AIIMS MAMC - PGI's Comprehensive Textbook of Diagnostic Radioloigy

Description

AIIMS MAMC - PGI's Comprehensive Textbook of Diagnostic Radiology is an extensive three volume review of conventional and novel imaging techniques for the diagnosis of a wide range of diseases. The first volume of this book covers neuroradiology, including head and neck, recent advances and applied physics in imaging. The second volume covers chest and cardiovascular, gastrointestinal and hepatobiliary, and genitourinary imaging. The final volume covers paediatric imaging, musculoskeletal imaging, including information on imaging for bone, soft tissue and joint diseases, and breast imaging including the role of mammography. AIIMS MAMC - PGI's Comprehensive Textbook of Diagnostic Radiology includes discussion on various imaging modalities and the potential for their future use. The book is enhanced by over 6250 images and illustrations, making this an ideal visual resource for radiology residents and practising radiologists. Key Points Three volume review of diagnostic imaging techniques Volumes cover neuroradiology, chest, cardiovascular, gastrointestinal, hepatobiliary, genitourinary, paediatric musculoskeletal, and breast imaging 6254 images and illustrations Cover Contents Neuroradiology including Head and Neck E v aluation of Plain X-ray Skull: A Systematic Approach Niranjan Khandelwal, Sudha Suri LATERAL VIEW OF SKULL FRONTAL VIEW (FIG. 2) W A TERS VIEW T O WNE’S VIEW B ASAL VIEW CALDWELL’S VIEW A bnormal Contour of the Skull A bnormal Density A bnormal Intracranial Volume Single Radiolucent Defect Sclerotic Areas of the Skull Intracranial Calcification Normal Anatomy of Brain on CT and MRI P aramjeet Singh TECHNIQUES AND NORMAL APPEARANCE General Considerations Normal Anatomy of Brain CEREBRAL HEMISPHERES Lateral Surface of the Cerebral Hemisphere (Fig. 2A) Medial Surface of the Cerebral Hemisphere (Fig. 2B) Inferior Surface of the Cerebral Hemisphere (Fig. 2C) BRAINSTEM AND CRANIAL NERVES CEREBELLUM WHITE MATTER OF THE CEREBRUM VENTRICLES AND CISTERNS GRAY MATTER NUCLEI AND ADJACENT STRUCTURES SUGGESTED READING Normal Cerebral Angiography Shailesh B Gaikwad, Ajay Kumar P ART 1: CEREBRAL ANGIOGRAPHY TECHNIQUE INTRODUCTION Historical Background Definition Six Vessel Angiography P a tient Preparation Requirement C a theterization Equipment Indications Site of the Puncture P r eparation L ocal Anesthesia A rtery Puncture P uncture Technique T ypes of Angiographic Catheters P ART 2: CEREBRAL ANGIOGRAPHIC ANATOMY A rterial Anatomy Seldinger Needle Important Points to Remember P ostprocedural Management V enous Anatomy (Fig. 14) Dural Sinuses C erebral Veins A dvances in Computed T omography Technology Niranjan Khandelwal, Paramjeet Singh, Sameer Vyas MULTIDETECTOR C OMPUTED TOMOGRAPHY DUAL SOURCE COMPUTED TOMOGRAPHY FLAT-PANEL VOLUME COMPUTED T OMOGRAPHY D Y NAMIC C OMPUTED TOMOGRAPHY ANGIOGRAPHY C OMPUTED TOMOGRAPHY IN NEUROIMAGING NONCONTRAST COMPUTED T OMOGRAPHY OF HEAD C omputed Tomography A ngiography T echnique Image Processing APPLICATIONS Extracranial Vasculature C arotid Artery Stenosis Dissections Intracranial Vasculature Aneurysms Arteriovenous Malformations T umors C omputed Tomography P erfusion T umors T echnique CLINICAL APPLICATIONS A cute Stroke C omputed Tomography Imaging of Acute Ischemic Stroke C omputed Tomography Venography T echnique MULTIDETECTOR COMPUTED T OMOGRAPHY OF SPINE CLINICAL APPLICATIONS RADIATION CONCERNS C ONCLUSION REFERENCES A dvances in Neuroimaging T echniques: Magnetic Resonance Imaging P aramjeet Singh, Niranjan Khandelwal IMPROVEMENTS IN MR HARDWARE AND SOFTWARE TECHNOLOGY (GRADIENTS, C OILS AND LARGE FIELD OF VIEW IMAGING HIGH FIELD STRENGTH MR IMAGING (3T AND BEYOND) IMPROVEMENTS IN PULSE SEQUENCES SHORT REVIEW OF PRINCIPLES BEHIND NEW MR PULSE TECHNIQUES EFFICIENT DATA PROCESSING TECHNIQUES CLASSIFICATION OF THE PULSE SEQUENCES (FLOW CHART 1) F AST SPIN ECHO Characteristics of FSE FLUID ATTENUATED INVERSION RECOVERY CLINICAL APPLICATION Single Shot Techniques of FSE (HASTE, SSFSE) Magnetic Resonance Myelography Gradient Echo Imaging and its Variants Cranial and Extracranial MR Angiography Susceptibility Weighted Imaging Steady State Variants of Gradient Echo Sequences MR Cisternography Using CISS/SPACE Special MR Techniques in Medial T emporal Sclerosis Echo Planar Imaging Clinical Applications of EPI Diffusion Studies Diffusion Tensor Imaging (DTI, T r actography or Fiber Tracking) Clinical Applications P erfusion Weighted Imaging Neuronal Activation Studies (fMRI) PWI in Stroke PWI of Cerebral Tumors Disadvantages REFERENCES Magnetization Transfer Magnetic Resonance Spectroscopy Niranjan Khandelwal, Paramjeet Singh PRINCIPLE Spectrum Spectrum and Echo Time Observable Biochemicals on MRS Hydrogen 1 ( 1 H-MRS) P hosphorus 31 ( 31 P -MRS) B 0 Field Gradient Methods Static Field Gradient Slice-selective B 0 -gradient L OCALIZATION TECHNIQUES B 1 Field Gradient Methods Surface Coils Quantitative Spectroscopy Data Acquisition and Analysis CLINICAL APPLICATIONS OF MRS OF BRAIN Brain Tumors Differentiation of I n tracranial Ring Enhancing L esions MRS IN PEDIATRICS P r ematurity and Birth Asphyxia Metabolic Disorders and Leukodystrophies MRS IN EPILEPSY Lateralization in T emporal L obe E pilepsy MRS in N eurodegenerative D iseases Alzheimer’s Disease Amyotrophic Lateral Sclerosis (ALS) Idiopathic Parkinson’s Disease (IPD) versus Other P arkinsonian Syndromes Huntington’s Disease (HD) MRS IN DEMYELINATING DISEASES Multiple Sclerosis MRS IN STROKE MRS IN HEAD TRAUMA MRS IN PSYCHIATRIC DISEASES MRS IN HIV/AIDS CLINICAL SUCCESS F uture Developments REFERENCES F unctional Magnetic Resonance Imaging Ajay Garg PRINCIPLE OF f MRI AND BOLD CONTRAST LIMITATIONS OF BOLD TECHNIQUE IMAGING ACQUISITION FUNCTIONAL MRI EXAMINATION DESIGN CURRENT CLINICAL APPLICATIONS OF FUNCTIONAL MRI Neurosurgical Planning FUNCTIONAL MRI EXAMINATION T ASK PARADIGM POSTPROCESSING AND DATA ANALYSIS Dementia Defining Disease Based on Patterns of Brain Function P sychiatric Disorders FUTURE DIRECTIONS Imaging and Interventions in C erebral Ischemia P A THOPHYSIOLOGICAL CONSIDERATIONS Significance of a Penumbra ROLE OF IMAGING IN ACUTE ISCHEMIC STROKE Imaging of Ischemic Infarct C omputed Tomography Magnetic Resonance Imaging C OMBINATION OF DIFFUSION AND PERFUSION MRI IN EVALUATION OF A CUTE STROKE V ascular Imaging in Ischemic Stroke C arotid Ultrasound (US) Magnetic Resonance Angiography CT Angiography IMAGING IN DIFFERENT STROKE SUBGROUPS Ischemic Stroke A therosclerotic Vascular Disease (ASVD) Arterial Dissection Other Vasculopathies Hemorrhagic Stroke A ortoarteritis F ibromuscular Dysplasia RECANALIZATION STRATEGIES Intravenous TPA E u r o pean Cooperative Acute Stroke Study (ECASS) Trials I and II 70 INTRA-ARTERIAL THERAPY T echnique Intra-arterial Abciximab C OMBINED IA + I/V MECHANICAL THROMBOLYSIS A cute Stroke Imaging Protocol (Flow chart 1) Imaging of Subarachnoid Hemorrhage INCIDENCE CLINICAL FEATURES GRADING SYSTEM OF SUBARACHNOID HEMORRHAGE DIAGNOSIS L umbar Puncture (LP) Magnetic Resonance Imaging C omputed Tomography C erebral Angiography CT Angiography (CTA) Magnetic Resonance Angiography (MRA) T r anscranial Doppler Ultrasound ANEURYSMS Clinical Presentation L ocation Multiple Aneurysms Unruptured Aneurysms T hrombosed Aneurysms Giant Aneurysms Mycotic Aneurysms F low-related Aneurysms V ASCULAR MALFORMATIONS P arenchymal AVMs Dural AVMs CAVERNOUS ANGIOMAS Mixed Pial and Dural AVMs CAPILLARY TELANGIECTASIAS VENOUS ANGIOMAS Nonaneurysmal SAH TRAUMATIC SUBARACHNOID HEMORRHAGE Subarachnoid Hemorrhage of Unknown Etiology SUMMARY Endovascular Management of Intracranial Aneurysms NK Mishra EPIDEMIOLOGY AND NATURAL HISTORY P A THOPHYSIOLOGY Diagnosis Initial Assessment, Management and Grading TIMING OF ANEURYSM OBLITERATION POOR GRADE PATIENT INTRACEREBRAL HEMORRHAGE A CUTE INTRAVENTRICULAR HEMORRHAGE AND HYDROCEPHALUS PREOPERATIVE CARE AND DIAGNOSTIC STUDIES PHARMACOLOGIC THERAPY ANEURYSM REPAIR SURGERY OR ENDOVASCULAR COILING POSTPROCEDURAL MANAGEMENT MONITORING CEREBRAL VASOSPASM AND IMPLEMENTING TREATMENT SUMMARY REFERENCES Endovascular Management of Arteriovenous Malformations Shailesh B Gaikwad, NK Mishra THERAPEUTIC OPTIONS T echnique of Endovascular Intervention Heparin Regimen F low-dependent Catheters Guidewire Dependent Catheters Guidewires Embolic Agents Liquid Agents: Acrylic Glue P articulate Agents P r eoperative Embolization Intraoperative Embolization P r eradiosurgery Embolization C urative Embolization P alliative (Partial) Embolization Staging Embolization C OMPLICATIONS OF AVM EMBOLIZATION DURAL ARTERIOVENOUS FISTULAE (DAVFs) Classification Radiological Evaluation T herapeutic Options C ompression Therapy T r ansarterial Embolization Brain AVM Embolization with Onyx INDICATION FOR TREATMENT T r ansvenous Embolization P r eoperative Embolization Onyx Liquid Embolic Agent C ONCLUSION REFERENCES Endovascular Management of C arotid-cavernous Fistulas SEGMENTS OF INTRACAVERNOUS INTERNAL CAROTID ARTERY Angiogram Radiological Evaluation CT Scan T echniques of Embolization Endovascular Management Embolic Materials Embolization Procedure T r ansarterial Embolization T r ansvenous Embolization Results of Endovascular Therapy DISCUSSION C entral Nervous System Infections NORMAL CRANIAL MENINGES AND EXTRA A XIAL SPACES BACTERIAL/PYOGENIC INFECTIONS P Y OGENIC MENINGITIS Clinical and Pathophysiologic Features Imaging in Meningitis MENINGITIS C OMPLICATIONS OR ALTERNATIVE MANIFESTATIONS OF BACTERIAL MENINGITIS Hydrocephalus Extra-axial Fluid and Pus Collections Subdural Effusion and Hygroma Subdural Abscess (Empyema) Epidural Abscess (Empyema) C erebritis and Abscess Imaging of Brain Abscess Diffusion Tensor Imaging (DTI) Distinction between Cerebral Abscesses and High Grade Neoplasms by Dynamic S Multiple Brain Abscesses Secondary to Septic Emboli C entral Nervous System Infarction V entriculitis RECURRENT MENINGITIS GRANULOMATOUS INFECTION TUBERCULOSIS P a thophysiology TUBERCULOUS MENINGITIS Clinical Manifestations C omputed Tomography Magnetic Resonance C OMPLICATIONS Hydrocephalus V asculitis Cranial Neuropathies GRANULOMATOUS TUBERCULOUS MENINGITIS P A CHYMENINGITIS P ARENCHYMAL TUBERCULOMAS Noncaseating Granuloma C aseating Solid Granuloma Granulomas with Central Liquefaction DISSEMINATED TUBERCULOMA P aradoxic Expansion TUBERCULOUS ABSCESSES TUBERCULOSIS ENCEPHALOPATHY FOCAL TUBERCULOUS CEREBRITIS CENTRAL NERVOUS SYSTEM TUBERCULOSIS AND ACQUIRED IMMUNE DEFICIENCY SYNDROME NEUROSARCOIDOSIS FUNGAL INFECTIONS OF THE CENTRAL NERVOUS SYSTEM ASPERGILLOSIS CRYPTOCOCCAL INFECTION MR Spectroscopy in Cryptococcomas 62 MUCORMYCOSIS Imaging Findings CANDIDIASIS C OCCIDIOIDOMYCOSIS HISTOPLASMOSIS NOCARDIOSIS P arenchymal Cysts P ARASITIC INFECTIONS NEUROCYSTICERCOSIS Hosts Clinical Features Intraventricular Cysticercosis Subarachnoid Cysticercosis SPINAL CYSTICERCOSIS ORBITAL DISEASE CENTRAL NERVOUS SYSTEM T O X OPLASMOSIS Imaging Findings Differentiation of Toxoplasmosis from CNS Lymphoma H Y D A TID DISEASE C ONGENITAL INFECTIONS C ONGENITAL TOXOPLASMOSIS SYPHILIS RUBELLA CYTOMEGALOVIRUS HERPES SIMPLEX VIRUS HUMAN IMMUNODEFICIENCY VIRUS (HIV) VIRAL INFECTIONS ENCEPHALITIS A CUTE INFECTIVE ENCEPHALITIS/HERPES SIMPLEX ENCEPHALITIS Imaging Findings Magnetic Resonance Spectroscopy HERPES VARICELLA ZOSTER ENCEPHALITIS JAPANESE ENCEPHALITIS Imaging Findings MEASLES ENCEPHALITIS A cute Measles Encephalitis Subacute Sclerosing Panencephalitis Imaging Findings Subacute Measles Encephalitis A CUTE DISSEMINATED ENCEPHALOMYELITIS RASMUSSEN’S ENCEPHALITIS A C QUIRED IMMUNODEFICIENCY SYNDROME (AIDS) AND ITS RELATED CNS INFECTIONS HUMAN IMMUNODEFICIENCY VIRUS ENCEPHALITIS PRION INFECTIONS—CREUTZFELDT–JAKOB DISEASE P r ogressive Multifocal Leukoencephalopathy Imaging Findings CYTOMEGALOVIRUS (CMV) ENCEPHALITIS REFERENCES Immune Reconstitution Inflammatory S yndrome (IRIS) 89 White Matter Diseases and Metabolic Brain Disorders Sumedha Pawa, Anjali Prakash MYELIN AND WHITE MATTER DEMYELINATING DISEASES: CLASSIFICATION Associated with Physical/Chemical Agents or Therapeutic Procedures IMAGING OF WHITE MATTER DISEASES NEWER MAGNETIC RESONANCE TECHNIQUES P r oton Magnetic Resonance Spectroscopy P rimary Demyelinating Diseases Multiple Sclerosis Disorders with Secondary Demyelination and Destruction of White Matter Associated with Infectious Agents and/or Vaccination Associated with Nutritional/Vitamin Deficiency Magnetization Transfer Magnetic Resonance Imaging PRIMARY DEMYELINATING DISORDERS Multiple Sclerosis Diffusion Magnetic Resonance Diagnosis Magnetic Resonance Findings Distribution and Characteristics of L esion in the Brain A cute or Chronic Multiple Sclerosis? T1 Black Holes: Chronic T1 Hypointense Lesions 22,23 Characteristics and Distribution of L esions in Spinal Cord NORMAL APPEARING WHITE AND GRAY MATTER Magnetization Transfer Imaging Diffusion Tensor Imaging in Multiple Sclerosis P r oton Magnetic Resonance Spectroscopy in Multiple Sclerosis Imaging of Basal Ganglia in Multiple Sclerosis P erfusion Imaging F unctional Magnetic Resonance Imaging High-Field Magnetic Resonance Imaging and Multiple Sclerosis Monitoring Patients by Magnetic Resonance Imaging V ariants of Multiple Sclerosis A cute Multiple Sclerosis (Marburg Type) Schilder Type or Diffuse Sclerosis C oncentric Sclerosis (Balo Type) Devic’s Neuromyelitis Optica TREATMENT DIFFERENTIAL DIAGNOSIS OF MULTIPLE SCLEROSIS LESION ON MAGNETIC RESONANCE Ischemic White Matter Lesions/Small Vessel Ischemic Changes/Leukoaraiosis V asculitis Migraine A cute Disseminated Encephalomyelitis T r auma Space-occupying Lesions DISORDERS WITH SECONDARY DEMYELINATION AND/OR DESTRUCTION OF WHITE MATTER W hite Matter Diseases Associated with V iral Agents Viral Encephalitides A cute Disseminated Encephalomyelitis A cute Hemorrhagic Leukoencephalitis Subacute Sclerosing Panencephalitis P r ogressive Rubella Panencephalitis P r ogressive Multifocal Leukoencephalopathy L yme Disease of the Central Nervous System Human Immunodeficiency Virus Encephalopathy METABOLIC CAUSES: WHITE MATTER DISEASES ASSOCIATED WITH NUTRITIONAL AND VITA C entral Pontine and Extrapontine Myelinolysis ( Osmotic Demyelination) Chronic Alcoholism W ernicke Encephalopathy Marchiafava–Bignami Disease Subacute Combined Degeneration of the Spinal Cord V ASCULAR CAUSES Reversible Posterior Leukoencephalopathy Eclampsia Ischemia and Arteritis Binswanger’s Disease (Subcortical Arteriosclerotic