Friday, April 30, 2010

Spinal Epidural Arachnoid Cyst-MRI

Submitted by Dr Sangeeta Aneja, MD Head of Dept, LLRM Meerut

First Branchial Cleft Cyst-CT

First branchial cleft cyst are of two types--Type I cysts are located near the external auditory canal. Most commonly, they are inferior and posterior to the tragus (base of the ear), but they may also be in the parotid gland or at the angle of the mandible. Type I cysts may be difficult to distinguish from a solid parotid mass on clinical examination. Type II cysts are associated with the submandibular gland or found in the anterior triangle of the neck. Thin capsular enhancement is noted on post contrast scans.

Carcinoma Stomach with Peritoneal Deposits- CT & MRI

Note the antropyloric mass with peritoneal deposits.

Spinal Epidural Lymphoma-MRI

Note the dense, nodular sheet like enhacement in the posterior epidural region. CT chest and abdomen of this patient reveals mediastinal & retroperitoneal lymphnodes. Biospy consistent with NHL.

Reported by Teleradiology Providers

Monday, April 26, 2010

Holoprosencephaly - MRI

Lobar holoprosencephaly occurs with partial fusion of the frontal lobe with an otherwise normally formed interhemispheric fissure, lateral ventricular formation, variable and incomplete absence of the anterior corpus callosum and/or septum pellucidum, and separate thalami.

Saturday, April 24, 2010

Müllerian Duct Cysts and Prostatic Utricle Cysts

Although these conditions are believed to be two different entities, it is difficult to differentiate them from one another on imaging and clinical studies. Both occur in the midline. Müllerian duct cysts originate from the remnants of the müllerian duct. Prostatic utricle cysts result from the dilatation of the prostatic utricle. Müllerian duct cysts may originate from the region of the verumontanum but usually extend above the prostate and may be slightly lateral to the midline. They do not communicate with the urethra. Prostatic utricle cysts always arise from the verumontanum and are always in the midline, and they communicate with the urethra.

Wednesday, April 21, 2010

Large Intracerebral Cavernoma

This is a 22 year old male, with T1/T2 hyperintense mass with signal suppression on T2 *GRE consiting of blood products in varying stages.  There was calcification on plain CT head. Pathological diagnosis was cavernoma. Cavernous malformations are benign vascular lesions of the central nervous system that lack intervening normal brain parenchyma. Giant cases are rare.

Saturday, April 17, 2010

Dorsal Dermal Sinus with Epidural Abscess-MRI

Extramedullary T1 hypointense and T2 hyperintense lesion at the level of D5-D6 vertebral level measuring 1.8 x 1.1cm with linear tract in the posterior spinal region. There is resultant cord compression and anterolateral displacement of the spinal cord at this level with altered intramedullary cord signal intensity. These findings possibly indicate dorsal dermal sinus and associated epidural abscess.

Friday, April 16, 2010

Acute Lateral Patellar Dislocation-MRI

Lateral patellar dislocation (LPD) is a common cause of acute traumatic hemarthrosis in young active patients. However, dislocation is usually transient, and patients are frequently unaware that it has occurred. Characteristic MRI findings include joint effusion and contusion or osteochondral injury of the anterolateral portion of the lateral femoral condyle and medial patella. Injury to the medial stabilizers of the patella is also identified as disruption of the medial retinaculum at its patellar attachment or midsubstance.

Spinal epidural lipomatosis-MRI

Spinal epidural lipomatosis is a disorder characterized by an abnormal accumulation of unencapsulated adipose tissue in the extradural space of the spinal canal. The distal lumbar spine and the mid and distal thoracic spine are the most commonly involved sites, with rare involvement of the cervical spine. Most cases have been attributed to long standing exogenous steroid administration. This is a 18 year old girl on treatment for neurocysticercosis on long term steroids presented with back ache. The dural sac will often have a characteristic geometric “Y-shaped,” polygonal spiculated or stellar deformation resulting from the presence of the meningovertebral ligaments.

Tuesday, April 13, 2010

Fibrous Dysplasia of Temporal Bone

Fibrous dysplasia of bone is characterized by the presence of fibroosseous tissue in the interior of the affected part or parts of the bone and occurs more frequent in female patients In the head and neck, the skull and facial bones are involved in 10-25% of cases of monostotic fibrous dysplasia and in 50% of the polyostotic variety. Involvement of the temporal bone is relatively rare and three patterns are described i.e. the pagetoid, sclerotic and cystic. The pagetoid pattern is the commonest and shows both sclerotic and radiolucent areas. Sclerotic lesions are homogenously dense whereas the cystic variety is characterized by a spherical and oval lucency surrounded by a dense bony shell.

Reported by Teleradiology Providers

Saturday, April 10, 2010

Friday, April 09, 2010

Poland's Syndrome-CT

The absence of the sternal head of the pectoralis major muscle is considered the minimal expression of poland's syndrome. The skin of the area is hypoplastic with a thinned subcutaneous layer, and the axillary hair may be absent. The ipsilateral nipple is often smaller and higher in both male and female patients, and the breast is generally hypoplastic in female patients. Incidentally reported in this case.
Teleradiology Providers

Arnold Chiari Malformation

Bilateral Thalamic Gliomas-MRI & MRS

Primary thalamic tumors are rare and bilateral thalamic tumors are even rarer. The incidence, clinical manifestations, natural history and prognosis of primary bilateral thalamic gliomas (PBTT) remain relatively obscure.  Spectroscopy reveals raised choline-creatinine ratio.

Monday, April 05, 2010

Coccygeal Lipoma-MRI

This is a 9year old boy with fecal incontinence with coccygeal lipoma and dermal sinus.
Reported by Teleradiology Providers

Creutzfeldt–Jakob disease-MRI

This is a patient who presented to our OPD with findings of progressive dementia and vision loss. MRI showed cortical hyperintensity on DWI.  EEG findings were also characteristic. Cerebral imaging is a vital part of the exclusion of other diagnosis & normal brain imaging, in the face of a rapidly progressive devasting encephalopathy, may lead to a consideration of CJD. MRI may show diffuse areas of increased cortical signal bilaterally on T2W and FLAIR images. The DWI demonstrates more accurately the hyperintense lesions.

Second Opinion by- Teleradiology Providers.

Increased Radiation concerns over CT scan

"Urgent warnings by government experts about the risks of routinely using powerful CT scans to screen patients for colon cancer were brushed aside by the Food and Drug Administration, according to agency documents and interviews with agency scientists. "

Source- NY TIMES

Friday, April 02, 2010

Polycystic Kidney Disease with Chronic Pancreatitis-CT & MRI

Less often reported association, note polycystic kidneys associated hepatic cysts, and chronic calcific pancreatitis. MRCP reveals dilated pancreatic duct with intraductal calculi.

Reported by- Teleradiology Providers

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