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Strategy Flashcards

1
Q

T1 Bright

A

Fat

melanin (melanoma)

blood (subacute)

protein rich fluid

calcification (hyalinized)

slow moving blood

laminar necrosis

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2
Q

T2 Bright

A

Fat

Water

blood (extracellular methemogloving)

most tumors

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3
Q

T1 and T2 dark

A

flow void

fibrosis/scar

metal

air

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4
Q

REstricts diffusion

A

stroke

hypercellular tumor

epidermoid

abscess (bacterial)

acute demyelinations

CJD

T2 shine through

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5
Q

PEDS neck looks cystic

A 
Thyroglossal Duct Cyst
Brachial cleft cyst
Necrotic Level 2 Node
Hemangioma of Infancy
Cystic Hygroma
Phlebectasia
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6
Q

PEDS neck looks cystic

Thyroglossal Duct Cyst

A 
*MIDLINE
Ultrasound in Axial Planes
C T / MRI in Sagital Planes
Posterior to Tongue
Anterior to Hyoid
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7
Q

PEDS neck looks cystic

Brachial Cleft Cyst

A

‘ LATERAL
Axial Plane Most Likely
Anterior to the
Sternocleidomastoid (type 2)

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8
Q

PEDS neck looks cystic

Necrotic Level 2 Node

A

Looks Just like BC Cyst - but the kid is too old (late teens / “young adult”)
Thyroid CA, or Nasopharyngeal HPV related CA
C T axial plane - most likely

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9
Q

PEDS neck looks cystic

Hemangioma of Infancy

A

T2 Bright
Enhances
Will have flow in it on doppler
If you saw it you’d think to yourself “if that doesn’t involute that kid is never getting a date to prom”

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10
Q

PEDS neck looks cystic

Cystic Hygroma

A 
OB Ultrasound - most likely modality
Cystic Hygroma . J2 Brjght
DOES NOT Enhance
Will NOT have flow in it on doppler
Turners, Downs.
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11
Q

PEDS neck looks cystic

Phlebectasia

A

Kinda looks like a big dilated jugular vein (because it is a big dilated jugular vein)
No stenosis or collaterals

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12
Q

PEDS neck looks solid

A 
Septic Thrombophlebitis
Ectopic Thyroid
Fibromatosis Coli
Rhabdomyosarcoma
Metastatic Neuroblastoma
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13
Q

PEDS neck looks solid

Septic Thrombophlebitis

A 
Jugular Vein with a clot - they will have to prove that has a clot in it - fprobably with doppler us
 Lemierre’s Syndrome
 Septic Emboli to the lungs
 Recent ENT procedure, or Infection
 Fusobacterium Necrophorum
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14
Q

PEDS neck looks solid

Ectopic Thyroid

A

Back of the tongue or in front of the hyoid

Tc-MIBI, or 1-123

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15
Q

PEDS neck looks solid

Fibromatosis Coli

A

Ultrasound

“Two Heads” of the Sternocleidomastoid

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16
Q

PEDS neck looks solid

Rhabdomyosarcoma

A

MRI orCT
Seriously pissed off looking mass (probably in the orbit - maybe in the masticator mass)
Enhances heterogenous,

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17
Q

PEDS neck looks solid

Metastatic Neuroblastoma

A 
MRI orCT
Soft Tissue Mass,
Calcifications,
Restricted Diffusion
Classic is the orbit
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18
Q

Cyanotic peds

A 
TOF
TAPVR
Transposition
truncus
tricuspid atresi
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19
Q

not cyaotic peds

A 
ASD
VSD
PDA
PAPVR
AORTIC coarctation (adutl type - post ductul)
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20
Q

Congenital Heart on C X R

cyanotic, right sided arch, incrased pulmonary vasculature

A

Truncus (types 1-3)

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21
Q

Congenital Heart on C X R

cyanotic, right sided arch,normal pulmonary vasculature

A

TOF

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22
Q

Congenital Heart on C X R

cyanotic, left arch, massive heart

A

Ebsteins or
Pulmonary Atresia without VSD

Non-Cardiac (wo n ’t be cyanotic)

  • Infantile Hemangioendothelioma
  • Vein o f Galen Malformation
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23
Q

Congenital Heart on C X R

cyanotic, left sided arch, normal heart size, increased pulmonary blood flow

A
  • TAPVR (especially type 3)
  • D-Transposition -Ebsteins
  • Truncus (look for R A rch)
  • “Tingle Ventricle”
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24
Q

Congenital Heart on C X R

cyanotic, left sided arch, normal heart size, decreased or normal pulmonary blood flow

A
  • TOF
  • Ebsteins
  • Tricuspid Atresia
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25
Q

Neonatal Chest

high lung volume symmetric pattern ( looks like pulmonary edema)

A

Transient Tachypnea

“Pulmonary Edema + Effusions”

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26
Q

Neonatal Chest

high lung volume, less symmetric pattern (perihilar/streaky

A

Meconium Aspiration
or
Non GB Neonatal Pneumonia

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27
Q

Neonatal chest

low lung volumes, not usually pleural effusions

A

Surfactant- Deficient Disease (SDD)

“Diffuse Granular”

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28
Q

Neonatal chest

low lung volumes, pleural effusions 25% of the time

A

Beta Hemolytic Pneumonia

“Diffuse Granular

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29
Q

T H IS vs THAT: Meconium Asp ira tion o r Non Group B Strep Pneumonia

A

This is su p e r tough without any history, an d b e cau se o f that I f e e l like the te st w rite r has
two o p tion s: (J) Stop being an a ssh o le an d g iv e you some history, (2) not include both as
an sw e r ch o ices - assuming only one is co rre c t. Now, a long those lines i f you saw both as
choices an d the question h ea d e r g iv e s you no h isto ry you c o u ld eliminate them both as
d istra c to rs - b ecause they both c a n ’t be co rre c t.

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30
Q

Prematurity

A

u e s s in g th at the kid is p rem a tu re can be h e lp fu l fo r e lim in a tin g
ch o ic e s (M e co n ium A sp ira tio n is m o re o f a p o s t te rm th in g ), an d ra isin g y o u r p rete st
p ro b ab ility (SD D , o r N EC in a belly film). T h e re are two main clues:
(1) Humeral H ea d Ossification - T h is ten d s to o c c u r c lo s e r to term . I f th e h um era l
h e ad is N O T ossified y o u can a ssum e (in th e w o rld o f m u ltip le ch o ic e ) th at the kid
is lik e ly p rem a tu re .
(2) Lack o f Subcutaneous Fat - P rem a tu re k id s ten d to be very sk in n y , a lth o u g h I th in k
o f th is m o re o f a soft sign th at is u se fu l w h en ab sen t m o re th an p re sen t. I ’ll ju s t
say th a t if the kid a p p e a rs ch u b b y he is p ro b ab ly N O T p rem a tu re .

