Dataset Viewer
Auto-converted to Parquet Duplicate
type
stringclasses
2 values
u_id
stringlengths
7
7
age
stringclasses
90 values
caption
stringlengths
6
1.19k
figure_part
stringclasses
65 values
modality
stringclasses
29 values
plane
stringclasses
15 values
sex
stringclasses
3 values
location
stringclasses
22 values
location_category
stringclasses
5 values
mri
listlengths
0
22
title
stringlengths
4
152
history
stringlengths
3
1.93k
exam
stringlengths
2
1.26k
findings
stringlengths
13
2.86k
differential_diagnosis
stringlengths
3
1.12k
case_diagnosis
stringlengths
3
241
diagnosis_by
stringclasses
402 values
disease_discussion
stringlengths
8
10.2k
category
stringclasses
70 values
image_acr_codes
stringclasses
115 values
case_acr_code
stringclasses
127 values
image
imagewidth (px)
96
512
discussion
stringclasses
408 values
reference
stringlengths
12
22.4k
treatment_&_follow_up
stringlengths
2
1.83k
keywords
stringlengths
3
108
external_links
stringclasses
95 values
media
stringclasses
1 value
CT
MPX1009
73
The prostate is enlarged with several calcifications noted within. No dominant prostate mass is evident.
null
CT - noncontrast
Coronal
male
Genitourinary
Reproductive and Urinary System
[]
Bladder Diverticulum
73-year-old male with hematuria and numerous white blood cells found on UA
N/A
Bladder with thickened wall and diverticulum on the right. Diverticulum is mostly likely secondary to chronic outflow obstruction. Prostate enlargement.
Bladder Diverticulum
Bladder Diverticulum
N/A
Bladder diverticula most often occur as a result of outlet obstruction. Occasionally, a congenital weakness in the bladder wall adjacent to the ureteral orifice results in a diverticulum. This is termed a "Hutch" diverticulum. In children, outlet obstruction causing a diverticulum is rare and can be seen with urethra...
Diverticulum
8.-1
8.9
null
null
null
null
null
null
CT
MPX1009
73
Bladder is prominent with mildly thickened wall. There is a small posteriolateral diverticulum on the rightward aspect.
null
CT - noncontrast
Axial
male
Genitourinary
Reproductive and Urinary System
[]
Bladder Diverticulum
73-year-old male with hematuria and numerous white blood cells found on UA
N/A
Bladder with thickened wall and diverticulum on the right. Diverticulum is mostly likely secondary to chronic outflow obstruction. Prostate enlargement.
Bladder Diverticulum
Bladder Diverticulum
N/A
Bladder diverticula most often occur as a result of outlet obstruction. Occasionally, a congenital weakness in the bladder wall adjacent to the ureteral orifice results in a diverticulum. This is termed a "Hutch" diverticulum. In children, outlet obstruction causing a diverticulum is rare and can be seen with urethra...
Diverticulum
8.-1
8.9
null
null
null
null
null
null
CT
MPX1024
60
CT of the chest reveals an obstructing mass and resultant LUL collapse.
null
CT - noncontrast
Axial
female
Chest, Pulmonary
Thorax
[]
Lung, lobar collapse (left upper lobe)
60-year-old woman presents with chest pain and shortness of breath.
null
• PA chest radiograph demonstrates left lung volume loss, silhouetting of the left cardiac border, and Luftsichel sign. • Lateral chest radiograph shows anterior displacement of the major fissure and elevation of the left mainstem bronchus. • CT of the chest reveals an obstructing mass and resultant LUL collapse.
This combination of radiographic findings are consistent with LUL collapse and highly suspicious for an underlying endobronchial mass causing obstruction of the LUL bronchus.
Left upper lobe collapse caused by an enlarging, obstructing small cell lung carcinoma.
Lung biopsy proven Small Cell Lung Cancer.
Total left upper lobe atelectasis is caused by obstruction of the left upper lobe bronchus. This may be due to pulmonary mass, mucous plugging or foreign bodies. In older individuals, a pulmonary mass is a common cause. PA films of left upper lobe atelectasis demonstrate opacification of the left upper lung field wi...
Obstruction or Stenosis
-1.-1
64.749
This woman had known small cell lung carcinoma. The radiographic findings described above are diagnostic of left upper lobe collapse. Such a finding should raise suspicion for an underlying obstructing mass. In this case, the patient presents with a known diagnosis of small cell lung carcinoma. Thus CT is not requi...
Fraser et al. Synopsis of Diseases of the Chest. 2nd ed. WB Saunders. Philadelphia. 1994.
null
null
null
null
CT
MPX1024
60
CT of the chest reveals an obstructing mass and resultant LUL collapse.
null
CT - noncontrast
Axial
female
Chest, Pulmonary
Thorax
[]
Lung, lobar collapse (left upper lobe)
60-year-old woman presents with chest pain and shortness of breath.
null
• PA chest radiograph demonstrates left lung volume loss, silhouetting of the left cardiac border, and Luftsichel sign. • Lateral chest radiograph shows anterior displacement of the major fissure and elevation of the left mainstem bronchus. • CT of the chest reveals an obstructing mass and resultant LUL collapse.
This combination of radiographic findings are consistent with LUL collapse and highly suspicious for an underlying endobronchial mass causing obstruction of the LUL bronchus.
Left upper lobe collapse caused by an enlarging, obstructing small cell lung carcinoma.
Lung biopsy proven Small Cell Lung Cancer.
Total left upper lobe atelectasis is caused by obstruction of the left upper lobe bronchus. This may be due to pulmonary mass, mucous plugging or foreign bodies. In older individuals, a pulmonary mass is a common cause. PA films of left upper lobe atelectasis demonstrate opacification of the left upper lung field wi...
Obstruction or Stenosis
-1.-1
64.749
This woman had known small cell lung carcinoma. The radiographic findings described above are diagnostic of left upper lobe collapse. Such a finding should raise suspicion for an underlying obstructing mass. In this case, the patient presents with a known diagnosis of small cell lung carcinoma. Thus CT is not requi...
Fraser et al. Synopsis of Diseases of the Chest. 2nd ed. WB Saunders. Philadelphia. 1994.
null
null
null
null
CT
MPX1012
14
pelvis
null
CT - GI & IV Contrast
Axial
female
Genitourinary
Reproductive and Urinary System
[]
Ovarian torsion
24 hours of pelvic, RLQ pain.
Tender in the right adnexa and right lower quadrant. Negative pregnancy test.
CT: Large heterogeneous pelvic mass displacing the uterus anteriorly. US: Enlarged right ovary with central cystic component. Absent blood flow.
Ovarian Torsion Ovarian mass, benign vs. malignant Hemorrhagic cyst Ectopic pregnancy TOA
Ovarian torsion
Laporoscopy
Ovarian torsion is caused by partial or complete rotation of the ovary on its mesenteric pedicle. This results first in compromise of the lymphatic and venous drainage, causing congestion and edema of the ovarian parenchyma and eventually leading to loss of the arterial perfusion and infarction. The condition is a su...
Infarction and/or Necrosis
8.2
8.2
null
Rumack, Diagnostic Ultrasound p. 550
null
null
null
null
CT
MPX1012
14
pelvis
null
CT - GI & IV Contrast
Axial
female
Genitourinary
Reproductive and Urinary System
[]
Ovarian torsion
24 hours of pelvic, RLQ pain.
Tender in the right adnexa and right lower quadrant. Negative pregnancy test.
CT: Large heterogeneous pelvic mass displacing the uterus anteriorly. US: Enlarged right ovary with central cystic component. Absent blood flow.
Ovarian Torsion Ovarian mass, benign vs. malignant Hemorrhagic cyst Ectopic pregnancy TOA
Ovarian torsion
Laporoscopy
Ovarian torsion is caused by partial or complete rotation of the ovary on its mesenteric pedicle. This results first in compromise of the lymphatic and venous drainage, causing congestion and edema of the ovarian parenchyma and eventually leading to loss of the arterial perfusion and infarction. The condition is a su...
Infarction and/or Necrosis
8.2
8.2
null
Rumack, Diagnostic Ultrasound p. 550
null
null
null
null
CT
MPX1016
43
Contrast enhanced chest CT shows diffuse increased interstitial markings involving the right middle and lower lobes.
2a
CT w/contrast (IV)
Axial
female
Chest, Pulmonary
Thorax
[]
Adenocarcinoma of the Lung
The patient is a 43-year-old female who presented with a 6-month history of progressively worsening shortness of breath with exertion during her 5-mile runs. The patient also complained of wheezing but denied having a cough, fevers, chills, or weight loss. This patient does not have a previous history of any chronic ...
Physical Exam: No abnormalities. Labs: - Fungal, acid-fast, and Gram stains showed no organisms. - Pleural fluid analysis was suspicious for malignancy. - Histopathologic analysis of tissue samples of all three right lung lobes including mediastinal lymph nodes revealed extensive lymphovascular invasion, focal ar...
Chest PA/LAT revealed increased interstitial markings in the right lower lobe. Contrast enhanced chest CT revealed diffuse increased interstitial markings involving the right middle and lower lobes, pleural thickening/scarring of the posterior right lower lobe, and a small right-sided pleural effusion.
lymphangitic spread of malignancy primary malignancy lymphoma Sjogrens syndrome lymphangioleiomyomatosis pneumonia (bacterial, atypical, viral) collagen vascular disease (SLE, RA) hypersensitivity pneumonitis asbestosis edema (secondary to fluid overload, CHF, or nephrotic syndrome)
Adenocarcinoma of the Lung
Biopsy histology
Lung cancer has surpassed breast cancer in becoming the leading cause of cancer death in women. Adenocarcinoma accounts for 30-40% of lung cancers and is the most common histologic type. It is also the most common type of lung cancer in non-smokers (an estimated 10-15% of patients diagnosed with lung cancer are non-sm...
