Radiology Notes

My notes during radiology residency, fellowship, and beyond…

Archive for the ‘Uncategorized’ Category

Perilymphatic Lung Nodules

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  • sarcoid
  • lymphangitic spread of tumor
  • silicosis and CWP
  • amyloid
  • LIP

Written by lmwong

April 25, 2010 at 5:00 pm

Jepperson-Wong-Lai Syndrome

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  • Bilateral fat filled inguinal hernias
  • caused by concomitant weakness in both inguinal rings plus herniation of intra-abdominal fat
  • asymptomatic
  • 50% male
  • Risk factors: obesity, midwest
  • Associations: fatty liver disease, heart disease, diabetes
  • Benign incidental finding

Written by lmwong

April 1, 2010 at 3:19 pm

Conference Cases

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  • peroneal split tear
  • pump bump
  • Krukenberg tumor
  • pulmonary hypertrophic osteopathy
  • adenomyosis
  • atrial myxoma
  • prostate abscess
  • biloma
  • Epstein anomaly
  • Anomalous pulmonary venous return
  • Swyer-James syndrome
  • Cor Tiatriatrium
  • Pulmonary sling
  • atrial septal lipoma
  • Malignant takeoff of LCA
  • atrial myxoma
  • intracranial pheochromocytoma
  • pericardial sarcoma
  • complete absent of pericardium
  • pseudocoarctation of aorta
  • calcific pericarditis
  • Scimitar syndrome
  • Doubel aortic arch
  • Azygous continuation of IVC
  • osteochondral defect
  • Bony Bankart lesion
  • double PCL sign; medial meniscus tear
  • paralabral cyst
  • anterior tibial tendon tear
  • synovial chondromatosis
  • quadralateral space impingement syndrome
  • cyclops lesion; anterior knee postop scar tissue
  • soft tissue tumor

Written by lmwong

February 15, 2010 at 4:15 pm

Posted in Uncategorized

Venous Branches

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Written by lmwong

January 17, 2010 at 10:06 am

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Arterial Branches

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Written by lmwong

January 17, 2010 at 10:03 am

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Upper Limits of Normal

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if you must be a bean counter… Walls

  • Appendix = 3 mm
  • Gallbladder wall = 3 mm
  • Bowel Wall = 3 mm
  • Stomach Wall = 7-10 mm
  • Stomach Folds, fundus = 10 mm
  • Stomach Folds, antrum = 5 mm
  • Left Atrium = 4 mm
  • Left Ventricle = 12 mm
  • Esophagus = 3 mm
  • Vessel = 1 mm
  • Uterine wall during pregnancy = 3 mm
  • Endometrial wall = 16 mm (secretory phase), 5 mm (postmenopausal)
  • Bladder (distended) = 5 mm
  • Common carotid artery = 0.8 mm
  • pericardial wall = 1-3 mm

Lumen Diameters

  • Colon = 5 cm
  • Cecum = 8 cm
  • Small Bowel = 3 cm
  • Appendix = 6 mm
  • CBD = 6 mm (AFIP: not including wall, 5 mm, 6-7 mm equivical)
  • Gallbladder = 4 cm
  • trachea = 25 mm
  • Benign extra-axial CSF space >5 mm