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31
Q

PEDs thing in the left upper lobe

A

Think Congenital Lobar Emphysema (CLE) first. But,
remember CCAM has no lobar prevalence, so it can be
anywhere

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32
Q

Peds thing in the lerft lower lobe

A

Think Sequestration First. Congenital Diaphragmatic

Hernia (CDHs) favors this side too

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33
Q

Intralobar sequestration is seen

A

older kids

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34
Q

Extralobar sequestration

A

is seen

in infants with comorbids

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35
Q

CLE is in the

A

upper lobe

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36
Q

The NG tube stops in the upper thoracic

esophagus:

A

The NG tube stops in the upper thoracic
esophagus: Think esophageal atresia (probably in
the setting o f VACTERL).

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37
Q

The NG tube curling into the chest

A

it’s either (1) in the lung, or (2) it’s in a congenital diaphragmatic hernia. If 1 had to pick between the two (and it wasn’t obvious), I’d say left side hernia, right side lung - ju st because those are the more common sides.

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38
Q

T h e C la s s ic C o n g e n ita l L o b a r Em p h y s em a T ric k

A

They can show you a
series o f CXRs. The first one has an opacity in the lung (the affected lung is fluid filled). The
next x-ray will show the opacity resolved. The following x-ray will show it getting more
lucent, and more lucent. Until it’s actually pushing the heart over. This is the classic way to
show it in case conference, or case books

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39
Q

T h e School Aged CXR: Things to look for

A

Big Heart - Probably showing you a sickle cell case. Look for bone infarcts in shoulders.
Lucent Lung - Think foreign Body (air trapping). Remember you put the affected side down (if it remains lucent- that confirms it).

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40
Q

THIS vs THAT: Cystic Fibrosis vs Primary Ciliary Dyskinesia

A

CF
Abnormal Mucus - Cilia c an ’t clear it
Bronchiectasis (upper lobes)
Normal sperm, obliterated vas deferens

PCD
Normal Mucus - Cilia do n ’t work
Bronchiectasis (lower lobes)
Normal vas deferens, sperm cannot swim normally

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41
Q

PEDs mandiible

A

There are only a few things that a mandible will be shown for with
regards to Peds. Think Caffeys first - especially if the picture looks blurry and old (there
hasn’t been a case o f this in 50 years). If it’s osteonecrosis think about O.I. on
bisphosphonates. If it’s a dwarf case, think wide angled mandible with Pycnodysostosis. A
“floating tooth” could be EG.

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42
Q

The Abdominal Plain Film - on a newborn

Single Bubble:

A

In a newborn this is Gastric (antral or pyloric atresia). In an older child think gastric volvulus

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43
Q

The Abdominal Plain Film - on a newborn

Double Bubble

A

duodenal atresia

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44
Q

The Abdominal Plain Film - on a newborn

triple bubble

A

jejunal atresia

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45
Q

The Abdominal Plain Film - on a newborn

Single Bubble + Distal Gas
+ “Bilious Vomiting

A

concern for mid gut volvulus

next step = upper gi

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46
Q

The Abdominal Plain Film - on a newborn

Multiple Dilated Loops

A

concern for lower obstruction

next step = contrast enema

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47
Q

THIS vs THAT: Duodenal Atresia vs Jejunal Atresia

A

Duodenal Atresia
double bubble
failure to canalize (often isolated atresia)
associated with downs

Jejunal atresia
triple bubble
Vascular Insult * More likely associated with other atresias

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48
Q

THIS vs THAT: In tra lob a r vs E x tra lo b a r S eq u e stra tion

A

intralobar
No pleural covering
More Common
Presents later with recurrent infection

extralobar
Has its own pleural covering
Less Common
Presents early with other bad congenital things (heart, etc…)

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49
Q

Right sided heterotaxia

A

Two Fissures in Left Lung
Asplenia
Increased Cardiac Malformations
Reversed Aorta/I VC

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50
Q

Left sided heterotaxia

A

One Fissure in Right Lung
Polysplenia
Less Cardiac Malformations
Azygous Continuation o f the IVC

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51
Q

orbital calcs less than 3

A

retinoblastoma
cmv
colomoatous dyst

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52
Q

orbital calcs older than 3

A

toxo

retinal astrocytoma

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53
Q

Peds Liver Masses

A

Infantile Hepatic Hemangioma

Hepatoblastoma

Mesenchymal Hamartoma

HCC

Fibrolamellar Subtvpe HCC

Undifferentiated Embryonal Sarcoma

Mets (Neuroblastoma, Wilms)

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54
Q

Peds Liver Masses

Infantile Hepatic
Hemangioma

A

Age 0-3

Endothelial growth factor is elevated

Progressively Calcify - as they involute

Associated:
High Output CHF
Skin Hemangiomas

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55
Q

Peds Liver Masses

Hepatoblastoma

A

Age 0-3

AFP is elevated

Calcifications are Common

Risk Factor = Prematurity

Many Association:
Wilms, Beckwith- Weidemann

may cause precocious puberty

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56
Q

Peds Liver Masses

Mesenchymal
Hamartoma

A

Age 0-3

AFP is negative

Calcification are RARE

CYSTIC MASS

Favors Right Lobe

“Developmental anomaly’’

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57
Q

Peds Liver Masses

HCC

A

Age > 5

AFP is elevated

Kids with cirrhosis (biliary atresia, Fanconi syndrome, glycogen storage disease)

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58
Q

Peds Liver Masses

Fibrolamellar Subtvpe
HCC

A

Age > 5

AFP is negative

Calcifies more often than conventional HCC

No Cirrhosis

Central Scar (scar does NOT enhance, and is T2 dark)

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59
Q

Peds Liver Masses

Undifferentiated Embryonal Sarcoma

A

Age > 5

AFP is negative

Cystic / Heterogeneously Solid Mass

Known to rupture

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60
Q

Peds Liver Masses

Mets
Neuroblastoma, Wilms

A

Fetus - 4

6 - Early Teens

Multiple Masses in the Setting of Known Primary

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61
Q

Adult Benign Liver Masses

A

Hemangioma

FNH

Heptaic adenoma

hepatic angiomyolipoma

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62
Q

Adult Benign Liver Masses

hemangioma

A

Ultrasound - Hyperechoic

CT - Peripheral Nodular Discontinuous Enhancement

MR - T2 bright

Trivia - rare in cirrhotics

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63
Q

Adult Benign Liver Masses

FNH

A

Ultrasound - spoke wheel

CT - homogenous arterial enhancement

MR - stelath lesion - iso on t1 and t2

Trivia - central scar, bright on delayed eovist (gd-eob-dtpa)