Neoplasm, carcinoma
6.3
6.3
Lung cancer must be ruled out in any patient with a nonresolving pneumonia. Lung cancer has surpassed breast cancer in becoming the leading cause of cancer death in women. Adenocarcinoma accounts for 30-40% of lung cancers and is the most common histologic type. It is also the most common type of lung cancer in non-s...
1. The American Thoracic Society and The European Respiratory Society. Pretreatment evaluation of non-small-cell lung cancer. Am J Respir Crit Care Med 1997;156: 320-332. 2. Cerfolio RJ, Bryant AS, Winokur TS, et al. Repeat FDG-PET after neoadjuvant therapy is a predictor of pathologic response in patients with non...
The patient was initially treated for pneumonia based on her symptoms and the findings on chest x-ray. Further evaluation was completed after recurrence of symptoms within one month of therapy. VATS and mediastinoscopy were performed after bronchoalveolar lavage yielded cells suspicious for malignancy. A whole body ...
adenocarcinomalungnon small cell lung cancer
null
null
CT
MPX1016
43
Contrast enhanced chest CT shows pleural thickening/scarring of the posterior right lower lobe.
2b
CT w/contrast (IV)
Axial
female
Chest, Pulmonary
Thorax
[]
Adenocarcinoma of the Lung
The patient is a 43-year-old female who presented with a 6-month history of progressively worsening shortness of breath with exertion during her 5-mile runs. The patient also complained of wheezing but denied having a cough, fevers, chills, or weight loss. This patient does not have a previous history of any chronic ...
Physical Exam: No abnormalities. Labs: - Fungal, acid-fast, and Gram stains showed no organisms. - Pleural fluid analysis was suspicious for malignancy. - Histopathologic analysis of tissue samples of all three right lung lobes including mediastinal lymph nodes revealed extensive lymphovascular invasion, focal ar...
Chest PA/LAT revealed increased interstitial markings in the right lower lobe. Contrast enhanced chest CT revealed diffuse increased interstitial markings involving the right middle and lower lobes, pleural thickening/scarring of the posterior right lower lobe, and a small right-sided pleural effusion.
lymphangitic spread of malignancy primary malignancy lymphoma Sjogrens syndrome lymphangioleiomyomatosis pneumonia (bacterial, atypical, viral) collagen vascular disease (SLE, RA) hypersensitivity pneumonitis asbestosis edema (secondary to fluid overload, CHF, or nephrotic syndrome)
Adenocarcinoma of the Lung
Biopsy histology
Lung cancer has surpassed breast cancer in becoming the leading cause of cancer death in women. Adenocarcinoma accounts for 30-40% of lung cancers and is the most common histologic type. It is also the most common type of lung cancer in non-smokers (an estimated 10-15% of patients diagnosed with lung cancer are non-sm...
Neoplasm, carcinoma
6.3
6.3
Lung cancer must be ruled out in any patient with a nonresolving pneumonia. Lung cancer has surpassed breast cancer in becoming the leading cause of cancer death in women. Adenocarcinoma accounts for 30-40% of lung cancers and is the most common histologic type. It is also the most common type of lung cancer in non-s...
1. The American Thoracic Society and The European Respiratory Society. Pretreatment evaluation of non-small-cell lung cancer. Am J Respir Crit Care Med 1997;156: 320-332. 2. Cerfolio RJ, Bryant AS, Winokur TS, et al. Repeat FDG-PET after neoadjuvant therapy is a predictor of pathologic response in patients with non...
The patient was initially treated for pneumonia based on her symptoms and the findings on chest x-ray. Further evaluation was completed after recurrence of symptoms within one month of therapy. VATS and mediastinoscopy were performed after bronchoalveolar lavage yielded cells suspicious for malignancy. A whole body ...
adenocarcinomalungnon small cell lung cancer
null
null
CT
MPX1035
22
Non-contrast CT axial view demonstrates a R occipital condyle fracture at the arrow. There is also a small amount of hemorrhage tracking posterior to the fracture.
null
CT - noncontrast
Axial
male
Head and Neck
Head
[]
Occipital Condyle Fractures
22yo M transported to the emergency department after a motorcycle accident. The head CT showed multiple intraparenchymal bleeds and small subarachnoid bleed. No other fractures of the cervical spine identified. Patient was monitored non-operatively by a hard collar. He developed a right cranial VI nerve palsy two days ...
R cranial nerve VI palsy
Axial and coronal CT of the head and cervical spine demonstrating a R Occipital condyle fracture.
Occipital condylar fracture Type I, II, or III
Occipital Condyle Fractures
CT
The most common classification is by Anderson and Montesano that describes three basic types of occipital condylar fractures. Type I is usually the result of an impaction type injury due to asymmetrical axial forces applied to the head and may be seen with other lateral mass fractures in the upper cervical spine. Th...
Miscellaneous
1.4
1.-1
null
Anderson PA, Montesano PX. Morphology and treatment of occipital condyle fractures. Spine 1988; 13:731-736
null
Occipital Condyle FractureOccipital Fracture
null
null
CT
MPX1031
74
CT (3mm collimation) shows peripheral interlobular septal thickening with scattered focal consolidation and GGO.
2
CT - noncontrast
Axial
female
Chest, Pulmonary
Thorax
[]
Interstital Lung Disease
74 yo female with history of leukemia and COPD now with acute onset of shortness of breath.
rales and crackles at the bases, CBC with elev white count (lymphocytes and neutrophils) and immature forms, BAL is PAS+
Predominately basilar and peripheral interlobular septal thickening with scattered areas of ground glass opacity, consolidation, and fibrosis.
DDX is that of ILD (see FACTOID). *Pulmonary edema (CHF) *Bacterial pneumonia *Pulmonary alveolar proteinosis
COPD and chronic ILD secondary to leukemia with acute PAP
Bronchoalveolar lavage PAP+
INTERSTITIAL LUNG DISEASE --- The lung interstitium is composed of three components: bronchoarterial (axial), peripheral and parenchymal (using the terminology of Fraser and Pare). The axial component consists of the bronchovascular couplets (bronchiole and accompanying pulmonary artery). The peripheral space is compos...
Inflammatory, non-infectious
6.2
6.2
null
Fraser, R.S. and Pare, P.D.; DIAGNOSIS OF DISEASES OF THE CHEST, 4th ed Vol IV, pgs 2700-08. Gotway, M.B.; "Interstitial Lung Disease", UCSF Resident Review Notes in Diagnostic Imaging, Feb. 2003.
null
pulmonary alveolar proteinosisPAPinterstitial lung disease
null
null
CT
MPX1034
4
Soft tissue mass in the middle ear space, extending toward but not filling the facial recess and oval window.
null
CT - noncontrast
Axial
male
Head and Neck
Head
[]
Congenital Cholesteatoma
4 year old male with presented with white mass behind the left tympanic membrane noted on routine physical exam. Pt has no hx of ear surgery, perforations or trauma.
Ear exam: White mass behind the tympanic membrane, with bilateral tympanostomy tubes. Audiometry: left sided airbone gap of 30dBs, left sided type B tympanogram, right sided type A tympanogram
- Cholesteatoma of the left mesotympanum and epitympanum - Extends medially toward the malleus and incus without clear erosion of the bones - No dehiscence of the facial nerve noted
Congenital Cholesteatoma Acquired Cholesteatoma Giant Cholesterol Cyst Acoustic Neuroma Glomus tumor Sarcoma Meningioma
Congenital Cholesteatoma
Appearance was consistant with cholesteatoma on specimen examination both grossly and histologically.
Congenital cholesteatoma Cholesteatomas can be divided into two catagories, aquired cholesteatomas caused by traumatic, infectious or post surgical causes and congenital ectopic tissue rests. Clinical criteria: pearly white mass medial to an intact tympanic membrane, a normal pars tensa and flaccida, and no history o...
Neoplasm, benign
1.3
1.3
null
Congenital cholesteatoma: theories, facts, and 53 patients. Bennett M - Otolaryngol Clin North Am - 01-DEC-2006; 39(6): 1081-94 The pathophysiology of cholesteatoma. Semaan MT - Otolaryngol Clin North Am - 01-DEC-2006; 39(6): 1143-59 Cummings: Otolaryngology Head and Neck Surgery 4th ed. Chapter 110, Deep Space Neck...
Canal wall up tympanomastoidectomy with complete removal of the ossicle chain. Planned reconstruction of the ossicle chain if no recurrence is noted.
cholesteatomacongenitalear disease
null
null
CT
MPX1034
4
Soft tissue mass in the middle ear space abutting the long process of the incus without obvious erosion.
null
CT - noncontrast
Coronal
male
Head and Neck
Head
[]
Congenital Cholesteatoma
4 year old male with presented with white mass behind the left tympanic membrane noted on routine physical exam. Pt has no hx of ear surgery, perforations or trauma.
Ear exam: White mass behind the tympanic membrane, with bilateral tympanostomy tubes. Audiometry: left sided airbone gap of 30dBs, left sided type B tympanogram, right sided type A tympanogram
- Cholesteatoma of the left mesotympanum and epitympanum - Extends medially toward the malleus and incus without clear erosion of the bones - No dehiscence of the facial nerve noted
Congenital Cholesteatoma Acquired Cholesteatoma Giant Cholesterol Cyst Acoustic Neuroma Glomus tumor Sarcoma Meningioma
Congenital Cholesteatoma
Appearance was consistant with cholesteatoma on specimen examination both grossly and histologically.