Miscellaneous

  • Air-fluid levels = 2-5 cm
  • Liver span = 15.5 cm
  • Spleen span = 12-14 cm
  • Hiatal width = 15 mm
  • Esophageal folds = 3 mm
  • ankle joint space = 3-4 mm
  • Achilles tendon thickness = 8 mm
  • Boehler’s angle = 28-48 degress
  • cerebellar tonsils < 10y = <6 mm; >10y = ❤ mm
  • Peak Systolic Velocity <125cm/s
  • filum terminale <1.5 mm
  • atlantodental distance = 3 mm adults; 5mm kids; 8mm Downs
  • AC joint <8 mm
  • CC joint <13 mm
  • ankle mortise = 3-4 mm
  • cartilaginous cap (osteochondromas) <1 cm CT; <2 cm MRI
  • pituitary gland height = 3-8 mm adults; <10 mm puberty; >10 mm during pregnancy
  • Ovarian volume: <6y = 1cm^3, 6-10y = 1.2-2cm^3, 11-12y = 2-2.5cm^3, older = 8cm^3
  • Heel pad = 2.5 cm
  • Mean Sac Diameter – Crown Rump >5 mm
  • Yolk sac = 5 mm
  • Gallbladder polyp <5 mm
  • Uterine Wall (important in interstitial ectopic pregnancy) = 5 mm
  • Thecal sac AP = >7 mm c-spine; >10 mm L-spine
  • pineal gland = 11 mm
  • pituitary infundibulum = 2 mm
  • Welcher basal angle < 140 degrees on x-ray, < 120 degrees on MR (< 115 degrees for kids); platybasia
  • pre-dentate space >2.5 mm in adults or >4.5 mm in kids = atlantoaxial subluxation
  • foramen cecum < 10 mm
  • vestibular aqueduct <1.5 mm

Bone Displacement

  • humeral head >1 cm
  • radial head >3 mm
  • prosthesis to bone <2 mm

Spleen size by age

  • 0-3m = 6 cm
  • 3-6m = 6.5
  • 6-12m = 7
  • 1-2y = 8
  • 2-4y = 9
  • 4-6y = 9.5
  • 6-8y = 10
  • 8-10y = 11
  • 10-12y = 11.5
  • 12-15y = 12
  • 15-20y = 12 (M), 13 (F)

Liver size by age

  • 1-3m = 4-9 cm
  • 4-6m = 4.5-9.5 cm
  • 7-9 m = 6-10 cm
  • 1-2y = 6.5-10.5 cm
  • 3-4y = 7-11.5 cm
  • 5-6y = 7.5-12.5 cm
  • 7-8y = 7.5-13
  • 9-10y = 7.5-13.5 cm
  • 11-14y = 8.5-14 cm
  • 15-16y = 9.5-14.5 cm

Fetal Heart Rate

  • 2 mm embryo: 75 beats per minute
  • 5 mm embryo: 100 beats per minute
  • 10 mm embryo: 120 beats per minute
  • 15 mm embryo: 130 beats per minute
  • followup scan if <100 at 5-9 wks, <110 bpm at 10-15 wks

Aorta (using true short-axis dimension per Radiographics)

  • Thoracic Aorta = 4-5 cm ectasia; >5 cm aneurysm; 6 cm or 5 mm/6mo = surgery
    • root = 3.6 cm
    • ascending = 3.5 cm
    • arch = 2.9 cm
    • descending = 2.4-2.6 cm
  • Abdominal Aorta = 2.5-3 cm ectasia; >3 cm aneurysm

Vessels

  • Iliac artery = 1.5 cm
  • Pulmonary Arteries = 2.9 cm (pulm arterial HTN)
  • Portal Vein = 13-15 mm (portal HTN)
  • Splenic vein and SMV = 10 mm (portal HTN)

Written by lmwong

January 16, 2010 at 10:15 am

Posted in Uncategorized

Double Contrast Upper GI Series Dictation

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Indication: [x]

Technique: A standard air contrast upper GI series was performed.

Comparison: [x]

Findings:
The patient swallowed barium without difficulty. The esophagus is structurally normal without intrinsic or extrinsic masses. The esophageal mucosa appears normal.
The stomach demonstrates normal distensibility. No mass or ulceration is identified. There is no evidence of gastritis. The duodenal bulb and sweep are unremarkable. No ulcers can be identified.
No gastroesophageal reflux was demonstrated during this examination, despite the performance of maneuvers to elicit GE reflux.

Impression: Unremarkable upper GI series.

Written by lmwong

April 7, 2008 at 8:50 pm

Posted in Uncategorized