The Radiologist Eye
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Geodes in rheum arthritis
Lymphangioleiomyomatosis. (A) There is a profusion of thin-walled cystic airspaces scattered evenly throughout the lungs. The cysts are relatively uniform in size. (B) In a more advanced case of LAM, note the small left-sided pleural effusion.
Chronic pancreatitis with pseudocyst
Van der Knaap’s disease or Megalencephalic leukodystrophy with subcortical cysts
Findings: punctate calcific deposits in cartilaginous skeleton -Spinal column, pelvis, epiphyses, scapula-severe & symmetric rhizomelic shortening Diagnosis : chondrodysplasia punctata (rhizomelic type)
Inverted Meckel's diverticulum.
Chondrodysplasia punctata is characterized by stippled calcifications in the infantile cartilaginous skeleton and surrounding tissues. There are two main forms: rhizomelic and non-rhizomelic Rhizomelic form is characterized by symmetric shortening of the proximal long bones and a lethal course within the first years of life. Paravertebral calcifications and vertebral anomalies are uncommon. Non-rhizomelic form is characterized by asymmetric shortening of the proximal long bones. In addition, paravertebral calcifications and vertebral anomalies are common.
Bilateral lymphangitic carcinomatosis showing bilateral thickened septal lines together with widespread nodulation of the lungs. The primary tumour in this 71 year old woman was presumed to be a bronchial carcinoma (a diagnosis based on sputum cytology).
Staghorn calculus R
Narrowing of subglottic airway – laryngotracheobronchitis:croup
Giant lung hamartoma
a single polypoid lesion in the greater curvature aspect of the antrum (due to aberrant pancreatic tissue) Small 1-3cm sized submucosal tumors generally found towards distal end of greater curve of the antrum or in proximal duodenum b/w cap & papilla
Pneumomediastinum- continuous diaphgram sign
Sclerosing peritonitis. Enhanced CT shows loculated fluid collection and extensive peritoneal calcification
Lipoma. (A) A large intraluminal filling defect is seen occupying and distending the second part of the duodenum on a barium examination. (B) CT shows the lesion to be a well-defined, round mass with low attenuation values, characteristic of fat.
Axial T2 image shows the hyperintense mass lesion causing marked expansion of pons (red arrow) more clearly and the flow void in basilar artery (yellow arrow). Notice the mass effect on the fourth ventricle that is distorted and displaced posteriorly (blue arrow). Sagittal post gad T1 image showing the cranio-caudal extent of mass lesion with involvement of entire brainstem (green arrow). Diffuse Brainstem Glioma
Multiple cystic lucencies seen in the left hemithorax causing contralateral cardiac &mediastinal shift and collapse of rt. Lung.Gastric bubble is not visualised in its normal location with paucity of small bowel loops in the abdomen. f/s/o lt sided diaphragmatic hernia with stomach & small bowel loops as its contents
Pulmonary arterial hypertension. Chest radiograph demonstrates gross dilatation of the main, left and right pulmonary arteries in a patient with Eisenmenger atrial septal defect.
Congenital Cytomegalovirus Infection
Mediastinal lipomatosis. A: Abundant fat is seen in the anterior mediastinum and right paratracheal region; (arrowheads) extrapleural fat. B: On T1-weighted magnetic resonance image at the same level, the fat is similar in signal intensity to subcutaneous fat. On T2-weighted images the fat was similar in signal intensity to subcutaneous fat as well.
Hypodense mass with capsule sitting on the dura over the anterior fontanelle but not extending intracranially. Anterior fontanelle dermoid.
Lucent multilocular abnormality projecting within the contours of the pericardium. Continuity of the lucent abnormality with a gas pattern below the hemidiaphragm. Dx: Hernia of the stomach and bowel into the pericardium
Pilocytic astrocytoma. The images reveal a large mass arising from the vermis of the cerebellum. There are two large cystic areas, with a central band of enhancing solid tissue, which terminates posteriorly into a heterogeneously enhancing nodule. The mass is behind the fourth ventricle, which is displaced anteriorly, and there is significant mass effect on the brainstem which is pushed against the clivus.There is also mass effect inferiorly, resulting in displacement of the cerebellar tonsils through the foramen magnum (sagittal scan).Moderate to severe hydrocephalus is noted, with enlarged third ventricle and temporal horns seen on the CT images.
Sarcoidosis. Typical HRCT features are (A) nodular opacities which (B) may become confluent, and (C) interlobular septal thickening.
Prominent flow voids in the regions of the basal ganglia bilaterally prominent posterior pericallosal flow voids absence of the normal proximal anterior and middle cerebral arteries with prominent collaterals seen in the basal ganglia bilaterall Moya moya.
Small tubular stomach, dilated esophagus. Microgastria.
Menetrier's disease. Thick folds on the upper GI series
(a) On precontrast CT, there is a hypodense mass. (b) The capsule of the mass enhances slightly with contrast. Posterior fossa dermoid.
Optic foraminal widening on xray
Sacral chordoma. CT shows a predominantly lytic mass with small foci of calcification. Age at presentation- 50-70
areas of sclerosis involving the iliac aspects of the SI joints b/la T2W axial MRI of the SI joints shows abnormal hypointense areas involving the iliac aspects of both SI joints Osteitis condensans ilii
Thickened small bowel- malabsorption (INTESTINAL LYMPHENGECTESIA) causing rickets
The erythroid hyperplasia of the marrow results in widening of the diploic space, thinning of the outer table, and a granular osteoporosis. In the more advanced state partial or total atrophy of the outer table is seen, with hair-on-end spiculation of bone. The frontal bones reveal the earliest and most severe changes, whereas the inferior occiput usually remains unaltered. Thalessemia