Resp Flashcards
Saccular dilation of the descending aorta with filling defect
CT mediastinal window axial
Dx :
Descending Aortic aneurysm
Double lumen & intima inbetween
Dx :
Aortic dissection
Bilateral maxillary acute Sinusitis
Modality
Characters
X ray open mouth view
“ water view”
Mucosal thickening
Fluid air level
One of them or both
Acute maxillary sinusitus
Another modality :
CT brain axial bone window
Air fluid level
Graves = Goiter
Mucopolysaccharides deposit bilaterally
Ex: swelling of medial recti muscle l not tendon
( …………. )
…….. sign
Diagnosis :
Fusiform swelling
Coca cola sign
Thyroid ophthalmopathy
CT axial paranasal sinus
CT axial orbit
At level of sinuses
At level of eyes
maxillary antral Carcinoma
Modality
Describe
CT axial sinus level
Heterogenous mass occupying the maxillary sinus with bone destruction
Difference between meningioma
& optic nerve glioma
CT axial orbit with IV contrast
Track sign = not originated from optic nerve
Optic glioma = no track sign
CT scan coronal paranasal sinuses
Soft tissue window
Bone window
Orbit contents descend to sinus
Dx :
Blow out fracture
Claw sign
In double contrast barium enema
Diagnosis :
Intussusception
Doppler uss
Grave’s thyroid disease
Sign :
Inferno sign
Technicium phosphate for ……
Then gamma ray
High uptake indicate :
Bone
High blood supply either
Cancer
Metastasis
Acute Inflammation
Healing fracture
Radionuclide
Hepatobiliary immunodye acetic acid
HIDA for ………
Gall bladder not appear means :
Liver & biliary system
Stone impact cystic duct
Cystic duct obstruction
Lingular pneumonia
Modality
Describe
CXR PA view
Opacification in the left lung with loss of cardiac silhouette, no shifting
Next = lateral view to confirm lingular pneumonia
Rt middle lobe pneumonia
Lingular pneumonia
Confirmed by :
X Ray lateral view
Opacification in the left upper & middle zone of the lung with loss silhouette sign , no shifting
Dx :
Sign can be seen :
Left upper & lingular pneumonia
Air bronchogram
CT lung window axial
Describe pneumonia in the RT lung
Opacification in the Rt lung with air bronchogram
Characters of lung collapse by CXR :
-Homogenous Opacifiation of the Lung zone
- Midline shifting toward the collapse
- displaced hila & fissures
- altered proportion of the rt & left lung
Opacification in RT upper lobe with Ipsilateral tracheal shifting
Dx: RT upper lobe collapse
Next step :
CT with contrast looking for underlying cancer
Homogenous opacification in the left lung with Ipsilateral tracheal shifting
Dx :
Next step :
Ddx:
Left lung atelectasis
CT mediastinal window with IV contrast
Ddx : atelectasis , pneumonectomy
Features of loss of lung volume :
Decrease in intercostal spaces
Mediastinal shifting ipsilaterally
Elevation of the diaphragm
Altered proportion between right & left lung
Uses of hysterosalpingiogram
Assess patency of fallopian tubes.
