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Learning Radiology: Recognizing the Basics E-Book

Learning Radiology: Recognizing the Basics E-Book

William Herring

(2011)

Additional Information

Book Details

Abstract

Learning Radiology: Recognizing the Basics, 2nd Edition, is an image-filled, practical, and clinical introduction to this integral part of the diagnostic process. William Herring, MD, a skilled radiology teacher, masterfully covers everything you need to know to effectively interpret medical images. Learn the latest on ultrasound, MRI, CT, and more, in a time-friendly format with brief, bulleted text and abundant high-quality images. Then ensure your mastery of the material with additional online content, bonus images, and self-assessment exercises at www.studentconsult.com.

  • Identify a wide range of common and uncommon conditions based upon their imaging findings.
  • Quickly grasp the fundamentals you need to know through easy-access bulleted text and more than 700 images.
  • Arrive at diagnoses by following a pattern recognition approach, and logically overcome difficult diagnostic challenges with the aid of decision trees.
  • Learn from the best, as Dr. Herring is both a skilled radiology teacher and the host of his own specialty website, www.learningradiology.com.
  • Easily master the fundamental principles of MRI, ultrasound, and CT with new chapters that cover principles of each modality and the recognition of normal and abnormal findings.

Table of Contents

Section Title Page Action Price
Front cover cover
Learning Radiology, 2/e i
Copyright page iv
Dedication v
Contributor vii
Preface to the First Edition ix
Preface to the Second Edition x
Acknowledgments xi
Table of Contents xiii
1 Recognizing Anything: 1
Let There Be Light … And Dark, and Shades of Gray 1
Conventional Radiography (Plain Films) 1
Computed Tomography (Ct or Cat Scans) 1
Ultrasound (US) 2
Magnetic Resonance Imaging (MRI) 2
Terminology 3
Terminology Conventions Used in This Book 3
The Five Basic Densities 4
The Best System is the One That Works 6
Conventions Used in This Book 7
Weblink 7
2 Recognizing Normal Chest Anatomy and a Technically Adequate Chest Radiograph 8
The Normal Frontal Chest Radiograph 8
The Lateral Chest Radiograph 8
Five Key Areas on the Lateral Chest X-Ray (Fig. 2-2 and Table 2-1) 8
The Retrosternal Clear Space 8
The Hilar Region 8
The Fissures 9
The Thoracic Spine 9
The Diaphragm and Posterior Costophrenic Sulci 10
Evaluating the Chest Radiograph for Technical Adequacy 12
Penetration 13
Inspiration 13
Rotation 14
Magnification 15
Angulation 16
Weblink 17
3 Recognizing Airspace Versus Interstitial Lung Disease 18
Classifying Parenchymal Lung Disease 18
Characteristics of Airspace Disease 18
Some Causes of Airspace Disease 18
Characteristics of Interstitial Lung Disease 20
Some Causes of Interstitial Lung Disease 22
Predominantly Reticular Interstitial Lung Diseases 22
Predominantly Nodular Interstitial Diseases 23
Mixed Reticular and Nodular Interstitial Disease (Reticulonodular Disease) 24
Weblink 24
4 Recognizing the Causes of an Opacified Hemithorax 27
Atelectasis of the Entire Lung 27
Massive Pleural Effusion 27
Pneumonia of an Entire Lung 27
Postpneumonectomy 28
Weblink 30
5 Recognizing Atelectasis 32
What is Atelectasis? 32
Signs of Atelectasis 32
Types of Atelectasis 32
Patterns of Collapse in Lobar Atelectasis 37
How Atelectasis Resolves 39
Weblink 39
6 Recognizing a Pleural Effusion 40
