Saturday, March 31, 2007

A Comprehensive Radiology Search Engine

This program allows to search radiology contents, specifically mentioned radiology journals (even all medical journals), radiology cases and teaching files, even single radiological images, radiology news, books, societies, vendors and products. A search for CMEopportunities is also offered. Access to almost all radiology journals and their websites/contents is also available.Most recent news and publications are also offered.

Wednesday, March 28, 2007

Radiology MCQs from AIIMS & AIPG-2007

1. In a case of multiple myeloma, bone scan will show
a. hot nodules b. cold nodules
c. diffuse increased uptake d. diffuse decreased uptake

2. Patient who had an Road traffic accident presents with presents with loss of consciousness CT shows multiple spotty hemorrhages and full basal cisterns-
a. Brain contusion b. Diffuse axonal injury
c. Subdural Hematoma d. Multiple infarcts

3. Tumour showing dural enhancement with a tail is:
a. Medulloblastoma b. Meningioma
c. Glioma d. Acoustic neuroma

4. A 25-yrs-old female presented with lower limb weakness, spasticity, urinary hesitancy, mid-dorsal intradural enhancing mass seen in MRI. What is the diagnosis?
Intradural lipoma b. Meningioma
c. Dermoid cyst d. Neuroepithelial cyst

5. A neonate presents with congestive heart failure, on examination enlarging fontanellae, bruit on auscultation, on USG shows midline hypoechoeic lesion, most likely diagnosis
A. Malformation of vein of galen B.Aqueduct stenosis
C. Arachnoid cyst D. Medulloblastoma.

6. Best investigation for temporal bone fracture is-
A) CT B) MRI C) X-RAY D) Ultrasound

Answer-1) (b)
The bone scan is usually normal in multiple myeloma because lytic lesions do not take up isotope.

Diffuse axonal injury (DAI) is a frequent result of traumatic deceleration injuries and a frequent cause of persistent vegetative state in patients. DAI is the most significant cause of morbidity in patients with traumatic brain injuries, which most commonly are the result of high-speed motor vehicle accidents. Typically, the process is diffuse and bilateral, involving the lobar white matter at the gray-white matter interface. The corpus callosum frequently is involved, as is the dorsolateral rostral brainstem. The most commonly involved area is the frontal and temporal white matter, followed by the posterior body and splenium of the corpus callosum, the caudate nuclei, thalamus, tegmentum, and internal capsule.

Meningiomas are usually dural-based tumors that are isoattenuating to slightly hyperattenuating. They enhance homogeneously and intensely after the injection of iodinated contrast material. Perilesional edema may be extensive. Hyperostosis and intratumoral calcifications may be present. The tumor compresses the brain without invading it. An enhancing tail involving the dura may be apparent on MRI.

Meningiomas are the second most common tumor in the intradural extramedullary location, second only to tumors of the nerve sheath. Meningiomas account for approximately 25% of all spinal tumors.MRI demonstrates the intradural extramedullary location of meningiomas. Lesions are usually isointense to spinal cord on both T1-weighted and T2-weighted images. Lesions are sometimes hypointense on T1-weighted images and hyperintense on T2-weighted images.

Answer-5) A Vein of galen malformation

Answer-6) A
for bony temporal bone – CT for inner ear- MRI for facial nerve- MRI

Questions by DAMS The Top most MD/MS entrance coaching academy
Delhi Academy Of Medical Sciences

Sunday, March 25, 2007

About the Author of Gray's Anatomy

Did you know that-
"We always pictured Gray as an old man with white hair and glasses, you know, that professor type. So I was shocked to find out that he was only 31 when he wrote Gray’s Anatomy. He did so much as a young man, imagine what he could have accomplished had he lived a full life. He is truly inspirational...."
Full article here-

Radiology Grand Rounds X are up

Radiology Grand Rounds-X are up at MidEssexRay a site by Dr Peng Hui Lee Chelmsford, Essex, GB,Clinical Director of Radiology, Mid Essex Hospitals NHS Trust. Check out this edition has many new contributors also.

Tuesday, March 20, 2007

Long waits for Medical imaging

Waits for scan results 'too long'
Detailed report in BBC HEALTH NEWS

"Waits for tests have come downWaits for the results of X-rays and other scans in England are often too long, a report finds. But two out of three doctors and nurses said they often did not get results when needed, and a half said the delays affected patient decisions daily."

Average wait for a non-urgent CT scan:
Seven weeks in 2001
Just over five weeks in 2005

Average wait for an MRI scan:
21 weeks in 2001
14 weeks in 2005

Seems like Teleradiology Providers is on th right track...

