Radiology Fundamentals (eBook)

Radiology Fundamentals 3
Preface to the FourthEdition 7
Contents 9
Contributors 13
1: Patient Radiation Safety and Risk 19
What Is Radiation? 19
Where Do We Use Radiation in a Hospital? 22
What Are the Risks? 22
Resources 22
References 23
2: Introduction to Radiology Concepts 24
Radiographic Densities 24
Main Radiographic Densities 24
The Silhouette Sign 26
3: Conventional Radiology 28
The Radiograph Projection 28
4: Ultrasound 33
Ultrasound 33
Color and Power Doppler Imaging in Ultrasound 36
Indications for Ultrasound Use 36
5: Computed Tomography 38
CT Imaging Orientation 38
Pixels and Voxels 38
CT Values or Hounsfield Units 40
Contrast Studies 41
Optimizing the Visualization of Specific Structures 41
6: MRI 43
Advantages and Disadvantages of MRI 44
7: Nuclear Medicine 45
Introduction to Nuclear Medicine 45
8: Cardiovascular and Interventional Radiology 49
Digital Subtraction Angiography 49
Central Venous Access 50
Other CVIR Activities 51
9: Heart and Mediastinum 52
Cardiac Contours 52
Cardiac Measurement on the Plain Radiograph 53
The Mediastinum 53
10: Lateral Chest 57
Chest Projection 57
Hemidiaphragms 59
Identifying Hilar Enlargement 61
11: Pulmonary Mass Lesions 62
Criteria to Consider in the Evaluation of a Mass Lesion 63
Pulmonary Nodules and Masses 63
Coin Lesion 64
Hamartoma 65
Cavitary Lesion 65
Pulmonary Nodules 67
Round Pneumonia 68
Pseudotumor 69
12: Air Space Disease 70
13: Interstitial Disease 74
Introduction 74
Kerley Lines 75
Peribronchial Cuffing 75
Reticular and Reticulonodular Patterns 76
Subpleural Thickening 76
The Differential Diagnosis for Interstitial Disease Is Exhaustive 77
14: Atelectasis 79
Introduction 79
Postobstructive Atelectasis 80
Cicatrization Atelectasis 80
Adhesive Atelectasis 80
Passive Atelectasis 81
Radiographic Opacity 83
15: Pulmonary Vasculature 84
Pulmonary Vessel Distribution in the Lung 84
Identifying Pulmonary Vessels 85
Pulmonary Artery Hypertension 86
Shunt Vascularity 87
Pulmonary Venous Hypertension 88
16: Pulmonary Edema 91
Changes of Cephalization 91
Interstitial Edema 93
17: Pneumothorax 96
Radiographic Appearance of a Pneumothorax 96
Tension Pneumothorax 98
Deep Sulcus Sign 99
18: Miscellaneous Chest Conditions 101
Calcific Pericarditis 101
Tuberculosis 102
Mediastinal Lymphadenopathy 103
Kaposi’s Sarcoma 104
Pneumocystis Carinii Pneumonia 105
Pulmonary Embolus 106
Asbestos 107
Opacified Hemithorax 109
19: Tubes and Lines 110
The Endotracheal Tube 110
Central Venous Catheters 111
The Nasogastric Tube 114
20: Breast Imaging 116
Standard Mammography Views: CC and MLO 117
Dense Fibroglandular Breast Tissue 118
Breast Implants 120
Mammographic Findings 121
Radiation Dosage 123
Ultrasound Utilization in Breast Imaging 125
Breast MRI 125
Image-Guided Biopsy 126
BI-RADS ® 127
Additional Reading 129
21: Women’s Ultrasound 130
Evaluation of Premenstrual Females 131
Evaluation of the Uterus and Uterine Bleeding 131
Evaluation of the Ovaries 132
Pregnancy 133
22: Women’s Health Interventions 136
Introduction 136
Uterine Artery or Fibroid Embolization 136
Ovarian Vein Embolization and Pelvic Congestion Syndrome 137
Fallopian Tube Recanalization 139
23: Abdominal Calcifications 141
Chronic Pancreatitis 141
Vascular Calcifications 142
Uterine Fibroids 143
Appendicolith 143
Urinary Tract Calculi 145
24: Abnormal Air Collections in the Abdomen 147
Pneumoperitoneum 147
Pneumatosis Intestinalis 148
25: Barium Studies of the Upper GI Tract 150
Fluoroscopy 150
Normal Esophageal Motility 151
Esophageal Carcinoma 152
Esophageal Diverticuli 152
Double and Single Contrast GI Studies 153
Small Bowel Follow Through 155
Conventional Enteroclysis 155
