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Giant parietal foramen



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Figure 47.35  AP radiograph of the proximal tibia showing a diaphyseal fibrous cortical defect. Note the ground-glass appearance of the matrix.




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Figure 20-33 Advanced prostate cancer. A: Coronal T2-weighted fast spin-echo (FSE) image (4000/108) of the prostate obtained using an endorectal coil shows diffuse abnormal low signal throughout the peripheral zone. These are multiple sites of adenocarcinoma. The ejaculatory ducts are also thickened (arrows). B: Axial T2-weighted FSE image using the same pulse sequence as in A shows thickening of the normally gracile seminal vesicle septa indicating tumor invasion (arrows).



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Figure 50.37  Kienböck's disease. (A) The lunate is collapsed and sclerotic indicating avascular necrosis (arrow). (B) T1-weighted MR image. The normal fatty marrow is replaced by low signal material indicating that the bone is avascular (arrow). (C) Fat-saturated FSE T2-weighted sequence shows a paucity of inflammatory change.




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Median arcuate ligament syndrome



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Rolando’s #



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Zenk divert



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Multiple sclerosis. (A) Axial proton density and (B) gadolinium-enhanced T1W images show multiple lesions in the periventricular white matter, two of which are in the acute phase and enhance.

Tumefactive MS. (A) Axial T2W fast spin-echo and (B) gadolinium-enhanced T1W spin-echo images show a large MS plaque with considerable associated oedema in the right frontal lobe. Note the smaller periventricular lesions on the T2W image, and the ‘open ring’ of contrast enhancement.



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5th  nerve schwanoma



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Ica aneurysm



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L atrial enlargement



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Cavernous haemangioma. (A) T2-weighted axial image showing typical mixed signal intensity lesions. High signal is due to methaemoglobin and the low signal intensity rim of haemosiderin indicates an old haemorrhage. The ‘popcorn’ appearance of the larger lesion is typical of a ‘cavernoma’. Note the blood–fluid level in the smaller lesion (arrow). (B) Unenhanced CT of the same patients shows the lesions to be predominantly high density with tiny foci of calcification (arrows).



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Figure 24-26 Extralobar pulmonary sequestration, 6-month-old boy with a left paraspinal mass on chest radiographs. A: Computed tomography (CT) scan shows the anomalous vein (arrow) arising from the sequestered lung (S) and crossing the midline to the right hemithorax. B: More caudal CT image demonstrates the anomalous arterial vessel (white arrow) arising from the celiac artery (black arrow). A, aorta.



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Figure 66.29  Nephroblastomatosis. (A) US demonstrating uniformly hypoechoic lesions surrounding the periphery of an enlarged kidney in a diffuse type of nephroblastomatosis. (B) Delayed post-contrast CT sections demonstrate these lesions, typically showing reduced vascularity in a fairly homogeneous pattern. Dense contrast medium is seen within the normal renal parenchyma.

The differential diagnosis of diffuse nephroblastomatosis on US mainly includes renal lymphoma or leukaemia.




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Figure 67.10  Chondrodysplasia punctata. Stippled or punctate calcification in the region of the epiphyses



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Figure 62.13  Fibro-osseous lesions. (A) The milky texture of bone typical of fibrous dysplasia is seen in this CT. (B) Fibrous dysplasia is a lesion which expands bone—note the compression of the pterygopalatine fissure.




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Figure 74.27  Haemophilia. Lateral radiograph of the knee shows extensive, hyperdense synovitis



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Figure 74.18  Multiple myeloma. (A) Sagittal T1-weighted spin-echo and (B) fat-suppressed T2-weighted fast spin-echo MRI showing pathological collapse of T11 with cord compression and multiple smaller areas of focal marrow involvement. (C) Sagittal T1-weighted spin-echo MRI showing the variegated pattern of marrow involvement.




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Figure 61.10  Optic nerve meningioma. (A) Axial T2, (B) axial T1 MRI with gadolinium and fat suppression. There is a mass at the right orbital apex, closely applied to the optic nerve but seen separate to it. On the contrast-enhanced image, ‘tram-track’ enhancement along the nerve can be seen.




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Figure 71.17  Insulinoma. (A) Contrast enhanced spiral CT demonstrating a small brightly enhancing insulinoma (curved arrow) in the head of the pancreas. (B) Axial T1-weighted spin echo MR image and (C) T2-weighted fast spin echo image show the corresponding lesion (arrow) on MRI of low signal intensity on the T1- and high signal intensity on the T2-weighted images. (D) A coeliac arteriogram in the same patient shows the vascular blush of the insulinoma (arrow).




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                                                                    RETICULO NODULAR




                                                            HISTO- OTHER FUNGAL




OCCUPATIONAL                       -             Anthraco, Berrylliosis


EMBOLIC                                 -             Fat embolism

IDIOPATHIC                  -           Haman rich

MALIGNANCY              -           leukamia, lymphoma

                                                            Alveolar cell carcinoma

METASTASIS                -           Lympho hematogram    -  Thyroid

                                                                                                            -  Colon, pancreas

                                                                                                            -  prostate

                                                                                                            -  Breast in female



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Figure 70.52  Hypothalamic hamartoma. Coronal T1 and sagittal T1-weighted post-contrast MRI shows a nonenhancing lesion arising from the floor of the third ventricle posterior to the pituitary infundibulum and projecting inferiorly into the suprasellar cistern (arrows).




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Figure 70.40  Apert's syndrome. (A,B) 3D CT surface-shaded display shows the wide open defect of the sagittal suture and brachycaphaly with bicoronal synostosis typical of Apert's syndrome. The coronal sutures appear fused and are ridged. (C,D) Plain radiographs of the hands show the ‘mitten hand’ appearance with syndactyly and shortened metacarpals.



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Figure 70.12  Child with skin lesions and right orbital cyst in oculocerebrocutaneous syndrome or Delleman's syndrome . (A) There is callosal agenesis with dorsal interhemispheric cysts. (B) The right cerebral hemisphere is dysplastic with thickening of the cortex and an indistinct grey–white matter junction (arrow). There is a cyst expanding the orbit with a small calcified globe seen inferiorly (arrowhead). (C) An associated Dandy–Walker posterior fossa malformation is also present.




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Figure 54.21  Endometrioma. Transvaginal US in sagittal (A) and coronal (B) planes demonstrates a complex cystic mass in the left ovary consistent with endometrioma (E in A, B). Although endometriomas can appear similar to haemorrhagic cysts, the irregular contour, homogeneity of the internal echoes and persistence over an extended period favours the diagnosis of endometrioma. Axial T1-weighted (C) and T1-weighted fat-suppressed MR (D) images in a different patient show multiple high signal intensity lesions within the left ovary (arrow, C), suggesting either endometriosis or haemorrhagic cysts. Note how fat suppression increases the conspicuity of haemorrhagic lesions and helps differentiate them from dermoids. Diagnosis of endometriosis was confirmed at surgery.




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Figure 4-117 Second branchial cleft cyst. Computed tomography reveals a large thin-walled cystic mass (asterisk) anterior to the left sternocleidomastoid muscle (m) and posterior to the left submandibular gland (G).




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