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64
Q

Adult Benign Liver Masses

hepatic adenoma

A

Ultrasound - variable

CT - variable

MR - fat containing on in/out phase

Trivia - ocp use, glycogen storage idsease, can explode and bleed

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65
Q

Adult Benign Liver Masses

hepatic angiomyolipoma

A

Ultrasound - hyperechoic

CT - gross fat

MR - t1/t2 bright

Trivia - unlike renal aml 50% dont have fat, Tuberous sclerosis

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66
Q

Liver Sulfur Colloid HOT or COLD

hepatic adenoma

A

cold

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67
Q

Liver Sulfur Colloid HOT or COLD

FNH

A

40% HOT,
30% COLD,
30% Warm

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68
Q

Liver Sulfur Colloid HOT or COLD

cavernous hemangioma

A

cold

RBC Scan HOT

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69
Q

Liver Sulfur Colloid HOT or COLD

HCC

A

cold

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70
Q

Liver Sulfur Colloid HOT or COLD

cholangiocarcinoma

A

cold

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71
Q

Liver Sulfur Colloid HOT or COLD

mets

A

cold

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72
Q

Liver Sulfur Colloid HOT or COLD

abscess

A

cold

gallium hot

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73
Q

Liver Sulfur Colloid HOT or COLD

focal fat

A

cold

xenon hot

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74
Q

regenerative liver nodules

A

contains iron

t1 dark, t2 dark

dots not enhance

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75
Q

dysplastic liver nodules

A

contains fat, glycoprotein

ti bright, t2 dark

usually does not enhance

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76
Q

hcc

A

T2 bright

does enhance

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77
Q

This vs That: HCC vs

Fibrolamellar Subtype HCC

A 
HCC:
Cirrhosis
Older (50s-60s) 
Rarely Calcifies
Elevated AFP
FL HCC:
No Cirrhosis
Young (30s)
Calcifies
Normal AFP
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78
Q

This vs That:

Central Scars of FIN H and Fibrolamellar HCC

A 
FNH:
T2 Bright
Enhances on Delays
Mass is Sulfur Colloid
Avid (sometimes)

FL HCC:
T2 Dark (usually)
Does NOT enhance
Mass is Gallium Avid

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79
Q

Multiple Low Density (NOT Cystic) Liver Lesions

METS

A

Think Colon First

- unless they have a known primary

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80
Q

Multiple Low Density (NOT Cystic) Liver Lesions

HCC

A

Does the Liver look Cirrhotic?

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81
Q

Multiple Low Density (NOT Cystic) Liver Lesions

Regrnative nodules

A

Does the Liver look Cirrhotic?

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82
Q

Multiple Low Density (NOT Cystic) Liver Lesions

infections

A

Low Density Nodes - Think Mycobacterium

Hyperenhancing Nodes - Think Bartonella

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83
Q

Multiple Low Density (NOT Cystic) Liver Lesions

sarcoid

A

Spleen Should be Involved Also
Gamesmanship - Probably gets some hints in the form of a CXR, or
Labs (elevated ACE)

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84
Q

Multiple Cystic Liver Lesions

AD Polycystic
Kidney

A

Different Size Cysts
(small and big)
Renal Cystic Disease

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85
Q

Multiple Cystic Liver Lesions

Von
Meyenburg
Complex
Hamatromas

A

Small ( < 1.5 cm)
Will NOT connect with Ducts
Uniform distribution

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86
Q

Multiple Cystic Liver Lesions

Choledochal
Cysts (Caroli)
A

WILL communicate with duct

Central “dot” Sign

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87
Q

Multiple Cystic Liver Lesions

Abscess

A 
Bacterial and Fungal =
Multiple, R > L
Amoebic = Single and Subdiaphragmatic
Peripheral Enhancement
Necrotic center will not
enhance
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88
Q

Liver infection buzzwords

Starry Sky (US)

A

Viral Hepatitis

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89
Q

Liver infection buzzwords

Double Target (CT)

A

Pyogenic Abscess

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90
Q

Liver infection buzzwords

Bull’s Eye (US)

A

Candida

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91
Q

Liver infection buzzwords

“Extra Hepatic Extension”

A

Amoebic Abscess

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92
Q

Liver infection buzzwords

Water Lily (CT, Sand Storm US

A

Hydatid Disease

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93
Q

Liver infection buzzwords

tortoise shell

A

Schistosomiasis

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94
Q

Primary Hemochromatosis

A

Genetic - increased absorption
Liver, P an c re a s
Heart, Thyroid, Pituitary

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95
Q

Secondary Hemochromatosis

A

Acquired - chronic illness, and multiple
transfusions
Liver, S p le en

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96
Q

This vs That: AIDS Cholangiopathy vs Primary Sclerosing Cholangitis

A

AIDS:
Focal Strictures o f the extrahepatic duct > 2cm
Absent saccular deformities o f the ducts Papillary Stenosis

PSC:
Extrahepatic strictures rarely > 5mm
Has saccular deformities o f the ducts

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97
Q

Intrahepatic biliary dilation ddx

A 
PSC
infection cholangitis
pancreatic head mass
cbd stone - late
biliary stricture
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98
Q

extrahepatic biliary dilation only ddx

A

post cholecystectoy
sphincter of oddi dysfucntion
type 1 choledochal cyst
cbd stone- early

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99
Q

THIS vs THAT: Chronic Pancreatitis Duct Dilation vs Pancreatic Malignancy Duct Dilation

A

CP:
Dilation is Irregular
Duct is < 50% o f the AP gland diameter

Cancer:
Dilation is uniform (usually)
Duct is > 50% o f the AP gland diameter (obstructive atrophy)

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100
Q

Uncommon Types and Causes o f Pancreatitis

A

Autoimmune
Pancreatitis

Groove
Pancreatitis

Tropic
Pancreatitis

Hereditary
Pancreatitis

Ascaris
Induced

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101
Q

Uncommon Types and Causes o f Pancreatitis

Autoimmune
Pancreatitis

A

Associated with elevated IgG4

Absence of Attack Symptoms

Responds to steroids

Sausage Shaped Pancreas, capsule like delayed rim enhancement around gland (like a scar). No duct dilation. No calcifications.

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102
Q

Uncommon Types and Causes o f Pancreatitis

Groove
Pancreatitis

A

Looks like a pancreatic head Cancer - but with little or no biliary obstruction.