Encephalopathy) 70 C erebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and L eu Global Hypoperfusion Syndromes C entral Nervous System Vasculitis Hypoxic–Ischemic Leukoencephalopathies WHITE MATTER DISEASES ASSOCIATED WITH PHYSICAL/CHEMICAL AGENTS OR THERAPEUTI Radiation and Chemotherapy Solvent Vapor Abuse Leukoencephalopathy C ONCLUSION REFERENCES C urrent Trends in Imaging of Epilepsy Shailesh B Gaikwad INDICATIONS FOR IMAGING 1 IMAGING OF REFRACTORY SEIZURES MRI Protocols S tructural Lesions in Chronic Epilepsy Mesial Temporal Sclerosis Disorders of Neuronal Migration and C ortical Organization T umors V ascular Malformations Other MR Features Associated with Epilepsy NEWER ADVANCES IN IMAGING IN EPILEPSY Reformatted Images Quantitative MRI Magnetic Resonance Spectroscopy T2 Relaxometry (Mapping) Diffusion Tensor Imaging T r actography F unctional MR Magnetoencephalography W ada’s Test P ositron Emission Tomography Single-photon Emission Computed T omography REFERENCES Imaging of Supratentorial Brain Tumors CLASSIFICATION OF SUPRATENTORIAL BRAIN TUMORS P rimary Brain Tumors GLIAL TUMORS Astrocytoma — Chordoma Metastatic Tumors C alvarial/Meningeal/Masses L o w -grade Astrocytoma V ariants: Protoplasmic, Gemistocytic, F ibrillary, Mixed L ocation Imaging Features Glioblastoma Multiforme (GBM) (WHO Grade IV ) V ariants: Giant Cell Glioblastoma, Gliosarcoma L ocation Imaging Features (CT/MRI) Anaplastic Astrocytoma (Malignant) (WHO Grade III) A dvanced MR Imaging: Techniques in Glioma Grading and Apparent Diffusion C Pleomorphic Xanthoastrocytoma (Noninvasive, WHO Grade I) Subependymal Giant Cell Astrocytoma Imaging Features Gliomatosis Cerebri Gliosarcoma Imaging Features Oligodendroglioma Imaging Features Ependymoma Imaging Features Subependymoma Choroid Plexus Papilloma Imaging Features C entral Neurocytoma Imaging Features Dysembryoplastic Neuroepithelial Tumor Imaging Features Ganglioglioma TUMORS OF THE MENINGES Meningioma Imaging Features P ineal Region Tumors Germ Cell Tumors P ineal Germinoma and Teratoma P ineal Cell Tumors Imaging Features E pendymoblastoma Supratentorial Primitive Neuroectodermal Tumors P rimary Cerebral Neuroblastoma Cranial Nerve Tumors Imaging Features P rimary Central Nervous System Lymphoma P ituitary Adenoma and Craniopharyngioma Imaging of Metastatic Tumors P a r enchymal Metastases Imaging Features L eptomeningeal Metastases Imaging Features Dural Metastases C alvarial Metastases Recent Advances in Brain Tumors MAGNETIC RESONANCE SPECTROSCOPY IN BRAIN T umor Imaging Magnetic Resonance Perfusion Imaging MAGNETIC RESONANCE SPECTROSCOPY P ositron-emission Tomography in Neuro-oncology Radiologic Pitfalls Encountered in Imaging of Brain Tumor Late Diagnosis of Gliomatosis Cerebri Differentiation between Peripherally Located Glioma (Gliosarcomas) and Meningi L ocalized Enhanced Meninges (Meningeal Tail) or Meningioma Differentiation of Radiation Effect from Recurrent or Residual Neoplasm Radiation Necrosis versus Glioma Recurrence C onventional MR Imaging Clues to Diagnosis Differentiation of Hemorrhagic Metastasis or Gliomas from Hematoma MR Features of Tumoral Hemorrhage Differentiation of Infarcts from Glioma Differentiating Multicentric Glioma/Multifocal Gliomas from Metastasis Differentiating Inflammatory Meningitis from L eptomeningeal Carcinomatosis 32, C erebrospinal Fluid Examination Imaging Features of Normal Meningeal Enhancement C ONCLUSION REFERENCES Imaging of Infratentorial Tumors Ajay Garg CLASSIFICATION OF INFRATENTORIAL TUMORS BASED ON TOPOGRAPHY 1 C erebellar Hemispheres and Vermis Medulloblastoma Ependymoma P ilocytic Astrocytoma Atypical Teratoid/Rhabdoid Tumor Hemangioblastoma Metastases Dysplastic Cerebellar Gangliocytoma Brainstem and Cervicomedullary Junction Brainstem Gliomas C erebellopontine Angle and Internal Auditory Canal V estibular Schwannomas Meningiomas Epidermoid and Dermoid Arachnoid Cyst F acial Nerve Schwannomas C erebellopontine Angle/Internal A uditory Canal Lipomas Metastatic Disease P rimary Parenchymal Neoplasms Endolymphatic Sac Tumor P araganglioma F ourth Ventricle Choroid Plexus Papillomas Subependymoma C ONCLUSION REFERENCES Sellar and Parasellar Lesions P aramjeet Singh, Niranjan Khandelwal NORMAL ANATOMY AND APPLIED PHYSIOLOGY IMAGING MODALITIES C OMPUTED TOMOGRAPHY MAGNETIC RESONANCE IMAGING P A THOLOGY OF THE SELLAR AND P ARASELLAR REGION TUMORS P ituitary Adenoma T ypes of Adenomas Imaging of Adenomas A typical Presentations of Adenomas P ostoperative Sella Craniopharyngioma P ituicytoma Meningioma Germinoma and Teratoma Dermoid and Epidermoid Tumors Chiasmatic/Hypothalamic Glioma Schwannoma SKULL BASE LESIONS Chordoma Metastasis C ongenital and Metabolic Abnormalities of P ituitary Gland Developmental Anomalies of Pituitary Gland P ituitary Hypoplasia and Congenital P ituitary Deficiency Disorders Empty Sella Diabetes Insipidus Hemochromatosis TUMOR LIKE LESIONS P ituitary Hyperplasia Arachnoid Cysts Rathke’s Cleft Cysts T uber Cinereum Hamartoma INFECTIVE CONDITIONS F ungal Infection INFLAMMATORY/GRANULOMATOUS C ONDITIONS Langerhans Cell Histiocytosis L ymphocytic Hypophysitis Sarcoidosis T olosa-Hunt Syndrome V ASCULAR LESIONS Aneurysms and Vascular Loops C arotid Cavernous Fistula and Cavernous Malformations Sheehan’s Syndrome REFERENCES Intraventricular Lesions Niranjan Khandelwal, Paramjeet Singh IMAGING MODALITIES Lateral Ventricular Masses Choroid Plexus Papilloma (CPP) Astrocytoma Subependymal Giant Cell Astrocytoma (SGCA) Ependymoma Meningioma Metastases P rimary CNS Lymphoma C entral Neurocytoma Subependymoma V ascular Malformations Choroid Plexus Cysts and Xanthogranulomas T hird Ventricular Masses Anterior Third Ventricular Masses C olloid Cyst Astrocytoma Ependymoma Germinoma Metastases Craniopharyngioma Epidermoid and Dermoids C ysticercosis P ituitary Tumor P osterior Third Ventricular Masses Glial Tumors Germinoma T eratoma P ineoblastoma P ineocytoma V ascular Masses F ourth Ventricular Masses C e r e bellar Astrocytoma Medulloblastoma Ependymoma Brainstem Gliomas REFERENCES Imaging of the Temporal Bone V ivek Gupta, Niranjan Khandelwal C OMPUTED TOMOGRAPHY TECHNIQUE MAGNETIC RESONANCE IMAGING C ONGENITAL ANOMALIES OF THE TEMPORAL BONE Anomalies of the External and Middle Ear Inner Ear Abnormalities C omplete Labyrinthine Aplasia or Michele Aplasia C ommon Cavity C ochlear Aplasia C ochlear Hypoplasia Incomplete Partition or Dilatational Defects C ongenital Dilatation of the Vestibular Aqueduct V estibular Anomalies V ascular Anomalies T emporal Bone Fractures Inflammatory Diseases of the Temporal Bone Inflammatory Conditions of the External Ear Inflammatory Condition of the Middle Ear C OMPLICATIONS A c quired Cholesteatomas O THER COMPLICATIONS Inflammatory Conditions of the Inner Ear RADIOLOGICAL EVALUATION OF VASCULAR TINNITUS AND VASCULAR TYMPANIC MEMBRANE C auses of Pulsatile Tinnitus 33 Normal Vascular Variants P a thological Vascular Causes Arterial Causes Arteriovenous Causes V enous Tinnitus Otosclerosis D Y SPLASTIC CONDITIONS OF THE TEMPORAL BONE T umors of the Temporal Bone Imaging of the Globe and Orbit Sanjay Sharma, Smriti Hari, Deep N Srivastava Radiographic Views Ultrasound NORMAL ANATOMY C omputed Tomography Magnetic Resonance Imaging P A THOLOGICAL CONDITIONS OCULAR LESIONS Ocular Detachments V itreous Hemorrhage Retinoblastoma P ersistent Hyperplastic Primary Vitreous C oats’ Disease U v eal Malignant Melanoma C horoidal Metastases F oreign Body C ongenital Anomalies P arasitic Infestation ORBITAL LESIONS ORBITAL TUMORS Hemangioma C apillary Hemangioma C avernous Hemangioma L ymphangioma Lacrimal Gland Tumors Optic Nerve Glioma Meningioma Sphenoid Wing Meningioma Optic Nerve Sheath Meningioma Rhabdomyosarcoma Meningioma Arising from Arachnoid Cells Rests W ithin the Orbit L ymphoma Schwannoma/Neurofibroma Orbital Metastases Developmental Cysts INFLAMMATORY LESIONS P seudotumor Endocrine Orbitopathy P arasitic Cysts V ASCULAR LESIONS C arotico-cavernous Fistula Orbital Varices Osseous Lesions T r auma REFERENCES Imaging of the Paranasal Sinuses V ivek Gupta, Niranjan Khandelwal P ARANASAL SINUS EMBRYOLOGY IMAGING MODALITIES AND TECHNIQUE OF EVALUATION C onventional Radiography MAGNETIC RESONANCE IMAGING NORMAL ANATOMY AND ANATOMIC V ARIATIONS 1 2-14 Normal Anatomy Nasal Structures Draining Pathways Anatomic Variations C oncha Bullosa Nasal Septum Deviation P aradoxical Middle Turbinate V ariations in the Uncinate Process INFLAMMATORY SINUS DISEASE A cute Sinusitis Chronic Sinusitis P ost-FESS Scanning Mucocele F ungal Sinusitis Allergic Fungal Rhinosinusitis (AFRS) GRANULOMATOUS DISEASES Invasive Fungal Sinusitis Noninvasive Chronic Fungal Sinusitis P olyps and Cysts NEOPLASTIC LESIONS OF THE PARANASAL SINUSES Epithelial Tumors of the PNS Epithelial Tumors of Glandular Origin NONEPITHELIAL TUMOR OF PARANASAL SINUSES Angiofibroma L ymphomas Plasmacytoma Olfactory Neuroblastoma (Olfactory Neuroepithelioma/Esthesioneuroblastoma) Neurofibromas FIBROSSEOUS LESIONS OF CRANIOFACIAL BONES 45,46 Ossifying Fibroma P aget’s Disease REFERENCES Imaging of the Neck Spaces NORMAL RADIOLOGICAL ANATOMY OF SUPRAHYOID AND INFRAHYOID NECK Superficial or Investing Layer Masticator Space P arotid Space Submandibular Space V isceral or Pretracheal Layer Pharyngeal Mucosal Space P arapharyngeal Space Buccal Space Retropharyngeal Space Deep Layer of Deep Cervical Fascia or P r evertebral Fascia C arotid Space P r evertebral Space IMAGING TECHNIQUES P erfusion Computed Tomography Magnetic Resonance Imaging Diffusion-weighted MRI of Nodes P erfusion MR Imaging L ymph Node Specific MR-contrast Agents T umor Recurrence versus Treatment Changes: P ositron-emission Tomography Dynamic Contrast-enhanced CT and MRI of the Nodes P r oton MR Spectroscopy NODAL NECK MASSES Staging Imaging Characteristics: Cross-sectional Imaging L ymph Node Size and Contour Nodal Necrosis Nodal Calcification Extracapsular Neoplastic Spread Skull Base and Vertebral Invasion NON-NODAL NECK MASSES MASSES OF DEVELOPMENTAL ORIGIN Branchial Cleft Cysts Ranula L ymphangioma T h yroglossal Duct Cyst T ornwaldt’s Cyst Imaging Features MASSES OF INFLAMMATORY ORIGIN Dermoid and Epidermoid Cysts T onsillitis and Peritonsillar Abscess Imaging Features A cute and Chronic Parotitis A cute Parotitis Chronic Parotitis Sialolithiasis L udwig’s Angina Ranula Inflammatory Pathology of the Carotid Space Inflammatory Disease of the Retropharyngeal Space Imaging Features Inflammatory Lesions of the Prevertebral Space MASSES OF NEOPLASTIC ORIGIN Benign Tumors Juvenile Nasopharyngeal Angiofibroma W arthin’s Tumor Neurogenic Tumors Benign Tumors of the Parotid Hemangiomas and Lymphangiomas Malignant Tumors Nasopharyngeal Carcinoma Oropharyngeal Carcinoma Non-Hodgkin’s Lymphoma Nasopharyngeal Rhabdomyosarcoma Malignant Tumors of the Salivary Glands Imaging Patterns on CT and MR P rimary Malignant Lesions in the P r evertebral Space MASSES OF NEURAL ORIGIN Neurofibromas Imaging Features Imaging Features MASSES OF VASCULAR ORIGIN Aneurysm P aragangliomas Diffusion-weighted Imaging in Paragangliomas 51 MASSES OF MESENCHYMAL ORIGIN REFERENCES Thyroid Imaging Alpana Manchanda THYROID GLAND Embryology Anatomy Endocrinology CLINICAL MANIFESTATIONS OF THYROID DISEASE THYROID IMAGING Plain Radiographs Nuclear Scintigraphy Ultrasonography Cross-sectional Imaging P A THOLOGY OF THE THYROID GLAND DEVELOPMENTAL ANOMALIES Lingual Thyroid T h yroglossal Duct Cyst DIFFUSE THYROID DISEASE Diffuse Nontoxic Goiter Imaging Features Graves’ Disease (Diffuse Toxic Goiter) Chronic Autoimmune Lymphocytic (Hashimoto’s) Thyroiditis Silent Painless Thyroiditis and P ostpartum Thyroiditis A cute Suppurative Thyroiditis Imaging Features Subacute Granulomatous Thyroiditis (de Quervain’s Disease) Imaging Features Invasive Fibrous Thyroiditis (Riedel’s Struma) MISCELLANEOUS THYROID C ONDITIONS Nodular Thyroid Disease Imaging Features DIFFERENTIATION OF BENIGN AND MALIGNANT THYROID NODULES Ultrasound-elastography C ontrast-enhanced Ultrasound for Evaluation of Thyroid Nodules Diffusion-weighted MRI (DW-MRI) T h yroid Incidentalomas MANAGEMENT OF THYROID NODULES DETECTED AT ULTRASOUND P ercutaneous Aspiration and Biopsy ULTRASOUND-GUIDED THYROID NODULE ALCOHOL ABLATION BENIGN NEOPLASMS T h yroid Adenoma Imaging Features MALIGNANT NEOPLASMS P apillary Carcinoma Imaging Features F ollicular Carcinoma Imaging Features Hurthle Cell Neoplasms of the Thyroid Medullary Carcinoma Anaplastic Carcinoma Imaging Features P rimary Lymphoma Metastatic Disease REFERENCES Malignancies of Upper A erodigestive Tract Sanjay Thulkar, Ashu Seith Bhalla, Sanjay Sharma ORAL CAVITY F loor of Mouth Oral Tongue Lip Gingivoalveolus Retromolar Trigone Buccal Mucosa Hard Palate S taging of Oral Cavity Cancers Imaging Strategies in Oral Cavity Cancer T r eatment of Oral Cavity Cancers NASOPHARYNX Nasopharyngeal Carcinoma S taging of Nasopharyngeal Carcinoma Imaging Strategies in Nasopharyngeal C arcinoma T r eatment of Nasopharyngeal Carcinoma OROPHARYNX C arcinoma of Tonsil C arcinoma of Soft Palate C arcinoma of Base of Tongue T r eatment of Carcinoma of Oropharynx H Y POPHARYNX C arcinoma of Posterior Wall of Hypopharynx C arcinoma of the Pyriform Sinus C arcinoma of the Postcricoid T r eatment of Carcinomas of Hypopharynx LARYNX Supraglottic Carcinoma Glottic Carcinoma Subglottic Carcinoma Imaging Strategies in Carcinoma of Larynx C artilage Invasion by Carcinoma of Larynx T r eatment of Carcinoma of Larynx CERVICAL LYMPH NODES Imaging of Cervical Lymph Nodes Management of Cervical Lymph Nodes C ervical Lymphadenopathy with Carcinoma of Unknown Primary Site (CUPS) Distant Metastases and Second Primary Tumors MISCELLANEOUS TUMORS Minor Salivary Gland Tumors Rhabdomyosarcoma L ymphoma POST-TREATMENT IMAGING P ostradiotherapy Neck Late Effects of Radiotherapy P ostoperative Neck REFERENCES Imaging of Skull Base Lesions Atin Kumar, Ashu Seith Bhalla ANATOMICAL DIVISION IMAGING TECHNIQUES AND THEIR ROLE ANTERIOR SKULL BASE Anatomy P a thology L esions Arising from Below Sinonasal Lesions Orbital Lesions Lacrimal Gland Tumors L esions Arising from Above Olfactory Groove Meningioma L esions of the Proper Skull Base T r auma and CSF Leak MIDDLE SKULL BASE Anatomy P a thology Midline Sagittal Central Skull Base Lesions Sphenoid Mucocele Clival Chordoma P ituitary Macroadenoma Craniopharyngioma Meningiomas Encephaloceles Other Miscellaneous Lesions P arasagittal, Central Skull Base Lesions P