By Lee A Grant BA (Hons) FRCR, Nyree Griffin MB ChB MD FRCR
Get the quick answers you wish on each element of diagnostic radiology and apply them on your daily practice. Grainger & Allison’s Diagnostic Radiology Essentials serves as a finished evaluate and reference for radiologists in education and in perform by way of offering sensible suggestions to diagnostic difficulties within the radiological acceptance and interpretation of a variety of affliction entities. equipped via physique zone, its cutting edge, available define layout, bullet element kind and diverse, top of the range, multi-modality photos make crucial key evidence approximately any given effortless to discover and retrieve. The content material follows an identical order and springs from the well known authoritative reference paintings Grainger & Allison’s Diagnostic Radiology. "The authors should be congratulated on their gargantuan efforts and i'm yes this textbook may be good thumbed via destiny radiology trainees getting ready for his or her examinations." RAD journal, Nov 2013
- Find the solutions you wish speedy and easily utilizing the synoptic, bullet element structure and constitution. each part is organised always to incorporate Definition, medical Findings, Radiological Findings and Pearls.
- Efficiently assessment the most important radiological features of a large spectrum of sickness entities - all pictures are associated with the textual content at the dealing with page.
- Avoid strength pitfalls in prognosis by touching on the diagnostic "Pearls" sections in every one bankruptcy.
- Differentiate an entire variety of ordinary and irregular findings with greater than 3,000 photographs, together with simple movie, CT, MRI, ultrasound and nuclear drugs imaging.
- Keep hard-to-remember details and details at your fingertips with an in depth Appendix part together with many ‘quick reference’ goods which are crucial in daily perform (e.g. TNM staging).
- Access the full textual content and pictures online, absolutely searchable, at specialist Consult.
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Additional resources for Grainger & Allison's Diagnostic Radiology Essentials
TRACHEOBRONCHOMALACIA Definition This results from weakened tracheal cartilage rings ▶ It is seen in association with tracheobronchomegaly, COPD, relapsing polychondritis and following trauma CT Luminal diameter narrowing > 50% on expiration compared with inspiration (>70% with COPD due to higher downstream resistance) ▶ a coronal tracheal diameter significantly larger than the sagittal diameter (producing a lunate configuration) • Central tracheobronchial tree involvement may be either diffuse or focal Tracheobronchomalacia.
Frontal chest radiograph shows a large right-sided mediastinal mass. Note the butterfly vertebral body (arrowhead). ) PA Ao S LA A Pericardial cyst. (A) Frontal and (B) lateral chest radiographs show a large well-marginated mass in the right cardiophrenic angle. B Pericardial cyst. Axial spin-echo MRI at the base of the heart. An intermediate signal intensity smooth mass extrinsic to the heart is identified (arrow). g. g. the GI tract, kidney, testis, head and neck tumours, breast) MIDDLE MEDIASTINAL MASSES Low-attenuation lymph node enlargement.
The patient developed cough and fever. (A) Initial chest radiograph demonstrates peripheral homogeneous opacities in both upper lobes and heterogeneous opacities in the left lower lobe. (B) A subsequent PA chest radiograph demonstrates cavitation within the peripheral left opacity following appropriate antifungal therapy and reconstitution of neutrophils 6 days into the course. g. from contaminated water) and by direct contact with dogs • Cysts develop within the lungs (less commonly within the mediastinum) and are usually solitary § 10% of cysts are multiple, bilateral, or associated with liver cysts § At presentation ⅔ of cysts are ruptured (⅓ remain intact) RADIOLOGICAL FEATURES Unruptured pulmonary cysts • One or more homogeneous, roughly spherical or oval, sharply demarcated mass lesions (1–10cm) ▶ these occur particularly within the mid or lower lobes ▶ they are of soft tissue density and almost never calcify (unlike their mediastinal counterparts) • The cysts are easily deformed where they come up against any major bronchovascular structures: § This leads to lobulation or an eccentric contour, or flattening of their peripheral aspects where they come into contact with the chest wall or mediastinum § They can also demonstrate changes in shape with breathing Ruptured pulmonary cysts • These are usually associated with secondary infection and rupture may occur into the airways or pleural spaces ▶ this is associated with acute symptoms which often precipitates presentation • Cyst wall layers: § Pericyst: adventitia formed of compressed host lung tissue § Ectocyst: middle layer of friable tissue § Endocyst: inner germinal layer from which are produced the scolices • If the two inner layers remain intact then airway communication results in a ring opacity containing a rounded, homogeneous density resembling the air crescent of a mycetoma • If there is disruption of the inner layers a complex cavitary lesion results which can demonstrate an airfluid level or the following signs: § ‘Double wall’ sign: ectocyst has separated from the pericyst 48 § ‘Water lily’/‘camalote’ sign: a floating membrane § ‘Rising sun’/‘serpent’ sign: an essentially dry cyst with crumpled membranes lying at its bottom § ‘Empty cyst’ sign: a cyst with all its contents expectorated PEARLS • Secondary infection may produce a lung abscess • Rupture into the pleural space can cause an effusion or if there is additional airway communication a hydropneumothorax Treatment Medical (albendazole) ▶ surgical resection PARAGONIMIASIS Definition A metazoal infestation due to a fluke (Paragonimus westermani) that develops from a larval form in the lung and produces ova ▶ it is acquired from eating raw or incompletely cooked freshwater crabs and crayfish • Intermediate hosts: water snails and crustaceans • It is mostly found within the Far East, southeast Asia and Africa Diagnosis Ova within the sputum ▶ anti-Paragonimus antibody within the blood Clinical presentation Chronic cough ▶ sputum ▶ haemoptysis CXR Consolidation, nodules, band, tubular and ring opacities (5–30mm) within any lobe (especially the mid lung) ▶ pleural effusions are seen in up to 50% of cases CT As above, but in addition peripheral lineal opacities (representing worm migration tracks) may be seen ENTAMOEBA HISTOLYTICA Definition A protozoal infection – pleuropulmonary amoebiasis is usually secondary to liver involvement (developing in 1/5 of patients with liver disease) • It characteristically affects young adults (M>F) CXR Lung involvement usually occurs at the right lung base with hemidiaphragmatic elevation, and a pleural effusion (Æ thickening and plate-like atelectasis) ▶ if a liver abscess erodes through the diaphragm the basal homogeneous opacification can cavitate • Haematogenous spread can occasionally give rise to similar appearances within other lung segments METAZOAL AND PROTOZOAL DISEASES A B Pulmonary hydatid disease.