Page 7 Flashcards
low-intensity curvilinear lines contained within the fibrous capsule, representing collapsed implant shell floating within the silicone gel; curvy noodle-shaped dark lines inside the implant that do not extend to the periphery
intracapsular silicone implant rupture,
intact multilumen implant (false +)
small amounts of silicone collected in a radial fold; focus of silicone gel trapped within a fold of the
implant shell
(subtle) intracapsular silicone implant rupture
microscopic silicone leaks through the intact implant shell and collect at the implant shell surface; difficult to differentite from a small intracapsular rupture
intracapsular rupture
echogenic finding caused by the slow velocity of sound in silicone with respect to the surrounding breast parenchyma; looks like air in the bowel
extracapsular rupture, gel bleed, silicone or paraffin injections
multiple thin echogenic lines within the implant that do not extend to the periphery of the implant. Thin lines represent echoes of the collapsing implant wall folding in on itself
intracapsular rupture, extracapsular rupture, intact multilumen implant (false +)
***Note: signs of intracapsular rupture will always be present with the finding of extracapsular rupture
hydrosalpinx
characteristic and definitive on plain films
leiomyoma
proliferative phase endometrium
vascular supply contiguous with the myometrium
exophytic leiomyoma
pattern of spaced dark linear echoes (shadows) emanating from the mass caused by increased absorption of sound by fibrous tissue within the tumor; may be useful in differentiating submucous
leiomyomas from endometrial polyps
leiomyoma
to differentiate from leiomyomas, lack of distinct margins and mass effect makes this appearance more characteristic of adenomyosis
adenomyosis
multiple punctate foci with high signal intensity in the junctional zone
adenomyosis
amorphous echogenic mass that fades into acoustic reverberation and shadowing
benign cystic teratoma
2 concentric lines due to the echogenic decidua capsularis-smooth chorion and the peripherally
located decidua parietalis
intrauterine pregnancy
echogenic ring formed by chorionic villi located eccentric to the endometrial cavity; not specific; tiny cystic structure / developing sac, implanted within the echogenic decidua, deviates the endometrial cavity reflection
early intrauterine pregnancy
abnormal intrauterine pregnancy or ectopic pregnancy
rare/uncommon; amniotic sac and yolk sac
(earliest demonstration of the) embryo
corpus luteum, ectopic pregnancy
extrauterine gestational sac appearing as a fluid-containing structure with an echogenic ring
ectopic pregnancy
blood in the uterine cavity surrounded bu the echogenic decidua produces cystic appearing mass
ectopic pregnancy
villi become swollen and vesicular; vesicles enlarge
H. mole (2nd tri)
theca lutein cysts seondary to the high hCG
H. mole
uterus is filled with an echogenic, solid, highly vascular mass
H. mole
normal spiral appearance of the 3-vessel cord
normal umbilical cord
ventriculomegaly
compression of the cerebellar hemispheres into a banana shape; cerebellum loses their round/lumpy appearance
Chiari II, spina bifida
bossing of the frontal bones
Chiari II, spina bifida
agenesis of corpus callosum
unicornuate uterus
fused/approximated iliac wings
caudal regression syndrome
normal
anatomic confluence of the intrahepatic portal veins
groove between the membranes at the insertion into the placenta appears thick
dichorionic-diamniotic
junction of the 3 interfetal membranes
trichorionic
insertion cleanly joins the chorionic plate of the placenta as a thin, wispy membrane
monochorionic-diamniotic
prominent or multiple hypoechoic-anechoic irregular spaces (lacunae) in the placenta
placentra accreta
hemorrhagic corpus luteum cyst
endometriomas, tubo-ovarian abscess
mucosal folds protruding into the lumen; cogwheel if tube is swollen/has thickened wall, beads-on-a- string if not
fluid-filled diseased tube
if the tube becomes blocked at the fimbrial or cornual end, it becomes convoluted and incomplete septa are visible
hydrosalpinx
PCOS
low T2 and cobblestone
leiomyoma with hyaline degeneration
layering of low-signal-intensity blood products within the cyst
endometriomas
pulling in or tethering of tissue in the glandular tissue edge
masses at the glandular edge or breast tissue
both round and linear shapes
fine linear branching calcifications in DCIS or invasive ductal ca
calcifying fibroadenomas
oval mass containing fat and fibroglandular tissue within a thin capsule or rim
hamartoma aka fibroadenolipoma
fatty hilum and close proximity to blood vessels
intramammary lymph node
suspicious enhancement curve
irregular narrowing
(intramural) TCC / tumor
ureteral dilatation distal to a filling defect / inferior margin of the lesion
TCC / tumor
may invade into and involve a large part of the kidney but the reniform shape of the kidney is usually preserved
urothelial tumor
round mass that often distorts the renal contour
RCC
normal seminal vesicles