eripheral Nerve Sheath Tumors P erineural Spread Juvenile Nasopharyngeal Angiofibroma C avernous Sinus Lesions Chondroid Tumors Lateral Central Skull Base Lesions Meningioma T emporomandibular Joint Lesions POSTERIOR SKULL BASE Anatomy P a thology Jugular Foramen Lesions Glomus Jugulare Paraganglioma Nerve Sheath Tumors L esions Extending into the Jugular Foramen Jugular Bulb Pseudolesion Large or High Riding Jugular Bulb P etrous Apex Lesions Nonaggressive Cystic Expansile Lesions A g gressive Appearing Solid Lesions F oramen Magnum Lesions DIFFUSE/NONSITE-SPECIFIC SKULL BASE LESIONS Metastases F ibrous Dysplasia C ONCLUSION REFERENCES P aget’s Disease Miscellaneous Conditions Maxillofacial Imaging: Imaging of Cysts, Tumors and Tumor-like C onditions o Ashu Seith Bhalla, Atin Kumar, Sanjay Thulkar IMAGING MODALITIES Plain Radiography Intraoral Radiographs Extraoral Radiographs Computed Tomography Dental Computed Tomography Reformatting Programs Cone-Beam Computed Tomography CLASSIFICATION CLINICAL FEATURES RADIOLOGICAL FEATURES/APPROACH Anatomical Location/Site Radiodensity and Internal Architecture of Lesion Relation to Dentition Relation to Mandibular Canal Size Shape OUTLINE/DEFINITION/MARGINATION Surrounding Bone Surrounding Soft Tissues WELL-DEFINED RADIOLUCENT LESIONS Jaw Cysts Odontogenic Cysts Effect on Surrounding Structures Teeth Nonodontogenic Cysts TUMORS OR TUMOR-LIKE CONDITIONS Odontogenic Tumors Ameloblastoma Nonodontogenic Lesions Central Giant Cell Granuloma Ameloblastic Fibroma Eosinophilic Granuloma Central Hemangioma Arteriovenous Malformation Radiolucent Lesions with Ill-defined Margins Malignant Tumors Primary Tumors Mixed-Density Lesions Odontogenic Lesions Nonodontogenic Lesions Radiopaque Lesions Odontogenic Lesions CONCLUSION REFERENCES Craniovertebral Junction Anomalies ANATOMY AND EMBRYOLOGY Skeletal Anatomy (Figs 1A to D) F oramen Magnum and the Occiput Atlas Ligamentous Anatomy (Figs 2A and B) Embryology BIOMECHANICS CLINICAL PRESENTATION CRANIOMETRY CLASSIFICATION OF CVJ ANOMALIES 12 C ongenital Anomalies and Malformations of the Craniovertebral Junction — Segmentation failure of C2-C3 Developmental and Acquired Abnormalities NEURORADIOLOGIC INVESTIGATIONS INCIDENCE SPECIFIC CONDITIONS Basilar Invagination Assimilation of Atlas A tlas Arch Anomalies Dens Dysplasias Os Terminale Os Odontoideum A tlantoaxial Instability Classification of AAI Inflammatory, Arthritic and Infectious Disorders TRAUMA SYNDROMES INVOLVING THE CVJ 35 Klippel-Feil Syndrome Down Syndrome Arnold-Chiari Malformation Chiari I Malformation Chiari II Malformation Chiari III Malformation A chondroplasia Mucopolysaccharidoses Osteogenesis Imperfecta SUMMARY REFERENCES Endovascular Management of Craniofacial Vascular Lesions Ajay Kumar, Niranjan Khandelwal EMBOLIC AGENTS PRETHERAPEUTIC EVALUATION IMPORTANT ANATOMIC CONSIDERATION POSTEMBOLIZATION CARE NASOPHARYNGEAL ANGIOFIBROMAS P ARAGANGLIOMA CRANIOFACIAL VASCULAR LESIONS V ascular Tumor Hemangiomas V ascular Malformations Aneurysms MISCELLANEOUS LESIONS Epistaxis SUMMARY Imaging of Head Trauma Shivanand Gamanagatti, Atin Kumar, Arun Kumar Gupta A c c ording to Clinical Severity [ Glasgow Coma Scale (GCS)] 3 Marshall CT Classification of Head Injury 4 C ategories TBI CLASSIFICATION Broad Classification A c c ording to Location of Lesions A c c o r ding to Mechanism GOALS OF NEUROIMAGING IMAGING TECHNIQUES Plain Radiographs E vidence Based Guidelines for Imaging Patients with Head Injury IMAGING FINDINGS Scalp Injury T y pes of Scalp Injury Skull Fractures T y pes of Skull Fractures Recommendations TEMPORAL BONE FRACTURES W hen to Suspect Temporal Bone Fractures? T ypes of Temporal Bone Fractures 23 (Figs 8A and B) PRIMARY HEAD INJURY LESIONS EXTRA-AXIAL INJURY 9,22 Epidural Hematoma Imaging Features Ominous Sign Management 25 Subdural Hematomas Imaging Features Challenges during Interpretation 9,22 Subdural Hematoma Evolution on MRI Subarachnoid Hemorrhage Magnetic Resonance Imaging of SAH Intraventricular Hemorrhage INTRA-AXIAL INJURY Diffuse Axonal Injury V ASCULAR INJURY CAROTID CAVERNOUS FISTULA T r eatment of Carotid Cavernous Fistula 31 T ypes of Carotid Cavernous Fistula 31 SECONDARY HEAD INJURY A CUTE SECONDARY CHANGES Diffuse Cerebral Swelling Imaging Features of Cerebral Edema Brain Herniation Subfalcine Herniation Uncal Herniation T r anstentorial Herniation Infarction or Ischemia CHRONIC SECONDARY CHANGES T r aumatic Hydrocephalus C erebrospinal Fluid Imaging 32,33 Encephalomalacia CT Imaging Magnetic Resonance Imaging C omputed Tomography Cisternography L eptomeningeal Cyst or “Growing Fracture” Imaging of Facial Trauma Ajay Kumar, Vivek Gupta IMAGING TECHNIQUES F A CIAL BUTTRESSES AND REGIONAL CLASSIFICATION OF INJURIES 5,6 Importance of Facial Buttresses 14 Regional Facial Fractures F r ontal Sinus Fractures CLASSIFICATION OF MAXILLOFACIAL FRACTURES Nasal Fractures C entral Midface Fractures L e Fort Fractures L ateral Midface Fractures Blowout Fractures of the Orbit Mandibular Fractures Sphenoid Sinus Fractures PEDIATRIC FACIAL FRACTURES CLINICAL ASPECTS OF MAXILLOFACIAL IMAGING Imaging of Acute Spinal Trauma Sameer Vyas, Niranjan Khandelwal, Paramjeet Singh IMAGING INDICATIONS IMAGING MODALITIES P lain Radiography C omputed Tomography Magnetic Resonance Imaging CLASSIFICATION OF SPINAL TRAUMA L e v el of Injury Severity of Injury Mechanism of Injury CERVICAL SPINE INJURY Upper Cervical Spine Injuries S table versus Unstable Fracture A tlanto-occipital Dislocation A tlantoaxial Injuries RADIOLOGICAL INTERPRETATION OF SPINAL TRAUMA (ABCS) F r actures of the Atlas (C1) F r actures of the Axis (C2) L o w er Cervical Spine Injury (C3-C7) THORACOLUMBAR SPINE INJURY C ompression or Wedge Fracture Burst Fracture F r acture Dislocation Lap Seat-belt Type Fracture or Chance Fracture NONOSSEOUS INJURY Spinal Cord Injuries Subacute and Chronic Injuries SCIWORA W hiplash Injury V ascular Injury SUMMARY REFERENCES Imaging of Spinal Neoplasms Ajay Garg INTRAMEDULLARY TUMORS Solitary Lesions Ependymomas CLASSIFICATION OF LESIONS Subependymoma Myxopapillary Ependymoma Astrocytomas Gangliogliomas Hemangioblastomas P araganglioma Multiple Lesions Intramedullary Lymphoma Intramedullary Metastases Nerve Sheath Tumors INTRADURAL-EXTRAMEDULLARY TUMORS Solitary Lesions Meningiomas Intradural Metastases EXTRADURAL TUMORS Multiple Lesions Metastatic Disease Multiple Myeloma L ymphoma Hemangioma Solitary Lesions Aneurysmal Bone Cyst Giant Cell Tumor Osteoid Osteoma Osteoblastoma Osteosarcoma Osteochondromas Chordoma Chondrosarcoma Chondroblastoma EPIDURAL LESIONS A ngiolipoma Epidural Lipomatosis Spinal Vascular Malformations SPINAL DURAL ARTERIOVENOUS FISTULA SPINAL CORD PERIMEDULLARY ARTERIOVENOUS FISTULA SPINAL CORD AVMS SPINAL VASCULAR MALFORMATIONS Imaging of Low Backache Raju Sharma, Shivanand Gamanagatti, Arun Kumar Gupta IMAGING OF LOW BACK PAIN W hen to Image C onditions Causing Back Pain IMAGING MODALITIES Radiographs Magnetic Resonance Imaging, Computed T omography, Myelography, Myelography/CT Magnetic Resonance Imaging Myelography/CT Discography, CT Discography Isotope Bone Scan TRANSITION VERTEBRA C omputed Tomography SPONDYLOLYSIS AND SPONDYLOLISTHESIS Imaging DEGENERATIVE DISEASES OF LUMBAR SPINE Degenerative Changes in the Anterior Elements SCHEUERMANN’S DISEASE Clinical Presentation Imaging and Diagnosis Degenerative Changes in the P osterior Elements DEGENERATIVE CHANGE OF THE NUCLEUS PULPOSUS Normal Disk C omplications of Degenerative Spinal Disease P r esentation MR Appearance of Normal Disk MR Appearance Abnormal Nucleus Disk Herniation (Abnormalities in Disk Morphology) P oints to Remember Sequestered disk. 25-27 P oints to Remember Annular Tears Method of Quantifying the Severity of Disk Disease L ocation of Focal Disk Abnormalities Significance of Disk Contour Abnormalities Intraosseous Disk Herniations P r esentation P oints to Remember OSSEOUS DEGENERATIVE CHANGES V e rtebral Bodies Osteophytes Endplates C auses F acet Joints Normal Facet Joints F a c et Joint Arthropathy P osterior Spinous Processes Spinal Stenosis T y pes of Involvement F ailed Back Syndrome Seronegative Spondyloarthropathy INFECTIONS T ubercular Infection CT Features MR Features Uncommon Patterns Differential Diagnosis Pyogenic Infection TUMORS Benign Tumors Hemangioma Osteoid Osteoma Osteoblastoma Aneurysmal Bone Cyst Giant Cell Tumor Malignant Tumors Chordoma Metastases Multiple Myeloma (Figs 28A to D) C ONCLUSION REFERENCES L ymphoma L ocalization in Clinical Neurology Manish Modi, Sudesh Prabhakar L OCALIZATION IN CLINICAL NEUROLOGY C linical Diagnosis and Lesion Localization DISORDERS OF CRANIAL NERVES OLFACTORY NERVE (CRANIAL NERVE I) A nosmia APPROACH TO NEUROLOGICAL DISORDER OPTIC NERVE (CRANIAL NERVE II) V isual Pathway Localization (Fig. 2) OCULOMOTOR SYSTEM (CRANIAL NERVE III, IV, VI) (TABLE 1) Supranuclear Lesions Nuclear Lesions Internuclear Ophthalmoplegia Infranuclear Lesions Other Disorders of Oculomotor System TRIGEMINAL NERVE (CRANIAL NERVE V) F A CIAL NERVE (CRANIAL NERVE VII) L ocalization of Facial Nerve Lesions (Fig. 3) Supranuclear Palsy Infranuclear Facial Nerve Palsy VESTIBULOCOCHLEAR NERVE (CRANIAL NERVE VIII) GLOSSOPHARYNGEAL AND VAGUS NERVE (CRANIAL NERVE IX, X) P alatal Myoclonus SPINAL ACCESSORY NERVE (CRANIAL NERVE XI) Muscle Bulk P o w er Testing Muscle Tone H Y POGLOSSAL NERVE (CRANIAL NERVE XII) DISORDERS OF MOTOR SYSTEM Spasticity Extrapyramidal Rigidity Reflexes Biceps Jerk Supinator Jerk T riceps Jerk Knee Jerk Ankle Jerk Hoffman Reflex A bnormalities of Tendon Reflexes Superficial Reflexes Abdominal Reflexes Cremasteric Reflex Anal Reflex P lantar Reflex Other Important Reflexes Grasp Reflex F orced Grasping Reflex Sucking Reflex Glabellar Tap C oordination F inger Nose Test Heel-Knee Test Dysdiadochokinesis P ast Pointing Test Sensory System Gait Dysphasia DISORDERS OF HIGHER MENTAL FUNCTION DISORDERS OF SPEECH Dysarthria APRAXIA P ARIETAL LOBE DYSFUNCTIONS A GNOSIA V isual Agnosia T actile Agnosia A uditory Agnosia C ONCLUSION SUGGESTED READING Basic Neuropathology Kirti Gupta, Rakesh Kumar Vasishta REMOVAL OF THE BRAIN FROM SKULL REMOVAL OF VENOUS SINUS, CAVERNOUS SINUS AND MIDDLE EAR EXAMINATION EXAMINATION OF THE BRAIN Gross Features to be Noted Slicing of Brain Choice of Blocks for Histology P ediatric Brain Examination Appearance of the Ventricles INFECTIONS C onsequences of Infection L eptomeningitis A cute Meningitis Routes of Infection T ubercular Meningitis (Figs 3B to 6) Chronic Meningitis F ungal Meningitis/Encephalitis Subdural Empyema Brain Abscess P urulent Encephalitis Associated with Subacute Bacterial Endocarditis V iral Encephalitis (Fig. 10) P ostmortem Examination in Cases of Suspected V iral Encephalitis Macroscopic Examination of the CNS and the Choice of Blocks for Microscopy P athological Features Common to Most Forms of V iral Encephalitis NEUROVASCULAR DISEASES Arterial Infarcts or Territorial Infarcts Embolic Infarcts C erebral Venous Infarcts (Fig. 13) Lacunar Infarcts P r actical Considerations Intracranial Hemorrhage Aneurysm Arteriovenous Malformations Demyelinating Disease and Multiple Sclerosis Gross Features Inherited Metabolic Diseases TUMORS P ostmortem Examination of Cases of CNS Tumor T umors of Neuroepithelial Tissue General Guidelines Recent Advances and Applied P h y sics in Imaging Ultrasound Instrumentation: P r actical Applications K ushaljit Singh Sodhi, Akshay Kumar Saxena, Mukesh Kumar Yadav High-frequency Transducer Medium-frequency Transducer L o w -frequency Transducer M A CHINE CONTROLS FREQUENCY OF TRANSDUCERS TYPES OF TRANSDUCERS Linear-array Transducer C urvilinear-array Transducer P hased-array Transducer Doppler T issue-harmonic Imaging Spatial-compound Imaging EXTENDED FIELD OF VIEW Elastography 3D and 4D Ultrasound Gynecology Obstetrics Limitations F usion Imaging CLINICAL APPLICATIONS OF FUSION IMAGING T herapeutic Applications of Ultrasound Limitations Ultrasound-based Molecular Imaging and Oncotherapy Ultrasound-image Artifacts Image Optimization in Ultrasound GRAYSCALE IMAGING Basic Guidelines 2-5 Factory Presets Transducer Selection Overall Gain Time-gain Compensation Depth Setting Focal-zone Setting Zoom Dynamic Range ARTIFACTS IN B MODE IMAGING 3 , Beam-width Artifact Slice-thickness Artifact Side-lobe and Grating-lobe Artifacts Artifacts Associated with Multiple Echoes Reverberation Bands Mirror-image Artifact Artifacts Associated with Velocity Errors Refractory Errors Attenuation Errors Acoustic Shadowing Edge Shadowing Increased through Transmission or Distal Bright-up’ Noise SPECTRAL AND COLOR DOPPLER EXAMINATION Basic Guidelines 7 Optimizing Color Doppler and Spectral Doppler Settings 7-11 Color Box or Color Doppler Sampling Window Doppler or Color Gain Velocity Scale Gate Size or Sample Volume Box Sample Volume or Gate Position Angle Correction Color-write Priority Directional Ambiguity Baseline Wall Filters Inversion of Flow Slow Flow Anatomically Related Artifacts Artifacts Unrelated to Blood Flow Perivascular or Color-bruit Artifact SPECIAL IMAGING MODES 1-3,10,13-16 Tissue-harmonic Imaging COMPOUND IMAGING Spatial-compound Imaging Coded-pulse Excitation Adaptive-image Processing Photopic-ultrasound Imaging Extended Field of View Imaging B-Mode Flow Imaging 3D–4D Ultrasound CONCLUSION REFERENCES Ultrasound Elastography: P rinciples and Application V eenu Singla, Tulika Singh, Anindita Sinha B ASIC PHYSICS S tress S train Elasticity V iscosity V iscoelasticity P oroelasticity DEPICTION OF ELASTOGRAMS DIFFERENT ELASTOGRAPHY TECHNIQUES C ompression Elastography Limitations A c oustic Radiation Force Impulse P rinciple and Technique Measurement Quantitative versus Qualitative A dvantages Disadvantages Safety Shear-wave Imaging Principle and Technique Measurement Qualitative versus Quantitative Advantages Disadvantages Advances in Shear-wave Imaging Harmonic-motion Imaging Technique Application Shear-dispersion Ultrasound Vibrometry T echnique Measurement Mechanical Imaging Measurement Application ELASTOGRAPHY APPLICATIONS Breast Elastosonographic Score (Fig. 3) Elastographic Appearances of the Breast Masses Liver Diffuse Liver Diseases: Fibrosis, Cirrhosis, Acute Hepatitis, Nonalcoholic Fat F actors Influencing Liver Stiffness Ultrasound Elastography C omparison Between ARFI, Real-time Elastography and Transient Elastography f F ocal Liver Lesions P r ostate L ymph Nodes T h yroid G ynecology C ervical Elastography C ervical Cancer F ibroids F