IMaging Abdomen

• Cirrhosis results in disproportionate diminution of the right lobe compared to the left lobe and caudate lobe of the liver
• Nodular regeneration of the liver results in a nodular edge of the liver and inhomogeneity of the parenchyma. The process is accompanied by, first, increased resistance to normal hepatopetal (toward the liver) flow and, finally, the development of hepatofugal (away from the liver) flow. The increased resistance in the portal vein secondarily enlarges the spleen. This process also creates enlarged collateral venous channels to reroute blood around the liver . These portosystemic collaterals are visible frequently on cross-sectional imaging studies, most commonly in paraumbilical veins, coronary veins, and even spontaneous splenorenal shunts. Ascites is nearly always present. Most authorities are increasingly convinced that MR imaging is the most sensitive imaging modality for examination of the liver in cirrhosis and other diffuse diseases of the liver. MR imaging can demonstrate not only the contour changes and collateral formation visible with CT, but also the more subtle intraparenchymal nodular changes consequent to formation of regenerative and dysplastic nodules characteristic of cirrhosis within the complex fibrotic and inflamed host hepatic tissue . Importantly, MR imaging is considered to be a sensitive imaging means in the diagnosis of tumors such as hepatocellular carcinoma superimposed on a background of cirrhosis .

pineal cyst on MRI

IMaging study

http://rad.usuhs.edu/medpix/parent.php3?mode=default

for Anatomy correwlation:
http://www.meddean.luc.edu/lumen/meded/grossanatomy/x_sec/mainx_sec.htm

Increased pulm vascular markings : Chest Xray

Pulm edema vs consolidation vs fibrosis

when Consolodation: u will see airbronchogram: markings for bronchi..and complete white out of that part of lung instead of fluffy markings or lines...
Fibrosis: white lines
edema: interstitial edema: small lines...while alveolar edema:  white small nidules

pulm fibrosis:



pulm edema: see fluffy white lesions






consolidation: see complete white out of lung









extensive scarring, fibrosis

Reading chest xray

reading Chest Xray








Following are the points to see  in Chest Xray:

1. check for rt  and LT side
2. Looks whether is well centralized or not,...check for medial end of Clavicle ...both should be at equi level from spine..i f not then it difficult to comment about cardiomegaly, medistinal deviation..     whichever end is more close to spine-----mediastinum is deviated on that side...           6th ant rib level or 9th post rib level        
3. look for exposure....if u see four spinal process then its well exposed...if over exposed then it looks translucent( like emphysema)
4. Looks for cardio and costophrenic angle...all should be  acute...if nt then its abnormal....also look for Diaphragmatic contour...if flattened ---then probably some lung disease....Both diaohragm are at
5. divide the lungs field into 3 section....Upper: above the anterior end of 2nd rib.....middle: between 2nd anf 4th rib...lower: below 4th rib...compare both lung field...
6. check Apical area ...esp behind the Clavicle for TB lesion then check lower lung filed for all 4 angle,,
7. check trachea...and trace it upto carina...should be patent
8. Cardiac: Let side border is made  by Aortic knob, pulm conus, lt atrium and Lt ventricle while rt side border is made by  SVC and rt atrium
9. Vascular markings: Lower lobe vessels are more prominent compare to Upper lobe coz of Gravity...If not then Cardiac problem.. rt side vessels look more prominent than lt side...

few other points...

• how to say number of thoracic vertebra using chest xray??:--- check anterior end of 1st rib which is connected to 1st thoracic vertebera...
• if engorged upper lobe vessels: probably it's puml veins...due to CCF
• Kerly A line: prominent vascular markings in upper lobe
• Kerly B lines: in Lower lobe of lungs on peripheral side ----which suggest fluid between septa...
• Carinal Ange is around 90...any angle above 90 is abnormal probably coz of Lt atrial enlargement----( lt atrium lies just below carina)
• batt wing's appearance:  Enlargement of hilar vessels....in Acute pulm edema..