Detect the congenital uterine anomalies
Types of bronchiactasis
Cylindrical
Cystic
Varicose
Congenital
X ray signs of Aortic Rupture :
Obscured Aortic knuckle
Depressed left main bronchus
Shifting of the trachea to the right
Wide mediastinum
Pneumothorax
Causes of intestinal obstruction
Mechanical (ABC)
Adhesion
Bowel strangulation “ hernia, volvulus”
Cancer
Paralytic : paralytic illeus , incompetence of illeocecal valve
Advantages of CXR PA view
Avoid radiological exposure to breast , thyroid , eyes s
Avoid heart magnification
Can centralize the patient
Patient can hold inspiration
Elemenate the anterior surface of the scapula
Differential diagnosis of
Anterior mediastinal mass :
4 T’s
Thyroid “ retrosternal goiter”
Thymoma
Teratoma
Terrible lymphoma
CXR PA view
Round opacification convex & continuous with mediastinum
Dx :
Next step :
Mediastinal mass
CXR lateral view
CXR lateral view
Obliteration of retrosternal space
Dx :
Ddx:
Next step :
Anterior mediastinal mass
Thyroid
Thymoma
Teratoma
Terrible lymphoma
Thymic cyst
Ascending Aortic aneurysm
CT mediatinal window with IV contrast
Retrosternal nodulocystic retrovascular Goiter
Modality
CT mediastinal window axial with IV contrast
Dermoid cyst describe by CT :
CT mediastinal window axial with IV contrast
Anterior mediastinal mass with density of Fluid & Fat
Sign : Fluid Fluid level
Thymic cyst describe by CT :
CT mediastinal window axial with IV contrast
Anterior mediastinal mass with fluid density
Thymic tumour
CT mediastinal window axial with IV contrast
Anterior mediastinal mass with density of soft tissue
mediastinal lymphoma
CT mediastinal window axial with IV contrast
Lobulated mass in anterior & middle mediatinum
If nodes clear lymphadenopathy
Middle mediastinal mass with Density of fluid
Dx:
Bronchogenic cyst
Middle mediastinal mass
Ddx:
Lymphoma
Metastasis of lung CA
Retrosternal goiter
Bronchogenic cyst
Aortic arch aneurysm
Posterior mediastinal mass
Ddx :
Neurogenic tumours :
Schwannoma
Neuroblastoma
Lymphadenopathy
Descending aortic aneurysm
Neurogenic tumour
Describe
CT mediastinal window with IV contrast
Posterior mediastinal mass with density of soft tissue
Fusiform paravertebral
Radiological signs of lower lobe pneumonia :
Homogenous Opacifiaction , with no loss of volume or tracheal deviation
Loss of diaphragmatic silhouette
Preserved cardiac silhouette
Causes of pneumoperitoniem
Perforated deudenal ulcer
Post surgical
Necrotizing enterocolitis
Trauma
Difference between benign & malignant gastric ulcer
Benign :
Common at lesser curvature
Mucosal folds attached to its margin
Regular ulcer
Malignant :
Located at antrum , greater curvature
Irregular ulcer
Muscosal folds not attached to its margin
Features of ectopic pregnancy on uss :
Empty uterus
Adnexal mass
Free fluid in doughlas pouch
Assess gestational age by uss :
Crown rump length
Biparietal diameter
Femoral length
Abdominal circumference
Radiological features of tension pneumothorax
Jet black lung
Contralateral mediastinal shifting
Low set diaphragm
Shadow of collapsed lung
Haziness of normal lung
Stages of sarcoidosis
Stage 0 : normal X ray
Stage 1= enlargement of hilar LN , paratracheal LN ( bilateral hilar LAP ) = stage of presentation
Stage 2 = parenchymal involvement “ peripheral cavitation or solitary pulmonary nodule “ + LN enlargement
Stage 3= parenchymal involvement only
Stage 4 =End stage “ Pulmonary fibrosis”
Radiological features of Pulmonary fibrosis
Honey comb : multiple small thick walled cystic lesions
Tractional bronchiactasis
Thick interstitial space
Causes of Pop corn calcification of breast
Fibroadenoma
Hematoma
Fat necrosis
Feature of malignant bone tumours :
Poorly defined margin
Wide transition zone
May destroy the cortex
No peritoneal reaction
Soft tissue involvement
Features of benign bone tumour
Well defined margin
Narrow transition zone
Cortical thinning no destruction
No periosteal reaction
No soft tissuee involvement
BIRAD 0
BIRAD 1
BIRAD 2
BIRAD 3
BIRAD 4
BIRAD 5
BIRAD 6
BIRAD 0 incomplete assessment
BIRAD 1 negative
BIRAD 2 benign
BIRAD 3 probably benign
BIRAD 4 probably malignant
BIRAD 5 malignant
BIRAD 6 biopsy proven malignancy
CT scan axial neck with iV contrast
Mass with density of fluid “ cystic mass” with imperceptive wall
Dx :
Non infective thyroglossal cyst
Thyroglossal duct cyst
Midline cyst , elevate with tongue protrusion
Infected thyroglossal cyst
Modality
Describe
CT scan axial neck with IV contrast
Central density of cystic mass with enhanced thick wall & fat strand
Thyroid CA
Uss :
Mass with mixed echogenicity in the right lobe of the thyroid & show high vascularity by the doppler
Mass in the glottis
Can be
-
-
Laryngeal papilloma
Laryngeal carcinoma
Enlarged LNs deep to sternocleidomustoid “ same density as the muscle”
In radiology :
Cervical LAP
Any lesion behind the nose : …….