ibroids vs Adenomyosis Endometrial Pathologies Musculoskeletal Appearance of Normal Tendons V enous Thrombosis O THER APPLICATIONS Renal Transplant A ssessment S kin and Soft Tissue Endoscopic Ultrasonography C ardiovascular Applications Limitations of EUS Elastography P itfalls C ONCLUSION C omputed Tomography Hardware: An Update Ashu Seith Bhalla, Arun Deep Arora B ASIC WORKFLOW OF CT SCANNER DETERMINANTS OF AN OPTIMAL IMAGE Spatial Resolution T emporal Resolution C ontrast Resolution ADVANCES IN HARDWARE A dvances in CT Tube A dvances in Detectors A dvances in Reconstruction Rebinning Algorithms SPECIAL C OMPUTED TOMOGRAPHY C one-beam CT/Volume CT C one-beam Geometry F lat-panel Detector Reconstruction R adiation Dose Applications C-arm Based CBCT Navigation Systems C ONCLUSION Dual-energy Computed Tomography Arun Kumar Gupta, Manisha Jana HISTORICAL PERSPECTIVE PRINCIPLE DUAL-ENERGY RATIO Spectral Separation and Selective-photon Shield Dual-source DEC T P r ocessing of Data and Image Reconstruction in Dual-energy Imaging Single-source DECT Dual-energy CT with Layered Detectors Image Display in DECT APPLICATIONS OF DECT Applications in Abdomen Renal Applications Applications in Adrenal A drenal Adenoma Hepatic Mass Characterization Application in Pancreas P ulmonary Applications Musculoskeletal Applications Applications in Head and Neck V ascular Applications C ardiac Applications Applications in Neuroimaging DOSE CONSIDERATIONS REFERENCES Limitation C ONCLUSION A CKNOWLEDGMENTS C omputed Tomography P erfusion Imaging PERFUSION COMPUTED TOMOGRAPHY TECHNIQUE BASIC PRINCIPLE Unenhanced CT Acquisition Dynamic CT Acquisition PERFUSION COMPUTED TOMOGRAPHY PROTOCOLS T echnique of CT Perfusion C OMPUTED TOMOGRAPHY PERFUSION IN A CUTE ISCHEMIC STROKE C ontrast Medium A c quisition Parameters C OMPUTED TOMOGRAPHY PERFUSION IN ONCOLOGY HEPATIC COMPUTED TOMOGRAPHY PERFUSION 3 5-39 P erfusion Parameters of Normal Liver CT Perfusion in Hepatocellular Carcinoma CT Perfusion in Metastatic Disease CT Perfusion in Focal Liver Lesions C OMPUTED TOMOGRAPHY PERFUSION IN P ANCREATIC NEOPLASMS C OMPUTED TOMOGRAPHY PERFUSION IN COLORECTAL CARCINOMA C OMPUTED TOMOGRAPHY PERFUSION IN PROSTATE CANCER C OMPUTED TOMOGRAPHY PERFUSION IN LYMPHOMA C OMPUTED TOMOGRAPHY PERFUSION IN BRAIN TUMORS C OMPUTED TOMOGRAPHY PERFUSION IN HEAD AND NECK TUMORS C OMPUTED TOMOGRAPHY PERFUSION IN L UNG CANCER O THER APPLICATIONS Nephrology Chronic Liver Diseases CT Perfusion in Liver Transplantation A cute Pancreatitis RADIATION ISSUES C ONCLUSION REFERENCES Magnetic Resonance Instrumentation: An Update Anjali Prakash THE MAGNET PREPOLARIZED MRI Superconducting Magnet Quench M A GNET GEOMETRY S him Coils 3 TESLA AND HIGHER-MAGNET STRENGTHS Gradient System Radiofrequency System MULTICHANNEL RF COILS AND P ARALLEL IMAGING C omputer Data Processing and Image Reconstruction ADVANCED MR APPLICATIONS AND HARDWARE Magnetic Resonance-High-Density Focussed Ultrasound (or MRgFUS) Magnetic Resonance Elastogram MR Surgical S uite: Interventional MRI Magnetic Resonance–Positron Emission Tomography REFERENCES Image Optimization in Magnetic Resonance Imaging P r oton Density C oil Type and Position SIGNAL-TO-NOISE RATIO F ield Strength Repetition Time F lip Angle Number of Signal Averages S lice Thickness Receiver Bandwidth E cho Time C ONTRAST-TO-NOISE RATIO A dministration of a Contrast Agent Magnetization Transfer C onstant C hemical Suppression E cho-train Length T ime from Inversion SPATIAL RESOLUTION V o x el Volume, FOV, Matrix SCAN TIME Scan time = TR × number of excitations × number of phase encodings Number of Excitations ARTIFACTS P hase Matrix Number of Slice Encodings in 3D Sequences Scan time = TR × number of excitations × number of phase encodings × sl Motion Artifacts (Phase Mismapping) Ghosting and Smearing Distance = TR × phase encoding steps × NEX × motion frequency P ulsatile Flow-related Artifacts Remedy A rtifacts Due to Measurement T echnique/Parameters Aliasing Moiré /Fringe Artifact Remedy Chemical-shift Artifacts A dvantage Chemical Shift in Echoplanar Imaging P hase-cancellation Artifact A dvantage T runcation Artifacts Magnetic Susceptibility Difference Artifacts A dvantage Section Cross Talk P arallel-imaging Artifact External Artifacts Artifacts Caused by Field Distortions A dvantage Zipper Artifact Spike (Herringbone) Artifact C ONCLUSION BIBLIOGRAPHY Diffusion Weighted Magnetic Resonance Imaging Devasenathipathy Kandasamy, Raju Sharma B ASIC PRINCIPLE B VALUE ADC AND EXPONENTIAL IMAGE D WI SEQUENCES AND OPTIMIZATION E cho Planar Imaging T urbo Spin Echo Sequences or Half-Fourier-acquisition Single-shot T urbo-spin Echo S t eady-state Free-precession ARTIFACTS AND PITFALLS Susceptibility Artifacts C hemical-shift Artifacts Motion Artifacts E ff ect of Contrast Media T2 S hine Through T2 Washout T2 Blackout E ddy Current Artifacts ADVANCED D W TECHNIQUES Diffusion Tensor Imaging W hole Body Diffusion-weighted Imaging DIFFUSION KURTOSIS IMAGING Intravoxel Incoherent Motion Histogram Analysis of ADC CLINICAL APPLICATIONS OF DWI Brain Head and Neck P ediatric Applications T horax Breast Liver Gallbladder and Biliary Ducts P ancreas Kidneys and Adrenal P r ostate F emale Pelvis C ONCLUSION F unctional Magnetic Resonance: P erfusion and Dynamic Contrast enhanced Mag Niranjan Khandelwal, Sameer Vyas PERFUSION MAGNETIC RESONANCE IMAGING Magnetic-contrast Agents in Neural Tissues Imaging Techniques and Methods Dynamic-susceptibility Contrast-enhanced MR Perfusion MRI Sequence Type Dynamic Contrast-enhanced MR Perfusion Arterial-spin Labeling MR Imaging D Y NAMIC CONTRAST-ENHANCED MRI Magnetic Resonance Angiography Ajay Kumar, Sameer Vyas, Naveen Kalra HISTORY AND INTRODUCTION FLOW PHENOMENA Outflow-related Signal Loss (Washout Effect, T2 Flow Void) Inflow-related Signal Enhancement (Inflow Effect) P hase Effects TIME-OF-FLIGHT ANGIOGRAPHY: TECHNIQUES P itfalls with TOF MRA Important Points for Optimization of TOF A ngiography 5-7 PHASE-CONTRAST ANGIOGRAPHY Magnitude-contrast Technique P hase-contrast Technique Optimization C ONTRAST-ENHANCED MR ANGIOGRAPHY CE-MRA Advantages 14 P arallel Imaging 12 T ime Resolved/4D CE-MRA A dvantages of Time-resolved MRA Limitation F uture Perspectives REFERENCES Magnetic Resonance Imaging Pulse Sequences: An Evolution V ivek Gupta, Niranjan Khandelwal B ASIC TERMINOLOGIES TYPES OF SEQUENCES C onventional Spin-echo Sequences F ast-spin-echo Sequences Half-fourier Acquisition Single-shot T urbo Spin Echo Inversion Recovery Sequence Gradient-echo Sequences Steady State Sequences C oherent-gradient-echo Sequence CISS/FIESTA-C Ultrafast Sequences T2*-Weighted Ultrafast Sequences Ultrafast-gradient-echo Sequence 3D Ultrafast-gradient-echo Sequence Hybrid Sequences Gradient/Spin-echo Hybrid BIBLIOGRAPHY Digital Radiography: An Update Alpana Manchanda LIMITATIONS OF FILM SCREEN RADIOGRAPHY EVOLUTION OF DIGITAL RADIOGRAPHY ADVANTAGES OF DIGITAL RADIOGRAPHY 2,3 PRINCIPLE OF DIGITAL RADIOGRAPHY DIGITAL-RADIOGRAPHY SYSTEMS Computed Radiography PHYSICS BEHIND DIGITAL RADIOGRAPHY A dvantages of Storage Phosphor Systems Drawbacks of CR/Storage Phosphor Systems Direct-digital Radiography Direct Conversion Selenium Drum-based System of Direct Conversion T hin-film Transistor—Direct Conversion T hin-film Transistor—Indirect Conversion TYPES OF SCINTILLATORS C harged-coupled Devices P hoton-counting Type DR System IMAGE PROCESSING ASPECTS OF IMAGE QUALITY P ixels Detector Size Grayscale Spatial Resolution C ontrast Resolution and Dynamic Range Modular Transfer F unction Detective-quantum Efficiency Radiation Exposure Newer Applications in CR Newer Applications in DR Exposure Indicator for Digital Radiography A CR Practice Guideline for Digital Radiography C ONCLUSION REFERENCES Digital Mammography Smriti Hari, Chandrashekhara SH, Surabhi Vyas DIGITAL MAMMOGRAPHY B ASIC PHYSICS OF DIGITAL MAMMOGRAPHY Detectors Spatial Resolution A nalog to Digital Units P r ocessing Algorithms Dynamic Range C omparison between Digital Mammograms and Film/Screen Mammograms S t orage of Digital Images Display of Digital Images A rtifacts APPLICATIONS OF DIGITAL MAMMOGRAPHY C omputer-aided Detection and Diagnosis Dual-energy Subtraction Mammography Digital Breast Tomosynthesis T echnique C ontrast-enhanced Digital Mammography R adiation Dose P otential Benefits of Clinical Breast Imaging with Tomosynthesis Clinical Tomosynthesis Evaluations T eleradiology Applications S t ereotactic Breast Biopsy S t ereo Mammography C ONCLUSION REFERENCES F luoroscopy and Digital Subtraction Angiography Deep N Srivastava, Madhusudhan KS O VERVIEW FLUOROSCOPY C omponents of Fluoroscopic System Image Intensifier Input S creen Electrostatic L ens Output P hosphor and A node P r operties of Image Intensifier Limitations of Image-intensifier System Optical Coupling and Video System Optical Distributor System V ideo S ystem Digital F luoroscopy P ostprocessing Techniques DIGITAL SUBTRACTION ANGIOGRAPHY T ypes of S ubtraction T echniques used in DSA P ostprocessing in DSA F lat-panel Detector A dvantages and L imitations of FPD S ystems A utomatic Exposure Control Recording M otion T ypes of Fluoroscopic E quipment Recording Fluoroscopic Images Direct-film Recording Indirect R ecording R adiography – Fluoroscopy Unit with Under-couch Tube R adiography – Fluoroscopy Unit with Over-couch Tube F ixed C-arm Fluoroscopic System Mobile C-arm System F actors Affecting Image Quality Radiation S afety in F luoroscopy P atient Dose Monitoring Methods Dose-reduction Techniques SUMMARY T ools in Interventional Radiology A tin Kumar, Chandan Jyoti Das PUNCTURE NEEDLES DILATORS SHEATHS CATHETERS P arts of C a theter Materials Sizes S hapes and H oles Balloon C a theters GUIDEWIRE Selection of Guidewires FINE NEEDLE ASPIRATION CYTOLOGY AND BIOPSY NEEDLE STENT V ascular S tent Biliary S tent Ureteral S t ents P ermanent Proximal Occluders EMBOLIZING AGENTS P ermanent Distal Occluders T emporary Distal Occluders BIBLIOGRAPHY T emporary Proximal Occluders Magnetic Resonance Contrast Media B ASIC PRINCIPLES OF MR CONTRAST AGENTS CLASSIFICATION OF MR CONTRAST AGENTS Magnetic Properties P aramagnetic Contrast Agents Superparamagnetic Contrast Agents Intravascular Agents Image Enhancement Biodistribution Extracellular-fluid Agents T issue-specific Agents GADOLINIUM-BASED CONTRAST AGENTS Interaction between Extracellular MRI C ontrast Agents with Clinical Tests A dverse Effects of GBCAs C ontrast-induced Nephropathy Extravasation Nephrogenic Systemic Fibrosis Risk F actors for NSF Guidelines on GBCA Usage GBCA Administration in Children 20 GBCAs during Pregnancy and Lactation 20 M ANGANESE-BASED CONTRAST AGENTS IRON OXIDE-BASED CONTRAST AGENTS L o w -low I n t ensity (Dark Lumen) High-high or Bright L umen ORAL-CONTRAST AGENTS High-low Intensity L o w -high Intensity ONGOING RESEARCH AND FUTURE TRENDS C ONCLUSION REFERENCES Ultrasound Contrast Agents Shashi Bala Paul, Manisha Jana EVOLUTION OF UCAS TECHNIQUE OF CEUS SAFETY OF UCA s DIAGNOSTIC APPLICATIONS OF UCA s A pplications in Hepatic Imaging Detection of Focal Liver Lesions by CEUS Characterization of FLL CEUS Patterns of Benign Focal Liver Lesions ( T able 3) CEUS Patterns of Malignant Focal L iver L esions ( T able 4) Guidance for Interventional Procedures Assessment of Treatment Response of Malignant T umors and Plan Additional T Hepatic Vein Transit Time Estimation Liver Transplant A pplications in Pancreatic Imaging Detection of Focal Pancreatic Lesions Differentiation of Cystic Pancreatic Tumors from Pancreatic Pseudocyst Detection of Pancreatic Necrosis in Acute Pancreatitis C ontrast-enhanced Endoscopic Ultrasound A pplications in Renal Imaging Characterization of Renal Masses Differentiation of Renal Tumors from Pseudotumors Renal Vascular Lesions Renal Tumor Ablation under CEUS Guidance A pplication in Abdominal Trauma A pplications in Breast Imaging Characterization of Breast Masses Assessment of Tumor Response after Chemotherapy in Breast Cancer A pplication in Prostatic Imaging Miscellaneous Intravascular Applications Intracavitary Applications Upcoming Applications A CKNOWLEDGMENTS Iodinated Contrast Media: An Update Chandrashekhara SH, Sanjay Thulkar HISTORY OF DEVELOPMENT OF ICM B ASIC CHEMISTRY OF ICM T ypes of ICM ICM PHARMACOKINETICS Basic Properties P ulmonary Effects of ICM Effects of ICM on Blood and Endothelium General Policies for ICM Administration Guidelines for Intravenous A dministration of ICM Dosage of Iodinated Contrast Media Administration A dverse Reactions ICM Interaction with Other Drugs and C linical Tests Guidelines for Selective Use of LOCM Iso-osmolar Dimeric Contrast Media FUTURE OF ICM C ONCLUSION C ontrast Reactions and Its Management Gaurav S Pradhan, Rajat Jain TYPES OF ADVERSE REACTION IDIOSYNCRATIC ANAPHYLACTOID REACTIONS Mechanism of Idiosyncratic Anaphylactoid Reactions 1,3-7 Risk Factors for Acute Idiosyncratic Drug Reactions 8 P r e v ention of Acute Idiosyncratic Reactions 9-11 T ypes and Management of A cute Idiosyncratic Reactions 1 C linical Features NONIDIOSYNCRATIC REACTIONS 22-25 C ontrast-extravasation Treatment Extravasation of Contrast 26-30 C ontrast-induced Nephropathy Diagnosis A cute Kidney Injury Network: Definition of Acute Kidney Injury 28,31 Risk Factors for CIN P a thogenesis Renal Dialysis Patients and the Use of Iodinated Contrast Medium 1 C ontrast Administration and Lactation 1 C ontrast Administration in Patients on Metformin 1 Recommendation of C ontrast Agents Based on Serum Creatinine Level C ontrast Administration and Pregnancy 1 C ontrast Administration and T h yroid Dysfunction 11 P r ophylaxis of Contrast Induced Thyrotoxicosis C ontrast Administration in Pheochromocytoma and Paraganglioma 11 C ontrast and Drug Interaction 47 C omorbidities for Lactic Acidosis with Use of Metformin C ontrast Administration and Interleukin-2 Therapy 47,11 Delayed Adverse Events to Iodinated Contrast Media Recommendations for the Departments P erforming Contrast-related Investigatio P icture Archiving and C ommunication System and R adiology Information Sys Shivanand Gamanagatti, Devasenathipathy Kandasamy, Arun Kumar Gupta PICTURE ARCHIVING AND C OMMUNICATION SYSTEM C omponents and Architecture of PACS W orkflow Mini-PACS T eleradiology A c quisition Image Compression T ypes of Image Compression Bits and Bytes Database Server Storage Storage Hardware N AS stands for N etwork Attached Storage S AN stands for S t orage Area Network. W orkstation Display