Less likely to cause obstructive jaundice (relative to pancreatic CA)

Duodenal stenosis and /or strictures of the CBD in 50% of the cases

Soft tissue within the pancreaticoduodenal groove, with or without delayed enhancement

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103
Q

Uncommon Types and Causes o f Pancreatitis

Tropic
Pancreatitis

A

Young Age at onset, associated with malnutrition

Increased risk of adenocarcinoma

Multiple large calculi within a dilated pancreatic duct

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104
Q

Uncommon Types and Causes o f Pancreatitis

hereditary pancreatitis

A

Young Age at Onset

Increased risk of adenocarcinoma

SPINK-1 gene

Similar to Tropic Pancreatitis

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105
Q

Uncommon Types and Causes o f Pancreatitis

Ascaris
Induced

A

Most commonly implicated parasite in pancreatitis

Worm may be seen within the bile ducts

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106
Q

I Say Autoimmune Pancreatitis

A

You Say IgG4

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107
Q

I Say IgG4

A 
Autoimmune Pancreatitis
Retroperitoneal Fibrosis
Sclerosing Cholangitis
Inflammatory Pseudotumor
Riedel’s Thyroiditis
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108
Q

THIS vs THAT:

Autoimmune Pancreatitis vs Chronic Pancreatitis

A

Autoimmune pacreatitis:
no ductal dilation
no calcs

chroic pancreatitis:
ductal dilation
ductal calcifications

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109
Q

Cystic Pancreatic Lesions

A

Main Branch
IPMN

Side Branch
IPMN

Serous Cystic

Mucinous
Cystic

Solid Pseudo-
Papillarv

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110
Q

Cystic Pancreatic Lesions

Main Branch
IPMN

A

40s - 50s

Main Duct

High Malignant Potential (60%)

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111
Q

Cystic Pancreatic Lesions

Side Branch
IPMN

A

50s - 60s

Favor head, Uncinate

Typically Benign
(maybe 5% will develop malignancy)
Communicates with duct

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112
Q

Cystic Pancreatic Lesions

serous cystic

A

Grandma F > M >60

Favor Head

Does NOT Communicate with Main Duct
Central Calcifications
“Micro-Cystic” - “Honeycomb”
Benign
Glycogen Rich
Associated with von Hippel Lindau
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113
Q

Cystic Pancreatic Lesions

Mucinous
Cystic

A

Mother F > M 40s

Favor Body / Tail

Does NOT Communicate with Main Duct
Peripheral Calcifications
Larger Cysts (sometimes uni-locular)
Premalignant

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114
Q

Cystic Pancreatic Lesions

Solid Pseudo-
Papillarv

A

Daughter F > M 20s

Favor Tail

Large (5-10 cms)
Solid with Cystic Parts
Enhances like a Hemangioma
Has a Capsule
Asian or Black Female
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115
Q

Malignant Ulcer

A 
Width > Depth
Located within Lumen
Nodular, Irregular Edges 
Folds adjacent to ulcer
Aunt Minnie: Carmen
Meniscus Sign
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116
Q

Benign Ulcer

A 
Depth > Width
Project behind the expected lumen
Sharp Contour
Folds radiate to ulcer
Aunt Minnie: Hampton’s Line
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117
Q

Direct Hernia

A

Less common
Medial to inferior Epigastric
Defect in Hesselbach triangle
NOT covered by internal spermatic fascia

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118
Q

Indirect Hernia

A

more common
lateral to inferio epigastric
failure of processus vaginalisu to close
coverved by internal spermatic fascia

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119
Q

Sigmoid volvulus

A

old person (constipated)

points to the RUQ

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120
Q

cecal volvulus

A

Younger Person (mass, prior surgery, or 3rd Trimester Pregnancy)

Points to the LUQ

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121
Q

Crohns

A 
Slightly less common in the USA
Discontinuous “Skips” 
Terminal Ileum - String Sign
Ileocecal Valve “Stenosed”
Mesenteric Fat Increased "creeping fat ”
Lymph nodes are usually enlarged
Makes Fistulae
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122
Q

Ulcerative Colitis

A 
Slightly more common in
the USA
Continuous
Rectum
Ileocecal Valve “Open”
Perirectal fat Increased
Lymph nodes are NOT usually enlarged
Doesn’t Usually Make Fistulae
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123
Q

Tumor markers

cholangio

A

CEA and CA19-9 increased

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124
Q

Tumor markers

pancreatic CA

A

CA19-9 increased

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125
Q

Tumor markers

Colon CA

A

CEA increased

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126
Q

More Common In :
Crohns vs UC

gallstones

A

crohns

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127
Q

More Common In :
Crohns vs UC

PSC

A

UC

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128
Q

More Common In :
Crohns vs UC

Hepatic abscess

A

Chrohns

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129
Q

More Common In :
Crohns vs UC

pancreatitis

A

crohns

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130
Q

Multicystic Dysplastic Kidney

A

unilateral

  • Neonate, No Renal Function (MAG 3)
  • Associated with congenital UPJ obstruction
  • Associated with reflux (VUR) -
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131
Q

Multilocular Cystic Nephroma

A

unilateral

  • “Micheal Jackson - Young Boy, Older Woman”
  • Multiple Cysts - Herniates into the Renal Pelvis”
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132
Q

cystic wilms

A

peds renal cyst mass, unilateral

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133
Q

AR- Polycystic Kidney Disease

A

bilateral

  • enlarged, hyperechoic
  • microcystic
134
Q

Peds Tumor / Mass kidney

A

Mesoblastic
Nephroma

Nephroblastomatosis

wilms

Clear Cell - Wilms

Rhabdoid - Wilms

Multi-Cystic
Nephroma

RCC

Renal Lymphoma

135
Q

Peds Tumor / Mass kidney

Mesoblastic
Nephroma

A

“Solid Tumor o f Infancy” (you can be born with it)

136
Q

Peds Tumor / Mass kidney

Nephroblastomatosis

A

“Nephrogenic Rests” - left over embryologic crap that didn’t go away
Might turn into wilms (bilateral wilms especially)
“Next Step” - f/u ultrasound till 7-8 years old
Variable appearance

137
Q

Peds Tumor / Mass kidney

wilms

A

90% + Renal Tumors
“Solid Tumor o f Childhood” - Never born with it
Grows like a solid ball (will invade rather than incase)
Met to the lung (most common)

138
Q

Peds Tumor / Mass kidney

Clear Cell - Wilms

A

Met to Bone

139
Q

Peds Tumor / Mass kidney

Rhabdoid - Wilms

A

Brain Tumors

It fucks you up, it takes the money (it believes in nothing Lcbowski)