Congenital cholesteatoma Cholesteatomas can be divided into two catagories, aquired cholesteatomas caused by traumatic, infectious or post surgical causes and congenital ectopic tissue rests. Clinical criteria: pearly white mass medial to an intact tympanic membrane, a normal pars tensa and flaccida, and no history o...
Neoplasm, benign
1.3
1.3
null
Congenital cholesteatoma: theories, facts, and 53 patients. Bennett M - Otolaryngol Clin North Am - 01-DEC-2006; 39(6): 1081-94 The pathophysiology of cholesteatoma. Semaan MT - Otolaryngol Clin North Am - 01-DEC-2006; 39(6): 1143-59 Cummings: Otolaryngology Head and Neck Surgery 4th ed. Chapter 110, Deep Space Neck...
Canal wall up tympanomastoidectomy with complete removal of the ossicle chain. Planned reconstruction of the ossicle chain if no recurrence is noted.
cholesteatomacongenitalear disease
null
null
CT
MPX1048
20
CT: homogenous fluid attenuating and smoothly marginated lesion abutting the right cardiac border with Hounsfield attenuation unit = 7; Measures 5 x 4.4 x 7 cm
null
CT w/contrast (IV)
Axial
male
Cardiovascular
Thorax
[]
Pericardial cyst
20 year old healthy male for re-commissioning physical exam. Patient also C/O worsening cough and congestion over last week
null
PA/LAT: smoothly marginated soft tissue opacity noted in Right cardiophrenic angle, otherwise normal. CT: homogenous fluid attenuating and smoothly marginated lesion abutting the right cardiac border with Hounsfield attenuation unit = 7; Measures 5 x 4.4 x 7 cm
• Pericardial cyst • Morgagni hernia • Cardiac (epicardial) fat pad • Adenopathy • Thymoma • Lymphoma
Pericardial cyst
null
Clinical importance lies in the need to differentiate pericardial cysts from other masses with a similar appearance. Pericardial cysts represent fluid-filled outpouchings of the parietal pericardium. They occur in 1/100,000 people. The cysts rarely calcify and do not communicate with the pericardial space. One-thir...
Unsure
55.1942
55.1942
null
Braunwald: Heart Disease: A Textbook of Cardiovascular Medicine, 6th ed Grainger & Allison’s Diagnostic Radiology: A Textbook of Medical Imaging, 4th Ed. Tekeda et al, Clinical Spectrum of Mediastinal Cyst. Chest Vol 124, Number 1, Jul 2003
This case may require puncture and drainage due to its increased size, but pericardial cysts rarely require surgical treatment. Usually they can be followed serially.
pericardialcysts
null
null
CT
MPX1038
27
Selected axial CT images in bone window.
1
CT - noncontrast
Axial
female
Brain and Neuro
Head
[]
Brain Tumor and Cancer Protocols
27 year old female involved in high speed motor vehicle accident.
Patient presented to ED with GCS of 12, no focal neurologic findings, as well as multiple abrasions and minor lacerations on all extremeties and the face.
Selected axial CT images in bone window show multiple fractures of C1 including bilateral anteriolateral fractures with no displacement of left lateral mass and moderate displacement of the right lateral mass best visualized on the coronal reformatted images. There is also a comminuted fracture in the right posteriola...
Fracture
Jefferson Fracture
NA
You may search the NIH/NCI cancer treatment protocol database: http://clinicalstudies.info.nih.gov/ Adult Brain tumors - http://www.cancer.gov/cancertopics/pdq/treatment/adultbrain/healthprofessional Pediatric Brain tumors - http://www.cancer.gov/cancertopics/pdq/treatment/childbrain/HealthProfessional Clinical Tria...
Neoplasm, malignant (NOS)
3.0
1.3
Multiple C1 ring fractures, otherwise known as Jefferson fractures,account for 10% of all cervical spine injuries and 25% of alantoaxial injuries and result from a significant axial force directed from vertex through occiput such as diving in shallow water or in this case a motor vehicle accident. The C1 ring much lik...
null
Patient should be stabilized with Halo for three months.
protocolscancer treatmentglioblastoma
clinicalstudies.info.nih.gov/
null
CT
MPX1038
27
Selected axial CT images in bone window.
3
CT - noncontrast
Axial
female
Brain and Neuro
Head
[]
Brain Tumor and Cancer Protocols
27 year old female involved in high speed motor vehicle accident.
Patient presented to ED with GCS of 12, no focal neurologic findings, as well as multiple abrasions and minor lacerations on all extremeties and the face.
Selected axial CT images in bone window show multiple fractures of C1 including bilateral anteriolateral fractures with no displacement of left lateral mass and moderate displacement of the right lateral mass best visualized on the coronal reformatted images. There is also a comminuted fracture in the right posteriola...
Fracture
Jefferson Fracture
NA
You may search the NIH/NCI cancer treatment protocol database: http://clinicalstudies.info.nih.gov/ Adult Brain tumors - http://www.cancer.gov/cancertopics/pdq/treatment/adultbrain/healthprofessional Pediatric Brain tumors - http://www.cancer.gov/cancertopics/pdq/treatment/childbrain/HealthProfessional Clinical Tria...
Neoplasm, malignant (NOS)
3.0
1.3
Multiple C1 ring fractures, otherwise known as Jefferson fractures,account for 10% of all cervical spine injuries and 25% of alantoaxial injuries and result from a significant axial force directed from vertex through occiput such as diving in shallow water or in this case a motor vehicle accident. The C1 ring much lik...
null
Patient should be stabilized with Halo for three months.
protocolscancer treatmentglioblastoma
clinicalstudies.info.nih.gov/
null
CT
MPX1038
27
Selected axial CT images in bone window.
4
CT - noncontrast
Axial
female
Brain and Neuro
Head
[]
Brain Tumor and Cancer Protocols
27 year old female involved in high speed motor vehicle accident.
Patient presented to ED with GCS of 12, no focal neurologic findings, as well as multiple abrasions and minor lacerations on all extremeties and the face.
Selected axial CT images in bone window show multiple fractures of C1 including bilateral anteriolateral fractures with no displacement of left lateral mass and moderate displacement of the right lateral mass best visualized on the coronal reformatted images. There is also a comminuted fracture in the right posteriola...
Fracture
Jefferson Fracture
NA
You may search the NIH/NCI cancer treatment protocol database: http://clinicalstudies.info.nih.gov/ Adult Brain tumors - http://www.cancer.gov/cancertopics/pdq/treatment/adultbrain/healthprofessional Pediatric Brain tumors - http://www.cancer.gov/cancertopics/pdq/treatment/childbrain/HealthProfessional Clinical Tria...
Neoplasm, malignant (NOS)
3.0
1.3
Multiple C1 ring fractures, otherwise known as Jefferson fractures,account for 10% of all cervical spine injuries and 25% of alantoaxial injuries and result from a significant axial force directed from vertex through occiput such as diving in shallow water or in this case a motor vehicle accident. The C1 ring much lik...
null
Patient should be stabilized with Halo for three months.
protocolscancer treatmentglioblastoma
clinicalstudies.info.nih.gov/
null
CT
MPX1038
27
Selected axial CT images in bone window.
5
CT - noncontrast
Axial
female
Brain and Neuro
Head
[]
Brain Tumor and Cancer Protocols
27 year old female involved in high speed motor vehicle accident.
Patient presented to ED with GCS of 12, no focal neurologic findings, as well as multiple abrasions and minor lacerations on all extremeties and the face.
Selected axial CT images in bone window show multiple fractures of C1 including bilateral anteriolateral fractures with no displacement of left lateral mass and moderate displacement of the right lateral mass best visualized on the coronal reformatted images. There is also a comminuted fracture in the right posteriola...
Fracture
Jefferson Fracture
NA
You may search the NIH/NCI cancer treatment protocol database: http://clinicalstudies.info.nih.gov/ Adult Brain tumors - http://www.cancer.gov/cancertopics/pdq/treatment/adultbrain/healthprofessional Pediatric Brain tumors - http://www.cancer.gov/cancertopics/pdq/treatment/childbrain/HealthProfessional Clinical Tria...
Neoplasm, malignant (NOS)
3.0
1.3
Multiple C1 ring fractures, otherwise known as Jefferson fractures,account for 10% of all cervical spine injuries and 25% of alantoaxial injuries and result from a significant axial force directed from vertex through occiput such as diving in shallow water or in this case a motor vehicle accident. The C1 ring much lik...
null
Patient should be stabilized with Halo for three months.
protocolscancer treatmentglioblastoma
clinicalstudies.info.nih.gov/
null
CT
MPX1045
78
There are a few small renal cysts in this Horseshoe kidney.
null
CT w/contrast (IV)
Axial
male
Genitourinary
Reproductive and Urinary System
[]
Horseshoe kidney
78 year old man with new onset of painless hematuria. There is no significant past medical history.
UA - hematuria
• Parenchymal bridge ("isthmus") connecting the inferior poles of both kidneys = Horseshoe kidneys • Complete duplication of the right ureter. • a 0.7 x 0.3 cm fat containing lesion in the inferior pole of the left kidney. • Multiple tiny calcifications bilaterally. • 1.3cm cyst in the anterior aspect of the lef...
