Friday, October 23, 2009

Diffuse Idiopathic Skeletal Hyperosteosis-MRI








DISH diagnostic criteria include the following : Flowing calcifications and ossifications along the anterolateral aspect of at least 4 contiguous vertebral bodies, with or without osteophytes. Preservation of disk height in the involved areas and an absence of excessive disk disease. Absence of bony ankylosis of facet joints and absence of sacroiliac erosion, sclerosis, or bony fusion, although narrowing and sclerosis of facet joints are acceptable.
Lower thoracic spine involvement is typical of DISH, but the lumbar and cervical spine also can be affected. The left side of the spine typically is spared or less involved, which probably is attributable to the pulsating aorta.

Wednesday, October 21, 2009

SSPE-MRI


This is a six year old boy with history of measles and neurological complaints. Subacute sclerosing panencephalitis (SSPE) is a progressive, slow virus infection of the brain, caused by the measles virus, attacking children and young adults. In the early period, lesions are in the grey matter and subcortical white matter. They are asymmetrical and had a predilection for the posterior parts of the hemispheres.

Monday, October 19, 2009

Plantar Fascitis-MRI



Marked edema is evident within the heel pad, the flexor digitorum brevis, and within the calcaneus s/o plantar myo-fascitis with enthesopathy. Reported by Teleradiology Providers

Ossification of posterior longitudnal ligament-CT







Ossification of posterior longitudinal ligament (OPLL) is a well-documented cause of cervical spine stenosis and myelopathy among Japanese patients. Its etiology still remains obscure. This entity is rarely seen in Indians. OPLL occurs after the age of 40 years and the most commonly affected region is the cervical spine, usually at C4/5, although the thoracic and lumbar regions are not exempt. The frequency of involvement diminishes as the level descends as follows: cervical 70-75%, thoracic 15-20% and lumbar 10%. The unexplained intimate relationship of OPLL with cervical spondylosis and diffuse idiopathic skeletal hyperostosis (DISH) is well known. This is post laminectomy CT scan of a case of OPLL.

Friday, October 16, 2009

OPTIC CHIASMATIC GLIOMA








Optic nerve glioma (also known as optic pathway glioma) is the most common primary neoplasm of the optic nerve. In 66% of NF-1 patients with optic nerve glioma, the growth involves the intraorbital optic nerve. In the absence of NF-1, the optic chiasm is most commonly involved, as is, less often, the intraorbital optic nerve. Optic nerve glioma may involve various portions of the retrobulbar visual pathway, including the optic nerve, chiasm, tracts, and radiations. Malignant lesions can invade the hypothalamus, basal ganglia, and internal capsule directly, or they may spread to the leptomeninges or subpial surfaces. On T1-weighted images, optic nerve gliomas are usually isointense to the cortex and hypointense to white matter. Invariably, the lesions are hypointense to orbital fat. On T2-weighted images, lesions demonstrate a mixed appearance that is isointense to hyperintense relative to white matter and the cortex. Following contrast administration, intense enhancement is common.

Wednesday, October 14, 2009

Iatrogenic Bile Duct Injury-MRCP


This is a 25 year old post cholecystectomy status female with collection in the GB fossa and suspected Bismuth type I injury. The overall incidence of ductal injury during laparoscopic cholecystectomy is 1.2% or less. Postoperative bile duct injury may be classified as a leak, stricture, or complete transection and excision of a segment of duct, with or without obstruction of the proximal biliary tree by surgical clips. According to Bismuth classifications of traumatic bile duct injury--


  1. Type I is injury more than 2 cm distal to biliary bifurcation.

  2. Type II is less than 2 cm from biliary confluence.

  3. Type III injury involves entire common hepatic duct and leaves confluence intact.

  4. Type IV is complete or partial destruction of biliary bifurcation.

Tuesday, October 13, 2009

Teleradiology on web TV

"According to J Telemed Telecare 2009;15:373-376 , in Brazil twelve videoconferences were recorded by the Health Channel and transformed into TV programmes, both for conventional broadcast and for access via the Internet. According to RUTE network has been used, a high-speed national research and education network. "

Friday, October 09, 2009

Fatal Swine Flu-Radiology

According to the latest article in AJR 2009; 193:1–4 In severe or potentially fatal cases radiography shows peripheral lung opacities. CT revealed peripheral ground-glass opacities suggesting peribronchial injury in severe cases of the same. Full text is available.

Thursday, October 08, 2009

Intraventricular Epidermoid-MRI





INTRAVENTRICULAR EPIDERMOID-MRI
Epidermoids represent 0.2-1% of all intracranial masses. They arise from inclusion of epithelial remnants trapped during 3-5 weeks of fetal life (remember that choroid plexus are also formed from invagination of ectodermal tissues).
Intraventricular epidermoids are more in 4th ventricle followed by lateral ventricles.
More common in middle age; very rare in children
If ruptured, aseptic meningitis occurs.
Long T1 and T2 are due to keratin in solid crystalline state. Epidermoids have restricted ADC and complex FLAIR signal, unlike arachnoid cysts.
FINDINGS
An expansive intraventricular lesion in lateral ventricle, iso-intense on T1-weighted image and hypo-intense on T2-weighted image with few cystic areas, demonstrating restricted diffusion suggestive of INTRAVENTRICULAR EPIDERMOID. Differential diagnosis includes Intraventricular Neurocytoma and Oligodendrogliomas but calcification is hallmark for their diagnosis. Case by- Teleradiology Providers

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