Normal Anatomy and Physiology of the Pleural Space 40
Causes of Pleural Effusions 40
Types of Pleural Effusions 40
Side Specificity of Pleural Effusions 40
Recognizing the Different Appearances of Pleural Effusions 41
Subpulmonic Effusions 41
Blunting of the Costophrenic Angles 41
The Meniscus Sign 42
Opacified Hemithorax 44
Loculated Effusions 45
Fissural Pseudotumors 45
Laminar Effusions 46
Hydropneumothorax 46
Weblink 49
7 Recognizing Pneumonia 50
General Considerations 50
General Characteristics of Pneumonia 50
Patterns of Pneumonia 50
Lobar Pneumonia 50
Segmental Pneumonia (Bronchopneumonia) 50
Interstitial Pneumonia 52
Round Pneumonia 53
Cavitary Pneumonia 53
Aspiration 54
Localizing Pneumonia 55
How Pneumonia Resolves 57
Weblink 57
8 Recognizing Pneumothorax, Pneumomediastinum, Pneumopericardium, and Subcutaneous Emphysema 59
Recognizing A Pneumothorax 59
Recognizing the Pitfalls in Overdiagnosing A Pneumothorax 59
Types of Pneumothoraces 61
Causes of A Pneumothorax 62
Other Ways to Diagnose A Pneumothorax 62
Pulmonary Interstitial Emphysema 63
Recognizing Pneumomediastinum 64
Recognizing Pneumopericardium 65
Recognizing Subcutaneous Emphysema 66
Weblink 66
9 Recognizing Adult Heart Disease 68
Recognizing an Enlarged Cardiac Silhouette 68
Pericardial Effusion 68
Extracardiac Causes of Apparent Cardiac Enlargement 68
Effect of Projection on Perception of Heart Size 68
Identifying Cardiac Enlargement on an Anteroposterior Chest Radiograph 68
Recognizing Cardiomegaly on the Lateral Chest Radiograph 69
Recognizing Cardiomegaly in Infants 70
Normal Cardiac Contours 70
Normal Pulmonary Vasculature 70
General Principles of Cardiac Imaging 71
Recognizing Common Cardiac Diseases 71
Congestive Heart Failure 71
Pulmonary Interstitial Edema 72
Pulmonary Alveolar Edema 75
Noncardiogenic Pulmonary Edema: General Considerations 76
Noncardiogenic Pulmonary Edema: Imaging Findings 77
Differentiating Cardiac from Noncardiac Pulmonary Edema 77
Hypertensive Cardiovascular Disease 77
Mitral Stenosis 78
Pulmonary Arterial Hypertension 78
Aortic Stenosis 79
Cardiomyopathy 79
Aortic Aneurysms: General Considerations 80
Recognizing a Thoracic Aortic Aneurysm 80
Thoracic Aortic Dissection 81
Coronary Artery Disease 82
Weblink 84
10 Recognizing the Correct Placement of Lines and Tubes: 86
Endotracheal and Tracheostomy Tubes 86
Endotracheal Tubes (ETT) 86
Tracheostomy Tubes 86
Intravascular Catheters 88
Central Venous Catheters (CVC) 88
Peripherally Inserted Central Catheters: “PICC Lines” 89
Pulmonary Artery Catheters: Swan-Ganz Catheters 90
Double Lumen Catheters: “Quinton Catheters,” Hemodialysis Catheters 90
Pleural Drainage Tubes (Chest Tubes, Thoracotomy Tubes) 91
Cardiac Devices 93
Pacemakers 93
Automatic Implantable Cardiac Defibrillators (AICDs) 94
Intraaortic Counterpulsation Balloon Pump (IACB or IABP) 94
Gastrointestinal Tubes and Lines 95
Nasogastric Tubes (NGTs) 95
Feeding Tubes (Dobbhoff Tubes, DHTs) 96
Weblink 97
11 Computed Tomography: 98
Introduction to CT 98
Intravenous Contrast in CT Scanning 99
Oral Contrast in CT Scanning 99
Normal Chest CT Anatomy 100
Five-Vessel Level 100
Aortic Arch Level 101
Aortopulmonary Window Level 101
Main Pulmonary Artery Level 101
High Cardiac Level 101
Low Cardiac Level 103
The Fissures 103
Cardiac CT 103
Abdominal CT 105
General Considerations 105
Liver 106
Spleen 106
Pancreas 106
Kidneys 106
Small and Large Bowel 107
Urinary Bladder 107
Weblink 107
12 Recognizing Diseases of the Chest 109
Mediastinal Masses 109