140
Q

Peds Tumor / Mass kidney

Multi-Cystic
Nephroma

A

Micheal Jackson Tumor (Young Boys, Middle Age Women)
Big cysts that don’t communicate
Septal Enhancement
Can’t Tell it is not Cystic Wilms (next step = resection)

141
Q

Peds Tumor / Mass kidney

RCC

A

“Solid Tumor o f Adolescent ”

Syndromes - VHL, TS

142
Q

Peds Tumor / Mass kidney

Renal Lymphoma

A

Non-Hodgkin

Multifocal

143
Q

Neuroblastoma v wilms

A 
Neuroblastoma:
Age: usually less than 2 (can occur in utero)
Calcifies 90%
Encases Vessels (doesn’t invade)
Poorly Marginated 
Mets to Bones
Wilms:
Age: Usually around age 4
(never before 2 months)
Calcifies Rarely (<10%)
Invades Vessels (doesn’t encase)
Well Circumscribed
Doesn’t usually met to bones (unless clear cell Wilms variant). Prefers lung.
144
Q

Neuroblastoma vs Adrenal Hemorrhage

A

Neuroblastoma:
Heterogenous and vascular
High on T2 , Iso-Low on T1
Will grow on followup

Adrenal Hemorrhage
Centrally Hypoechoic and Avascular
High on T1 (7 days - 7 weeks)
Should shrink on followup

145
Q

Adult RCC Associations

clear cell

A

Von Hippel-Lindau

146
Q

Adult RCC Associations

papillary

A

Hereditary papillary renal.

carcinoma

147
Q

Adult RCC Associations

chromophobe

A

birt hogg dube

148
Q

Adult RCC Associations

medullary

A

sickle cell trait

149
Q

Bladder Cancer

Transitional Cell
CA

A

The “normal” kind Bladder CA » > Ureter CA

150
Q

Bladder Cancer

Squamous Cell
CA

A

Calcifications
Chronic Catheter
Schistosomiasis (worm)

151
Q

Bladder Cancer

adenocarcinoma

A

Midline
Urachus Association
Bladder Exstrophy

152
Q

Urethra cancer

Prostatic Urethra

A

TCC

153
Q

Urethra cancer

Bulbar / Penile Urethra

A

SCC

154
Q

Urethra cancer

Urethral
Diverticulum

A

Adenocarcinoma

155
Q

Renal Cyst Associations

ADPCKD

A

Cysts in Liver

Kidneys are BIG

156
Q

Renal Cyst Associations

VHL

A

cysts in pancreas

157
Q

Renal Cyst Associations

Acquired (uremic)

A

kidneys are small

158
Q

Big Kidney with Lots o f Cysts

Liver Cysts

A

AD Polycystic Kidney

159
Q 
Normal Sized Kidneys with Lots o f Cysts
Solid Renal Masses (RCCs)
Pancreatic Cysts (simple and serous cystic)
Pancreatic Masses
Adrenal Masses (paragangliomas)
A

von Hippel - Lindau

160
Q

Renal Cysts
Multiple Fat Containing Renal Masses
(AMLs) - maybe bleeding
Lungs Cysts (LAM)

A

Tuberous Sclerosis

161
Q

Small / Calcified Spleen
Gallstones (or absent GB)
Bone Infarcts

A

sickle cell

162
Q

Severe Pancreatic Fatty Atrophy
Small bowel stool
Fatty Liver

A

CF

163
Q

Big Liver, Big Spleen
Bone Infarcts
Extramedullary Hematopoiesis

A

Gaucher

164
Q

Bilateral Adrenal Masses
(Pheochromocytoma - not adenoma)
Thyroid Cancer

A

MEN 2

165
Q

Islet Cell Tumors

Pituitary Adenoma

A

MEN 1

166
Q

Renal Masses (Wilms, AML)
Adrenal Masses (Pheochromocytoma)
Skin Nodules
Scoliosis

A

NF-1

167
Q 
Vascular Malformation in the Liver
Bowel Angiodysplasia
Enlarged Hepatic Artery
Pulmonary AVM
Brain Abscess
A

Osier Weber Rendu

Hereditary Hemorrhagic Telangiectasia

168
Q

Cyst Morphology Trivia:

A
  • ADPCKD - Round and Distributed Throughout Kidney

* ARPCKD - Tubular Cysts which Spare Cortex

169
Q

Anterior Mediastinal Mass

normal htymus

A
  • Age < 10
  • Homogenous
  • No Mass Effect
170
Q

Anterior Mediastinal Mass

lymphoma

A
  • Age > 1 0
  • Mass Effect
  • Lymph Nodes
  • SV C Compression
  • Hodkin> NHL
171
Q

Anterior Mediastinal Mass

teratoma

A
  • Fat
  • Cystic
  • Calcifications
172
Q

Anterior Mediastinal Mass

NS - Germ cell tumore

A
  • Big
  • Aggressive
  • Hemorrhage
  • Klinefelter
  • Necrosis
173
Q

Anterior Mediastinal Mass

Seminoma

A
  • Straddle Midline
  • Bulky
  • Lobulated
174
Q

DIP

A 
- Apical Emphysema
(smoking related)
- Basilar Ground Glass
- Peripheral Basilar
Reticulation
- Smoker - Severe end of
RB-ILD
175
Q

NSIP

A

Basilar Ground Glass
(sub-pleural sparing)

Traction Bronchiectasis

Scleroderma Association
(dilated esophagus)

176
Q

UIP

A

Honeycombing - basilar

predominant

177
Q

LAM

A
  • Thin walled cysts -
    distributed evenly
    ‘ Tuberous sclerosis
178
Q

LCH

A 
■ Nodules with cavitation
(early)
* Apical - “B izarre” Cysts (late)
' Smoker -20s-30s
' Sparing of the costophrenic
recesses
179
Q

LIP

A 
■ Thin walled c ysts (less than
LAM)
" Ground Glass - clears with
treatment
" Sjogrens, RA, HIV
180
Q

Eosinophilic pneumonia

A

Reverse Pulmonary
Edema Pattern
(peripheral)

Ground glass and
consolidation

181
Q

COP

A 
- Atoll / Reverse Halo Sign -
Consolidation around
Ground Glass
- Patchy, Peripheral
Consolidation
182
Q

Aspergillosis

A

■ Halo Sign - Ground Glass
around consolidation
* Air Crescent - “invas ive”

183
Q

Upper Lobe Predominant

A

Most inhaled stuff (not asbestosis). Coal
Workers, and Silicosis. This includes
progressive massive fibrosis.