vertically oriented bladder with irregular contour consistent with trabeculation and frequently with multiple diverticula
neurogenic bladder specifically detrusor hyperreflexia / detrusor-external sphincter dyssnergia
avascular solitary structures with concentric hyperechoic and hypoechoic rings
epidermoid cysts of the testes
dilation of the posterior urethra in males and entire urethra in females
nonneurogenic neurogenic bladder / Hinman syndrome
lower pole system is inferiorly displaced / reversal of its normal axis, fewer than normal number of its calyces, lateral deviation of its proximal ureter (all because of the dilated upper moiety)
lower pole system of ureteral duplication / presence of nonfunctioning upper pole collecting system
distal ureter protruding into the bladder lumen in the region of the trigone
orthotopic/simple/adult-type ureterocele
absence of collecting system elements or renal sinus fat in the junction of the upper and lower moieties; may help identify duplication even in plain studies
duplication
lesions are usually multiple and may coalesce
malakoplakia
may give a corduroy appearance
leukoplakia
characteristic deformity of the distal ureters consisting of medial and cephalic displacement
schistosomiasis
pelvic ureter extends laterally through the sacrosciatic notch
sacrosciatic herniation of the ureter
widening of the distal ureters
bladder exstrophy / exstrophy-epispadiac anomaly
elevates the interureteric ridge, UVJs are displaced superiorly
prostate enlargement
one pattern of papillary necrosis resulting from bilateral forniceal erosions into the medullary pyramid above the papilla
papillary necrosis
high signal characteristic but seen in only 70%
pheochromocytoma
(earliest stages of) renal TB
small and completely calcified kidney reflecting the texture of caseous necrosis mixed with calcification
(end-stage) renal TB
ureter is shortened and straightened owing to periureteral fibrosis
TB
oncocytoma, RCC (chromophobe?)
course of the proximal ureter before it crosses behind and around the IVC
circumcaval/retrocaval ureter
streaks and wedges of low attenuation extending to the renal capsule
acute pyelonephritis
replacement of smooth muscle by collages that forms thick ridges, alternating with areas of small aneurysm formation
medial fibroplasia
circumferential compression of the bladder, normal variant of a narrow pelvis with prominent iliopsoas muscles, diffuse pelvic hematoma, pelvic
lipomatosis, bilateral pelvic LN enlargement, bilateral external iliac arterty aneurysms, massive venous collaterals, retroperitoneal fibrosis,
lymphoceles that form after pelvic LN dissection
thin rim of soft tissue around a calcification lodged in the ureter; edematous wall of the ureter surrounding a stone
ureteral stone
linear or curvilinear soft-tissue density that extends from a pelvic calcification felt to represent the vein / thrombosed vein in which the phlebolith forms
phlebolith
plexiform neurofibroma
urethral rupture
mid- and hindbrain malformation resembling a molar tooth
Joubert syndrome, JS-related disorders
Joubert syndrome related disorders
ecchymosis over mastoid process
temporal bone fracture
marked narrowing of both supraclinoid ICAs
moyamoya disease
increased conspicuity of deep medullary veins
moyamoya disease
splayed configuration of teh cerebral peduncles as a manifestation of mild atrophy of the midbrain
Parkinson disease
symmetric hypodensities in the cerebellar white matter
acute heroin CNS toxicity
symmetric involvement of the corpus callosum
GBM / butterfly glioma
early imaging hallmark; confluent pattern of deep cerebral hemispheric altered CT attenuation and MR signal intensity
metachromatic leukodystrophy
linear hypointensities in a sea of confluent hyperintensity; reflects early sparing of perivenular myelin
metachromatic leukodystrophy
nearly pathognomonic pattern of alternating inner hyperintense and outer hypointense layers in enlarged cerebellar folia
dysplastic cerebellar gangliocytoma / Lhermitte-Duclos disease
enhancing rim of compressed pituitary gland surrounding the nonenhancing cyst
Rathke cleft cyst
serpentine hyperintensities in the sulci from slow flow in leptomeningeal collaterals
Sturge-Weber syndrone, moyamoya disease, SCD with moyamoya pattern*
*Conditions with moyamoya-like collaterals: radiation, NF1, trisomy 21, sickle cell disease, slowly progressive ASVD
literal Japanese translation of moyamoya; (+) blush representing dramatic proliferation of tiny collateral vessels
moyamoya disease
well-corticated density above the condylar neck on lateral views because of the horixontal axis of the fragment
subcondylar fractures
alternating areas of linear hyperintensity along the ependyma
MS
centripetal perivenular extension radiating outward from the lateral ventricles
MS
Toxoplasmosis
ring-shaped zone of peripheral enhancement with a small eccentric mural nodule
ring of marked hypointensity caused by excess Fe accumulation surrounding a central hyperintense focus in the medial globus pallidus
acute organophosphate poisoning, PKAN (formerly known as Hallervorden-Spatz disease), later stages of neuroferritinopathy