• Horseshoe kidney • Right Ureter duplication • Angiomyolipoma • Nonobstructing stones • Renal Cyst
Horseshoe kidney
Imaging configuration
Horseshoe kidney is in a group of congenital kidney anomalies called fusion anomalies. The fusion occurs at the lower poles in 90% of the cases, while 10% are fused at the upper pole. This anomaly is found in approximately 1/500-100 people. It is thought that the abnormal fusion likely occurs when the kidneys are st...
Congenital, malformation
8.1
8.1
null
) Irshad, A; Ackerman, S; Ravenel, J. Horseshoe Kidney. www.emedicine.com Feb 03 2) Gross, G. Crossed fused Renal Ectopia. www.emedicine.com Feb 02 3) Cotran, R S; Kumar, V; Collins, T. Robins Pathologic Basis of Disease. W.B. Saunders Company. 1999. p 937.
null
Horseshoe kidneyfused kidneys
null
null
CT
MPX1045
78
There is a small angiomyolipoma in the left portion of the horseshoe kidney - the attenuation is lower than the water in the cysts.
null
CT w/contrast (IV)
Axial
male
Genitourinary
Reproductive and Urinary System
[]
Horseshoe kidney
78 year old man with new onset of painless hematuria. There is no significant past medical history.
UA - hematuria
• Parenchymal bridge ("isthmus") connecting the inferior poles of both kidneys = Horseshoe kidneys • Complete duplication of the right ureter. • a 0.7 x 0.3 cm fat containing lesion in the inferior pole of the left kidney. • Multiple tiny calcifications bilaterally. • 1.3cm cyst in the anterior aspect of the lef...
• Horseshoe kidney • Right Ureter duplication • Angiomyolipoma • Nonobstructing stones • Renal Cyst
Horseshoe kidney
Imaging configuration
Horseshoe kidney is in a group of congenital kidney anomalies called fusion anomalies. The fusion occurs at the lower poles in 90% of the cases, while 10% are fused at the upper pole. This anomaly is found in approximately 1/500-100 people. It is thought that the abnormal fusion likely occurs when the kidneys are st...
Congenital, malformation
8.1
8.1
null
) Irshad, A; Ackerman, S; Ravenel, J. Horseshoe Kidney. www.emedicine.com Feb 03 2) Gross, G. Crossed fused Renal Ectopia. www.emedicine.com Feb 02 3) Cotran, R S; Kumar, V; Collins, T. Robins Pathologic Basis of Disease. W.B. Saunders Company. 1999. p 937.
null
Horseshoe kidneyfused kidneys
null
null
CT
MPX1056
51
Large, diffusely infiltrated fatty liver with accessory left lobe. Compare to density of spleen. Multiple areas of focal sparing in left lobe that appears nodular.
null
CT w/contrast (IV)
Axial
female
Abdomen
Abdomen
[]
Hepatic fatty infiltration with focal sparing
This is 51 year old woman with known history of nephrolithiasis and left renal cyst. She was being followed for stones and had long history of abdominal/pelvic CT’s and KUB films.
Physical Exam - unremarkable Labs: CMP, amylase, Lipase pending
Selected Images – CT (contrast, arterial phase) of abdomen/pelvis 1. Large, diffusely infiltrated fatty liver with accessory left lobe. Compare to density of spleen. Multiple areas of focal sparing in left lobe that appears nodular. 2. Area of focal sparing near portal vein. 3. Area focal sparing in left lobe. ...
Hepatomegaly 1. Metabolic/diffuse infiltration • Fatty infiltration – EtOH, drugs, toxins, Guacher’s • Carbohydrate – diabetes, glycogen storage disease • Iron – hemochromatosis • Amyloid - amyloidosis 2. Tumor 3. Cysts 4. Inflammation/infection 5. Vascular congestion Nodular appearance 1. focal fat infiltration/s...
Hepatic fatty infiltration with focal sparing
Radiographically
Fatty metamorphosis is a common metabolic response of the liver to a variety of inciting agents and disease states. These agents and states include corticosteroids, chemotherapy, diabetes mellitus, hyperlipidemia, hepatotoxic drugs, obesity, severe hepatitis, chronic alcoholism, malnutrition / malabsorption, jejuno-il...
Metabolic (see also Toxic)
7.5
7.3
Previous non-contrast abdominal CT dating back approx 6 months showed evidence for diffuse fatty infiltration and hepatomegaly. Additionally, a non-contrast CT performed 1 month ago showed increased thickness of the pancreatic head. A pre- and post-contrast CT were obtained to evaluate for change. This is a presumpt...
Wanless IR. Clinics in Liver Disease. Volume 6, Number 2, May 2002 White EM. Focal Periportal Sparing in Hepatic Fatty Infiltration: A Cause of Hepatic Pseudomass on US. Radiology 1987; 162:57-9
No specific treatment at this time. Follow-up with liver function tests to determine if stable or continuing to rise.
Hepatic fatty infiltration with focal sparingLiver fatty infiltrationfocal sparing
null
null
CT
MPX1056
51
Large, diffusely infiltrated fatty liver with accessory left lobe. Compare to density of spleen. Multiple areas of focal sparing in left lobe that appears nodular.
null
CT w/contrast (IV)
Axial
female
Abdomen
Abdomen
[]
Hepatic fatty infiltration with focal sparing
This is 51 year old woman with known history of nephrolithiasis and left renal cyst. She was being followed for stones and had long history of abdominal/pelvic CT’s and KUB films.
Physical Exam - unremarkable Labs: CMP, amylase, Lipase pending
Selected Images – CT (contrast, arterial phase) of abdomen/pelvis 1. Large, diffusely infiltrated fatty liver with accessory left lobe. Compare to density of spleen. Multiple areas of focal sparing in left lobe that appears nodular. 2. Area of focal sparing near portal vein. 3. Area focal sparing in left lobe. ...
Hepatomegaly 1. Metabolic/diffuse infiltration • Fatty infiltration – EtOH, drugs, toxins, Guacher’s • Carbohydrate – diabetes, glycogen storage disease • Iron – hemochromatosis • Amyloid - amyloidosis 2. Tumor 3. Cysts 4. Inflammation/infection 5. Vascular congestion Nodular appearance 1. focal fat infiltration/s...
Hepatic fatty infiltration with focal sparing
Radiographically
Fatty metamorphosis is a common metabolic response of the liver to a variety of inciting agents and disease states. These agents and states include corticosteroids, chemotherapy, diabetes mellitus, hyperlipidemia, hepatotoxic drugs, obesity, severe hepatitis, chronic alcoholism, malnutrition / malabsorption, jejuno-il...
Metabolic (see also Toxic)
7.5
7.3
Previous non-contrast abdominal CT dating back approx 6 months showed evidence for diffuse fatty infiltration and hepatomegaly. Additionally, a non-contrast CT performed 1 month ago showed increased thickness of the pancreatic head. A pre- and post-contrast CT were obtained to evaluate for change. This is a presumpt...
Wanless IR. Clinics in Liver Disease. Volume 6, Number 2, May 2002 White EM. Focal Periportal Sparing in Hepatic Fatty Infiltration: A Cause of Hepatic Pseudomass on US. Radiology 1987; 162:57-9
No specific treatment at this time. Follow-up with liver function tests to determine if stable or continuing to rise.
Hepatic fatty infiltration with focal sparingLiver fatty infiltrationfocal sparing
null
null
CT
MPX1033
6
IN PROGRESS
null
CT - noncontrast
Axial
female
Chest, Pulmonary
Thorax
[]
Idiopathic Pulmonary Hemosiderosis
Patient with diagnosis of idiopathic pulmonary hemosiderosis per open lung biopsy 10/07 who has been relatively asymptomatic but with persistent presence of hemosiderin-laden macrophages in bronchoalveolar lavage and desaturation noted on exercise test in May 2008. HISTORY Patient was product of pregnancy complicated...
VS: T 98.4 HR BP RR O2 Sat 98% on RA Wt 15.2 kg Ht 44cm Gen: Small for age; NORMAL ACTIVITY FOR AGE, ALERT AND RESPONSIVE, HEENT: left TM well visualized with good light reflex; right TM occluded by cerumen (unable to extract at this time); EOMI, PERRLA, no nasal discharge, oropharynx clear and w/o exudates ...
During acute bleeding episode, areas of increased opacity and decreased lung volume are seen throughout the lungs, especially in the bases.
DDX for diffuse alveolar hemorrhage: immune related- anti-basement membrane antibody disease (Goodpasture's syndrome), vasculitis and collagen vascular disease (systemic lupus erythematosus, Wegener's granulomatosis, systemic necrotizing vasculitis, and others), and pulmonary capillaritis associated with idiopathic r...
Idiopathic Pulmonary Hemosiderosis
Open Lung Biopsy, 10/07 - reviewed by TAMC pathology, AFIP, Texas Children’s Hospital Common findings on diagnostic tests: CXR: “butterfly or batwing” pattern – symmetrical alveolar infiltrates slanting upwards towards lateral chest wall CT: “ground glass appearance” Dx: BAL showing hemosiderin-laden macrophages Lun...
