Radiology Notes

My notes during radiology residency, fellowship, and beyond…

Archive for December 2009

Bronchial Isomerism

leave a comment »

  • bilateral symmetry of bronchi and pulmonary lobes
  • ~CHD
  • bilateral RS ~ asplenia
  • bilateral LS ~ polysplenia

Written by lmwong

December 22, 2009 at 10:44 am

Posted in chest, lung

Congenital Cystic Adenomatoid Malformation

leave a comment »

  • Type 1
    • big cysts (2-10 cm)
  • Type 2
    • multiple small cysts
    • renal and cardiac anomalies
  • Type 3
    • solid
  • any lobe
  • alveoli replaced by adenomatoid
  • surgical resection
  • 70% present during 1st week of life
  • 10% diagnosed after 1st year
  • supplied by pulmonary artery; systemic supply rare
  • can involve entire lobe
  • prenatal diagnosis
    • polyhydramnios
    • fetal hydrops
    • solid or cystic mass in fetal thorax
  • excise affected lobe

Written by lmwong

December 22, 2009 at 10:42 am

Posted in chest, lung, pediatrics

Achalasia

leave a comment »

  • dysphagia, regurgitation, aspiration PNA
  • aperistalsis of the distal 2/3 and failure of the LES to relax
  • single contrast UGI = bird-beak narrowing and column of contrast opacifying dilated esophagus.
  • recommend Manometry
  • Rx: balloon dilatation and Heller myotomy (surgical incision)
  • DDx: Chagas disease, pseudoachalasia (carcinoma of the GE junction)
  • Eventual LES relaxation with continued drinking, distinguishes this from pseduoachalasia
  • Complications: Candida from stasis and Carcioma in upper/mid esophagus (20 years).

Written by lmwong

December 19, 2009 at 2:21 am

Posted in esophagus, gi

Acalculous Cholecystitis CT criteria

leave a comment »

2 major or 1 major + 2 minor

Major criteria:

  • Gallbladder wall thickening greater than 3 mm
  • Subserosal halo (ie, gallbladder wall edema)
  • Pericholecystic fatty inflammation
  • Pericholecystic fluid (without ascites or hypoalbuminemia)
  • Mucosal sloughing
  • Intramural gas

Minor criteria:

  • Gallbladder distention (>5 cm transverse)
  • High-attenuation bile (sludge)

Written by lmwong

December 19, 2009 at 2:18 am

Posted in abdomen, ct, gallbladder, gi

Abnormal Renal Vasculature

leave a comment »

  • multiple renal arties is common, 25% of population
  • second, diminutive artery supplying lower pole
  • supernumerary veins, less common than arteries
  • left is retroaortic
  • significant for preop planning

Written by lmwong

December 19, 2009 at 2:15 am

Posted in gi, renal

Aberrant tracheal bronchus

leave a comment »

  • RUL or segment of, originates from trachea
  • no clinical consequence
  • if intubated, may block origin and cause atelectasis

Written by lmwong

December 19, 2009 at 2:13 am

Posted in chest, lung, pulmonary

Abdominal walls and spaces

leave a comment »

Walls

  • falciform ligament
  • lesser omentum
  • greater omentum
  • anterior and posterior renal fascia

Spaces

  • peritoneal space
  • left subphrenic space
  • right subphrenic space
  • Morrion’s pouch
  • lesser sac
  • retroperitoneal space
  • anterior pararenal
  • perirenal
  • pelvis
  • pouch of Douglas (cel-de-sac)
  • retrovesical
  • extraperitoneal space

Written by lmwong

December 19, 2009 at 2:12 am

Posted in abdomen, gi