Radiology Notes

My notes during radiology residency, fellowship, and beyond…

Aspergillosis Spectrum

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  • fungus ball
  • preexisting cavity, bulla, bronchiectasis
  • saprophytic
  • sarcoidosis, CF
  • Hemoptysis
  • round opacity within cyst or cavity
  • air crescent
  • mobile
  • pleural thickening

Semiinvasive Aspergillosis

  • Mildly immunosuppressed hosts
  • focal consolidation > cavity > air crescent > thick-walled cyst > fungus ball

Invasive Aspergillosis

  • Immunocompromised hosts
  • granulocytopenia
  • single or multiple nodules
  • cavitation
  • air crescent
  • “Halo” sign on CT

Allergic Bronchopulmonary Aspergillosis

  • Hypersensitiviy reaction to aspergillus in mucous plugs
  • mucoid impaction
  • asthmatic patients
  • lobar consolidation
  • chronic, upper lobe scarring and bronchiectasis

Written by lmwong

October 8, 2013 at 9:12 pm

Posted in chest, differential


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What are those devices called and what are they used for? Here are some helpful links I use:

Gallery of Medical Devices, Part 1. Radiographics.

Gallery of Medical Devices, Part 2. Radiographics.

Ortho Atlas from University of Washington

Written by lmwong

June 12, 2013 at 9:10 am

Posted in abdomen, chest, fracture, msk, x-ray

Cord Insertion Types

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Required element in a complete >14wk OB ultrasound report.

Cord Insertion types: central, eccentric, marginal, and velamentous

Nice youtube video for ultrasound images.

Written by lmwong

May 16, 2013 at 11:05 am

Posted in OB, ultrasound

Hypertrophic Olivary Degeneration

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Written by lmwong

May 8, 2012 at 12:56 pm

Posted in neuro, pediatrics

Blount’s disease

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  • tibia vara, causes genu varum.
  • metaphyseal-diaphyseal angle >11 degrees
  • bilateral ~infantile type
  • pain in adolescent

Written by lmwong

May 8, 2012 at 8:41 am

Posted in bone, msk, pediatrics

Vascular Anomalies, ISSVA Classification

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2 categories: vascular tumors or vascular malformations. Distinction determines therapy.

Vascular Tumors

  • infantile hemangiomas: grow rapidly after birth, GLUT1+
  • congenital hemangiomas (RICH and NICH): fully mature at birth, GLUT1-
  • Tufted angioma
  • Kaposiform hemangioendothelioma
  • Spindle cell hemangioendotheliomas
  • Dermatologic acquired vascular tumors

Vascular malformations (slow)

  • capillary malformation (port-wine stain, telangiectasia, angiokeratoma)
  • venous malformation
  • lymphatic malformation

Vascular malformations (fast)

  • arterial malformation
  • arteriovenous fistula
  • arteriovenous malformation

PDF link

Written by lmwong

April 23, 2012 at 12:57 pm

Status Marmoratus

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Status marmoratus is the presence in full-term infants of basal nucleus lesions resulting from acute total asphyxia. The lesions have a marbled appearance caused by neuronal loss and an overgrowth of myelin in the putamen, caudate, and thalamus.  – wiki

Link about HIE

Another good link about HIE

Written by lmwong

April 12, 2012 at 12:09 pm

Posted in basal ganglia, head, neuro

Tagged with

Etat Crible

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  • dilatation of perivascular spaces around cerebral arterioles in the basal ganglia of elderly people
  • associated with vascular parkinsonism


Written by lmwong

April 12, 2012 at 8:13 am

Posted in neuro

MRI Hand and Wrist anatomy link

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A nice PDF link to an old radiographics article diagraming MRI hand and wrist anatomy in a concise fashion:

Written by lmwong

April 9, 2012 at 4:03 pm

Posted in hand, mri, msk, wrist

Persistent fetal origin of PCA

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The best picture of persistent fetal origin of the PCA I can find on the net…

  • PCA originates from ICA, rather than basilar artery
  • 15% of people

Written by lmwong

April 9, 2012 at 8:45 am

Posted in carotid, neuro

Categories and Causes of Hydrocephalus

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Pediatric specific causes of hydrocephalus…

Written by lmwong

March 25, 2012 at 10:48 am

Pituitary Hyperplasia

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  • convex superior margin of pituitary
  • upper limits of normal CC dimension
    • lactating women: 12 mm
    • menstruating women: 10 mm
    • males/postmenopause: 8 mm
    • infants: 6 mm
  • DDx: Turner, Klinefilters, hypothyroidis, Addison, end-organ failure.
Source: StatDX

Written by lmwong

November 3, 2011 at 2:31 pm

Posted in neuro, upper

Wilm’s Tumor

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  • Age: 80% <6yo; most common abdominal neoplasm 1-8 yo.
  • Appearance: solid mass in kidney (claw sign), pushing away vessels, not crossing mid-line
  • IVC and renal vein thrombosis
  • Mets to lung, liver, brain, bone
  • Staging
    • I = confined to kidney
    • II = local extension to perinephric space
    • III = lymph nodes
    • IV = distant mets
    • V = bilateral renal
  • DDx: neuroblastoma (crosses mid-line, encases vessels, calcify), multilocular cystic nephroma, sarcoma, RCC, nephroblastomatosis, mesoblastic nephroma, AML, renal medullary carcinoma


Written by lmwong

October 28, 2011 at 1:17 pm

Posted in abdomen, GU, pediatrics, renal

Sites of Metastasis

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Nice graphic of where primaries metastasize: link

Written by lmwong

October 28, 2011 at 9:54 am

Posted in cancer, metastasis

Red Marrow

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  • more water content, bright on T2
  • amorphous and feathery, flame shaped
  • metaphyseal and metadiaphyseal
  • smoking and obesity, middle aged females

Written by lmwong

July 12, 2011 at 7:32 am

Posted in bone, mri, msk

Ultrasound Landmarks for Early Pregnancy Failure

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Written by lmwong

March 6, 2011 at 7:45 am

Posted in OB, ultrasound

Disc Disease Nomenclature

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Divide axial disc into 4 quadrants of 25%:

Focal Herniation = <25% [pic] (protusion type or extrusion type) [pic]

Broad based Herniation = 25-50% [pic]

Bulge = >50% normal disc circumference.

Symmetric Disc Bulging = 100% [pic]


Written by lmwong

January 5, 2011 at 4:00 pm

Posted in classification, neuro, spine

Spinal Mass Differential

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A. Intradural, Intramedullary: astrocytoma, ependymoma, hemangioma, cavernoma, dermoid/epidermoid
B. Intradural, Extramedullary:  nerve sheath tumors, meningioma
C. Extradural: bone neoplasm, mets, abscess, TB, hematoma, disk, synovial cyst, lipomatosis, neuroblastoma/ganglioneuroma

Written by lmwong

December 17, 2010 at 1:14 pm

Posted in differential, neuro, tumor

Lung Cancer Staging

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New 7th Edition of for Lung Cancer Staging, Radiographics Sept 2010.

Written by lmwong

December 16, 2010 at 4:07 pm

MRI Ankle Checklist

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Written by lmwong

December 16, 2010 at 10:00 am

Posted in bone, checklist, msk