Diagnostic Imaging

Diagnostic Imaging

von: Andrea G. Rockall, Andrew Hatrick, Peter Armstrong, Martin Wastie

Wiley-Blackwell, 2013

ISBN: 9781118524237 , 520 Seiten

7. Auflage

Format: PDF, OL

Kopierschutz: DRM

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Diagnostic Imaging


 

Cover

1

Title page

5

Copyright

6

Contents

7

Preface

9

Acknowledgements

10

List of Abbreviations

11

The Anytime, Anywhere Textbook

12

1: Technical Considerations

15

Use of the imaging department

15

Conventional radiography

15

Computed tomography

16

Computed tomography angiography

17

Artefacts

17

Contrast agents in conventional radiography and computed tomography

17

Ultrasound

19

Doppler effect

21

Radionuclide imaging

22

Positron emission tomography

25

Magnetic resonance imaging

26

Contrast agents for magnetic resonance imaging

30

Picture archiving and communication systems

31

Radiation hazards

31

2: Chest

33

Thoracic Disease

33

Imaging techniques

33

Plain chest radiograph

33

Computed tomography

37

Magnetic resonance imaging

38

Radionuclide lung scanning

38

Positron emission tomography

38

Ultrasound

38

Diseases of the chest with a normal chest radiograph

40

Obstructive airways disease

40

Small lesions

41

Pulmonary emboli without infarction

41

Infections

41

Diffuse pulmonary fibrosis

41

Pleural abnormality

41

Mediastinal masses

41

Abnormal chest signs

42

Silhouette sign

42

Radiological signs of lung disease

44

Air-space opacification

44

Pulmonary collapse (atelectasis)

45

Spherical opacities (lung mass, lung nodule)

54

Line or band-like opacities

58

Widespread small pulmonary opacities

60

Increased transradiancy of the lungs

62

Pleura

63

Pleural effusion

63

Pleural thickening (pleural fibrosis)

66

Pleural tumours

69

Pleural calcification

71

Pneumothorax

71

Mediastinum

73

Computed tomography and magnetic resonance imaging of the normal mediastinum

73

Mediastinal masses

74

Aortic aneurysm

81

Pneumomediastinum

82

Hilar enlargement

82

Lymph node enlargement

84

Diaphragm

84

Chest wall

85

Specific Disorders

85

Bacterial pneumonia

86

Viral and mycoplasma pneumonia

86

Lung abscess

86

Pulmonary tuberculosis

87

Primary tuberculosis

87

Postprimary tuberculosis

87

Fungal and parasitic diseases

90

Hydatid disease

91

Pneumonia in the immunocompromised host

91

Sarcoidosis

92

Diffuse interstitial pulmonary fibrosis

93

Usual interstitial pneumonia (cryptogenic fibrosing alveolitis, idiopathic pulmonary fibrosis)