CT Enteroclysis 156
CT Enterography 157
26: Barium Enema and CT Colonography 159
Colonic Diverticuli and Polyps 162
Crohn’s Disease 162
Intussusception 164
CT Colonography (“Virtual Colonoscopy”) 164
27: Bowel Obstruction 168
Small Bowel Obstruction 168
Large Bowel Obstruction 170
Evaluation for Obstruction 172
Ileus 172
Mucosal Edema 172
28: Inflammatory Bowel Disease 175
Crohn’s Disease 175
Crohn’s Cobblestoning 176
The “String Sign” 176
Ulcerative Colitis 177
Polypoid Changes in Inflammatory Bowel Disease 177
Ulcerative Colitis and Colon Cancer 178
Toxic Megacolon 178
29: Defecography 180
Indications 180
Technique 180
Anatomy 181
Physiology 182
Abnormal Defecography Findings 182
30: Intra-abdominal Lymphadenopathy 187
Lymphadenopathy 187
Lymphangiogram (Historical Perspective) 188
Computerized Tomography Scanning 188
31: The Gallbladder 191
The Gallbladder on Plain Radiograph 191
Gallbladder on Ultrasound 192
The IDA Scan 193
Visualizing the Biliary Tree 193
Gallstones on CT 196
32: Abdominal and Pelvic Pain Evaluation 198
Imaging of Acute Types of Pain 199
33: Imaging the Trauma Patient 208
34: Concerning Lesions 215
Abscess 215
Pneumoperitoneum 216
Abdominal Aortic Aneursym 217
Renal Cell Cancer 218
Hepatocellular Carcinoma 219
Portal Venous Gas 220
Pancreatic Mass 220
Colitis 222
35: Incidental Lesions 224
Introduction 224
Incidental Cystic Renal Lesion 224
Incidental Solid Renal Lesion 225
Incidental Hepatic Lesion 225
Incidental Adrenal Lesion 227
Incidental Pancreatic Lesion 228
References 230
36: Radionucleotide Evaluation of GI Bleeding 231
37: Radionucleotide Bone Imaging 235
Radiotracer Uptake 235
38: Lung Ventilation and Perfusion Imaging 240
Interpreting Lung Ventilation–Perfusion Study Results 241
39: Radionucleotide Cardiac Imaging 243
40: F-18 FDG Positron Emission Tomography 246
Overview 246
Patient Preparation 247
Application in Oncology 249
PET Pitfalls 251
41: Diagnostic Arteriography 254
Femoral and Brachial Artery Access 254
Arteriography Complications 256
42: Pulmonary Arteriography and IVC Filter Placement 258
IVC Filter Placement 260
Reference 262
43: Percutaneous Nephrostomy Placement 263
44: TIPS 266
TIPS Placement 267
Long-Term Survival 269
45: Central Venous Access 271
46: Fractures: Part I 275
The Simple Fracture 275
Fracture Nomenclature 275
Pediatric Fractures 278
Salter–Harris Fracture Classification 279
Greenstick and Torus Fractures in Children 280
Battered Child Syndrome 281
Pathologic Fracture 281
Osteoporosis 282
Reference 285
47: Fractures: Part 2 286
Shoulder Views 286
Shoulder Dislocation 288
Fat Pad Sign 288
Colles’ Fracture 290
The Scottie Dog 291
Pelvic Fractures 292
Femoral Neck Fractures 292
Knee Joint Effusion 293
Tibial Plateau Fractures 296
Ankle Fractures 296
Reference 300
48: Arthritides 301
Osteoarthritis 301
Rheumatoid Arthritis 302
Distinctions Between Osteoarthritis and Rheumatoid Arthritis 302
Gout 304
49: Bone Tumor Characteristics 306
50: CNS Anatomy 311
51: The Cervical Spine 313
Systematic Approach to Evaluating the Cervical Spine with CT or Plain Film 313
MRI in the Cervical Spine Evaluation 316
52: Head Trauma 317
Skull Radiograph 317
Epidural Hematoma 318
Subdural Hematoma 319
Subarachnoid Hemorrhage 319
Parenchymal Contusion 320
Diffuse Axonal Injury 320
53: Stroke 323
Introduction 323
Imaging Findings in Stroke 323
Summary 328
54: Headache and Back Pain 329
Introduction 329
Intracranial Hemorrhage 329
Other Common Causes of Headache on Imaging 330
Back Pain 330
Summary 332
55: Radiology Coming Soon 333
MR Enterography: Michael Moore, MD 333
Tissue Ablation Techniques: Allene Burdette, MD 334
Coronary CTA 335
References 338
Index 339