Monitors R adiologist Reading Stations P h ysician Review Stations S ystem Architecture Network Client/Server-based Systems Distributed Systems W eb-based Systems Related Applications Industry Standards RADIOLOGY INFORMATION SYSTEM REFERENCES E vidence-based Radiology Sanjay Sharma, Manisha Jana B A CKGROUND WHY EVIDENCE-BASED PRACTICE? F orms of Evidence-based Practice ‘Bottom-up’ Evidence-based Practice z I mpact assessment: How does Evidence-based Radiology Differ from Evidence-based Medicine? Limitations of Evidence-based Practice REFERENCES R adiation Hazards and Radiation Units P r atik Kumar, Anil K Pandey RADIATION HAZARDS D AMAGE TO DNA BY THE RADIATION THE EFFECT OF RADIATION S t ochastic and Nonstochastic (Deterministic) Effects Radiation Doses and Expected Effect Radiation Effect on Embryo T en-day Rule P r otection of Patient, Staff and P ublic from Radiation R adiation Risk R adiation Protection Guidelines and LNT Model Justification C ardinal principle of radiation protection is distance, Radiation Units F luence Flux Energy Fluence Exposure Absorbed Dose K erma E quivalent Dose Effective Dose R adiation Dose Measurement in CT C omputed-Tomography Dose Index R adiation Dose Measurement in Fluoroscopy BIBLIOGRAPHY R adiation Protection Sapna Singh HISTORICAL PERSPECTIVE RADIATION UNITS C onventional Units SI Units Dose Equivalent SPECIFIC QUANTITIES AND THEIR ASSOCIATED UNITS EXPOSURE A bsorbed Dose Units BIOLOGICAL IMPACT E ff ective Dose Equivalent (Effective Dose) INTERACTION OF RADIATION WITH M A TTER RADIATION TYPES AND SOURCES BIOLOGICAL EFFECT OF RADIATION CLASSIFICATION OF RADIATION INJURY Malignancies Associated with Radiation Exposure Genetic Effects of Radiation DETERMINISTIC EFFECTS AS DOCUMENTED FROM RADIATION ACCIDENTS A cute Total-body Irradiation THE REGULATORY BODIES C hronic Radiation Effects Role of AERB Radiation Protection Survey and Program (Flow chart 1) PROTECTION AGAINST RADIATION HAZARD PRINCIPLES OF RADIATION PROTECTION S hielding CARDINAL PRINCIPLE OF RADIATION PROTECTION T ime Distance X -ray Tube Shielding (Source Shielding) Room Shielding (Structural Shielding) Exposure Calculations Shielding of the X-ray Control Room P ersonnel Shielding P atient Shielding E quipment SAFETY OF RADIOGRAPHIC IMAGING DURING PREGNANCY RECOMMENDED DOSE LIMITS TO PREGNANT WOMEN 18,19 RADIATION DETECTION AND MEASUREMENT Methods of Detection Ionization P hotographic Effect L uminescence Scintillation PERSONNEL DOSIMETRY P ocket Dosimeter F ilm Badge Monitoring Electronic Dosimeters W earing the Dosimeter During Radiography During Fluoroscopy C OMPUTED TOMOGRAPHY (RADIATION EXPOSURE AND DOSE MODULATIONS) Radiation Dose Measures: CT Specific C onventional Radiographic Projections CT Radiation Projections TYPICAL DOSE MEASUREMENTS CTDI W CTDI vol Dose-length Product (DLP) T echniques for Controlling Radiation Dose at CT Multiple Scan Average Dose C omputed Tomography Dose Index (CTDI) CTDI 100 USING AUTOMATED EXPOSURE CONTROL MODIFYING THE ACQUISITION PARAMETERS Increasing Pitch V arying the Milliampere-seconds Value b y Patient Size Optimum Tube P otential 47 ITERATIVE RECONSTRUCTION Reducing the Milliampere-seconds Value C ONCLUSION P lanning a Modern Imaging Department S C Bansal, Niranjan Khandelwal, Ajay Gulati PLANNING AND ORGANIZATION Divisions of the Radiology Department LAYOUT EQUIPMENT C onventional Radiography Darkroom L OCATION Storage Phosphor Radiography ( C omputed Radiography) Dual-reading CR systems Digital Radiography P arallel Reading (Line Scanning) Needle-crystalline CR Detectors F lat-panel Direct Detector Systems C CD Detector Technology Slot-scanning CCD Technology C omputer-aided Diagnosis Dual-energy Subtraction T emporal Subtraction Digital Tomosynthesis Mobile Image Intensifiers Units M AMMOGRAPHY Dual-energy X-ray Absorptiometry C OMPUTED TOMOGRAPHY ULTRASOUND Magnetic Resonance Imaging Digital Subtraction Angiography Nuclear Imaging Systems PICTURE ARCHIVING AND C OMMUNICATION SYSTEMS SAFETY STANDARDS AND QUALITY ASSURANCE TELERADIOLOGY REFERENCES C ommon Drugs Used in an Imaging Department Anupam Lal, Vivek Gupta, Manphool Singhal DRUGS FOR PATIENT PREPARATION: SEDATIVES L ocal Anesthetics A dverse Effects Sting Free LA Methods of Administration DRUGS USED FOR OPTIMIZING IMAGING EVALUATION: DIURETICS Infiltration Anesthesia U ses V asodilators P apaverine Nimodipine Milrinone P a tient Preparation in Suspected P heochromocytoma Drugs for Cardiac Imaging C ardiac CT β-blockers Ivabradine C ardiac Stress MRI Dobutamine A denosine DRUGS AFFECTING COAGULATION: PROCOAGULANTS T hrombin A n ticoagulants T hrombolytics Classification of Thrombolytics Heparin Antiplatelets C ontraindications C y clooxygenase-1 Inhibitor T hienopyridines F or thrombosis associated with Aneurysmal coiling: P hosphodiesterase Inhibitors SCLEROSANTS AND EMBOLIC AGENTS GELATIN FOAM POLYVINYL ALCOHOL TRIS-ACRYL GELATIN MICROSPHERES N-BUTYL-2 CYANOACRYLATE ETHYLENE VINYL ALCOHOL COPOLYMER ABSOLUTE ALCOHOL SODIUM TETRADECYL SULFATE T r ansarterial Chemoembolization REFERENCES Molecular Imaging Anish Bhattacharya, BR Mittal MOLECULAR IMAGING PROBES IN NUCLEAR MEDICINE CLINICAL APPLICATIONS OF NUCLEAR MOLECULAR IMAGING Oncology Diagnosis and Staging Assessment of Response to Treatment Role in Drug Development CENTRAL NERVOUS SYSTEM DISORDERS Epilepsy Dementia Movement Disorders C oronary Flow Reserve A therosclerosis INFECTIOUS AND INFLAMMATORY PROCESSES CARDIOVASCULAR DISORDERS Myocardial Viability Newer Agents for Imaging Infection/Inflammation C ONCLUSION E thical and Legal Issues in Radiology Mandeep Kang, Manavjit Singh Sandhu ETHICAL ISSUES DOCTOR-PATIENT RELATIONSHIP RADIATION ISSUES P a tient Protection S taff Protection P ublic Protection P r otection During Interventions LEGAL ISSUES Image Interpretation and Reporting F irst Study the Images Know How the Examination was Performed How to Look (Detect the Abnormalities) When an Abnormality is Found Reach a Conclusion When to Make the Report Giving the Report a Title P r oofread the Report General Format L ength of the Report Negative Reporting Internal Architecture LAWS/LEGAL ACTS APPLICABLE T O MEDICINE PCPNDT Act C onsumer Protection Act (1986) Archiving and Ownership of Diagnostic Imaging Data P atient Referral Radiologist as a Witness As Expert Witness Radiologist as a Defendant In a Malpractice Claim Duty of Care C onsent W riting a Radiological Opinion C omments on Other Radiological Reports Appearing in Court P ersonal Communication by the Radiologists Issue of Self-referral TELERADIOLOGY: WHO IS RESPONSIBLE? REFERENCES Gastrointestinal and Hepatobiliary Imaging C urrent Status of Conventional T echniques and Advances in Gastrointestinal Arun Kumar Gupta, Atin Kumar, Chandan Jyoti Das DEVELOPMENT OF GASTROINTESTINAL RADIOLOGY C ONVENTIONAL TECHNIQUES: PRESENT SCENARIO ADVANCES IN GASTROINTESTINAL TRACT IMAGING Ultrasonography (US) in GIT CT Enteroclysis (Fig. 2) T echnique of CT Enteroclysis Indications CT Enterography MRI and MR Enteroclysis (MRE) PET-CT Enteroclysis and PET-CT Colonography Nuclear Scintigraphy CHARACTERISTIC T uberculosis C r ohn’s Disease Imaging in Small Bowel Obstruction Mesenteric Ischemia Neoplasms Malignant C ONCLUSION REFERENCES Nontraumatic Acute Abdomen Mandeep Kang, Veenu Singla DIAGNOSTIC WORK-UP CT Technique P lain Radiographs in Evaluation of the Acute Abdomen P erforation Miscellaneous Conditions Role of Cross-sectional Imaging in Specific Disease Entities A cute Appendicitis A cute Cholecystitis A cute Pancreatitis Intra-abdominal Abscess Bowel Perforation Mesenteric Ischemia V ascular Causes MISCELLANEOUS Diverticulitis T o xic Megacolon P elvic Disease A cute Pyelonephritis A cute Urinary Colic A cute Epiploic Appendagitis, Omental Infarction REFERENCES Imaging in Abdominal Trauma A tin Kumar, Sanjay Thulkar DIAGNOSTIC IMAGING P lain Radiography Ultrasonography Radionuclide Scanning Magnetic Resonance Imaging A ngiography C omputed Tomography C omputed Tomography Technique CT Signs in Blunt Abdominal Trauma 10 ORGAN TRAUMA P eritoneal Cavity P neumoperitoneum Hemoperitoneum SPLEEN LIVER AND BILIARY TRACT A AST Liver Injury Grading System P ANCREAS URINARY TRACT ADRENAL HOLLOW VISCUS, OMENTAL AND MESENTERIC INJURY DIAPHRAGM PENETRATING ABDOMINAL TRAUMA RETROPERITONEUM ABDOMINAL WALL INJURY C ONCLUSION REFERENCES Imaging of the Esophagus Sumedha Pawa, Anjali Prakash P haryngeal and Esophageal Anatomy P h y siology of Swallowing Examination Technique CLINICAL PERSPECTIVE Investigation of Dysphagia Barium Studies C r oss-sectional Studies P harynx Esophagus Endoscopic Ultrasound Others Techniques for Evaluation of Esophagus V ideoendoscopic Swallowing Study Esophageal Scintigraphy Esophageal Manometry Ambulatory pH Monitoring Oropharyngeal Lesions Neuromuscular Disease Cricopharyngeal Prominence Cricopharyngeal Webs P haryngeal Diverticula and Pouches P haryngeal Tumors P haryngeal Foreign Bodies Esophageal Motility Disorders P rimary Nonspecific Esophageal Motility Disorder Diffuse Esophageal Spasm A chalasia Nutcracker Esophagus Secondary Motility Disorders ESOPHAGITIS Gastroesophageal Reflux Disease and Barrett’s Esophagus Infectious Esophagitis C andida Esophagitis V iral Esophagitis T uberculosis C austic Esophagitis Drug-induced Esophagitis Radiation-induced Esophagitis Miscellaneous Causes ESOPHAGEAL DIVERTICULA Intramural Pseudodiverticulosis ESOPHAGEAL VARICES TRAUMATIC LESIONS F oreign Bodies MISCELLANEOUS LESIONS ESOPHAGEAL TUMORS Benign Tumors Malignant Tumors C arcinoma Metastases INDENTATIONS AND DISPLACEMENT RECENT ADVANCES AND FUTURE DIRECTIONS REFERENCES Benign Lesions of Stomach and Small Intestine Gaurav S Pradhan T echniques of Examination Hypotonic Duodenography MDCT and 3D Imaging Techniques Erosive and Ulcerative Lesions of Stomach and Duodenum NARROWING OF STOMACH THICKENED GASTRIC FOLDS AND FILLING DEFECTS REDUCED OR ABSENT RUGAL FOLDS GAS IN WALL OF STOMACH GASTRIC OUTLET OBSTRUCTION GASTRIC DILATATION WITHOUT OBSTRUCTION POSITIONAL ABNORMALITIES THICKENING OF DUODENAL FOLDS DUODENAL FILLING DEFECTS DUODENAL NARROWING OR OBSTRUCTION EXTRINSIC IMPRESSION ON BULB WIDENING OF DUODENAL SWEEP REFERENCES MISCELLANEOUS ABNORMALITIES C ONCLUSION Malignant Lesions of the Stomach and Small Intestine Sanjay Thulkar, Arun Kumar Gupta CARCINOMA OF THE STOMACH Risk Factors for Gastric Cancer Clinical Features P a thology Diagnosis Barium UGI Series Features of Gastric Cancer Staging CT Features of Gastric Cancer Other Investigations for Preoperative Staging of Gastric Cancer Limitations of CT T r eatment and Prognosis CARCINOMA OF THE SMALL BOWEL A denocarcinoma of the Small Bowel Clinical Features Barium Studies of the Small Bowel Barium Study Features of Carcinoma of the Small Bowel CT of the Small Bowel CT Features of Adenocarcinoma of the Small Bowel MRI of the Small Bowel Staging T r eatment and Prognosis F ollow-up C arcinoid C arcinoids of the Stomach and Duodenum Imaging Features of Gastric and Duodenal Carcinoids Small Bowel Carcinoids Imaging Features of Small Bowel Carcinoids Differential Diagnosis of Carcinoids T r eatment and Prognosis GASTROINTESTINAL STROMAL TUMORS Imaging Features of GIST T r eatment of GIST METASTASES TO THE STOMACH AND SMALL BOWEL MISCELLANEOUS MALIGNANT TUMORS OF STOMACH AND SMALL BOWEL REFERENCES Abdominal Tuberculosis P a thological Findings Clinical Spectrum TUBERCULOUS PERITONITIS P eritoneum Omentum Small Bowel Mesentery TUBERCULAR LYMPHADENITIS GASTROINTESTINAL TUBERCULOSIS ESOPHAGEAL TUBERCULOSIS GASTRIC TUBERCULOSIS DUODENAL TUBERCULOSIS TUBERCULOSIS ENTERITIS F irst Stage Second Stage Third Stage ILEOCECAL TUBERCULOSIS Group 1 Group 2 Group 3 Group 4 APPENDICEAL TUBERCULOSIS 41 C OLONIC TUBERCULOSIS ANORECTAL TUBERCULOSIS 29 Enterolithiasis VISCERAL TUBERCULOSIS Liver and Spleen P ancreas V ascular Involvement in Gastrointestinal T uberculosis AIDS AND TUBERCULOSIS P ercutaneous Biopsy in the Diagnosis of Abdominal Tuberculosis NUCLEAR IMAGING REFERENCES Nontubercular Inflammatory Bowel Diseases Birinder Nagi, Anupam Lal, Manphool Singhal INFLAMMATORY BOWEL DISEASES RADIOLOGY ULCERATIVE COLITIS CROHN’S DISEASE A ctive Inflammatory Subtype F ibrostenotic Subtype F istulizing/Perforating Subtype Reparative or Regenerative Subtype C omplications of IBD Extraintestinal Complications Ulcerative Colitis versus Crohn’s Disease Crohn’s Disease versus Tuberculosis Distribution of Disease O THER INFLAMMATORY BOWEL DISEASES Ischemic Bowel Disease Appendicitis Epiploic Appendagitis Diverticulitis Radiation Colitis P seudomembranous Colitis Amebic Colitis T yphilitis C eliac Disease Eosinophilic Enteritis Amyloidosis REFERENCES C olorectal Malignancies Naveen Kalra, Mandeep Kang EPIDEMIOLOGY RISK FACTORS P A THOGENESIS CLINICAL FEATURES P A THOLOGY R OUTE OF SPREAD STAGING R OLE OF RADIOLOGY P rimary Tumor (T ) Regional Lymph Node (N) Distant Metastasis (M) S tage Grouping 24 Screening for Colorectal Cancer DIAGNOSTIC METHODS Plain Radiographs Barium Enema Problem Areas in Barium Studies Ultrasound Computed Tomography CT Colonography MR Imaging Arteriography MR Colonography Immunoscintigraphy Positron Emission Tomography Recent Advances Other Malignant Tumors of Colon CONCLUSION REFERENCES L ymphoma of the Gastrointestinal Tract Anupam Lal, Mahesh Prakash P A THOLOGY STAGING CLINICAL PRESENTATION AND INVESTIGATION Imaging Modalities Barium Studies and Computed T omography CT Enteroclysis Magnetic Resonance Imaging Radionuclide Imaging Radiological Findings Esophagus Stomach Small Intestine Appendix C olon and Rectum L ymphoma Variants Burkitt’s Lymphoma Mediterranean Lymphoma Multiple Lymphomatous Polyposis Imaging of Appendix NORMAL IMAGING APPEARANCE A CUTE APPENDICITIS P a thophysiology C linical Picture IMAGING C onventional Radiography Ultrasonography U S Technique Sonographic Findings Doppler Imaging P itfalls in Sonographic Diagnosis CT Technique CT Findings in Acute Appendicitis Magnetic Resonance Imaging WHICH MODALITY AND WHEN MUCOCELE OF APPENDIX PRIMARY APPENDICEAL INTUSSUSCEPTION POSTOPERATIVE APPENDICEAL DEFECTS TUMORS OF THE APPENDIX Liver Anatomy and T echniques of Imaging Smriti Hari NORMAL ANATOMY BISMUTH AND COUINAUD’S SEGMENTAL NOMENCLATURE ULTRASONOGRAPHY T echnique Ultrasound Contrast Agents Sonographic Anatomy Intraoperative Ultrasonography C omputed Tomography CT Anatomy Magnetic Resonance Imaging T echnique Magnetic Resonance Imaging Contrast Agents Magnetic Resonance Anatomy ANGIOGRAPHY T echnique Anatomy