mass with mixed intensity in nasopharynx
Nasopharyngeal carcinoma
Can lead to deafness , nose bleeding epistaxis
Clubbing with normal pelvis
Dx :
History of :
Papilla sloughed & close minor calyx
History of diabetic , NSAIDs or sickle cell anemia
Papillary necrosis
Acute tubular necrosis
Describe
Modality :
Kidney with white lines
CT urography
Hyperdense lines
Chronic pyelonephritis ( ……….)
Describe CT
Uss
Reflux nephropathy
Rt kidney small kidney ( clubbing by IVU ) delayed in contrast excretion.
Thin parenchyma ( cortex)
MRI T1 pelvis
Endometrium ….
Grey
Hydrosalpinx by Hysterosalpingiogram
Indicate :
Chronic obstruction
Endometrial heterogenicity indicate
Endometrial carcinoma
MRI T2 sagital pelvis
Transition zone widening :
Mass at cervix
Potato like mass hypointense
Adenomyosis
Cervical Carrcinoma
Uterine fibroid
Calcification near pelvis “ femuro or illiac bone ”
Indicate :
Describe
Chondrosarcoma
Exophytic growth arising form bone
Bone cyst
Characters
Lytic lesion
At metaphysis
Children
Humerus or femur
Cortical thinnig without destruction
Osteoclastoma
Common site
Epiphysis
Soap bubble appearnace
DDX of lung cavity “ cavity inside opacification”
Air fluid level = abscess
Secondary TB , cancer
Round opacification inside cavity
Aspergilloma “ mycetoma”
Crescent sign !
Multiple hypodense serpiginous lesions in the liver
History of jaundice & itching
Dx:
Next step :
Biliary obstruction
MRCP or ERCP
ERCP
Showing multiple filling defect at common bile duct with dilation
Indicate
Multiple common bile duct stones
ERCP
Shouldering & apple core
Dx:
Management :
Cholangiocarcinoma
stent
CT abdomin axial with IV contrast
Splenic laceration
Describe
Linear hypodense lesion in spleen
CT abdomen axial with IV contrast
Contrast extravasation in spleen
Active bleeding in the spleen
Hemiperitoniem & subcapsular hematoma of the spleen
CT abdomen axial with Iv contrast
Density of blood occupying the peritonium & under capsule of spleen
Fragmented spleen
Shattered spleen
Management :
Spleenectomy
Splenic devascularization
Modality
Describe
CT abdomen axial with IV contrast
Non enhanced area in the spleen with cut off line with normal tissue
Hepatic contusion
Modality
Describe
CT abdomen axial with IV contrast
Hypodense less defined lesion lesion in the liver
CT abdomen axial with Iv contrast
Density of blood in the peritoneum & under capsule of spleen
Well defined hypodense lesion in the liver & linear hypodense lesion in the liver
Dx
Hemiperitonieum , subcapsular hematoma of the spleen ,
Hepatic laceration with hematoma
Multiple hepatic linear hypodense lesions
Multiple hepatic laceration