CF

RB-ILD

Centrilobular emphysema

AS

SArcoid

184
Q

Lower Lobe Predominant

A

asbestosis

primary cilia dyskinesia

Most Interstitial Lung Diseases
(UIP, NSIP, DIP)

Panlobular Emphysema (Alpha 1)

Rheumatoid Lung

Scleroderma (associated with NSIP)

185
Q

Collagen Vascular Disease Pulmonary Manifestations

lupus

A

More pleural effusions and
pericardial effusions than
with other connective tissue
disease

Fibrosis is uncommon. Can
get a “shrinking lung.”

186
Q

Collagen Vascular Disease Pulmonary Manifestations

RA

A 
Looks like UIP and COP.
Lower lobes are favored.
Reticulations with or without
honeycombing, and
consolidative opacities which
are organizing pneumonia
187
Q

Collagen Vascular Disease Pulmonary Manifestations

scleroderma

A

NSIP> UIP; lower lobe
predominant findings.

Look for the dilated fluid filled
esophagus.

188
Q

Collagen Vascular Disease Pulmonary Manifestations

sjogrens

A

LIP

Extensive ground glass
attenuation with scattered thin
walled cysts.

189
Q

Collagen Vascular Disease Pulmonary Manifestations

ankylosing spondylitis

A

Upper lobe fibrobullous
disease

Usually unilateral first, then
progresses to bilateral.

190
Q

Infections in AIDS by CD4

A

> 200 Bacterial Infections, TB
<200 PCP, Atypical Mycobacterial
< 100 CMV, Disseminated Fungal, Mycobacterial

191
Q

ACR Appropriateness Criteria

A

First Line for Suspected Metastatic Disease
= CXR

Recommendation for patients on
mechanical ventilation = Daily CXR

First Line for Chest Pain and High
Suspicion for Aortic Dissection = CXR

192
Q

Which Sequence(s) most useful?

Cardiac Myxoma

A

Low T l , High T2 (high myxoid content)

193
Q

Which Sequence(s) most useful?

Acute vs Chronic MI

A

Look at T2 - Bright on Acute ; Dark on Chronic

fibrous scar

194
Q

Which Sequence(s) most useful?

Arrhythmogenic Right Ventricular
Dysplasia (ARVD)

A

T l Bright

195
Q

Which Sequence(s) most useful?

Microvascular Obstruction

A

First Pass Perfusion (25 seconds post Gad)

196
Q

Which Sequence(s) most useful?

infarct

A

Delayed Enhancement (10-12 mins post Gad)

197
Q

Cardiac MRI Enhancement Patterns

subendocardial

A

infarct

198
Q

Cardiac MRI Enhancement Patterns

transmural

A

infarct

199
Q

Cardiac MRI Enhancement Patterns

Subendocardial Circumferential:

A

Amyloidosis *can also be transmural

200
Q

Cardiac MRI Enhancement Patterns

midwall focal

A

HCM

201
Q

Cardiac MRI Enhancement Patterns

Midwall septal linear

A

mycoraditis, idiopathic dilated cm

202
Q

Cardiac MRI Enhancement Patterns

midwall outer linear

A

myocraditis, sarcoidosis

203
Q

Cardiac MRI Enhancement Patterns

epicardial

A

myocarditis, sarcoidosis

204
Q

C a rd ia c S u rg e ry T y p e s / In d ic a tio n s

CHF in Infancy, Single Ventricle

A

Pulmonary Artery Banding

205
Q

C a rd ia c S u rg e ry T y p e s / In d ic a tio n s

Transposition, Pulmonary Outflow Obstruction

A

Rastelli (RV Baffle)

206
Q

C a rd ia c S u rg e ry T y p e s / In d ic a tio n s

Transposition

A

Jatene (a type o f arterial switch)

207
Q

C a rd ia c S u rg e ry T y p e s / In d ic a tio n s

Diseased Aortic Valves in Children

A

Ross

208
Q

C a rd ia c S u rg e ry T y p e s / In d ic a tio n s

Aortic Root / Valve Replacement in Marfan

A

Bentall

209
Q

Cardiac surgery

Glenn

A

Vein to Artery
(SV C to Pulmonary Artery)

Primary Purpose: Take
systemic blood directly to the
pulmonary circulation (it
bypasses the right heart).

Most Testable Complications:

  • SVC Syndrome
  • PA Aneurysms
210
Q

Cardiac surgery

Blalock Taussig

A

Artery to Artery
(Subclavian Artery to Pulmonary
Artery)

Primary Purpose: Increase
pulmonary blood flow

Most Testable Complications:
-Stenosis at the sh u n t’s
pulmonary insertion site

211
Q

Cardiac surgery

Fotan

A

It’s complicated with multiple
versions - steps are unlikely to
be tested

Primary Purpose: Bypass the
right ventricle / direct systemic
circulation into the PAs.

Most Testable Complications:
-Enlarged Right Artium causing
arrhythmia
-Plastic Bronchitis

212
Q

Large Vessel Vasulitis

A

Takayasu

giant cell

cogan syndrome

213
Q

Takayasu

A

Large Vessel Vasulitis

Young Asian Female - thickened aneurysmal aorta

214
Q

giant cell

A

Large Vessel Vasulitis

Old Person with involvement o f the “crutches” / armpit region
(Subclavian, axillary, brachial).

215
Q

cogan syndrome

A

Large Vessel Vasulitis

Kid with eye and ear symptoms + Aortitis

216
Q

Medium Vessel vasculitis

A

PAN

Kawasaki

217
Q

PAN

A

Medium Vessel vasculitis

PAN is more common in a MAN (M > F). Renal Microaneurysm
(similar to speed kidney). Associated with Hep B.

218
Q

KAwasaki

A

Medium Vessel vasculitis

Coronary Artery Aneurysm

219
Q

Small Vessel (ANCA +) vasculitis

A

Wegeners

Churg Strauss

Microscopic Polyangiitis

220
Q

Wegeners

A

Small Vessel (ANCA +) vasculitis

Nasal Septum Erosions, Cavitary Lung Lesions

221
Q

Churg Strauss

A

Small Vessel (ANCA +) vasculitis

Transient peripheral lung consolidations.

222
Q

Microscopic Polyangiitis

A

Small Vessel (ANCA +) vasculitis

Diffuse pulmonary hemorrhage

223
Q

Small Vessel (ANCA -) vasculitis

A

HSP

Bechcets

buergers

224
Q

HSP

A

Small Vessel (ANCA -) vasculitis

Kids. Intussusception. Massive scrotal edema.