***IN PROGRESS**** Lesions/Condition: Idiopathic Pulmonary Hemosiderosis Cell of Origin: WHO Grade(s): Synonyms: Associations/Predisposing Factors: Common Locations: Demographics: Gross Morphology: Histology: Special Stains: Gross Appearance: Radiology: Prognosis and Treatment:
Idiopathic or Unknown
6.2
6.9
null
null
Patient is presently receiving monthly IVIG (2mg/kg) infusions with pretreatment of Tylenol 15mg/kg and concurrent steroid bursts (Solumedrol 30mg/kg). Will reassess with CT, PFTs every 6 months. Literature review shows current recommendations as follows: * Systemic glucocorticoids - noted improvement during acute p...
pulmonary hemorrhagehemosiderosispediatric
null
null
CT
MPX1033
6
IN PROGRESS.
null
CT - noncontrast
Axial
female
Chest, Pulmonary
Thorax
[]
Idiopathic Pulmonary Hemosiderosis
Patient with diagnosis of idiopathic pulmonary hemosiderosis per open lung biopsy 10/07 who has been relatively asymptomatic but with persistent presence of hemosiderin-laden macrophages in bronchoalveolar lavage and desaturation noted on exercise test in May 2008. HISTORY Patient was product of pregnancy complicated...
VS: T 98.4 HR BP RR O2 Sat 98% on RA Wt 15.2 kg Ht 44cm Gen: Small for age; NORMAL ACTIVITY FOR AGE, ALERT AND RESPONSIVE, HEENT: left TM well visualized with good light reflex; right TM occluded by cerumen (unable to extract at this time); EOMI, PERRLA, no nasal discharge, oropharynx clear and w/o exudates ...
During acute bleeding episode, areas of increased opacity and decreased lung volume are seen throughout the lungs, especially in the bases.
DDX for diffuse alveolar hemorrhage: immune related- anti-basement membrane antibody disease (Goodpasture's syndrome), vasculitis and collagen vascular disease (systemic lupus erythematosus, Wegener's granulomatosis, systemic necrotizing vasculitis, and others), and pulmonary capillaritis associated with idiopathic r...
Idiopathic Pulmonary Hemosiderosis
Open Lung Biopsy, 10/07 - reviewed by TAMC pathology, AFIP, Texas Children’s Hospital Common findings on diagnostic tests: CXR: “butterfly or batwing” pattern – symmetrical alveolar infiltrates slanting upwards towards lateral chest wall CT: “ground glass appearance” Dx: BAL showing hemosiderin-laden macrophages Lun...
***IN PROGRESS**** Lesions/Condition: Idiopathic Pulmonary Hemosiderosis Cell of Origin: WHO Grade(s): Synonyms: Associations/Predisposing Factors: Common Locations: Demographics: Gross Morphology: Histology: Special Stains: Gross Appearance: Radiology: Prognosis and Treatment:
Idiopathic or Unknown
6.2
6.9
null
null
Patient is presently receiving monthly IVIG (2mg/kg) infusions with pretreatment of Tylenol 15mg/kg and concurrent steroid bursts (Solumedrol 30mg/kg). Will reassess with CT, PFTs every 6 months. Literature review shows current recommendations as follows: * Systemic glucocorticoids - noted improvement during acute p...
pulmonary hemorrhagehemosiderosispediatric
null
null
CT
MPX1058
78
Large filling defect draped at main pulmonary artery bifurcation. Filling defect in RLL branch pulmonary artery. Non loculated right pleural effusion.
4
CT w/contrast (IV)
Axial
female
Chest, Pulmonary
Thorax
[]
Pulmonary Embolism
Complains of several days of vague abdominal pain, general weakness and shortness of breath.
Decreased breath sounds to right lower lobe. Elevated ESR. Normocytic anemia.
Bilateral pleural effusions, R>>L. Right basilar atelectasis. Main PA filling defect C/W saddle embolism. Right lower lobe branch of PA filling defect c/w thromboembolism.
Clot embolus In situ thrombus Tumor embolus
Pulmonary Embolism
Imaging of clot
Pulmonary embolism (PE) can be associated with significant mortality if untreated. The clinical diagnosis of pulmonary embolism is unreliable. Symptoms of PE include tachypnea/dyspnea (most common), tachycardia, hypoxia, pleuritic chest pain, hemoptysis, syncope, and atrial fibrillation. Blood gas may be normal. The ...
Vascular
5.6
5.6
null
Pulmonary embolism revealed on helical CT angiography: comparison with ventilation-perfusion radionuclide lung scanning. Journal of Vascular Surgery. 33(1):206, January 2001. AJR 2000; Blachere H, et al Henteleff, Harry J.A.. Drover, John W.. Members of the CAGS Evidence Based Reviews in Surgery Group *. Canadian Ass...
null
Pulmonay embolismv/q scanhelical ct
www.auntminnie.com
null
CT
MPX1043
23
Sagittal CT performed a few weeks later demonstrates worsening expansile lytic lesions to T10, T11, and T12.
null
CT - noncontrast
Sagittal
male
Spine
Spine and Muscles
[ "MPX1043_synpic47071", "MPX1043_synpic47074", "MPX1043_synpic47075", "MPX1043_synpic47076" ]
Disseminated Coccidioidomycosis
The patient is a 23 year old man who presented with four weeks of persistent mid back pain. He received pain medications with minimal relief. His pain gradually worsened over three months to involve his left leg and hip. The patient had associated fevers, weight loss, night sweats, fatigue, and intermittent abdominal p...
Pertinent physical exam findings included: » splenomegaly to 1 cm below the costal margin » mild tenderness to palpation in the left upper quadrant » 1-2 cm firm immobile nodule left midclavicular costovertebral margin » midline tenderness to T12 and L1 » decreased range of motion in flexion secondary to pain. WBC: 9.3...
The frontal and lateral views of the thoracic spine demonstrate a mixed lucent/sclerotic appearance of the T12 vertebral body and the left pedicle. A sagittal view MRI with gadolinium of the thoracic spine and lumbar spine demonstrates enhancing lesions multiple vertebrae, including T12. Soft tissue enhancement is a...
--Osteomyelitis, including mycobacterial and fungal. --Metastatic disease --Multiple myeloma
Disseminated Coccidioidomycosis
A biopsy of the L3 vertebral body lesion demonstrates Coccidioides spores.
Lesions/Condition: Disseminated Coccidioidomycosis Cell of Origin: Dimorphic fungus Synonyms: Valley Fever Associations/Predisposing Factors: Immunosuppressed or certain ethnic groups Common Locations: Lungs, bone, meninges, skin Demographics: Filipinos, Latinos, Asians, African Americans, pregnant women, i...
Infection, fungi
3.9
3.6
Coccidioidomyocosis is a common fungal infection in the southwestern United States. It usually leads to a self limited pulmonary infection. However, in less than 5% of cases, the infection can disseminate to the soft tissue, meninges, and bone. Those who are most susceptible to dissemination include the immunocompromis...
Anstead GM, Corcoran G, Lewis J, Berg D, Grayhill JR. "Refractory Coccidioidomycosis Treated with Posaconazole." Clinical Infectious Diseases 2005;40:1770-1776. Blair, J.E. "State-of-the-Art Treatment of Coccidioidomycosis Skeletal Infections." Annals of the New York Academy of Sciences 2007; 1111: 422-433. Johnson R...
The patient was placed on amphotericin B and fluconazole and was discharged from the hospital. However, he returned to the hospital one month later with worsening back pain. Imaging demonstrated progressive disease. He was placed on multiple antifungal therapies with no success. The patient was then placed on interfero...
InfectionFungal
null
null
CT
MPX1064
27
Expansion and opacification of frontal sinus, with thinning and disruption of bone comprising the inner table of the frontal bone
null
CT - noncontrast
Axial
male
Head and Neck
Head
[ "MPX1064_synpic41380", "MPX1064_synpic41381" ]
Chronic Fungal Sinusitis
Patient presented after a 9-month cruise - his parents did not recognize his face. His nose was bigger and his eyes were farther apart than they remembered. He complained of slight frontal headaches, but had no other symptoms.
Showed hypertelorism of the eyes.
• Image 1: Axial CT with expansion and opacification of frontal sinus, with marked thinning and disruption of bone comprising the inner table of the frontal bone • Image 2: Axial CT with expansion of ethmoid sinus, with disruption of bone comprising the left lamina papyracea • Image 3: Coronal CT with expansion of a...
• Sinus neoplasm • Chronic bacterial sinusitis • Allergic fungal sinusitis • Acute fungal sinusitis • Chronic fungal sinusitis • Granulomatous fungal sinusitis • Sinus mycetoma
Chronic Fungal Sinusitis
Histopathology and culture
Lesions/Condition: Nasal sinus aspergillosis Synonyms: Fungal sinusitis Associations/Predisposing Factors: Immunocompromised (invasive fungal sinusitis), Anatomic abnormalities (mycetomas may occur after sinus surgery), Atopic patients (allergic fungal sinusitis) Demographics: -Mycetoma: Equal in race and gen...
Infection, fungi
2.7
2.7
The patient had not noticed the cosmetic effects on his face of the expanding sinonasal fungal ball; nor did his coworkers aboard the ship. It was only after he saw that his parents did not recognize him that anyone realized that his face had changed shape. This may be due to the slowly progressive changes. More on ...
UpToDate: Fungal Sinusitis, by Dr. Gary Cox and Dr. John Perfect Mukherji SK et al: Allergic fungal sinusitis: CT findings. Radiology. 207(2):417-22, 1998 Manning SC et al: Computed tomography and magnetic resonance diagnosis of allergic fungal sinusitis. Laryngoscope. 107(2): 170-6, 1997 Siliverman CS et al: Per...