POSITRON EMISSION TOMOGRAPHY REFERENCES Benign Focal Lesions of the Liver Sapna Singh, Veena Chowdhury CLASSIFICATION HEPATIC CYSTS Ultrasonography Nuclear Scintigrams Angiogram MRI C ONGENITAL HEPATIC FIBROSIS AND POLYCYSTIC LIVER DISEASE BILIARY CYSTADENOMA U S G and CT MR Imaging BILE DUCT HAMARTOMA HEMANGIOMA P a thology Imaging Features of Cavernous Hemangiomas Plain Film Findings USG and CT Microbubble-enhanced USG Multiple Phase Imaging MRI Red Blood Cell Scintigraphy MR Imaging Characteristics in Giant Hemangioma of the Liver Angiographic Findings HEPATOCELLULAR ADENOMA USG T riphasic Study Radionuclide Scintigraphy MRI Angiograms FOCAL NODULAR HYPERPLASIA F ocal Nodular Hyperplasia and Hepatic Adenoma: Differentiation with Low Index P a thology Imaging Features USG C olor Doppler C ontrast-enhanced USG Hemodynamic Characterization of F ocal Nodular Hyperplasia Nuclear Scintigraphy Hepatic Adenoma and Focal Nodular Hyperplasia: MR Findings with Super parama NODULAR REGENERATIVE HYPERPLASIA ADENOMATOUS HYPERPLASTIC NODULE MRI PEDIATRIC LIVER TUMORS Mesenchymal Hamartoma LIPOMATOUS TUMORS MRI Infantile Hemangioendothelioma USG MRI Hepatic Arteriograph FOCAL INFLAMMATORY LESIONS OF LIVER Bacterial (Pyogenic) Liver Abscess P athology Plain Film Findings USG ERCP CT and MR Imaging Amebic Abscess P athology Plain Film Findings Nuclear Scintigrams USG MRI C omplications F ungal Hepatic Abscesses Imaging Features H Y D A TID DISEASE Hydatid Cyst Structure Hepatic Hydatid Disease Imaging Features Plain Film Findings Nuclear Scintigraphy MRI L ocal Complications Intrahepatic Complications Exophytic Growth T r ansdiaphragmatic Thoracic Involvement P erforation into Hollow Viscera P ortal Vein Involvement P eritoneal Seeding Biliary Communication Abdominal Wall Invasion HEPATIC TUBERCULOSIS P a thology Imaging Features Plain Film Findings Nuclear Scintigraphy USG HEPATIC SCHISTOSOMIASIS Plain Film Findings USG MRI HEPATIC PNEUMOCYSTIS CARINII INFECTION Miscellaneous Lesions F atty Infiltration Hematoma Biloma REFERENCES Malignant Focal Lesions of the Liver Raju Sharma, Madhusudhan KS PRIMARY MALIGNANT FOCAL LESIONS Hepatocellular Carcinoma Clinical Presentation Imaging in HCC Ultrasonography C omputed Tomography Magnetic Resonance Imaging Angiography Interventional Techniques Intrahepatic Cholangiocarcinoma Imaging F ibrolamellar Hepatocellular Carcinoma Hepatoblastoma Imaging Epithelioid Hemangioendothelioma Imaging Angiosarcoma SECONDARY MALIGNANCIES Metastatic Disease Ultrasonography C omputed Tomography Magnetic Resonance Imaging Image-guided Biopsy L ymphoma REFERENCES Diffuse Liver Diseases Ashu Seith Bhalla, Harsh Kandpal, Sanjay Thulkar F A TTY LIVER (HEPATIC STEATOSIS) Ultrasonography C omputed Tomography Magnetic Resonance Imaging C omputed Tomography Magnetic Resonance Imaging A lcoholic Hepatitis Radiation Hepatitis HEPATITIS V iral Hepatitis Ultrasonography HEMOCHROMATOSIS AND HEMOSIDEROSIS C omputed Tomography Magnetic Resonance Imaging AMYLOIDOSIS WILSON’S DISEASE GRANULOMATOUS DISEASES T uberculosis Sarcoidosis Schistosomiasis Liver Fluke or Fasciola Hepatica CIRRHOSIS Ultrasonography C omputed Tomography Magnetic Resonance Imaging M ALIGNANT DIFFUSE LIVER DISEASES Imaging of Obstructive Biliopathy R aju Sharma, Harsh Kandpal Ultrasonography Endoscopic Ultrasonography C omputed Tomography Hepatobiliary Scintigraphy Magnetic Resonance Imaging Endoscopic Retrograde C holangiopancreatography BENIGN LESIONS CAUSING OBSTRUCTIVE BILIOPATHY C holedocholithiasis Ultrasonography C omputed Tomography Magnetic Resonance Cholangiopancreatography Benign Strictures P ostoperative Biliary Strictures P ostinflammatory Strictures Bile Duct Fistula Mirizzi Syndrome C holedochal Cysts P rimary Sclerosing Cholangitis P rimary Biliary Cirrhosis Recurrent Pyogenic Cholangitis P arasitic Diseases Bacterial Cholangitis and Aids-related Biliary Abnormalities Rare Infections A mpullary Stenosis P ortal Biliopathy Hemobilia Benign Tumors of the Bile Duct M ALIGNANT LESIONS CAUSING OBSTRUCTIVE BILIOPATHY C arcinoma Gallbladder C holangiocarcinoma Intrahepatic (Peripheral) Cholangiocarcinoma Hilar Cholangiocarcinoma (Klatskin Tumor) Extrahepatic Cholangiocarcinoma C arcinoma Head of the Pancreas Other Malignant Tumors of Biliary Tract REFERENCES Clinical Aspects of Liver Cirrhosis: A Perspective for the Radiologists Shashi Bala Paul, Shivanand Gamanagatti, Arun Kumar Gupta, Subrat Kumar Achary EPIDEMIOLOGY P A THOLOGY CAUSES AND RISK FACTORS OF CIRRHOSIS NATURAL HISTORY AND PROGNOSIS SEVERITY OF CIRRHOSIS TYPES OF CIRRHOSIS DIAGNOSIS OF CIRRHOSIS Endoscopy Liver Biopsy Imaging in Cirrhosis C OMPLICATIONS OF CIRRHOSIS C irrhosis and Hepatocellular Carcinoma Screening Tests Surveillance Intervals P r otocol for HCC Surveillance C ost Effectiveness TREATMENT OF CIRRHOSIS T r eatment of Complications C ONCLUSION REFERENCES Imaging and Interventions in Pancreatitis Ashu Seith Bhalla, Chandan Jyoti Das A CUTE PANCREATITIS Classification Assessment of Severity Role of Imaging in Patient Management C omputed Tomography CT Protocol CT Findings in Acute Pancreatitis MILD ACUTE PANCREATITIS OR EDEMATOUS PANCREATITIS SEVERE ACUTE PANCREATITIS A cute Fluid Collections A cute Pseudocyst P ancreatic Abscess P ancreatic Necrosis V ascular Complications Extrapancreatic Adjacent Organ Involvement Staging of Acute Pancreatitis Magnetic Resonance Imaging P ercutaneous Cross-sectional Image-guided Interventions CHRONIC PANCREATITIS Etiology and Pathophysiology Plain Films Imaging in Chronic Pancreatitis Endoscopic Ultrasonography Endoscopic Retrograde Pancreatography MR Cholangiopancreatography Magnetic Resonance Imaging A dvantages of MRP over ERP A dvantages of ERP over MRP P ositron-emission Tomography Imaging in Special Situations and Variants SUMMARY REFERENCES T umors of Pancreas ANATOMY T opography Histology Physiology MACROANATOMY Ductal System V ascular System P A THOLOGY Classification of Tumors (Based on Predominant C ell Type and Radiological App Epithelial Exocrine Other Pancreatic Neoplasms P ANCREATIC ADENOCARCINOMA P A THOLOGICAL ANATOMY AND BIOLOGICAL BEHAVIOR Endocrine Islets Cell Tumors Ultrasonography C olor Doppler Flow Imaging Endoscopic US C omputed Tomography Dual Phase Helical CT Magnetic Resonance Imaging MRCP ERCP PET DSA T umor Markers in Pancreatic Carcinoma Laparoscopy F ine Needle Aspiration STAGING OF PANCREATIC TUMORS CYSTIC TUMORS Mucinous Cystic Neoplasms Microcystic Adenoma (Serous Cystadenoma) Intraductal Papillary Mucinous T umors/Neoplasms Solid and Papillary Epithelial T umors/ Neoplasms UNCOMMON CYSTIC PANCREATIC TUMORS C y stic Endocrine Tumors Glucagonoma V ipoma Insulinoma Gastrinoma Somatostatinoma Nonfunctioning ICTs Arteriography and Venous Sampling Arterial Stimulation and Venous Sampling Endoscopic US UNCOMMON SOLID PANCREATIC TUMORS P ancreatoblastoma A cinar Cell Carcinomas T umors of Neural Origin Metastasis L ymphoma REFERENCES Imaging in Portal Hypertension V eena Chowdhury, Rashmi Dixit ANATOMY AND COLLATERAL CIRCULATION T ributary Collaterals (Hepatofugal) Developed Collaterals (Hepatofugal) Bridging Collaterals (Hepatopedal) ETIOLOGY OF PORTAL HYPERTENSION NONINVASIVE RADIOLOGICAL EVALUATION Barium Contrast Examinations Sonography and CDFI C omputed Tomographic Imaging Magnetic Resonance Imaging MR Portography P itfalls 22 INTRAHEPATIC PORTAL HYPERTENSION Organ Parameters Splenomegaly Ascites V ascular Evaluation P ortal Vein, Superior Mesenteric Vein and Splenic Vein Diameter P itfalls of Portal Flow Assessment P ortosystemic Venous Collaterals 12 Assessment of Hepatic Veins Arterial Evaluation Extrahepatic Portal Hypertension: Prehepatic P ortal Vein Occlusion Spleinic Vein Occlusion SMV Occlusion Extrahepatic Portal Hypertension: Posthepatic Hyperkinetic Portal Hypertension 6 MEDICAL TREATMENT FOLLOW-UP E v aluation of Surgical Portosystemic Shunts and Tips T r ansjugular Intrahepatic Portosystemic Shunt REFERENCES Hepatic Venous Outflow Tract Obstruction DIAGNOSTIC TECHNIQUES EVALUATION OF HEPATIC VEINS IN BCS EVALUATION OF IVC IN BCS ASSESSMENT OF LIVER PARENCHYMA IN BCS C ollateral Pathways M ANAGEMENT OF BCS REFERENCES Gastrointestinal Hemorrhage Deep N Srivastava, Shivanand Gamanagatti Angiography T echnical Considerations Radionuclide Studies Angiographic Findings in GIH C omputed Tomography Barium Studies C ONTROL OF GASTROINTESTINAL HEMORRHAGE T r anscatheter Embolization SPECIFIC SITUATIONS IN GI HEMORRHAGES Upper Gastrointestinal Hemorrhage Hemobilia L o w er Gastrointestinal Hemorrhage C olonic Diverticula P ancreatitis and UGIH Meckel’s Diverticulum Angiodysplasia Hemangioma and Arteriovenous Malformation T umors Inflammatory Bowel Diseases and Small Bowel or Colonic Ulcers Others REFERENCES Interventions in Obstructive Biliopathy Mandeep Kang, Naveen Kalra INDICATIONS FOR BILIARY DRAINAGE P ercutaneous Transhepatic C holangiography P r eprocedure Evaluation and Preparation P ercutaneous Transhepatic Biliary Drainage F luoroscopic Guidance T echnique Internal and External Drainage C omplications of Biliary Drainage F ollow-up of Biliary Catheters Biliary Stenting Intraluminal Brachytherapy with PTBD P ercutaneous Cholecystostomy T echnique Dilatation of Benign Biliary Structures C omplications Gallbladder Biopsy BIBLIOGRAPHY Interventional Treatment of Liver Tumors Deep N Srivastava, Shivanand Gamanagatti TREATMENT OF LIVER TUMORS Hepatocellular Carcinoma Chemical Ablation Radiofrequency Ablation T r anscatheter Arterial Chemoembolization T r anscatheter Arterial Embolization T r ansarterial Radionuclide Therapy Right Portal Vein Embolization Hepatic Vein Stenting METASTATIC TUMORS OF LIVER BENIGN TUMORS OF LIVER C ONCLUSION REFERENCES P ercutaneous Nonvascular Gastrointestinal Tract Interventions Shivanand Gamanagatti, Deep N Srivastava PERCUTANEOUS GASTROSTOMY Indications Other Indications C ontraindications T echnique C omplications PERCUTANEOUS JEJUNOSTOMY Indications T echnical Difficulty T echnique (Figs 1A to D) C omplications ESOPHAGEAL STENTING S t ent Designs C ommercially Available Stents (Fig. 2) 18 S t ent Selection Indications T echnique (Figs 3 and 4) P ostprocedure Care C omplications E arly Complications L ate Complications GASTRODUODENAL STENTING Indications C ontraindications A v ailable Devices Endoscopic versus Fluoroscopic Placement T echnique (Figs 5A to D) P ostprocedure Care C omplications C OLORECTAL STENTING Indications P ostprocedure Follow-up C omplications PERCUTANEOUS ENTEROCUTANEOUS FISTULA CLOSURE WITH N-BUTYL-2-CYANOACRYLATE T echnical Considerations F luoroscopic Guidance Mechanism of Action of the Glue (N-butyl-2-cyanoacrylate) P r erequisites T echnical Consideration P r eparation T echnique (Figs 6A to D) REFERENCES Interventional Radiology in Portal Hypertension TRANSJUGULAR INTRAHEPATIC PORTOSYSTEMIC SHUNT Indications of TIPS 2 C ontraindications of TIPS 2 C omplications of TIPS 2 REVISION OF OCCLUDED SURGICAL SHUNT ARTERIOPORTAL FISTULAS RECANALIZATION OF OCCLUDED PORTAL VEIN AND ITS TRIBUTARIES P ARTIAL SPLENIC EMBOLIZATION PERCUTANEOUS TRANSHEPATIC VARICEAL EMBOLIZATION A ngiographic Vasopressin Infusion B ALLOON-OCCLUDED RETROGRADE TRANSVENOUS OBLITERATION OF GASTRIC VARICES BUDD–CHIARI SYNDROME RECENT ADVANCES REFERENCES Genitourinary Imaging C urrent Status of Conventional T echniques in Urogenital Imaging Naveen Kalra, Manavjit Singh Sandhu B A CKGROUND Ultrasound of Urogenital Tract: T echniques and Normal Appearances Anju Garg KIDNEYS AND URETERS T echnique Normal Sonographic Appearance Normal Variations Doppler Evaluation T echnique Normal Doppler Pattern Ureters URINARY BLADDER AND URETHRA T echnique Indications Urethra Normal Sonographic Appearance PROSTATE AND SEMINAL VESICLES T echnique Normal Sonographic Appearance Normal Variants SCROTUM T echnique Normal Appearances Doppler Evaluation Indications PENIS T echnique and Normal Appearance UTERUS AND ADNEXA T echnique Normal Appearances CERVIX AND VAGINA ADNEXA Indications for Evaluation of Uterus and Adnexa Doppler Evaluation Indications T hree-dimensional Sonography Indications Extended Field of View (EFOV) Imaging 33 Elastography 34 C ontrast-enhanced Ultrasonography (CEUS) C ONCLUSION REFERENCES C omputed Tomography of Urogenital Tract: Techniques and Normal Appearances NORMAL RENAL STRUCTURE AND CT ANATOMY OF KIDNEYS NORMAL CT ANATOMY OF THE PELVIS MULTIDETECTOR CT Advantages of Renal Multidetector Row CT Increased Diagnostic Images Increased Temporal Resolution Isotropic Data Acquisition and Increased Spatial Resolution EXAMINATION TECHNIQUE AND IMAGING PROTOCOLS OF MULTI DETECTOR ROW CT OF THE Noncontrast CT Contrast-enhanced CT Oral Contrast Medium Administration of Intravenous Contrast Medium PHASES OF RENAL ENHANCEMENT/ MULTIPHASIC HELICAL CT Normal CT Nephrogram Corticomedullary Phase (CMP) Nephrographic Phase (NP) Pathological CT Nephrogram Excretory Phase (EP) IMAGE PROCESSING AND POSTPROCESSING TECHNIQUES Multiplanar Reformation (MPR) Maximum Intensity Projection (MIP) Shaded Surface Displays (SSD) V olume Rendered Technique (VRT ) MULTIDETECTOR CT UROGRAPHY C alculi Renal Tumors Urothelial Tumors PUJ Obstruction C ongenital Anomalies MDCTU Protocol Split Bolus MDCT Urography with Synchronus Nephrographic and Exceretory Phase C ompression Saline Infusion Diuretic Administration P atient Positioning Image Interpretation MULTIDETECTOR CT IN RENAL MASSES MDCT IN BLUNT RENAL TRAUMA MDCT IN EVALUATION OF FLANK PAIN AND URINARY CALCULI MDCT IN RENAL INFECTIONS HELICAL CT FOR LOWER URINARY TRACT AND PELVIS CT ANGIOGRAPHY (CTA) OF RENAL ARTERIES VIRTUAL CYSTOSCOPY/ENDOSCOPY REFERENCES MRI of Urogenital Tract: Techniques and Normal Appearances P aramjeet Singh, Sameer Vyas KIDNEY T echniques and Recommended Imaging Sequences MR Urography Renal Angiography and Venography Normal Appearances URINARY BLADDER Normal Appearance T echnique and Recommended Sequences PROSTATE GLAND Normal Appearance of Prostate on MRI UTERUS AND OVARIES T echnique and Recommended Sequences Normal MR Appearance PELVIC LYMPH NODES C urrent Status of Nuclear Medicine in Urinary Tract Imaging Rakesh Kumar, Shamim Ahmed Shamim, Rama Mohan Reddy 99m T c-MAG-3 99m T c-LLEC RADIOPHARMACEUTICALS 99m T c-DTPA 123 I-OIH 99m T c-GHA 99m T c-DMSA IMAGING TECHNIQUES Renal Dynamic Scintigraphy Dynamic Renography Normal Dynamic Renal Study Diuretic Renography C aptopril Renography C ortical Scintigraphy/Static Renal Scintigraphy Imaging Techniques Radionuclide Cystography Clinical