Radiology Notes

My notes during radiology residency, fellowship, and beyond…

Archive for March 2010

Urethral Injury Types

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urethral injury typesPosterior urethra: from bladder neck, through prostate, to membranous urethra

Anterior urethra: bulbar and penile urethra

  • type 1: stretched, periurethral hematoma
  • type 2: rupture above urogenital diaphragm, extraperitoneal contrast
  • type 3: rupture below urogenital diaphragm, extraperitoneal and perinium contrast
  • type 4: bladder extending to urethra
  • Type 5: anterior urethral injury
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Written by lmwong

March 31, 2010 at 2:53 pm

Posted in classification, GU, trauma

Bladder Rupture Classification

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  • Type 1: contusion
  • Type 2: intraperitoneal rupture
  • Type 3: interstitial bladder injury
  • Type 4: Extraperitoneal rupture; a = simple; b = complex
  • Type 5: Combined bladder injury

Written by lmwong

March 31, 2010 at 2:48 pm

Renal Scintigraphy

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MAG-3 or DTPA

  • Perfusion/Obstruction
  • normal uptake 50/50 L and R kidney; >60/40 is abnormal
  • normal peak < 5 minutes
  • normal residual coritcal activiy < 0.3
  • Lasix
    • increases urine output
    • inject 15 min before MAG3/DTPA
    • no washout after Lasix = obstruction
    • normal T1/2 = < 10 min
    • obstructed T1/2 = >20 min
  • Captopril
    • evaluate renal artery (renal artery stenosis, ischemia, renovascular hypertension)
    • baseline scan, captopril scan, post scan
    • high prob RVH = marked captopril induced changed

DMSA = Morphology

  • for UTI or pyelonephritis, congenital malformation
  • cold spots: pyelonnephritis, tumors, cyts, hydronephrosis, trauma, infarct

Radionuclide Cystogram

  • UTI, VUR
  • sulfur colloid, DTPA, MAG-3
  • fill bladder until reverse flow

Source: ppt

Written by lmwong

March 31, 2010 at 10:39 am

Posted in nuclear medicine, renal

Tumor Cancer Staging

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Nasophyngeal Squamous Cell Carcinoma Head and Neck

  • Tis = carcinoma in situ
  • T1 = confined to 1 site
  • T2 = 2 sites
  • T3 = extends to nasal cavity or oropharynx
  • T4 = invades skull, cranial nerve
  • N0 = no nodes
  • N1 = homolateral node ❤ cm
  • N2 = homolateral node > 3 cm
  • N3 = node > 6 cm
  • M0 = no mets
  • M1 = distant mets

Thyroid Cancer

  • T1a = nodule < 4cm
  • T1b = nodule > 4cm
  • T2 = nodule with partial fixation
  • T3 = nodule with complete fixation
  • N1 = regional nodes
  • N2 = fixed regional nodes
  • M1 = mets

Lung Cancer (TNM)

  • T0 = no tumor
  • T1 ❤ cm
  • T2 >3 cm, >2 cm from carina
  • T3 extends to chest wall, sulus, diaphragm, pleura, pericardium, <2 cm from carina
  • T4 distant mets
  • N0 = no nodes
  • N1 = ipsilateral hilar
  • N2 = ipsilateral mediastinal and subcarinal
  • N3 = contralateral, supraclavicular
  • M0 = no mets
  • M1 distant mets

Stomach Cancer

  • T1 = mucosa
  • T2 = muscle, serosa
  • T3 = penetration
  • T4 = adjacent organs

Renal Cell Carcinoma

  • Stage I = confined to kidney, <7 cm
  • Stage II = confined to kidney, >7 cm
  • Stage III = fatty infiltration, venous invasion, LN mets
  • Stage IV = through Gerota’s fascia, distant mets

Wilm’s Tumor

  • I = kidney
  • II = extend to perinephric space
  • III = LN
  • IV = mets to lung or liver
  • V = bilateral renal involvement

Colon Cancer (Dukes)

  • A = bowel wall only
  • B = serosa
  • C = LN
  • D = mets

Colon Cancer (TNM)

  • T1 = mucosa or submucosa
  • T2 = invasion or muscularis propria
  • T3 = invasion into subseroa
  • T3 = adjacent structures, fistulas
  • N1 = 1-3 LN
  • N2 = >4 LN
  • N3 =  LN along named vascular trunk
  • M = Mets

Bladder Cancer

  • T1 = mucosal and submucosal tumors
  • T2 = superficial muscle layers
  • T3a = deep muscular wall
  • T3b = perivesicular fat
  • T4 = other organs

Prostate Cancer (Jewett)

  • A = nonpalpable, found at biopsy
  • B = palpable, confined to prostate
  • C = through prostate capsule
  • D = mets

Endometrial Carcinoma

  • 1 and 2 = confined to uterus
  • 3 and 4 = extrauterine

Cervical Cancer

  • IA = confined to cervix
  • IB = extend to uterus
  • IIA = extend to upper vagina
  • IIB = parametrial involvement
  • IIIA = extend to lower vagina
  • IIIB = pelvic wall
  • IVA = adjacent organs
  • IVB = distant organs

Ovarian Cancer

  • 1 = ovary
  • 2 = both ovaries +/- ascites
  • 3 = intraperitoneal mets
  • 4 = mets outside peritoneal cavity

Breast Cancer

  • 0 = DCIS
  • 1 = <2 cm
  • 2 = 2-5 cm, axillary nodes
  • 3 = >5 cm, pectoralis involvement or matted LN
  • 4 = distant mets

Written by lmwong

March 30, 2010 at 9:56 am

Cardiomyopathies

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Hypertrophic

  • familial (AD)
  • sporadic

Dilated

  • infectious
  • metabolic
  • toxic: alcohol, Adriamycin
  • Collagen vascular disease

Restrictive

  • amyloid
  • sarcoid
  • Loeffer’s eosinophilic endocarditis
  • collagen vascular disease

Written by lmwong

March 30, 2010 at 8:33 am

Posted in cardiac, chest, differential

Cryptogenic Organizing Pneumonia

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  • aka: BOOP, proliferative bronchiolitis
  • pattern
    • 90% multiple basilar nodular consolidation
    • band-like opacities
    • perilobular pattern
  • DDx:
    • chronic eosinophilic pneumonia
    • bronchioalveolar cell carcinoma
    • sarcoid
    • aspiration
    • lipoid pneumonia
    • pulmonary embolism
    • lymphoma

Written by lmwong

March 29, 2010 at 1:32 pm

Posted in chest

Neonatal Ascites

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Written by lmwong

March 24, 2010 at 8:20 pm