Surgical exploration and resection IV amphotericin B Long-term itraconazole Follow-up is with otorhinolaryngology, with repeat culture of nasal discharge and radiologic studies
sinusaspergillosisaspergilis
www.utdol.com.gw3.lrc.usuhs.mil/utd/content/topic.do?topicKey=fung_inf/5646&selectedTitle=3~150&source=search_result
null
CT
MPX1064
27
Expansion and opacification of ethmoid sinus, with disruption of bone comprising the left lamina papyrecea
null
CT - noncontrast
Axial
male
Head and Neck
Head
[ "MPX1064_synpic41380", "MPX1064_synpic41381" ]
Chronic Fungal Sinusitis
Patient presented after a 9-month cruise - his parents did not recognize his face. His nose was bigger and his eyes were farther apart than they remembered. He complained of slight frontal headaches, but had no other symptoms.
Showed hypertelorism of the eyes.
• Image 1: Axial CT with expansion and opacification of frontal sinus, with marked thinning and disruption of bone comprising the inner table of the frontal bone • Image 2: Axial CT with expansion of ethmoid sinus, with disruption of bone comprising the left lamina papyracea • Image 3: Coronal CT with expansion of a...
• Sinus neoplasm • Chronic bacterial sinusitis • Allergic fungal sinusitis • Acute fungal sinusitis • Chronic fungal sinusitis • Granulomatous fungal sinusitis • Sinus mycetoma
Chronic Fungal Sinusitis
Histopathology and culture
Lesions/Condition: Nasal sinus aspergillosis Synonyms: Fungal sinusitis Associations/Predisposing Factors: Immunocompromised (invasive fungal sinusitis), Anatomic abnormalities (mycetomas may occur after sinus surgery), Atopic patients (allergic fungal sinusitis) Demographics: -Mycetoma: Equal in race and gen...
Infection, fungi
2.7
2.7
The patient had not noticed the cosmetic effects on his face of the expanding sinonasal fungal ball; nor did his coworkers aboard the ship. It was only after he saw that his parents did not recognize him that anyone realized that his face had changed shape. This may be due to the slowly progressive changes. More on ...
UpToDate: Fungal Sinusitis, by Dr. Gary Cox and Dr. John Perfect Mukherji SK et al: Allergic fungal sinusitis: CT findings. Radiology. 207(2):417-22, 1998 Manning SC et al: Computed tomography and magnetic resonance diagnosis of allergic fungal sinusitis. Laryngoscope. 107(2): 170-6, 1997 Siliverman CS et al: Per...
Surgical exploration and resection IV amphotericin B Long-term itraconazole Follow-up is with otorhinolaryngology, with repeat culture of nasal discharge and radiologic studies
sinusaspergillosisaspergilis
www.utdol.com.gw3.lrc.usuhs.mil/utd/content/topic.do?topicKey=fung_inf/5646&selectedTitle=3~150&source=search_result
null
CT
MPX1063
76
Multiple axial CT images of the chest with intravenous contrast material demonstrates a Stanford type A thoracic aortic dissection, with a clear intimal flap separating the true and false lumens of the ascending aorta. Additionally, a pericardial effusion is noted suspicious for hemopericardium.
null
CT w/contrast (IV)
Axial
female
Vascular
Thorax
[]
thoracic aortic dissection
76 year-old woman with long history of hypertension, with acute-onset chest pain.
N/C
Multiple axial CT images of the chest with intravenous contrast material demonstrates a Stanford type A thoracic aortic dissection, with a clear intimal flap separating the true and false lumens of the ascending aorta. Additionally, the pericardium full of dense fluid, likely hemopericardium.
thoracic aortic dissection
thoracic aortic dissection
confirmed during surgery
Multidetector CT imaging, with faster acquisition of images and utilization of contrast-tracking/event-triggering protocols like CARE Bolus (Siemens) or SmartPrep (GE), is fast becoming the imaging modality of choice for many acute clinical settings such as trauma and the diagnoses of pulmonary embolism as well as aort...
Vascular
9.9
9.9
null
1. Hatem Alkadhi, Simon Wildermuth, Lotus Desbiolles, Thomas Schertler, David Crook, Borut Marincek, and Thomas Boehm. Vascular Emergencies of the Thorax after Blunt and Iatrogenic Trauma: Multi–Detector Row CT and Three-dimensional Imaging. RadioGraphics 2004; 24: 1239-1255. 2. Eva Casta?er, Marta Andreu, Xavier Gal...
Despite prompt surgical treatment, the patient did not survive the post-operative course. The patient passed away at post-operative day 3.
aortic dissection
null
null
CT
MPX1063
76
Multiple axial CT images of the chest with intravenous contrast material demonstrates a Stanford type A thoracic aortic dissection, with a clear intimal flap separating the true and false lumens of the ascending aorta. Additionally, the pericardium full of dense fluid, likely hemopericardium.
null
CT w/contrast (IV)
Axial
female
Vascular
Thorax
[]
thoracic aortic dissection
76 year-old woman with long history of hypertension, with acute-onset chest pain.
N/C
Multiple axial CT images of the chest with intravenous contrast material demonstrates a Stanford type A thoracic aortic dissection, with a clear intimal flap separating the true and false lumens of the ascending aorta. Additionally, the pericardium full of dense fluid, likely hemopericardium.
thoracic aortic dissection
thoracic aortic dissection
confirmed during surgery
Multidetector CT imaging, with faster acquisition of images and utilization of contrast-tracking/event-triggering protocols like CARE Bolus (Siemens) or SmartPrep (GE), is fast becoming the imaging modality of choice for many acute clinical settings such as trauma and the diagnoses of pulmonary embolism as well as aort...
Vascular
9.9
9.9
null
1. Hatem Alkadhi, Simon Wildermuth, Lotus Desbiolles, Thomas Schertler, David Crook, Borut Marincek, and Thomas Boehm. Vascular Emergencies of the Thorax after Blunt and Iatrogenic Trauma: Multi–Detector Row CT and Three-dimensional Imaging. RadioGraphics 2004; 24: 1239-1255. 2. Eva Casta?er, Marta Andreu, Xavier Gal...
Despite prompt surgical treatment, the patient did not survive the post-operative course. The patient passed away at post-operative day 3.
aortic dissection
null
null
CT
MPX1063
76
Multiple axial CT images of the chest with intravenous contrast material demonstrates a Stanford type A thoracic aortic dissection, with a clear intimal flap separating the true and false lumens of the ascending aorta. Additionally, the pericardium full of dense fluid, likely hemopericardium.
null
CT w/contrast (IV)
Axial
female
Vascular
Thorax
[]
thoracic aortic dissection
76 year-old woman with long history of hypertension, with acute-onset chest pain.
N/C
Multiple axial CT images of the chest with intravenous contrast material demonstrates a Stanford type A thoracic aortic dissection, with a clear intimal flap separating the true and false lumens of the ascending aorta. Additionally, the pericardium full of dense fluid, likely hemopericardium.
thoracic aortic dissection
thoracic aortic dissection
confirmed during surgery
Multidetector CT imaging, with faster acquisition of images and utilization of contrast-tracking/event-triggering protocols like CARE Bolus (Siemens) or SmartPrep (GE), is fast becoming the imaging modality of choice for many acute clinical settings such as trauma and the diagnoses of pulmonary embolism as well as aort...
Vascular
9.9
9.9
null
1. Hatem Alkadhi, Simon Wildermuth, Lotus Desbiolles, Thomas Schertler, David Crook, Borut Marincek, and Thomas Boehm. Vascular Emergencies of the Thorax after Blunt and Iatrogenic Trauma: Multi–Detector Row CT and Three-dimensional Imaging. RadioGraphics 2004; 24: 1239-1255. 2. Eva Casta?er, Marta Andreu, Xavier Gal...
Despite prompt surgical treatment, the patient did not survive the post-operative course. The patient passed away at post-operative day 3.
aortic dissection
null
null
CT
MPX1072
45
Noncontrast axial CT image through orbits. Optic nerve intact, medial rectus muscle bellies enlarged with tapering of tendons, lateral recti normal. Uniform, smooth, normal scleral wall thickness bilateral, increased intraconal fat.
null
CT - noncontrast
Axial
male
Eye and Orbit
Head
[]
Grave's Ophthalmopathy
45 year-old man with a past history of malignant testicular neoplasm and Hashimoto’s thyroiditis, presents now with a several-month history of worsening eye swelling, dryness, and irritation, gradually progressing to lid retraction and intermittent blurry vision, prompting a referral to ophthalmology. He denies recent...
PE: Bilateral proptosis, mild periorbital edema, sclera clear, PERRLA, EOMI, no discharge
• Bilateral proptosis and periorbital tissue edema • Enlarged inferior recti muscles • Increased periorbital fat distribution • Bellies of medial recti enlarged with normal tapering of tendons. • Enlarged superior, medial, inferior rectus muscles
• Periorbital / Orbital Cellulitis • Histiocytosis • Orbital Myositis / Orbital Pseudotumor • Grave’s Orbitopathy • Lymphoma
Grave's Ophthalmopathy
Clinical findings and CT images
Grave’s ophthalmopathy (orbitopathy). Although rare, it can occur in 2% patients with a history of Hashimoto’s thyroiditis. Grave’s and Hashimoto’s diseases are on opposite sides of the thyroid disease spectrum — manifesting hyperthyroid and hypothyroid symptoms, respectively. Both diseases can occur in the same per...
Ophthalmology
1.-1
1.2
The patient has Grave’s ophthalmopathy, but he does not have symptoms of hyperthyroidism such as heat intolerance, tachycardia, heart palpitations, tremors, anxiousness, and unintentional weight loss. Rather, he is clinically hypothyroid and requires synthroid treatment. With his past history of Hashimoto's thyroidit...