tuberous sclerosis complex
MSUD
uplifting of the superolateral orbital rim
unilateral coronal craniosynostosis
due to atrophy of the caudate nucleus
Huntington disease
corpus callosum dysgenesis
spoke-wheel gyral pattern extending perpendicularly to the roof of the third ventricle
complete corpus callosum agenesis
seen in the frontal horns of the lateral ventricles
corpus callosum dysgenesis
spoke-wheel or reticulated densities caused by fewer but thicker trabeculae
osseous hemangioma
classic lissencephaly
vermian hypoplasia, Blake pouch cyst
hair-like collection of dilated medullary veins within the WM
developmental venous anomaly
symmetric T2-hyperintensity in the posterior and dorsomedial aspects of the thalamic nuclei
new variant CJ disease
T1 hyperintensity in the posterior thalamus
Fabry disease
classic angiographic appearance; vessels extend from the base of the tumor toward its periphery
meningioma
string of small WM lesions
watershed infarct
characteristic pattern of mixed areas of hypodensity and hyperdensity
cortical contusions (1st week)
Chiari 2
focal contrast extravasation within an acute hematoma
high risk of clot expansion over the 1st several hours after admission in hypertensive hemorrhages
absent cavum septi pellucidi
numerous areas of cystic change
central neurocytoma
abnormal separation of the gray-white matter junction from the inner table of the skull
isodense phase of subdural hematoma
looks like a double cortex
band heterotopias
funnel-shaped area of blurred gray-white interface at the bottom of the sulcus
focal cortical dysplasia type IIb
osmotic demyelination syndrome
inward compression of the WM (often with thinning of the fronds of the WM)
extra-axial lesion
trigeminal schwannoma
stripes of hyperdense blood layered over the cerebellar folia
remote cerebellar hemorrhage (rare)
pituitary macroadenoma
moth-eaten destruction of the bone surrounding the jugular fossa
paraganglioma
peripheral nerve sheath enhances rather than the nerve itself
optic nerve sheath meningiomas, may be mimicked by sarcoidosis, leukemia, or
lymphoma
typically heterogeneous, numerous flow voids
paraganglioma
LA becoming border forming on the right
massive LA enlargement
Occurs when R side of LA indents the adj lung forming its own distinct silhouette
LA enlargement
TOF
as patients grow older, especially if they remain untreated, their lung fields become peppered with small, reticular blood vessels
decreased pulmonary vascularity
pericardial effusion (lucent margin along the left heart border on PA or along the posterior cardiac border on lateral view)
pericardial effusion
> 500 mL
very large pericardial effusion
pericardial effusion or generalized cardiomyopathy
Aortic dissection
constriction due to the coarctation separates two areas of enlargement: 1) proximal aorta or aortic knob extending to the base of the subclavian artery due to pre-stenotic dilatation and 2) aorta distal to the coarctation
COA
upper curve of the S is produced by the large posterior arch while the lower curve is produced by the smaller anterior arch
double aortic arch, all true vascular rings
ex: bicuspid aortic valve
kung bicuspid iyong valve
during diastole, there is prolapse of the MV leaflets into the LV leading to elongation of the left outflow tract
ASD specifically ostium primum (complete form) / endocardial cushion defect
slight accentuation of the normal concavity of the left cardiac border, associated with downward displacement of the cardiac apex
LV dilatation
increased convexity or prominence of the left cardiac border (resembles RV enlargement)
LV hypertrophy
when the LV extends >1.8 cm posterior to the IVC at a level 2 cm cephalad to the intersection of the LV (or diaphragm sa 5th ed) and IVC
LV enlargement
mild LV wall hypertrophy especially in cardiac amyloidosis (restrictive)
prominence of the upwardly and outwardly displaced right ventricular outflow tract, just below the pulmonary artery
Ebstein’s anomaly
Uhl anomaly
flattening in the region of the hypoplastic RV and prominence of the enlarged RA appendage
tricuspid atresia
The pulmonary veins join to form a common vessel behind the LA. The common vein then joins the vertical vein (persistent left SVC), and it then joins the innominate vein. The innominate vein travels across the mediastinum and empties into the SVC. These connections form an inverted U-shaped vessel, best appreciated on PA radiograph, but also seen on lateral view, just anterior to the trachea. This U-shaped vessel accounts for the upper portion of the snowman. The lower portion is made up of the enlarged heart, specifically the RA and RV.
type I TAPVR
reversed flow distribution (CHF and pulmonary venous hypertension)
angiographic hallmark appearance of arteries representing collaterals around areas of occlusion (most often at wrists and akles) and the absence of atherosclerotic findings
Buerger disease
GI bleeding
alternating areas of vasospasm
nonocclusive ischemia
compression of the intrahepatic IVC by swollen liver and enlarged caudate lobe
Budd-Chiari syndrome
