (99m Tc)-pertechnetate radiotracer
Region: thyroid gland
Sign: Increased uptake in the left lobe of the thyroid, low uptake in the other parts of the gland.
Diagnosis: Hot nodule in the thyroid (toxic nodule), other parts of the thyroid are supressed.