Applications Measurement of Renal Function P ositron Emission Tomography—Computed T omography (PET-CT ) Renal Cancer Urinary Bladder Cancer REFERENCES C urrent Status of Urographic C ontrast Media Sumedha Pawa, Gaurav S Pradhan DEVELOPMENT OF CONTRAST MEDIA TYPES OF RADIOGRAPHIC CONTRAST MEDIA PHARMACOKINETICS OF EXTRACELLULAR IODINATED CONTRAST AGENTS PHYSICOCHEMICAL PROPERTIES OF C ONTRAST MEDIA W a t er Solubility, Hydrophilicity and Osmolality V iscosity P harmaceutical Characteristics: T he Role of Formulation ADVERSE REACTIONS TO CONTRAST MEDIA Guidelines on Prevention and Management of Acute Reactions Guidelines on Late Adverse Reactions Guidelines on Renal Adverse Reactions Guidelines on Prevention and Management of Extravasation of Contrast Media EVALUATING THE PATIENT BEFORE C ONTRAST MEDIA INJECTION AND IDENTIFYING GROU A GGRAVATION OF DISEASES B Y CONTRAST MEDIA Guidelines on the Use of Iodinated Contrast Media in Patients with Thyroid Di Guidelines on the Use of Contrast Media in P a tients with Catecholamine-prod Guidelines on Interaction between Contrast Media with Other Drugs and Clinica Guidelines on the Use of Iodinated Contrast Media during Pregnancy or Lactati SELECTIVE VERSUS UNIVERSAL USE OF NONIONIC CONTRAST MATERIAL STRATEGIES FOR CLINICAL USE: C OST CONTAINMENT T u bercular Infection of the Urinary Tract Ashu Seith Bhalla, Arun Kumar Gupta, Raju Sharma P A THOGENESIS CLINICAL PICTURE LABORATORY INVESTIGATIONS CYSTOSCOPY RADIOLOGICAL EXAMINATION Plain Films Intravenous Urography (IVU) Kidney Ureter Urinary Bladder Urethral TB Retrograde Pyelography Ultrasonography Kidney Ureter C omputed Tomography Kidney Ureter MRI C OMPLICATIONS Differential Diagnosis Genitourinary Tuberculosis in HIV REFERENCES Nontubercular Infections of the Urinary Tract Naveen Kalra, Ajay Kumar A CUTE PYELONEPHRITIS P a thology Radiology A CUTE FOCAL BACTERIAL NEPHRITIS RENAL AND PERIRENAL ABSCESS EMPHYSEMATOUS PYELONEPHRITIS P Y ONEPHROSIS CHRONIC PYELONEPHRITIS REFLUX NEPHROPATHY X ANTHOGRANULOMATOUS P Y ELONEPHRITIS HIV-ASSOCIATED NEPHROPATHY F A T PROLIFERATION IN THE KIDNEY RENAL PAPILLARY NECROSIS M ALACOPLAKIA SQUAMOUS METAPLASIA P ARASITIC INFECTION P athology of Renal Tumors K usum Joshi ADULT RENAL TUMORS Renal Cell Tumors Clear Cell (or Nonpapillary or C onventional) RCC Multilocular Cystic Renal Cell Carcinoma P apillary (or Chromophilic) Renal Cell Carcinoma Chromophobe Renal Cell Carcinoma C ollecting Duct (Duct Bellini) RCC (CDC) Renal Medullary Carcinoma Renal Carcinomas Associated with XP11.2 T r anslocations/TFE3 Gene Fusions Mucinous Tubular and Spindle Cell C arcinoma Renal Cell Carcinoma—Unclassified P apillary Adenoma Renal Oncocytoma MOLECULAR/GENETIC FEATURES OF RENAL CELL CARCINOMA Clear Cell Renal Cell Carcinoma P apillary Renal Adenomas and Carcinomas Renal Oncocytoma Chromophobe Renal Carcinomas C ollecting Duct Carcinomas Sarcomatoid Transformation in RCC NUCLEAR GRADING P a thological Staging AJCC Staging METANEPHRIC TUMORS MESENCHYMAL RENAL TUMORS OCCURRING IN ADULTS Angiomyolipoma (AML) Epithelioid Angiomyolipoma Juxtaglomerular Cell Tumor Renomedullary Interstitial Cell Tumor Nephroblastoma [Wilms’ Tumor (WT)] PEDIATRIC RENAL TUMORS Gross Features Microscopic Features Anaplasia Nephrogenic Rests C y stic Partially Differentiated Nephroblastoma (CPDN) C ongenital Mesoblastic Nephroma (CMN) Clear Cell Sarcoma of Kidney (CCSK) Rhabdoid Tumor BIBLIOGRAPHY P athology of Gynecological Malignancies Radhika Srinivasan NEOPLASMS OF THE OVARY Ovarian Surface Epithelial Tumors Serous Tumors Mucinous Tumors Endometrioid Tumors Clear Cell Adenocarcinoma of the Ovary Brenner’s Tumor Malignant Mixed Müllerian Tumor (MMMT) Germ Cell Tumors Dysgerminoma Yolk Sac Tumor (Endodermal Sinus Tumor) Immature Teratoma Mature Cystic Teratoma Carcinoid Tumor and Strumal Carcinoid Sex Cord Stromal Tumors Granulosa Cell Tumor Juvenile Granulosa Cell Tumor (JGCT) Thecoma, Fibroma and Other Tumors Sertoli-Leydig Cell Tumor Metastatic Tumors CARCINOMA OF THE FALLOPIAN TUBE MALIGNANT TUMORS OF THE UTERUS Type I: Endometrioid Adenocarcinoma Type II: Carcinoma Endometrial Stromal Tumors MMMT Carcinosarcoma Müllerian Adenosarcoma Leiomyosarcoma CARCINOMA OF THE UTERINE CERVIX Invasive Cervical Carcinoma MALIGNANT TUMORS OF THE VULVA Squamous Cell Carcinoma Vulvar Paget’s Disease BIBLIOGRAPHY Imaging in Renal Tumors BALLS VERSUS BEANS Imaging Modalities Plain Films Intravenous Urograms Magnetic Resonance Imaging Angiography Retrograde and Antegrade Pyelography RENAL CELL CARCINOMA 23 Ultrasound Doppler Magnetic Resonance Imaging Angiography Nuclear Scintigraphy Staging of Renal Cell Carcinoma 7-11 F ollow-up UROTHELIAL TUMOR T r ansitional Cell Carcinoma Ultrasonography C omputed Tomography and Magnetic Resonance Imaging 13-15 Staging Squamous Cell Carcinoma C ollecting Duct Carcinoma (Bellini Duct C a r cinoma/Renal Medullary Carcino Renal Sarcoma 3 L ymphoma Renal Metastasis 23 Oncocytoma Renal Adenomas MIXED EPITHELIAL AND STROMAL TUMORS (MESTs) 3,26 CYSTIC NEPHROMA ANGIOMYOLIPOMA PNET OF THE KIDNEY Biopsy 2,3,35 Incidental Solid Renal Mass Imaging of Urinary Bladder and Urethra Anupam Lal, Paramjeet Singh ANATOMY Urinary Bladder Urethra Male Urethra F emale Urethra P lain Films Retrograde Urethrography V oiding Cystourethrography (VCUG) C y stography Urodynamic Studies of the L o w er Urinary Tract Ultrasonography Magnetic Resonance Imaging Radionuclide Imaging SPECIFIC DISEASES OF THE URINARY BLADDER Bladder Diverticulae Urachal Anomalies Exstrophy Other Anomalies Neurogenic Bladder Infections A cute Cystitis Chronic Cystitis C ystitis Cystica Malakoplakia Schistosomiasis Extravesical Processes Bladder Tumors SPECIFIC DISEASES OF URETHRA Gonococcal and Nongonococcal Urethritis C ondyloma Acuminata (Venereal Warts) T uberculosis Urethral Strictures Urethral Calculi Urethral Diverticulum T umors of the Male Urethra T umors of the Female Urethra Metastatic Tumors of Urethra Imaging of the Prostate Gland P aramjeet Singh, Anupam Lal ANATOMY IMAGING MODALITIES 3 Ultrasonography C omputed Tomography BENIGN PROSTATIC HYPERPLASIA Ultrasonography Magnetic Resonance Imaging Other Imaging Modalities PROSTATE CANCER T r ansrectal Ultrasonography C omputed Tomography Magnetic Resonance Imaging P ositron Emission Tomography EVALUATION OF THE METASTASES PROSTATITIS AND PROSTATIC ABSCESS PROSTATIC CYSTS REFERENCES Renal Cystic Diseases V eena Chowdhury EMBRYOLOGY CLASSIFICATION Bosniak Classification System IMAGING MODALITIES Conventional Radiography Ultrasonography Computed Tomography Magnetic Resonance Imaging Angiography Cyst Puncture/Cystography SIMPLE RENAL CYST Pathology Clinical Features Complicated Simple Renal Cyst Hemorrhagic Cyst Infected Cyst Cyst Rupture Carcinoma in Wall of a Preexisting Cyst ATYPICAL SIMPLE CYSTS Calcified Cyst Hyperdense Cyst Septated Cysts Multiple Simple Cysts Localized Cystic Disease POLYCYSTIC KIDNEY DISEASE Autosomal Dominant Polycystic Kidney Disease (ADPKD) (Potter Type III) Pathology Clinical Features Autosomal Recessive Polycystic Kidney Disease (ARPKD) (Potter Type I) Imaging Features Clinicopathologic Features Imaging Features MEDULLARY SPONGE KIDNEY Imaging Features MEDULLARY CYSTIC DISEASE Clinical Features Clinicopathologic Features Imaging Features MULTICYSTIC DYSPLASTIC KIDNEY (MCDK) (POTTER TYPE II) Pathology Imaging Features CYSTIC DISEASE ASSOCIATED WITH RENAL NEOPLASM Acquired Cystic Kidney Disease (ACKD) Clinical Features Imaging Features von Hippel–Lindau Disease (VHL) Pathology Imaging Features TUBEROUS SCLEROSIS (TSC) CYSTS OF RENAL SINUS MISCELLANEOUS CYSTIC DISEASE Inflammatory Hydatid Cysts Pyogenic Cyst Tuberculous Cysts Pleuricystic Kidney Disease Glomerulocystic Disease Microcystic Disease CYSTIC RENAL CELL CARCINOMAS Renovascular Hypertension Niranjan Khandelwal, Anupam Lal, Manphool Singhal P A THOPHYSIOLOGY ETIOLOGY OF RENAL ARTERY STENOSIS A therosclerosis F ibromuscular Dysplasia Nonspecific Aortoarteritis/Takayasu’s A rteritis 22-24 Middle Aortic Syndrome 25-27 SCREENING FOR RENOVASCULAR H Y PERTENSION C linical C linical and Biochemical Tests IMAGING MODALITIES FOR ASSESSMENT OF RAS Radionuclide Renal Scintigraphy P rinciples of Angiotensin-converting Enzyme Inhibitor (Captopril) Scintigrap P r otocol Results Ultrasound C olor Doppler Flow Imaging (CDFI) Direct Approach Indirect Approach CT Angiography (CTA) Magnetic Resonance Angiography C ontrast-enhanced MRA (CE-MRA) Noncontrast-enhanced MR Imaging of the Renal Arteries T OF MRA P hase-contrast (PC) MRA Steady-state Free Precession Magnetic Resonance Angiography Arterial Spin Labeling Renal Angiography F eatures of RAS on Arteriography P ercutaneous Transluminal Renal Angioplasty (PTRA) and Stenting TREATMENT A therosclerotic Disease Renal Artery Stenting F uture Management of RAS T akayasu’s Arteritis/Nonspecific Aortoarteritis Surgical Therapy Renal Artery Stenosis in Children 27,90 C auses Renal Parenchymal Disease and Renal Failure Anupam Lal, Hina Arif Mumtaz DEFINITION AND CLASSIFICATION OF RENAL FAILURE A cute Renal Failure Radiological Approach to Renal P arenchymal Disease C hronic Renal Failure (CRF) R OLE OF IMAGING IN RENAL FAILURE Imaging Techniques P lain Radiography and Urography C olor Doppler Magnetic Resonance Imaging Renal Angiography R adionulceotide Imaging C ontrast Medium-associated Nephropathy IMAGING IN RENAL PARENCHYMAL DISEASE A cute Renal Parenchymal Disease A cute Tubular Necrosis Imaging Features A cute Cortical Necrosis Imaging Features L eukemia Imaging Features A cute Interstitial Nephritis Imaging Features A m yloidosis Imaging Features A m yloidosis of Renal Pelvis Multiple Myeloma Imaging Features P aroxysmal Nocturnal Hemoglobinuria (PNH) C hronic Renal Parenchymal Disease Renal Papillary Necrosis A lport’s Syndrome Imaging Features Benign and Malignant Nephrosclerosis Imaging Features Renal Osteodystrophy C ONCLUSION REFERENCES Renal Transplant Ajay Gulati, Manavjit Singh Sandhu TECHNIQUE C OMPLICATIONS A cute Tubular Necrosis Rejection Renal Artery Thrombosis Renal Artery Stenosis P seudoaneurysm Renal Vein Thrombosis Arteriovenous Fistula P eritransplant Fluid Collections Urinary Complications Malignancy IMAGING TECHNIQUES Radiography Plain Radiography Intravenous Urography C ystography Radionuclide Imaging Ultrasonography (US) C omputed Tomography Magnetic Resonance Imaging Angiography P ercutaneous Interventional Techniques REFERENCES A CKNOWLEDGMENTS Imaging of Obstructive Uropathy and Diseases of Ureter Mahesh Prakash, Mandeep Kang IMAGING OF ACUTE OBSTRUCTION Plain X-ray Intravenous Urography PATHOPHYSIOLOGY Sonography Duplex and Color Doppler Sonography Computed Tomography Radionuclide Renography Magnetic Resonance Imaging IMAGING OF CHRONIC OBSTRUCTION Sonography Intravenous Urography Computed Tomography Magnetic Resonance Imaging INVASIVE TECHNIQUES IN URINARY OBSTRUCTION Antegrade Pyelography Retrograde Pyelography CAUSES OF OBSTRUCTION AND DISEASES OF URETER Congenital Ureteric Obstruction Ureteropelvic Junction Obstruction Ureterocele Primary Megaureter Circumcaval Ureter Acquired Ureteric Obstruction Intraluminal Causes Ureteric Calculus Intramural Causes Ureteral Tumors Transitional Cell Carcinoma Benign Tumors Nonepithelial Tumors Secondary Tumors and Contiguous Infiltration Inflammatory Lesions of Ureter Retroperitoneal Fibrosis Inflammatory Bowel Disease Extrinsic Causes of Ureteral Obstruction Retroperitoneal Neoplasms Pelvic Lipomatosis Gynecological Causes Gastrointestinal Diseases P regnancy-related Dilatation of Ureter Miscellaneous Diseases of Ureter Ureteral Injury Ureteral Herniation Ureteral Fistula REFERENCES Urinary Tract Trauma Atin Kumar, Shivanand Gamanagatti Role of Radiography (Plain Radiographs) Role of Ultrasound RENAL TRAUMA Imaging Work-up in a Patient with Suspected Renal Trauma Role of Intravenous Urography Role of CT Role of Angiography Role of Retrograde Pyelography Role of Radionuclide Renal Scintigraphy Role of MRI Radiological Findings Grade 1 Grade 4 Grade 2 Grade 3 Grade 5 Vascular Contrast Extravasation Renal Trauma with Pre-existing Abnormality Management of Renal Trauma URETERAL TRAUMA Imaging Work-up Role of IVU Classification Role of CT Role of Antegrade and Retrograde Ureterograms Management BLADDER TRAUMA Cystography Conventional Cystography CT Cystography Classification Blunt Trauma Iatrogenic Bladder Trauma Management of Bladder Trauma Penetrating Bladder Trauma URETHRAL TRAUMA Radiology Technique of Urethrography Blunt Urethral Trauma Posterior Urethral Injuries Associated with Pelvic Fracture Anterior Urethral Injury Classification Evaluation before Delayed Urethroplasty Management of Urethral Trauma Penetrating Injury Iatrogenic Injury Female Urethra Imaging the Adrenal Gland Raju Sharma, Ashu Seith Bhalla, Arun Kumar Gupta ANATOMY AND PHYSIOLOGY IMAGING MODALITIES Ultrasound Computed Tomography Magnetic Resonance Imaging Radionuclide Imaging Positron Emission Tomography ADRENAL DISEASES Group I: Adrenal Hyperfunctional Diseases Cushing’s Syndrome ACTH-independent Cushing’s Syndrome Aldosteronism Androgenital Syndrome Pheochromocytoma Group II : Adrenal Insufficiency Group III: Adrenal Diseases with Normal Function Incidentaloma Adenoma versus Metastasis Adrenal Carcinoma Adrenal Lymphoma Adrenal Collision Tumor Adrenal Cyst Myelolipoma Neuroblastoma SUMMARY REFERENCES Retroperitoneum Smriti Hari, Atin Kumar NORMAL ANATOMY IMAGING MODALITIES RETROPERITONEAL COLLECTIONS A ORTA A ortic Aneurysm A o rtic Dissection C ongenital Anomalies V enous Thrombosis INFERIOR VENA CAVA P rimary Tumors of the IVC L Y MPH NODES Benign Lymphadenopathy L ymphoma HIV Lymphadenopathy Metastatic Lymphadenopathy PRIMARY NEOPLASMS Malignant Neoplasms Liposarcomas L eiomyosarcomas Hemangiopericytomas Malignant Fibrous Histiocytomas Other Malignancies Benign Neoplasms P aragangliomas Neurogenic Tumors T eratomas Lipoma RETROPERITONEAL FIBROSIS Iliopsoas Muscle Compartment REFERENCES Nonvascular Interventions in the Urinary Tract Mandeep Kang, Anupam Lal, Naveen Kalra PERCUTANEOUS NEPHROSTOMY Indications A natomy Relevant to Percutaneous Renal Entry T echnique Results C omplications S ystemic Complications P ostprocedure Care L ocal Complications Extended Applications of Percutaneous Nephrostomy Antegrade Ureteric Stenting L arge Bore Track Creation SCLEROTHERAPY FOR RENAL CYSTS PERCUTANEOUS CATHETER DRAINAGE BIOPSIES C OMPLICATED RENAL TRANSPLANT RADIOFREQUENCY ABLATION OF RENAL TUMORS A blation Process E quipment