93

Determining the cause of diffuse pulmonary fibrosis

93

Radiation pneumonitis

95

Collagen vascular diseases

95

Rheumatoid lung

95

Systemic lupus erythematosus

95

Scleroderma and dermatomyositis

96

Wegener’s granulomatosis

96

Pneumoconiosis

96

Coal workers’ pneumoconiosis

96

Asbestos-related disease

96

Diseases of the airways

96

Asthma

96

Bronchiolitis

97

Acute bronchitis

97

Chronic obstructive pulmonary disease

97

Cystic fibrosis

98

Respiratory distress in the newborn

100

Adult respiratory distress syndrome

100

Pulmonary emboli and infarction

101

Plain film abnormalities

101

Radionuclide lung scans

102

Computed tomography pulmonary angiography

102

Trauma to the chest

102

Carcinoma of the bronchus

105

Signs of a central tumour

105

Signs of a peripheral tumour

105

Spread of bronchial carcinoma

105

Metastatic neoplasms

108

Pulmonary metastases

108

Pleural metastases

109

Metastases to ribs

109

Lymphoma

113

3: Cardiac Disorders

115

Imaging techniques

115

Plain chest radiography

115

Echocardiography

121

Radionuclide studies

123

Computed tomography

126

Magnetic resonance imaging

126

Cardiac catheterization and angiography

126

Specific cardiac diseases

126

Heart failure

126

Ischaemic heart disease

127

Hypertensive heart disease and other myocardial diseases

129

Valvular heart disease

130

Pericardial effusion

133

Subacute bacterial endocarditis

135

Left atrial myxoma and other intracardiac masses

135

Congenital heart disease

135

4: Breast Imaging

137

Mammography

137

Breast ultrasound

137

Breast magnetic resonance imaging

141

Breast screening

141

5: Plain Abdomen

143

Intestinal gas pattern

143

Dilatation of the bowel

143

Pneumoperitoneum

146

Gas in an abscess

146

Gas in the wall of the bowel

146

Gas in the biliary system

149

Ascites

150

Abdominal calcification

150

Liver and spleen

152

Abdominal and pelvic masses

153

6: Gastrointestinal Tract

155

Imaging techniques: general principles

155

Contrast examinations

155

Computed tomography

156

Ultrasound examinations

156

Magnetic resonance imaging

156

Nuclear medicine

156

Basic descriptive terms

156

Oesophagus

157

Imaging techniques

157

Plain films

157

Barium swallow examination

157

Computed tomograpphy

160

Fluorodeoxyglucose positron emission tomography/computed tomography

160

Oesophageal abnormalities

160

Strictures of the oesophagus

160

Dilatation of the oesophagus

162

Other abnormalities of the oesophagus

164

Stomach and Duodenum

167

Imaging techniques

167

Barium meal examination

167

Computed tomography

167

Specific diseases of the stomach and duodenum

169

Peptic ulcer

169

Gastric carcinoma

170

Other gastric tumours

171

Gastric polyps

171

Lymphoma

172

Gastric outlet obstruction

172

Hiatus hernia

172

Small Intestine

173

Imaging techniques

175

Normal appearances of the small bowel

175

Imaging signs of disease of the small intestine

177

Dilatation

177

Mucosal abnormality

177

Narrowing

177

Ulceration

177

Specific diseases of the small intestine

178

Crohn’s disease

178

Small bowel ischaemia

181

Tuberculosis

181

Lymphoma

182

Malabsorption

182

Acute small bowel obstruction

183

Malrotation

184

Worm infestation

184

Large Intestine

184

Imaging techniques

184

Colonoscopy

184

Barium enema

185

Computed tomography pneumocolon

185

Magnetic resonance imaging

185

Nuclear medicine studies

185

Normal appearance of the colon

185

Imaging signs of disease of the large intestine

186

Narrowing of the lumen

186

Dilatation

187

Filling defects

188

Diverticula and muscle hypertrophy

188

Ulceration

188

Specific diseases of the colon

188

Inflammatory bowel disease

188

Diverticular disease

192

Appendicitis

194

Ischaemic colitis

194

Pneumatosis coli

197

Volvulus

197

Intussusception

197

Colorectal tumours

198

Hirschsprung’s disease (congenital aganglionosis)

202

Idiopathic megacolon (functional megacolon)

204

Anal fistula and perianal abscess

204

Specific Uses of Imaging in the Gastrointestinal Tract

204

Imaging investigation of the acute abdomen

204

Plain films

205

Barium or Gastrografin follow-through

205

Ultrasound

205

Computed tomography

205

Imaging investigation of acute bleeding from the gastrointestinal tract

206

Imaging investigation of abdominal trauma

208

7: Hepatobiliary System, Spleen and Pancreas

209

Liver

209

Imaging techniques

209

Ultrasound

209

Computed tomography

211

Magnetic resonance imaging

213

Liver masses

213

Malignant liver neoplasms

214

Benign liver masses

214

Liver abscesses

219

Cirrhosis of the liver and portal hypertension

219

Liver trauma

220

Fatty infiltration of the liver

221

Biliary System

222

Imaging techniques

222

Ultrasound

222

Magnetic resonance cholangiopancreatography

223

Endoscopic retrograde cholangiopancreatography

223

Percutaneous transhepatic cholangiogram

223

Hepatobiliary radionuclide scanning

223

Gall stones and cholecystitis

225

Cholecystitis

226

Jaundice

226

Pancreas

227

Pancreatic masses

230

Acute pancreatitis

231

Chronic pancreatitis

232

Pancreatic trauma

235

Spleen

235

Splenic trauma

235

8: Urinary Tract

237

Imaging techniques

237

Ultrasound

237

Urography

238

Magnetic resonance imaging

246

Radionuclide examination

247

Special techniques

251

Urinary tract disorders

251

Urinary calculi

251

Nephrocalcinosis

255

Urinary tract obstruction

255

Renal parenchymal masses

259

Urothelial tumours

265

Acute infections of the upper urinary tracts

266

Tuberculosis

270

Chronic pyelonephritis (reflux nephropathy)