Bahn RS; Heufelder AE. Pathogenesis of Graves' ophthalmopathy. N Engl J Med 1993 Nov 11;329(20):1468-75. Bartley GB; et al. Chronology of Graves' ophthalmopathy in an incidence cohort. Am J Ophthalmol 1996 Apr;121(4):426-34. Lyons CJ; Rootman J. Orbital decompression for disfiguring exophthalmos in thyroid orbitop...
Treatment for Grave's ophthalmopathy depends on severity of symptoms. If present, treat hyperthyroidism with methimazole. For mild involvement including dry, irritated eyes, natural tears are helpful during the day and an eye lubricant (methycellulose) is appropriate at night. For moderate disease that can include c...
Graveorbitopathyophthalmopathy
null
null
CT
MPX1072
45
Noncontrast axial CT image through orbits. Optic nerve intact, medial rectus muscle bellies enlarged with tapering of tendons, lateral recti normal. Uniform, smooth, normal scleral wall thickness bilateral, increased intraconal fat.
null
CT - noncontrast
Axial
male
Eye and Orbit
Head
[]
Grave's Ophthalmopathy
45 year-old man with a past history of malignant testicular neoplasm and Hashimoto’s thyroiditis, presents now with a several-month history of worsening eye swelling, dryness, and irritation, gradually progressing to lid retraction and intermittent blurry vision, prompting a referral to ophthalmology. He denies recent...
PE: Bilateral proptosis, mild periorbital edema, sclera clear, PERRLA, EOMI, no discharge
• Bilateral proptosis and periorbital tissue edema • Enlarged inferior recti muscles • Increased periorbital fat distribution • Bellies of medial recti enlarged with normal tapering of tendons. • Enlarged superior, medial, inferior rectus muscles
• Periorbital / Orbital Cellulitis • Histiocytosis • Orbital Myositis / Orbital Pseudotumor • Grave’s Orbitopathy • Lymphoma
Grave's Ophthalmopathy
Clinical findings and CT images
Grave’s ophthalmopathy (orbitopathy). Although rare, it can occur in 2% patients with a history of Hashimoto’s thyroiditis. Grave’s and Hashimoto’s diseases are on opposite sides of the thyroid disease spectrum — manifesting hyperthyroid and hypothyroid symptoms, respectively. Both diseases can occur in the same per...
Ophthalmology
1.-1
1.2
The patient has Grave’s ophthalmopathy, but he does not have symptoms of hyperthyroidism such as heat intolerance, tachycardia, heart palpitations, tremors, anxiousness, and unintentional weight loss. Rather, he is clinically hypothyroid and requires synthroid treatment. With his past history of Hashimoto's thyroidit...
Bahn RS; Heufelder AE. Pathogenesis of Graves' ophthalmopathy. N Engl J Med 1993 Nov 11;329(20):1468-75. Bartley GB; et al. Chronology of Graves' ophthalmopathy in an incidence cohort. Am J Ophthalmol 1996 Apr;121(4):426-34. Lyons CJ; Rootman J. Orbital decompression for disfiguring exophthalmos in thyroid orbitop...
Treatment for Grave's ophthalmopathy depends on severity of symptoms. If present, treat hyperthyroidism with methimazole. For mild involvement including dry, irritated eyes, natural tears are helpful during the day and an eye lubricant (methycellulose) is appropriate at night. For moderate disease that can include c...
Graveorbitopathyophthalmopathy
null
null
CT
MPX1072
45
Noncontrast axial CT image through orbits. Enlarged superior recti.
null
CT - noncontrast
Axial
male
Eye and Orbit
Head
[]
Grave's Ophthalmopathy
45 year-old man with a past history of malignant testicular neoplasm and Hashimoto’s thyroiditis, presents now with a several-month history of worsening eye swelling, dryness, and irritation, gradually progressing to lid retraction and intermittent blurry vision, prompting a referral to ophthalmology. He denies recent...
PE: Bilateral proptosis, mild periorbital edema, sclera clear, PERRLA, EOMI, no discharge
• Bilateral proptosis and periorbital tissue edema • Enlarged inferior recti muscles • Increased periorbital fat distribution • Bellies of medial recti enlarged with normal tapering of tendons. • Enlarged superior, medial, inferior rectus muscles
• Periorbital / Orbital Cellulitis • Histiocytosis • Orbital Myositis / Orbital Pseudotumor • Grave’s Orbitopathy • Lymphoma
Grave's Ophthalmopathy
Clinical findings and CT images
Grave’s ophthalmopathy (orbitopathy). Although rare, it can occur in 2% patients with a history of Hashimoto’s thyroiditis. Grave’s and Hashimoto’s diseases are on opposite sides of the thyroid disease spectrum — manifesting hyperthyroid and hypothyroid symptoms, respectively. Both diseases can occur in the same per...
Ophthalmology
1.-1
1.2
The patient has Grave’s ophthalmopathy, but he does not have symptoms of hyperthyroidism such as heat intolerance, tachycardia, heart palpitations, tremors, anxiousness, and unintentional weight loss. Rather, he is clinically hypothyroid and requires synthroid treatment. With his past history of Hashimoto's thyroidit...
Bahn RS; Heufelder AE. Pathogenesis of Graves' ophthalmopathy. N Engl J Med 1993 Nov 11;329(20):1468-75. Bartley GB; et al. Chronology of Graves' ophthalmopathy in an incidence cohort. Am J Ophthalmol 1996 Apr;121(4):426-34. Lyons CJ; Rootman J. Orbital decompression for disfiguring exophthalmos in thyroid orbitop...
Treatment for Grave's ophthalmopathy depends on severity of symptoms. If present, treat hyperthyroidism with methimazole. For mild involvement including dry, irritated eyes, natural tears are helpful during the day and an eye lubricant (methycellulose) is appropriate at night. For moderate disease that can include c...
Graveorbitopathyophthalmopathy
null
null
CT
MPX1081
34
CT scan abdomen: Positive “arrowhead sign” in appendix. Presence of thickened appendix. Questionable appendicolith. Terminal ileum normal and seen with contrast, Good visualization of ileocecal juntion. Cecum normal size without evidence of edema.
null
CT - GI & IV Contrast
Axial
female
Gastrointestinal
Abdomen
[]
Acute appendicitis
34 y/o WF w/ abdominal pain for past 30hrs. Pain started midepigastric and has moved slightly inferior and to the right. No radiation and no relief with oral meds. Has had nausea but no vomiting. Denies fevers, chills, melena, hematachezia, constipation, diarrhea. Anorexia for 30 hrs. No BM since pain began. LMP ...
Vitals: BP 130/75 P 95 T 99.9oF Gen: well nourished and developed. MS: alert and oriented X3. Chest.Lungs: RRR no M/R/G CTA bil. AB: nondistended, TTP with guarding, no palpable masses, BS+. Ext: no cyanosis clubbing or edema. Labs: bHCG negative. WBC 13.2 H/H 14/40 plt 123 85%neutr. Amylase/lipase normal
CT scan abdomen: Positive “arrowhead sign” in appendix. Presence of thickened appendix. Questionable appendicolith. Terminal ileum normal and seen with contrast, Good visualization of ileocecal juntion. Cecum normal size without evidence of edema.
Diff from History: Appendicitis, Ectopic pregnancy, Crohns Dz, Mesenteric adenitis Diff from viewing CT: Appendicitis from… lymphoprolifertation, apendicolith, cecal obstruction of proximal opening (cancer)
Acute appendicitis
Surgery
In the ED the patient clearly had a diffusely tender abdomen, with evidence of appendicitis. B-HCG was used to rule out ectopic preg and amylase and lipase were normal. Likely the patient clinical picture was not overtly obvious for appendicitis (while on paper it seems that way) or else a CT scan should not have bee...
Clinical Exam Finding or Sign
7.2
7.2
In the ED the patient clearly had a diffusely tender abdomen, with evidence of appendicitis. B-HCG was used to rule out ectopic preg and amylase and lipase were normal. Likely the patient clinical picture was not overtly obvious for appendicitis (while on paper it seems that way) or else a CT scan should not have bee...
Way, Lawrence. Current Surgical Diagnosis and Treatment 11th Edition. McGraw Hill Co. 2003. Kang, Peter MD. WRAMC Department of Radiology.
Emergent Laproscopic Appendectomy
Acute appendicitisappendicitisfecolith
null
null
CT
MPX1075
66
1.6 x 1.8cm right middle lobe nodule, adjacent/anterior to the medial segment bronchus.
null
CT w/contrast (IV)
Axial
female
Chest, Pulmonary
Thorax
[]
Bronchial Carcinoid
66yo asymptomatic female with significant past smoking history and abnormal, incidental chest finding on routine EBCT.
Asymptomatic. Initial labs (CBC/Chem) WNL.
PA/Lat CXR: There is irregularity to the contour of the right hilum on the PA view. On the lateral view, there is a central, RML nodule which when going back to the PA, can barely be seen. Axial CT: Note the round, smooth nodule just anterior to the takeoff of the medial RML bronchus. There is no calcification, an...
Hilar LAD Primary Bronchial Neoplasm Primary Lung Neoplasm Metastatic Disease
Typical Bronchial Carcinoid
Confirmed by bronchoscopy and biopsy
Carcinoids are neuroendocrine neoplasms that are considered malignant based on potential for metastasis (15%)—typically to the liver, bone, adrenals, and brain. While the vast majority of carcinoids arise in the GI tract (~90%), bronchial carcinoid accounts for 1-2% of all lung neoplasms. These lesions are classified ...
Neoplasm, malignant (NOS)
6.3
6.3
The location of this lesion is somewhat more peripheral than is usually seen with typical carcinoids. This carcinoid is also "atypical" in that it does not enhance, and is not calcified. The pathology, however, was consistent with a low-grade (typical) bronchial carcinoid. This patient fell into the 25% of patients ...