Anterior Mediastinum 109
Thyroid Masses 109
Lymphoma 110
Thymic Masses 111
Teratoma 112
Middle Mediastinum 112
Posterior Mediastinum 112
Neurogenic Tumors 112
Solitary Nodule/Mass in the Lung 113
Signs of a Benign Versus Malignant Solitary Pulmonary Nodule 114
Benign Causes of Solitary Pulmonary Nodules 115
Bronchogenic Carcinoma 115
Bronchogenic Carcinomas Presenting as a Nodule/Mass in the Lung 116
Bronchogenic Carcinoma Presenting with Bronchial Obstruction 116
Bronchogenic Carcinoma Presenting with Direct Extension or Metastatic Lesions 117
Metastatic Neoplasms In The Lung 119
Multiple Nodules 119
Lymphangitic Spread of Carcinoma 119
Pulmonary Thromboembolic Disease 120
Chronic Obstructive Pulmonary Disease 120
Blebs And Bullae, Cysts And Cavities 122
Blebs 123
Bullae 123
Cysts 123
Cavities 123
Bronchiectasis 123
Weblink 124
13 Recognizing the Normal Abdomen: 127
What To Look For 127
Normal Bowel Gas Pattern 127
Normal Fluid Levels 127
Differentiating Large From Small Bowel 128
Acute Abdominal Series: The Views And What They Show 129
Acute Abdominal Series: Supine View (“Scout Film”) 130
Acute Abdominal Series: Prone View 130
Acute Abdominal Series: Upright View of Abdomen 131
Acute Abdominal Series: Upright View of Chest 132
Calcifications 133
Organomegaly 133
Liver 134
Spleen 134
Kidneys 135
Urinary Bladder 135
Uterus 135
Psoas Muscles 135
Weblink 136
14 Recognizing Bowel Obstruction and Ileus 138
Abnormal Gas Patterns 138
Laws Of The Gut 138
Functional Ileus, Localized: Sentinel Loops 138
Functional Ileus, Generalized: Adynamic Ileus 139
Mechanical Obstruction: Small Bowel Obstruction (Sbo) 139
Mechanical Obstruction: Large Bowel Obstruction (Lbo) 144
Volvulus Of The Colon 146
Intestinal Pseudo-Obstruction (Ogilvie Syndrome) 146
Weblink 147
15 Recognizing Extraluminal Air in the Abdomen 148
Signs Of Free Intraperitoneal Air 148
Air Beneath the Diaphragm 148
Visualization of Both Sides of the Bowel Wall 148
Visualization of the Falciform Ligament 148
Causes Of Free Air 149
Signs Of Extraperitoneal Air (Retroperitoneal Air) 150
Causes Of Extraperitoneal Air 150
Signs Of Air In The Bowel Wall 151
Causes And Significance Of Air In The Bowel Wall 153
Signs Of Air In The Biliary System 154
Causes Of Air In The Biliary System 154
Weblink 155
16 Recognizing Abnormal Calcifications and Their Causes 156
Patterns Of Calcification 156
Rimlike Calcification 156
Linear Or Tracklike Calcification 156
Lamellar Or Laminar Calcification 156
Cloudlike, Amorphous, Or Popcorn Calcification 158
Location Of Calcification 159
Weblink 163
17 Recognizing the Imaging Findings of Trauma 164
Chest Trauma 164
Rib Fractures 164
Pulmonary Contusions 164
Pulmonary Lacerations (Hematoma or Traumatic Pneumatocele) 164
Aortic Trauma 164
Abdominal Trauma 167
Liver 167
Spleen 168
Kidneys 168
Shock Bowel 169
Pelvic Trauma 169
Rupture of the Urinary Bladder 169
Urethral Injuries 170
Weblink 170
18 Recognizing Gastrointestinal, Hepatic, and Urinary Tract Abnormalities 172
Barium Studies of the Gastrointestinal Tract 172
Esophagus 172
Esophageal Diverticula 172
Esophageal Carcinoma 172
Hiatal Hernia and Gastroesophageal Reflux (GERD) 172
Stomach and Duodenum 174
Gastric Ulcers 174
Gastric Carcinoma 174
Duodenal Ulcer 174
Small and Large Bowel 176
General Considerations 176
Small Bowel: Crohn Disease 176
Large Bowel 178
Diverticulosis 178
Diverticulitis 178
Colonic Polyps 179
Colonic Carcinoma 180
Colitis 180
Appendicitis 181
Pancreas 183
Pancreatitis 183