271

Papillary necrosis

272

Renal trauma

272

Hypertension in renal disease

273

Renal failure

274

Congenital anomalies of the urinary tract

275

Bladder disorders

277

Bladder tumours

277

Bladder diverticula

278

Bladder calcification

278

Neurogenic bladder

278

Trauma to the bladder and urethra

280

Prostate and urethra disorders

281

Prostatic enlargement

281

Prostatic calcification

282

Bladder outflow obstruction

282

Scrotum and testes disorders

283

9: Female Genital Tract

287

Normal appearances

287

Ultrasound

287

Computed tomography

287

Magnetic resonance imaging

288

Positron emission tomography/computed tomography

288

Gynaecological pathology

288

Pelvic masses

288

Ovarian masses

289

Uterine masses

295

Pelvic inflammatory disease

296

Endometriosis

296

Detection of intrauterine contraceptive devices

296

Hysterosalpingography

296

Obstetric ultrasound

299

Ultrasound in the first trimester

300

Ultrasound in the second and third trimesters

301

Placental imaging

301

‘Large for dates’ uterus

301

‘Small for dates’ uterus: intrauterine growth retardation

302

Ultrasound for karyotyping

302

Fetal death

302

Ectopic pregnancy

302

10: Peritoneal Cavity and Retroperitoneum

305

Peritoneal Cavity

305

Peritoneal cavity disorders

305

Ascites

305

Peritoneal tumours

305

Intraperitoneal abscesses

307

Retroperitoneum

310

Imaging techniques

311

Computed tomography

311

Ultrasound

311

Magnetic resonance imaging

311

Retroperitoneal disorders

311

Retroperitoneal lymphadenopathy

311

Adrenal gland disorders

313

Retroperitoneal tumours

317

Aortic aneurysm

318

Retroperitoneal haematoma

321

Retroperitoneal and psoas abscesses

321

11: Bones

323

Imaging techniques

323

Plain bone radiographs

323

Ultrasound in musculoskeletal disease

324

Radionuclide bone imaging

326

Computed tomography in bone disease

327

Magnetic resonance imaging in bone disease

328

Bone disease diagnosis

328

Solitary lesions

328

Bone tumours

334

Osteomyelitis

339

Bone infarction

342

Multiple focal lesions

343

Metastases

343

Multiple myeloma

346

Lymphoma and leukaemia

347

Multiple periosteal reactions

347

Generalized decrease in bone density (osteopenia)

348

Osteoporosis

349

Rickets and osteomalacia

350

Hyperparathyroidism

351

Renal osteodystrophy

352

Generalized increase in bone density

353

Alteration of trabecular pattern and change in shape

354

Paget’s disease

354

Haemolytic anaemia

355

Sarcoidosis

355

Radiation-induced disease of bone

355

Changes in bone shape

360

Bone dysplasias

360

12: Joints

361

Imaging techniques

361

Plain film radiographs

361

Magnetic resonance imaging

361

Arthrography

361

Ultrasound

361

Arthritis

362

Signs indicating the presence of arthritis

362

Signs that point to the cause of arthritis

363

Diagnosis of arthritis

363

Rheumatoid arthritis

364

Gout

366

Calcium pyrophosphate dihydrate crystal deposition disease

367

Osteoarthritis

367

Haemophilia and bleeding disorders

368

Joint infections

368

Pyogenic arthritis

370

Tuberculous arthritis

370

Avascular (aseptic) necrosis

370

Osteochondritis

372

Internal derangement of the knee

373

Menisci

373

Cruciate ligaments

373

Collateral ligaments

373

Shoulder and rotator cuff disorders

373

Supraspinatus tendon tears

376

Calcific tendonitis

376

Miscellaneous joint conditions

377

Neuropathic joint

377

Synovial sarcoma (synovioma)

377

Slipped femoral epiphysis

377

Developmental dysplasia of the hip

377

Osteitis condensans ilii

382

Scleroderma

382

13: Spine

383

Imaging techniques

383

Radiographic signs of spinal abnormality

384

Disc space narrowing

384

Collapse of vertebral bodies

387

Pedicle abnormalities

389

Dense vertebrae

389

Spinal abnormalities

389

Spinal trauma

389

Degenerative spinal disease

395

Disc herniation

396

Spondylolisthesis

399

Infection

399

Inflammatory spondylarthropathy

403

Congenital abnormalities

405

Spinal cord and cauda equine compression

405

Intrinsic disorders of the spinal cord

405

Transverse myelitis and multiple sclerosis

411

14: Skeletal Trauma

413

Imaging techniques

413

Plain radiographs

413

Computed tomography

413

Magnetic resonance imaging

415

Radionuclide bone scanning

415

Imaging fractures

417

Imaging dislocations

417

Further plain film views

417

Specific injuries

421

Salter–Harris classification

421

Stress fracture

434

Insufficiency fracture

434

Pathological fracture

435

Non-accidental injury

435

Avulsion fractures

440

15: Brain

441

Imaging techniques

441

Computed tomography

441

Magnetic resonance imaging

446

Neurosonography

450

Specific brain disorders

450

Brain tumours

450

Stroke

454

Infection

457

Multiple sclerosis

461

Ageing

462

Dementia

464

Head injury

464

Extracerebral haematoma

466

Intracerebral lesion

466

Fracture

469

16: Orbits, Head and Neck

471

Sinuses

471

Opaque sinus

471

Nasopharynx

472

Orbits

473

Blowout fracture

474

Salivary glands

475

Sialography

475

Neck

475

Larynx

477

Thyroid imaging

477

Parathyroid imaging

479

17: Vascular and Interventional Radiology

485

Diagnostic vascular angiography

485

Arteriography

485

Magnetic resonance angiography

485

Computed tomography angiography

485

Ultrasound of the arterial system

487

Ultrasound venography

487

Contrast venography

488

Interventional radiology

489

Angioplasty and stents

489

Therapeutic embolization

492

Therapeutic ablation

492

Vascular catheterization for infusion

493

Inferior vena cava filters

493

Percutaneous needle biopsy

493

Percutaneous drainage of abscesses and other fluid collections

495

Transjugular liver biopsy

495

Transjugular intrahepatic portosystemic shunt

499

Interventional radiology of the gastrointestinal tract

499

Interventional radiology of the urinary tract

500

Interventional radiology of the biliary tract

500

Appendix: Computed Tomography Anatomy of the Abdomen

505

Index

0