Jeung MY, Gasser B, et al. Bronchial Carcinoid Tumors of the Thorax: Spectrum of Radiologic Findings. Radiographics 2002; 22:351-365.
Patient is scheduled for lesion resection in August 2004.
CarcinoidBronchi, NeoplasmBronchi, CT
null
null
CT
MPX1067
22
Carotid stenosis
1
CT w/contrast (IV)
Axial
female
Vascular
Thorax
[]
Takayasu's Arteritis
22 y.o. woman with hypertension.
null
ABDOMINAL AORTA: There is narrowing of the abdominal aorta, both above and below the renal arteries. The superior mesenteric artery is occluded at its origin, and not seen on the lateral view. There is a large Arc of Riolan from the IMA, which reconstitutes the SMA distribution. The celiac axis is patent, however, ...
• TAKAYASU"S ARTERITIS • giant cell arteritis • syphilis, tuberculosis • SLE, rheumatoid arthritis • Buerger’s disease • Kawasaki disease • Arteritis with spondyloarthropathies
Takayasu"s Arteritis
Imaging
DEFINITION Takayasu’s arteritis refers to a chronic systemic granulomatous vasculitis primarily affecting large arteries (aorta and its branches). SYNONYMS Pulseless disease Aortitis syndrome Aortic arch arteritis EPIDEMIOLOGY & DEMOGRAPHICS • Most cases have been reported from Japan, China, India, and Mexico. • E...
Inflammatory, non-infectious
9.2
9.2
null
Arend WP et al: American College of Rheumatology 1990 criteria for the classification of Takayasu’s arteritis, Arthr Rheum 33:1129, 1990. Ishikawa K, Maetani S: Long-term outcome for 120 Japanese patients with Takayasu’s disease: clinical and statistical analyses of related prognostic factors, Circulation 90:1855, 19...
null
takayasu's takayasuarteritisvasculitis
null
null
CT
MPX1073
45
Axial CT with intravenous and oral contrast material demonstrates a large fluid collection predominantly within the porta hepatis around multiple surgical clips consistent with prior cholecystectomy. More fluid is seen around the right lobe of the liver and more inferiorly within the right paracolic gutter. Peritonea...
null
CT w/contrast (IV)
Axial
male
Gastrointestinal
Abdomen
[]
biliary leak, status post laparoscopic cholecystectomy
s/p recent laparoscopic cholecystectomy, now with fevers and abdominal pain
fever right upper quadrant abdominal tenderness
Axial CT with intravenous and oral contrast material demonstrates a large fluid collection predominantly within the porta hepatis around multiple surgical clips consistent with prior cholecystectomy. More fluid is seen around the right lobe of the liver and more inferiorly within the right paracolic gutter. Peritonea...
biliary leak, status post laparoscopic cholecystectomy
biliary leak, status post laparoscopic cholecystectomy
null
Laparoscopic cholecystectomy (LC) has replaced open cholecystectomy for most routine treatment of gallbladder disease by cholecystectomy due to clear advantages associated with any laparoscopic procedures, namely shortened inpatient stays, smaller incisions yielding better cosmetic results and requiring smaller amounts...
Iatrogenic or Surgical (complications)
7.9
7.9
null
1. Rossi P, et al. Bile leak from the hepatic bed after laparoscopic cholecystectomy. Chir Ital. 2002 Jul-Aug;54(4): 507-9. (treatment with endoscopic sphincterectomy and stent placement) 2. Slater K, et al. Iatrogenic bile duct injury: the scourge of laparoscopic cholecystectomy. ANZ J Surg. 2002 Feb;72(2)83-8. 3. ...
null
laparoscopic cholecystectomybiliary leakbiliary scintigraphy
null
null
CT
MPX1073
45
Axial CT with intravenous and oral contrast material demonstrates a large fluid collection predominantly within the porta hepatis around multiple surgical clips consistent with prior cholecystectomy. More fluid is seen around the right lobe of the liver and more inferiorly within the right paracolic gutter. Peritonea...
null
CT w/contrast (IV)
Axial
male
Gastrointestinal
Abdomen
[]
biliary leak, status post laparoscopic cholecystectomy
s/p recent laparoscopic cholecystectomy, now with fevers and abdominal pain
fever right upper quadrant abdominal tenderness
Axial CT with intravenous and oral contrast material demonstrates a large fluid collection predominantly within the porta hepatis around multiple surgical clips consistent with prior cholecystectomy. More fluid is seen around the right lobe of the liver and more inferiorly within the right paracolic gutter. Peritonea...
biliary leak, status post laparoscopic cholecystectomy
biliary leak, status post laparoscopic cholecystectomy
null
Laparoscopic cholecystectomy (LC) has replaced open cholecystectomy for most routine treatment of gallbladder disease by cholecystectomy due to clear advantages associated with any laparoscopic procedures, namely shortened inpatient stays, smaller incisions yielding better cosmetic results and requiring smaller amounts...
Iatrogenic or Surgical (complications)
7.9
7.9
null
1. Rossi P, et al. Bile leak from the hepatic bed after laparoscopic cholecystectomy. Chir Ital. 2002 Jul-Aug;54(4): 507-9. (treatment with endoscopic sphincterectomy and stent placement) 2. Slater K, et al. Iatrogenic bile duct injury: the scourge of laparoscopic cholecystectomy. ANZ J Surg. 2002 Feb;72(2)83-8. 3. ...
null
laparoscopic cholecystectomybiliary leakbiliary scintigraphy
null
null
CT
MPX1060
74
Noncontrast CT shows hypodensity in L parietal lobe with no visible compression of other structures. No hemorrhage noted.
null
CT - noncontrast
Axial
female
Brain and Neuro
Head
[ "MPX1060_synpic19251" ]
Stroke, ischemic infarction
74 yo WF with Diabetes and HTN, S/P cystectomy, TAH/RSO and ventral hernia now with acute mental status changes 2 days post op. On first night postop, patient had a one-hour episode of hypotension (SBP 80-90)
Tachycardia, difficulty with word finding, ideomotor apraxia and confusion.
Noncontrast CT shows hypodensity in L parietal lobe with no visible compression of other structures. No hyperdens or hemorrhagic areas are noted. MRI DWI image shows hyperintense signal within same area demonstrating restricted diffusion of water molecules.
Ischemic infarction of L parietal lobe with no evidence of hemorrhagic nature.
L parietal ischemic infarct
Radiologic diagnosis
CT has been recognized as the standard of care for initial imaging of suspected strokes. It is able to discriminate between an ischemic vs a hemorrhagic cerebral infarct. However, it may be relatively less sensitive during the first 12 hours and is not consistently high until after 24 hrs. MRI may be needed - espec...
Infarction and/or Necrosis
1.6
1.7
null
Chung et al; “Diffusion-weighted MRI of intracerebral hemorrhage clinically undifferentiated from ischemic stroke”; American Journal of Emergency Medicine; May 2003, 21(3) .
Transfusion with PBRC’s, IVF, Aspirin 325 mg po qd, Carotid Doppler US, TTE, started heparin drip at 700 units/hr. Repeat CT in 48 hrs to rule out hemorrhagic conversion as patient is starting heparin drip. Speech therapy and swallow test to assure no possibility of aspiration. MRA can be used to visualize the vascu...
ischemicinfarct
null
null
CT
MPX1106
58
Contrast enhanced axial CT images show a homogeneous, well-marginated, solid mass with minimal contrast enhancement in the left upper lobe. No fat or calcification is evident.
null
CT w/contrast (IV)
Axial
male
Chest, Pulmonary
Thorax
[ "MPX1106_synpic45735", "MPX1106_synpic45736" ]
Pulmonary Hamartoma
58 yo man presented with neck pain to his primary care physician. An MRI of the cervical spine was obtained revealing an abnormal finding.
null
T2 weighted axial MR image reveals a well-marginated mass with smooth borders in the left lung at the level of the aortic arch, which demonstrates multiple small foci of increased T2 signal intensity, giving the mass a speckled appearance. Contrast enhanced axial CT image shows a homogeneous, well-marginated, solid ma...
• Tuberculoma • Metastatic Disease • Carcinoid Tumor • Adenocarcinoma • Small-cell carcinoma • Pulmonary hamartoma
Atypical Pulmonary Hamartoma
Patient underwent biopsy, with histological evaluation.
Lesions/Condition: Pulmonary Hamartoma Predisposing Factors: Most commonly occurs in the fourth to fifth decade. Most common chromosomal abnormality involves the q13-q15 region of chromosome 12. Symptoms: Most patients presenting with peripheral pulmonary hamartomas are asymptomatic. When symptomatic, hemoptysi...
Neoplasm, benign
6.3
6.3
The biopsy demonstrated cartilage lobules without intervening stroma, and sparse cellularity. Additionally, respiratory epithelium was visualized lining the margin of the mass and invaginating into the mass forming multiple small cystic areas, with fat tissue intermixed within adjacent respiratory epithelium, consist...
Brant W., Helms C. Fundamentals of Diagnostic Radiology. 2nd Edition. Lippincott Willliams & Wilkins. Philadelphia, PA 1999. Fraser et al. Synopsis of Diseases of the Chest. Third Edition. Elsevier Saunders. Philadelphia, PA. 2005.
null
Pulmonary HamartomaBenign Neoplasm of the LungPopcorn Calcification
null
null
End of preview. Expand in Data Studio
README.md exists but content is empty.
Downloads last month
27