225
Q

behcets

A

Small Vessel (ANCA -) vasculitis

Pulmonary artery aneurysm

226
Q

buergers

A

Small Vessel (ANCA -) vasculitis

Male smoker. Hand angiogram shows finger occlusions.

227
Q

Tc-99m

A

Energy - “Low” - 140

Physical half life - 6 hours

228
Q

Iodine - 123

A

Analog - iodine

Energy - low 159

Physical half life - 13 hours

229
Q

Xenon - 133

A

Energy - low 81

Physical half life - 125 hours (biologic t l /2
30 seconds)

230
Q

Thallium -201

A

Analog - Potassium

Energy - “Low” - 135 (2%), 167
(8%), use 71 ^01Hg
daughter x-rays

Physical half life -73 hours

231
Q

Indium - 111

A

Energy - “Medium” - 173 (89%),
247 (94%)

Physical half life -67 hours

232
Q

Gallium - 67

A

Analog - iron

Energy - Multiple; 93 (40%), 184
(20%), 300 (20%), 393
(5%)

Physical half life - 78 hours

233
Q

Iodine -131

A

Analog - iodine

Energy - high 365

Physical half life - 8 days

234
Q

Fluorine - 18

A

Analog - sugar

Energy - high 511

Physical half life - 110 mins

235
Q

Strontium 89

A

physical half - life - 50.5 DAYS

14 days in bone

236
Q

Samarium 153

A

physical half - life - 46 hours

237
Q

Radium

A

physical half - life - 11 days

238
Q

Yttrium 90

A

physical half - life - 64 hours

239
Q

Rubidium 82

A

physical half - life - 75 seconds

240
Q

Nitrogen 13

A

physical half - life - 10 mins

241
Q

Probable Critical Organ

Tc - MDP

A

Bladder (some sources say bone)

242
Q

Probable Critical Organ

Tc - Sulfur Colloid (IV)

A

Liver

243
Q

Probable Critical Organ

Tc - Sulfur Colloid (Oral)

A

Proximal Colon

244
Q

Probable Critical Organ

Tc - Pertechnetate

A

Stomach > Thyroid (some sources say colon)

245
Q

Probable Critical Organ

Tc - Sestamibi

A

Proximal Colon

246
Q

Probable Critical Organ

Tc - Heat Treated RBC

A

Spleen > Heart

247
Q

Probable Critical Organ

Tagged RBC - MUGA

A

Heart

248
Q

Probable Critical Organ

Tc - MAA

A

Lung

249
Q

Probable Critical Organ

Tc - DMSA

A

Renal Cortex

250
Q

Probable Critical Organ

Tc - MAG 3

A

Bladder

251
Q

Probable Critical Organ

DTPA

A

Bladder

252
Q

Probable Critical Organ

1-123 M1BG

A

Bladder (some sources say adrenal medulla)

253
Q

Probable Critical Organ

1-131 M1BG

A

Liver (some sources say adrenal medulla)

254
Q

Probable Critical Organ

1-131,1-123

A

Thyroid

255
Q

Probable Critical Organ

In-111 WBC

A

Spleen

256
Q

Probable Critical Organ

In-111 ProstaScint

A

Liver

257
Q

Probable Critical Organ

In-111 Octreoscan

A

Spleen

258
Q

Probable Critical Organ

Thallium 201

A

Renal Cortex

259
Q

Probable Critical Organ

F I8 FDG

A

Bladder

260
Q

Probable Critical Organ

Gallium

A

Distal Colon

261
Q

Probable Critical Organ

HIDA

A

Gallbladder Wall

262
Q

Mechanism o f Localization

Tc - Sestamibi

A

Passive Diffusion

Cross the cell membrane via lipophilic
diffusion

263
Q

Mechanism o f Localization

Tc - Tetrofosmin

A

Passive Diffusion

Cross the cell membrane via lipophilic
diffusion

264
Q

Mechanism o f Localization

Tc - HMPAO

A

Passive Diffusion

Delivery is flow related - then diffuse into
brain

265
Q

Mechanism o f Localization

Tc - ECD

A

Passive Diffusion

Delivery is flow related - then diffuse into
brain

266
Q

Mechanism o f Localization

DTPA

A

Filtration

267
Q

Mechanism o f Localization

F18-FDG

A

Facilitated Diffusion

Carrier mediated transport across membrane
via GLUT

268
Q

Mechanism o f Localization

1-123,1-131

A

Active Transport

Use ATP to move AGAINST concentration gradient

269
Q

Mechanism o f Localization

Thallium

A

Active Transport (Na/K Pump)

270
Q

Mechanism o f Localization

Rubidium

A

Active Transport (Na/K Pump)

271
Q

Mechanism o f Localization

M1BG

A 
Active Transport (Na facilitated
norepinephrine uptake system)
272
Q

Mechanism o f Localization

DMSA

A

Active Transport

273
Q

Mechanism o f Localization

Pertechnatate

A

Secretion

Active transport OUT of a gland or tissue

274
Q

Mechanism o f Localization

MAG-3

A

Secretion

Secreted by peritubular capillaries

275
Q

Mechanism o f Localization

Tc-99m IDA

A

Secretion

Secreted by hepatocytes

276
Q

Mechanism o f Localization

Sulfur Colloid

A

Phagocytosis

RES eats the colloid particles

277
Q

Mechanism o f Localization

Heat Treated RBCs

A

Sequestration

278
Q

Mechanism o f Localization

MAA

A

Capillary Blockade

Lung Perfusion

279
Q

Mechanism o f Localization

MDP

A

Chemisorption

Chemical Covalent + Hydrogen Bonding

280
Q

Mechanism o f Localization

SM -153

A

Chemisorption

281
Q

Mechanism o f Localization

Indium WBC

A

Cellular Migration

Cells migrate to the response of stimuli

282
Q

Mechanism o f Localization

Octreotide

A

Receptor Binding

283
Q

Mechanism o f Localization

DAT Scan
1-123 Isoflupane

A

Receptor Binding

284
Q

Tumors that are PET COLD

A

BAC (Adeno In Situ) - Lung Cancer

carcinoid

rcc

peritoeal bowlel/liver implants

anything mucinous

prostate

285
Q

Not Cancer but PET HOT

A

infection

inflammation

ovaries in follicular phase

muscles

brown fat

thymus

286
Q

FDG PET - Brain

alzheimer

A

Low posterior
temporoparietal cortical
activity

Identical to Parkinson
Dementia

287
Q

FDG PET - Brain

multi infarct

A

Scattered areas o f decreased

activity

288
Q

FDG PET - Brain

dementia with lewy bodies

A

Low in lateral occipital
cortex

Preservation o f the mid
posterior cingulate gyrus
(Cingulate Island Sign)

