Subject: Radiology
Topic: Um..?
Lecturer: The usual

CT is highly useful for:
1. Diagnosing and staging renal injuries
2. Determining the depth of cortical

lacerations
3. The quantity of devascularized renal tissue
4. The status of the renal collecting system
5. The extent of peri-renal hemorrhage

Lacerations that do not
communicate with the collecting
system

The susceptibility of bladder to injury is
dependent on degree of distention, a distended
urinary bladder is much more prone to injury
than a nearly empty one

Urine extravasation, whether intraperitoneal or
extraperitoneal, is dependent on the location of
the bladder. Intraperitoneal rupture often
results from a direct blow to a distended
bladder

In a patient with a known neoplasm, especially
lung cancer, an adrenal mass is problematic
and diagnosing a metastasis versus and
adenoma is critical for prognosis

metastases or adrenal carcinoma
- heterogeneous appearance and irregular
shape are malignant characteristics

characteristics
- intracellular lipid in adenoma results in low
attenuation on CT

Little intracytoplasmic fat in metastases
results in high attenuation on non-enhanced
CT

Non-enhanced CT (NECT)
- threshold 10 HU
- sensitivity 79%, specificity 96%

Contrast-enhanced CT (CECT)
-because majority of CT examinations in
oncology use IV contrast, the % washout is
useful after 10 minutes.
- adenomas have greater than 50%
washout after 10 minutes
-washout can also be used on adrenal
masses that measure >10 HU on NECT
- alternative is to do MR or PET

MARY YVETTE ALLAIN TINA RALPH SHERYL BART HEINRICH PIPOY KC JAM CECILLE DENESSE VINCE HOOPS CES XTIAN LAINEY RIZ KIX EZRA GOLDIE BUFF MONA AM MAAN ADI KC
PENG KARLA ALPHE AARON KYTH ANNE EISA KRING CANDY ISAY MARCO JOSHUA FARS RAIN JASSIE MIKA SHAR ERIKA MACKY VIKI JOAN PREI KATE BAM AMS HANNAH MEMAY PAU
RACHE ESTHER JOEL GLENN TONI

Chemical Shift
- most sensitive method for differentiating
adenomas from metastases
- sensitivity 81-100%, specificity 94-100%
- the difference in resonance rate of protons in
fat and water is exploited in chemical shift

standard to visually quantify signal drop-off
- liver is not a reliable standard because of
steatosis

Cushing syndrome is the most common
clinical presentation in adults with adrenal
cortical carcinoma, although

Patients can present with virilization,
feminization, precocious puberty, or Conn
syndrome

In children, the most common clinical
presentation is virilization , followed by
Cushing syndrome

A large mass
- lower signal intensity than the liver on T1-
weighted images and
- higher signal intensity than the liver on T2-
weighted images
- often, the tumor demonstrates
heterogeneously hyperintensity on T1- and T2-
weighted images, due to the central necrosis
and hemorrhage

Coronal and sagittal images may be helpful in
determining adrenal origin of the mass, thus
differentiating it from renal cell carcinoma or
hepatocellular carcinoma, especially if CT is
equivocal

trauma, bleeding disorder), histoplasmosis, hyperplasia, metastasis (eg, lung or breast related), neuroblastoma, and tuberculosis

amyloidosis, carcinomas (eg, multiple, primary),
infection (ie, others), lymphoma,
pheochromocytoma (multiple endocrine neoplasia),
and Wolman disease (eg, familial xanthomatosis)

and may have thick enhancing rims. They may
also invade contiguous organs such as the
kidneys.

Occasionally, lesions may remain hyperintense
on long-echo time T2-weighted images,
mimicking pheochromocytomas

A middle aged woman presented to her primary
care physician with hypertension and episode
sweating. She was referred to a urologist who
obtained a 24 hour urinary vanillymandelic acid
(VMA) which was elevated

A large, right-sided, inhomogenous, adrenal mass with a central area of low attenuation that represents hemorrhage or necrosis

Usually hypointense or isointense relative to
the liver on T1-weighted spin-echo (SE) images,
and

The reason for this difference is unknown, but
likely results from the high water content in
cellular homogenous tumors or the high water
content in necrotic regions

Tumors that have bled show the features
typical of hemorrhage, depending on the age of
the hemorrhage

By ultrasound, the normal postmenarchal
nulliparous uterus is 5-8 cm in length, 1.5-3 cm
thick, 2.5-5 cm wide.

The normal myometrium is hypoechoic,
homogenous, and reasonably well demarcated
from the endometrial echos

The endometrium consists of a constant basal
layer (basalis), and a cycling functional layer
(functionalis). The functional layer includes a thin
compactum layer and a thick spongiosum layer.