Pancreatic Adenocarcinoma 184
Hepatobiliary Abnormalities 184
Liver: General Considerations 184
Fatty Infiltration 185
Cirrhosis 185
Space-Occupying Lesions of the Liver 185
Metastases 187
Hepatocellular Carcinoma (Hepatoma) 187
Cavernous Hemangiomas 187
Hepatic Cysts 187
Biliary System: Magnetic Resonance Cholangiopancreatography (MRCP) 188
Urinary Tract 189
Kidneys: General Considerations 189
Space-Occupying Lesions 189
Renal Cysts 189
Renal Cell Carcinoma (Hypernephroma) 189
Pelvis 190
General Considerations 190
Urinary Bladder 190
Bladder Tumors 190
Adenopathy 190
Weblink 191
19 Ultrasonography: 193
How it Works 193
Doppler Ultrasonography 193
Adverse Effects and Safety Issues 194
Medical Uses of Ultrasonography 194
Biliary System 194
Normal Ultrasound Anatomy 194
Gallstones and Acute Cholecystitis 194
Bile Ducts 196
Urinary Tract 197
Normal Ultrasound Anatomy 197
Hydronephrosis 197
Medical Renal Disease 197
Abdominal Aortic Aneurysms 198
Female Pelvic Organs 198
Normal Ultrasound Anatomy of the Uterus 198
Uterine Leiomyomas (Fibroids) 200
Normal Ultrasound Anatomy of the Ovaries 200
Ovarian Cysts 200
Ovarian Tumors 201
Pelvic Inflammatory Disease 202
Ascites 203
Appendicitis 203
Pregnancy 203
Ectopic Pregnancy 204
Fetal Abnormalities 205
Molar Pregnancy 206
Vascular Ultrasound 206
Deep Vein Thrombosis 207
Weblink 207
20 Magnetic Resonance Imaging: 209
How MRI Works 209
Hardware that Makes Up an MRI Scanner 209
Main Magnet 209
Coils 210
Computer 210
What Happens Once Scanning Begins 210
Pulse Sequences 210
How can You Identify a T1-Weighted or T2-Weighted Image? 211
MRI Contrast: General Considerations 213
MRI Safety Issues 215
General Considerations 215
Claustrophobia 215
Ferromagnetic Objects 215
Mechanical or Electrical Devices 216
Pregnant Patients 216
Nephrogenic Systemic Fibrosis 217
Diagnostic Applications of MRI 217
Weblink 217
21 Recognizing Abnormalities of Bone Density 218
Normal Bone Anatomy 218
Conventional Radiography 218
CT and MRI 218
The Effect of Bone Physiology on Bone Anatomy 218
Recognizing a Generalized Increase in Bone Density 219
Carcinoma of the Prostate 219
Osteopetrosis 220
Recognizing a Focal Increase in Bone Density 221
Carcinoma of the Prostate 221
Avascular Necrosis of Bone 221
Paget Disease 222
Recognizing a Generalized Decrease in Bone Density 223
Osteoporosis 223
Hyperparathyroidism 224
Rickets 225
Osteomalacia 226
Recognizing a Focal Decrease in Bone Density 226
Osteolytic Metastatic Disease 226
Multiple Myeloma 227
Osteomyelitis 227
Pathologic Fractures 229
Weblink 230
22 Recognizing Fractures and Dislocations 232
Recognizing an Acute Fracture 232
Recognizing Dislocations and Subluxations 232
Describing Fractures 232
How Fractures are Described: by the Number of Fracture Fragments 232
How Fractures are Described: by the Direction of the Fracture Line (Table 22-4) 234
How Fractures are Described: by the Relationship of One Fracture Fragment to Another 234
How Fractures are Described: by the Relationship of the Fracture to the Atmosphere 235
Avulsion Fractures 237
Salter-Harris Fractures: Epiphyseal Plate Fractures in Children 238
Child Abuse 240
Stress Fractures 241
Common Fracture Eponyms 241
Some Easily Missed Fractures or Dislocations 241
Fracture Healing 244
Weblink 247
23 Recognizing Joint Disease: 249
Anatomy of A Joint 249
Classification of Arthritis 249
Hypertrophic Arthritis 249
Primary Osteoarthritis (Also Known as Primary Degenerative Arthritis, Degenerative Joint Disease) 249
