Radiology Flashcards
229 This is an abdominal x-ray taken of a 40 year old lady who has been admitted through ED with a 2 week history of diarrhoea, weight loss, lethargy and abdominal cramps. Please look at this image. Please tell me what the significant features are, whether they are normal or abnormal.
Signs of colitis:
“Thumbprinting” = haustral thickening indicative of inflammation
Pseudopolyps = “mucosal islands”/patchy bowel wall appearance
Toxic megacolon = massively dilated colon
230 This is an X ray of a 71 year old man, previous laparotomy 10 years ago. Now has 24 hours of abdominal cramps, distension and vomiting. Please look at this image. Please tell me what the significant features are, whether they are normal or abnormal (ignore the zipper).
Likely adhesional SBO
Orientation - erect
Gases - fluid levels, free gas
Masses - point of obstruction, dilated bowel looks
Bones
Stones
AXR is only 50-60% sensitive for SBO
231 What are the advantages of CT as an investigation?
Consists of a diametrically opposed radiation beam and detector that moves in synchrony around the body seection
Advantages include:
- Quick and painless
- Provides detailed images that may negative need for exploratory surgery
- Provides information on depth (i.e. cross-sections) by imaging from different angles
- Good for imaging bones, organs, tissues, and tumours
232 What are the disadvantages of CT as an investigation?
Disadvantages:
- Increased risk of cancer due to ionising radiation (higher dose than x-ray)
- Complications related to IV contrast (allergic reaction, injection site reactions, AKI)
- Not portable
- Expensive
233 This is a CT of a young person’s head, taken after an assault. Please look at this image. Please tell me what the significant features are and whether they are normal or abnormal.
Would expect extra-dural haemorrhage = crescent/lens-shaped, contained by sutures, possible skull fracture
Blood
Cisterns
Brain
Ventricles
Bone
234 This is a CT abdomen of a 19 year old woman who has presented with a history of “full abdomen, and swelling up” which has happened over several weeks. Please look at this image. Please tell me what the significant features are, whether they are normal or abnormal.
?Diverticulitis
?Budd-Chiari
(Systematic process question)
235 This is a CT of the legs of the font seat passenger of a car involved in a high speed accident. Please look at this image. Please tell me what the significant features are, whether they are normal or abnormal.
Some sort of trauma with blood, vascular disruption, fracture
(Systematic process question)
236 This is a CT of the abdomen of the driver of a car involved in a high speed accident. Please look at this image. Please tell me what the significant features are, whether they are normal or abnormal.
Things to look for in abdominal trauma
- Haemoperitoneum
- Contrast blush consistent with active extravasation
- Lacteration - linear shaped hypodense areas
Haematomas - oval or round-shaped areas
Contusions - vague ill-definted hypodense areas that are less well perfused
- Pneumoperitoneum
- Devascularisation of organs or parts of organs
- Subcapsular haematomas
237 This is the chest of a motorbike rider involved in a high speed accident. Please look at this image. Please tell me what the significant features are, whether they are normal or abnormal.
CXR interpretation process
1) Patient details and technique
2) History of patient
3) Lungs - comparison of 3 zones
4) Heart and mediastinal structures
5) Bone
6) Extras (lines, tubes, etc.)
7) Review areas
238 What are the advantages of MRI as an investigation?
MRI uses magnetic fields and radiowaves to show detailed images of organs, soft tissues, bones, ligaments, and cartilage
Advantages include:
- Greater detail of soft tissues, ligaments, and cartilage
- Non-invasive and painless
- No ionising radiation while providing similar information to CT
239 What are the disadvantages of MRI as an investigation?
MRI uses magnetic fields and radiowaves to show detailed images of organs, soft tissues, bones, ligaments, and cartilage
Disadvantages:
- Lengthy, noisy
- Requires patient to lie perfectly still or image can be ruined (may require anaesthesia or sedation)
- Issues with claustrophobia
- Contra-indicated with cardiac pacemakers and metal implants
240 What are the advantages of ultrasound as an investigation?
- Usually non-invasive and painless
- No ionising radiation exposure
- No IV contrast required
- Aids diagnosis of conditions in the abdomen, pelvis, blood vessels, breast, kidneys, muscles, joints
241 What are the disadvantages of ultrasound as an investigation?
- Image quality and interpretation varies with skill of user
- Image quality can be impaired by air, calcification, body habitus
- Sometimes requires patient preparation (e.g. fasting, full bladder)
- Sometimes requires uncomfortable probes (oesophageal, rectal, vaginal)