Monday, March 19, 2007

Submissions requested for the next Radiology Grand Rounds

Next Radiology Grand Rounds will be hosted on last sunday of this month 25-3-07 at MidEssexRay by Dr Peng Hui Lee, so hurry send all your Radiology Related submissions to me at or to Dr Peng at If you are not familiar with the concept of the Radiology Grand Rounds check out the archive and concept here-
Radiology Grand Rounds

Tuesday, March 13, 2007


Diagnostic Imaging is offering a webcast of European Congress of Radiology, with many interesting articles. Here is the link-

Monday, March 12, 2007

A case Lingual Thyroid

The radfiles blog this week has a very typical CT images of a case of lingual thyroid. A typical spotter for radiology residents.

Here is the case- Lingual Thyroid

Friday, March 09, 2007

Useful Radiology Teaching resource

Came across this very useful teaching resource from ACR known as Case in point. I suggest this link all radiology residents especially the ones who are about to appear for their examination. It is very easy to subscribe to the "case in point" via your email.

Monday, March 05, 2007

New ACR guidelines on Gadolinium in End-Stage Renal Disease

Patients with any stage of renal disease should not receive the MR gadolinium contrast agent Omniscan, to help prevent a rare and life-threatening skin disease according to new, comprehensive MR Safe Practice Guidelines from the American College of Radiology.
Link to detailed guidelines here-

Friday, March 02, 2007

Radiology MCQs for FRCR

Here is an excellent link for Radiology MCQs especially useful for residents preparing for FRCR. Radiology MCQs

Here is an example from the site-

Regarding pancreatic adenocarcinoma, (***)
Cigarette smoking is thought to be a significant risk factor
Whipple's procedure, a radical surgery for pancreatic carcinoma, carries a risk of mortality of 20%
Overall 5 year survival rate is 20%
In approximately 80%, the carcinoma arises from the head
Carinomas arising from the head carry worse prognosis than those arising from the body or tail
Answers: T, F, F, T, F
Regarding resectability of pancreatic adenocarcinoma, (***)
Tumour size more than 3cm is likely to be unresectable
Peripancreatic lymphadenoapthy is absolute contraindication for surgery
The tumour is likely to be irresectible if the contiguity between tumour and major vessel is more than 50%
Vascular occlusion makes the tumour irresectible
Invasion of splenic vessels is absolute contraindication for surgery

Answers: T, F, T, T, F
Cigarette smoking is thought to account for 30% of deaths from pancreatic adenocarcinoma. Diabetes and chronic pancreatitis are also associated with increased risk of pancreatic adenocarcinoma. Whipple's procedure carries a risk of 5% mortality. The survival rate, including the ones undergone Whipple's, is not more than 5%. 80% of carcinomas arise from the head. The carconomas arising from body, tail and uncinate process carry worse prognosis than those arising from the head, because of late presentation.
Tumours more than 3cm are unlikely to be resectable. Peripancreatic lymphadenopathy is relative contraindication for surgery. Contuguity of 25-50% is equivocal for resectability, where as more than 50% makes it irresectable. Vascular encasement, occlusion or alterationin contour or caliber makes the tumour irresectable. Involvement of gastroduodenal, celiac or superior mesenteric artery is indicator of advanced disease, where as invasion of splenic vessels or spleen is not absolute contraindication for surgery.
Reference: Smith Sl et al. Imaging of pancreatic adenocarcinoma with emphasis on multidetector CT . Clinical Radiology 59 (January 2004): 26-38

Thursday, March 01, 2007

Acromion and Rotator Cuff Impingement

Review of Literature
The supraspinatus and caudal tilt views correlate significantly with distinct intraoperative measurements of acromial spur size. Kitay GS et al advocate the evaluation of both views for preoperative assessment of the acromial spur in the rotator cuff impingement syndrome.
J Shoulder Elbow Surg 1995 Nov-Dec;4(6):441-8

The acromial angle is an objective and fairly reproducible measure of anterior acromial shape. The angle is useful in identifying patients with a greater likelihood of having a rotator cuff tear and in distinguishing patients with primary impingement from those with instability.
AJR Am J Roentgenol 1995 Sep;165(3):609-13

Tendon tears and fatty muscle degeneration in the rotator cuff correlate with reduced acromiohumeral distance. Size of rotator cuff tear and degree of fatty degeneration of the infraspinatus muscle have the most pronounced influence on acromiohumeral distance.
AJR Am J Roentgenol 2006 Aug;187(2):376-82

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