Secondary Osteoarthritis (Secondary Degenerative Arthritis) 250
Erosive Osteoarthritis 251
Charcot Arthropathy (Neuropathic Joint) 253
Calcium Pyrophosphate Deposition Disease (Pyrophosphate Arthropathy) 254
Erosive Arthritis 255
Rheumatoid Arthritis 255
Gout 256
Psoriatic Arthritis 257
Ankylosing Spondylitis 258
Infectious Arthritis 259
Weblink 260
24 Recognizing Some Common Causes of Neck and Back Pain 261
Conventional Radiography, MRI, and CT 261
The Normal Spine 261
Vertebral Body 261
Intervertebral Disks 261
Spinal Cord and Spinal Nerves 263
Spinal Ligaments 263
Normal MRI Appearance of the Spine 263
Back Pain 263
Herniated Disks 264
Degenerative Disk Disease 264
Osteoarthritis of the Facet Joints 265
Diffuse Idiopathic Skeletal Hyperostosis 266
Compression Fractures of the Spine 266
Spondylolisthesis and Spondylolysis 267
Spinal Stenosis 267
Malignancy Involving the Spine 268
Mri in Metastatic Spine Disease 269
Infections of the Spine: Diskitis and Osteomyelitis 271
Spinal Trauma 271
Jefferson’s Fracture 272
Hangman’s Fracture 272
Burst Fractures 273
Locked Facets 273
Weblink 273
25 Recognizing Some Common Causes of Intracranial Pathology 276
Normal Anatomy 276
Mri and the Brain 276
Head Trauma 278
Skull Fractures 278
Facial Fractures 278
Intracranial Hemorrhage 281
Epidural Hematoma (Extradural Hematoma) 281
Subdural Hematoma (SDH) 282
Intracerebral Hematoma (Intracerebral Hemorrhage) 282
Diffuse Axonal Injury 283
Increased Intracranial Pressure 285
Stroke 285
General Considerations 285
Ischemic Stroke 286
Hemorrhagic Stroke 287
Ruptured Aneurysms 288
Hydrocephalus 289
Obstructive Hydrocephalus 291
Normal-Pressure Hydrocephalus (NPH) 291
Cerebral Atrophy 293
Brain Tumors 293
Gliomas of the Brain 293
Metastases 293
Meningioma 295
Vestibular Schwannoma (Acoustic Neuroma) 295
Multiple Sclerosis 296
Terminology 297
Weblink 297
The ABCs of Heart Disease: e1
Heart Size e1
Cardiac Contours e1
Ascending Aorta e1
“Double Density” of Left Atrial Enlargement e1
Right Atrium e3
Aortic Knob e3
Main Pulmonary Artery e3
Concavity for Left Atrium e5
Left Ventricle e6
Descending Aorta e6
The Pulmonary Vasculature e6
Normal e7
Pulmonary Venous Hypertension e7
Pulmonary Arterial Hypertension e8
Increased Flow to the Lungs e8
Decreased Flow to the Lungs e9
The Abcs of Heart Disease System* e9
A—Is the Left Atrium Enlarged? e10
B—Is the Main Pulmonary Artery Big or Bulbous? e10
C—Is the Main Pulmonary Artery Segment Concave? e11
D—Is the Heart a Dilated or Delta-Shaped Heart? e12
Other Facts e13
Nuclear Medicine: e15
How It Works e15
Radioactive Decay e15
Half-Life e15
Nuclear Medicine Equipment e15
Detecting and Measuring the Radioactivity of an Isotope e16
Nuclear Medicine Safety e16
Commonly Used Nuclear Medicine Studies e17
Bone Scans e17
Pulmonary Ventilation/Perfusion Scans for Pulmonary Embolism e20
Cardiac Scans e23
Thyroid Scintigraphy e25
HIDA Scans e26
Gastrointestinal Bleeding Scans e28
Positron Emission Tomography e28
Uses of Pet Scans e30
Safety Issues and Pet Scans e31
Pet Scan Images e31
Appendix Recognizing What to Order 299
Thoracic Imaging 299
Cardiac Imaging 299
Gastrointestinal Imaging 300
Musculoskeletal Imaging 300
Genitourinary Imaging 301
Neurologic Imaging 301
Pediatric Imaging 302
Reproductive Imaging 303
Bibliography 304
Texts 304
Journal Articles 304
Index 305
A 305
B 306
C 307
D 308
E 309
F 309
G 310
H 310
I 311
J 311
K 311
L 312
M 312
N 313
O 313
P 313
Q 315
R 315
S 315
T 316
U 317
V 317
W 317
X 317
Y 317
Z 317
The Last Printed Page 318