289
Q

FDG PET - Brain

picks/frontotemporal

A

low in frontal lobe

290
Q

FDG PET - Brain

huntingtons

A

low activity in caudate nucleus and putamen

291
Q

Tc DTPA

overview

A

Filtered (GFR)

Good For Native Kidneys with
Normal Renal Function

Critical Organ Bladder

292
Q

Tc MAG 3

overview

A

Secreted (ERPF)

Concentrated better by kidneys
with poor renal function

Critical Organ Bladder

293
Q

Tc GH

overview

A

filtered

Good for dynamic and cortical
imaging.

critical organ bladder

294
Q

ATN

A

Immediate Post OP
(3-4 days post op)

Perfusion Normal

Excretion Delayed

295
Q

Cyclosporin Toxicity

A

Long Standing

Perfusion Normal

Excretion Delayed

296
Q

Acute Rejection - renal

A

immediate post op

poor perfusion

excretion delayed

297
Q

Tc WBC vs In WBC

A

Tc WBC: renal and GI

ln WBC: no renal or gi

298
Q

Localization indium wbc

A

spleen

299
Q

Localization indium wbc damaged

A

liver and bone marrow

300
Q

Localization rbc tagged

A

heart

301
Q

Localization rbc damaged

A

spleen

302
Q

Tc WBC 4 hours

A

lung

303
Q

Tc WBC 24 hours

A

lunc clear

bowel starting

304
Q

Indium is BETTER than Gallium

for Evaluating

A

Suspected abdominal-pelvic abscess due
to the lack o f a normal bowel excretory
pathway

305
Q

Gallium is BETTER than Indium

for Evaluating

A 
• Spine
• Diffuse Pulmonary Processes: Gallium is
probably the agent o f choice for the
evaluation o f pulmonary inflammatory
abnormalities.
• Lymphocyte mediated infection
306
Q

Tc HMPAO is BETTER than In WBC

for Evaluating

A 
• Children (lower Dose)
• Inflammatory Bowel - *but you have to
image early - like around an hour {or 30
mins - depending on who you ask).
• Osteomyelitis in Extremity
307
Q

In WBC is BETTER than Tc HMPAO

for Evaluating

A

fouo

308
Q

Neuro toxo

A

ring enhancing

hemorrhage more common after treatment

thallium cold

pet cold

mr perfusion: decreased CBV

309
Q

Lymphoma neuro

A

ring enhancing

hemorrhage less common after treatment

thallium hot

pet hot

mr perfusion: increased or decreased CBV

310
Q

MR

AIDS
Encephalitis

A

Symmetric T2

Bright

311
Q

MR

PML

A

Asymmetric T2
Bright

T1 dark

312
Q

MR

CMV

A

periventricular t2 bright

ependymal enhancement

313
Q

MR

Toxo

A

ring enhancement

thallium cold

314
Q

MR

Cryptococcus

A

dilated perivascular spaces

basilar meninginitis

315
Q

Neuro Trivia

nf1

A

Optic Nerve Gliomas

316
Q

Neuro Trivia

nf2

A

MSME; Multiple Schwannomas, Meningiomas, Ependymomas

317
Q

Neuro Trivia

vhl

A

Hemangioblastoma (brain and retina)

318
Q

Neuro Trivia

ts

A

Subependymal Giant Cell Astrocytoma, Cortical Tubers

319
Q

Neuro Trivia

nevoid basal cell syndrome (gorlin)

A

Medulloblastoma

320
Q

Neuro Trivia

turcot

A

GBM, Medulloblastoma

321
Q

Neuro Trivia

cowdens

A

Lhermitte-Dulcos (Dysplastic cerebellar gangliocytoma)

322
Q

Maximum B le ed in g -A n eu r y sm Location

ACOM

A

Interhemispheric Fissure

323
Q

Maximum B le ed in g -A n eu r y sm Location

PCOM

A

Ipsilateral Basal Cistern

324
Q

Maximum B le ed in g -A n eu r y sm Location

MCA trifurcation

A

Sylvian Fissure

325
Q

Maximum B le ed in g -A n eu r y sm Location

Basilar Tip

A

Interpeduncular Cistern, or Intraventricular

326
Q

Maximum B le ed in g -A n eu r y sm Location

PICA

A

Posterior Fossa or Intraventricular

327
Q

Neuro

Inverting Papilloma

A

Demographics: 40-70
M>F (4:1)

Typical Location: Lateral nasal wall
centered at the middle
meatus, with
occasional extension
into the antrum
 Trivia: 40% show
"entrapped bone"
Cerebriform
Pattern
10% Harbor a
Squamous Cell
CA

Imaging Characteristics: Cerebriform Pattern
May have focal
hyperostosis on CT

328
Q

Neuro

Esthesioneuroblastoma

A

Demographics: Bimodal 20s &
60s

Typical Location: Dumbbell shaped with
waist at the cribiform
plate

Imaging Characteristics: AVID homogeneous
enhancement

329
Q

Neuro

SNUC

A

Demographics: Broad Range
(30s-90s)

Typical Location: Ethmoid origin more
common than
maxillary

Trivia: Large, typically >
4cm on
presentation

Imaging Characteristics: Fungating and
Poorly defined
Heterogeneous
enhancement with
necrosis
330
Q

Neuro

Squamous Cell CA

A

Demographics: 95% > 40 years
old

Typical Location: Maxillary Antrum is
involved in 80%

Trivia: Most Common
Malignancy of
Sino-Nasal track

Imaging Characteristics: Aggressive Antral Soft
Tissue Mass, with
destruction of sinus
walls Low signal
on T2 (highly
cellular)
Enhances less than
some other sinus
malignancies
331
Q

Neuro

JNA
(Juvenile
Nasopharyngeal
Angiofibroma)

A 
Demographics: Nearly
Exclusively
Male
Rare < 8 or >
25

Typical Location: Origin in the
Spenopalantine
Foramen (SPF)

Trivia: Radiation alone
cures in 80%

Imaging Characteristics: Enhancing mass
arising from the SPF
in adolescent male
Dark Flow Voids on
Tl
Avidly Enhances
332
Q

Neuro

Sinonasal Lymphoma

A

Demographics: Usually older,
peak is 60s

Typical Location: Nasal Cavity >
Sinuses

Trivia: Highly variable
appearance

Imaging Characteristics: Homogeneous mass in
nasal cavity with bony
destruction
Low Signal on T2
(highly cellular)

CTC (17 decks)

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