P a tient Selection and Preprocedure Evaluation Guidance P r ocedure P ostprocedure and Follow-up C omplications Other Applications of RFA REFERENCES V ascular Interventions in the Genitourinary Tract Shivanand Gamanagatti, Deep N Srivastava RENAL ARTERY ANGIOPLASTY Imaging the Renal Arteries Renal Artery Angioplasty RENAL ARTERY STENTING Outcome Renal Artery Intervention in Renal Transplants C omplications RENAL ARTERIAL EMBOLIZATION T echnique TRANSCATHETER EMBOLIZATION OF RENAL NEOPLASMS T r anscatheter Embolization of Renal P seudoaneurysms Incidence C auses Risks Posed by the Aneurysm Anatomic/Physiologic Considerations T echnique Results of Embolization C omplications Embolization of End-stage Kidney T echnique UTERINE ARTERY EMBOLIZATION Indications Uterine Leiomyoma Uterine Arteriovenous Malformations P ostsurgical and Postpartum Hemorrhage T echnique Results C omplications V ARICOCELE EMBOLIZATION V A GINAL AVM EMBOLIZATION C ONCLUSION SCROTAL AVM AND TESTICULAR TUMOR EMBOLIZATION REFERENCES Imaging in Female Infertility Rashmi Dixit CAUSES OF INFERTILITY Imaging Modalities Hysterosalpingography 8,9 T r ansvaginal Sonography Sonohysterosalpingography Normal Menstrual Cycle 1 C ervical Factor L eiomyoma Endometrial–Uterine Factor Endometrial Adhesions or Synechiae Endometrial Polyps 9 Mullerian Duct Abnormalities 1,9,21,22 A denomyosis Nontubercular Chronic Endometritis T ubal Factor P eritoneal Factor Endometriosis Genital Tuberculosis Ovarian Factor P olycystic Ovarian Syndrome F ollicular Monitoring Spontaneous Cycles 15,52 Induced Cycles 2,15 P r ediction of Ovulation 1,15,52 L uteinized Unruptured Follicle (LUF) 3,15 Ovarian Hyperstimulation Syndrome F ollicle Aspiration 15,64,65 TREATING INFERTILITY REFERENCES Benign Diseases of the Female Pelvis Alpana Manchanda, Veena Chowdhury BENIGN UTERINE LESIONS C ongenital Uterine Anomalies Classification Class I: Müllerian Agenesis or Hypoplasia Class II: Unicornuate Uterus Class III: Uterus Didelphys Class IV: Bicornuate Uterus Class V: Septate Uterus Class VI: Arcuate Uterus Class VII: Diethylstilbestrol Exposed Uterus L eiomyomas T r eatment of Uterine Leiomyomas O THER BENIGN MESENCHYMAL TUMORS A denomyosis Endometrial Polyps Endometrial Hyperplasia Endometrial Synechiae UTERINE ARTERIOVENOUS MALFORMATION BENIGN OVARIAN MASSES BENIGN CYSTIC MASSES OF PELVIS FUNCTIONAL CYSTS F ollicular Cysts C orpus Luteum Cyst Hemorrhagic Cyst P eritoneal Inclusion Cyst T heca Lutein Cysts P olycystic Ovarian Disease Hydrosalpinx P araovarian Cysts CYSTADENOMAS C OMPLEX MASSES T ubo-ovarian Abscess Endometriosis Dermoid Cyst/Mature Cystic Teratoma Ovarian Torsion Ectopic Pregnancy BENIGN SOLID OVARIAN MASSES C ONCLUSION Imaging in Gynecological Malignancies Sanjay Thulkar, Smriti Hari GYNECOLOGICAL MALIGNANCIES IN INDIA CARCINOMA OF CERVIX Imaging Modalities Conventional Radiography Ultrasonography Computed Tomography Magnetic Resonance Imaging Imaging Strategies in Cervical Cancer Positron Emission Tomography Treatment and Follow-up CARCINOMA OF ENDOMETRIUM Spread and Staging Imaging Modalities Conventional Radiography Ultrasonography Computed Tomography Magnetic Resonance Imaging Imaging Strategies in Endometrial Cancer Treatment and Follow-up OVARIAN MALIGNANCIES Epithelial Ovarian Carcinoma Ultrasonography Screening for Ovarian Cancer Computed Tomography Magnetic Resonance Imaging Positron Emission Tomography Staging and Treatment Imaging Strategies in Carcinoma of Ovary Primary Papillary Serous Carcinoma of the Peritoneum Borderline Epithelial Carcinoma Pseudomyxoma Peritonei Follow-up Imaging Germ Cell Tumors of the Ovary Stromal Sex Cord Tumors Metastatic Ovarian Tumors Rare Ovarian Tumors MISCELLANEOUS GYNECOLOGICAL MALIGNANCIES Carcinoma of Vagina and Vulva Sarcoma of the Uterus Fallopian Tube Carcinoma Gestational Trophoblastic Neoplasms Lymphoma of the Female Genital Tract REFERENCES Imaging of Scrotum Anupam Lal, Manphool Singhal ANATOMY IMAGING MODALITIES T echnique of Sonography MRI of Scrotum C ONGENITAL ANOMALIES OF THE TESTIS C ryptorchidism Miscellaneous Congenital Anomalies A CUTE SCROTUM Epididymitis and Orchitis T orsion Scrotal Trauma TESTICULAR TUMORS Germ-cell Tumors Seminomas Nonseminomatous Germ-cell Tumors Nongerm C ell Testicular Tumors S taging or Testicular Cancer P rimary Tumor ( T ) Regional Lymph Nodes (N) Distant Metastasis (M) Imaging in Evaluation of Testicular Cancer MRI PET C alcifications BENIGN INTRATESTICULAR LESIONS C y sts A drenal Rests EXTRATESTICULAR PATHOLOGIES F luid Collections Epididymal Cysts P ostorchidectomy Scrotum Extratesticular Tumors V aricocele REFERENCES Male Infertility and Erectile Dysfunction Deep N Srivastava, Sanjay Thulkar M ALE INFERTILITY E tiology Imaging Approach in Male Infertility V aricocele T estis Epididymis TRUS Evaluation of Distal Genital Ductal System Seminal Vesicles and Vas Deferens P r ostate Ejaculatory Ducts MRI in Infertility Imaging in Assisted Fertilization ERECTILE DYSFUNCTION A natomy and Physiology of Penile Erection E v aluation of Erectile Dysfunction P harmacopenile Duplex Ultrasonography P eyronie’s Disease C avernosometry C avernosography P enile Angiography P riapism P ediatric Imaging T echnical Considerations in P ediatric Imaging Ashu Seith Bhalla, Arun Kumar Gupta, Amar Mukund MINIMIZING HEAT LOSS SEDATION IMMOBILIZATION NIL PER ORALLY STATUS P harmacological Agents REDUCTION OF RADIATION DOSAGE Radiography and Fluoroscopy R adiographic Equipment Factors Operator-dependent Techniques C omputed Tomography USE OF CONTRAST MEDIA High Osmolality Contrast Media L o w Osmolality Contrast Agents Iso-osmolar Contrast Agents MR Contrast Agents Recent Advances in Pediatric R adiology RADIATION PROTECTION NEURORADIOLOGY THORACIC IMAGING GASTROINTESTINAL IMAGING URORADIOLOGY MUSCULOSKELETAL IMAGING SUMMARY REFERENCES Interventions in Children P ART A: VASCULAR INTERVENTIONS Gurpreet Singh Gulati, Sanjiv Sharma INTRODUCTION P A TIENT PREPARATION History and Physical Examination Informed Consent C oagulation SPECIAL CONSIDERATIONS FOR THE PEDIATRIC PATIENT A nesthesia P a tient Immobilization T emperature Control Diet and Medications Dose of Radiation and Fluids TECHNIQUES Access PROCEDURES Hemangioma EMBOLIZATION Embolization Materials and Substances V ascular Anomalies Arteriovenous Malformation C ervicofacial AVMs Extremity AVMs P ulmonary AVMs Arteriovenous Fistula V ascular Malformation L ymphatic Malformation Hemorrhage Gastrointestinal Hemorrhage P elvic Hemorrhage Hemoptysis Epistaxis P ost-traumatic Hemorrhage P seudoaneurysm Malignant Tumors Chemoembolization Organ Ablation ANGIOPLASTY C omplications of Angioplasty Procedures THROMBOLYSIS FOREIGN BODY REMOVAL C ONCLUSION P ART B: NONVASCULAR INTERVENTIONS Amar Mukund, Ashu Seith Bhalla, Shivanand Gamanagatti P A TIENT EVALUATION SEDATION AND ANESTHESIA B ASIC PROCEDURES F ine Needle Aspiration/Biopsy Sampling Technique A bscess Drainage THORACIC INTERVENTIONS GASTROINTESTINAL INTERVENTIONS Salivary Gland Interventions Esophageal Interventions Gastric Interventions Hepatic Interventions Biliary Intervention P ancreatic Interventions GENITOURINARY INTERVENTIONS Renal Biopsy P ercutaneous Nephrostomy Ureteric Dilatation and Stenting Imaging of Pediatric Trauma Shivanand Gamanagatti, Atin Kumar IMAGING METHODS 6 P otential Uses of the FAST Examination 8 Abdominal Trauma 11-13 Spleen and Liver P ancreas Kidney Bowel and Mesentery Pleura Chest Trauma Blunt Trauma Chest 9 P enetrating Chest Trauma Musculoskeletal Injuries 7,10 Imaging 15 T y pes of Pediatric Fractures Physeal Fractures Salter-Harris Classification Head Trauma 16 Broad Classification A c c ording to Location of Lesions Skull Fractures 17 Extra-axial Injury Secondary Head Injury T r aumatic Ischemia–infarction Spinal Injuries Thoracic and Lumbar Spine Trauma C ONCLUSION REFERENCES Neonatal Respiratory Distress MEDICAL CAUSES OF NEONATAL RESPIRATORY DISTRESS Hyaline Membrane Disease T r ansient Tachypnea of Newborn Neonatal Pneumonia Meconium Aspiration Syndrome P neumothorax SURGICAL CAUSES OF NEONATAL RESPIRATORY DISTRESS C ongenital Lobar Emphysema C ongenital Cystic Adenomatoid Malformation C ongenital Diaphragmatic Hernia Esophageal Atresia with T r acheoesophageal Fistula MISCELLANEOUS CAUSES REFERENCES Childhood Pulmonary Infections Jyoti Kumar PNEUMONIA Epidemiology Imaging V iral Pneumonia Bacterial Pneumonia Exclusion of Other Pathologies Nonresolving Pneumonia EVALUATION OF ASSOCIATED C OMPLICATIONS Pleural Complications L ung Parenchymal Complications P urulent Pericarditis Chronic Effects of Pneumonia TUBERCULOSIS P rimary Pulmonary Tuberculosis P ostprimary Tuberculosis FUNGAL INFECTIONS A ctinomyces Aspergillosis Histoplasmosis C occidioidomycosis P ARASITIC INFESTATIONS Hydatid Disease of the Lung Others PULMONARY INFECTIONS IN HIV-POSITIVE CHILDREN Bacterial Pneumonias Mycobacterial Pneumonias F ungal Pneumonias V iral Pneumonias L ymphocytic Interstitial Pneumonitis C ONCLUSION REFERENCES Chest Masses Sanjay Thulkar, Arun Kumar Gupta L UNG MASSES C ongenital Cystic Adenomatoid Malformation P ulmonary Sequestration Bronchogenic Cyst V ascular Lesions L ung Abscess Hydatid Cysts P ulmonary Metastasis P rimary L ung Tumors MEDIASTINAL MASSES A n t erior Mediastinal Masses Germ C ell Tumors L ymphoma T h ymic Masses L ymphangioma P ericardial Cysts Middle and Posterior Mediastinal Masses Neurogenic Tumors Neuroblastoma and Other Ganglion Tumors Neurofibroma and Schwannoma A n t erior Thoracic Meningocele Extramedullary Hematopoiesis P araganglioma CHEST WALL MASSES C hest Wall Infections Duplication Cysts L ymphangioma Hemangioma Neurofibroma Benign Osseous Masses P rimitive Neuroectodermal Tumor Rhabdomyosarcoma Miscellaneous Malignant Chest Wall Masses P ediatric Airway Ashu Seith Bhalla IMAGING MODALITIES Plain Radiographs F luoroscopy Barium Swallow MDCT MRI UPPER AIRWAY OBSTRUCTION Normal Anatomy (Plain Radiographs) (Figs 1A and B) A CUTE OBSTRUCTION Croup (Acute Laryngotracheobronchitis) Epiglottitis Retropharyngeal Cellulitis and Abscess Exudative Tracheitis F o r eign Body CHRONIC OBSTRUCTION Obstructive Sleep Apnea (OSA) Enlarged Tonsils/Adenoids Glossoptosis Hypopharyngeal Collapse Subglottic Obstruction Subglottic Stenosis P ostintubation Stenosis Subglottic Hemangioma L O WER AIRWAY OBSTRUCTION C entral Airways Extrinsic Causes V ascular Causes V a scular Rings Intrinsic Causes W all Abnormalities V ascular Malformations Intraluminal Causes P eripheral Airways Bronchiolitis/Small Airway Disease L ung Disease of Prematurity Bronchiectasis Asthma REFERENCES Developmental Anomalies of Gastrointestinal Tract Alpana Manchanda, Sumedha Pawa FUNCTIONAL ANATOMICAL C OMBINED ANATOMICAL: FUNCTIONAL P lain Film Radiography C ontrast Studies Ultrasonography ESOPHAGUS Esophageal Atresia and Tracheoesophageal F istula Embryology Clinical Features Classification Radiological Evaluation of Postoperative C omplications STOMACH Microgastria DEVELOPMENTAL OBSTRUCTIVE DEFECTS Gastric Atresia Pyloric Stenosis or Prepyloric Membrane or Antral Web E ctopic Pancreas Hypertrophic Pyloric Stenosis Ultrasonography Barium Study A dult Idiopathic Hypertrophic Pyloric S t enosis (AIHPS) DUODENUM Duodenal Atresia and Stenosis Duodenal Web A nnular Pancreas P r eduodenal Portal Vein SMALL BOWEL A nomalies of Rotation and Fixation Embryology Imaging Features Jejunoileal Atresia and Stenosis Embryology Classification Meconium Ileus Megacystis-microcolon-intestinal Hypoperistalsis Syndrome (Berdon’s Syndrome) Meckel’s Diverticulum Enteric Duplication Clinical Features Imaging Features LARGE BOWEL C olonic Obstruction C olonic Atresia Embryology Clinical Features Imaging Features Hirschsprung’s Disease (Aganglionosis of the Colon) Clinical Features Imaging Features F unctional Immaturity of the Colon/Neonatal F unctional Colonic Obstruction Clinical Features Meconium Plug Syndrome Small Left Colon Syndrome C ONCLUSION REFERENCES Imaging of Anorectal Anomalies Arun Kumar Gupta EMBRYOLOGY OF THE CLOACA RELATED TO ARA Internal Cloaca External Cloaca CLASSIFICATION INFORMATION REQUIRED IN A PATIENT OF ARA CLINICAL CLUES Males F emales IMAGING WORK-UP Invertography C ontrast Studies C ontrast Studies in Males ANORECTAL ANOMALIES IN MALES High Anomalies Anorectal Agenesis without Fistula Anorectal Agenesis with Rectoprostatic Urethral Fistula H or N Type of Rectoprostatic Urethral Fistula Rectovesical Fistula Rectal Atresia Intermediate Anomalies Anal Agenesis without Fistula Anal Agenesis with Rectobulbar Urethral Fistula Anorectal Stenosis L o w Anomalies Anocutaneous Fistula Anterior Perineal Anus ANORECTAL ANOMALIES IN FEMALES High Anomalies Anorectal Agenesis without Fistula Anorectal Agenesis with High Rectovaginal F istula ( W ithout a Urogenital S Cloacal Anomalies Rectovesical Fistula Rectal Atresia Intermediate Anomalies Anal Agenesis without Fistula Rectovestibular Fistula L o w Rectovaginal Fistula L o w Anomalies Anovestibular Fistula Anocutaneous Fistula/Anterior Perineal Anus Anal Stenosis INVESTIGATIONS O THER INVESTIGATIONS Ultrasound CT Scan MRI Scan Relationship of Sacral Development and Levator Muscle Development A ssociated Anomalies Diagnostic Algorithm REFERENCES BIBLIOGRAPHY Gastrointestinal Masses in Children PLAIN RADIOGRAPHS C ONTRAST STUDIES ULTRASONOGRAPHY C OMPUTED TOMOGRAPHY M A GNETIC RESONANCE IMAGING ESOPHAGEAL MASSES IN CHILDREN z N eoplastic C ongenital Masses Clinical Presentation Imaging Features Neoplasms GASTRIC MASSES IN CHILDREN C ongenital A c quired Outlet Obstruction of Stomach E tiology Clinical Presentation F indings on US Imaging Features Ultrasound 6-12 Barium Study 4 Neoplastic Masses Benign Masses 4,13 Gastric Teratoma 1,4,14,15 Gastric Leiomyoma 4,16-19 Malignant Gastric Tumors A denocarcinoma of Stomach Gastric Lymphoma Gastric Leiomyosarcoma Gastrointestinal Stromal Tumors BEZOARS 4,28 SMALL BOWEL MASSES IN CHILDREN Clinical Presentation Imaging Features C ongenital Enteric Duplication Cyst 4,29-32 Infection Neoplastic Masses Benign Malignant Small Bowel Masses Small Bowel Lymphoma 4,17,23,38 L eiomyosarcomas 36 Gastrointestinal Stromal Tumor (GIST ) 27 A denocarcinoma Intussusception Clinical Presentation Imaging Features Clinical Presentation Imaging Features MESENTERIC MASSES IN CHILDREN Differential Diagnosis Mesenteric and Omental Tumors C OLONIC MASSES IN CHILDREN Neoplastic Mass Benign Colonic Neoplasms z N eoplastic C ongenital Mass Duplication Cysts 50 Inflammatory Mass Appendicular Lump 51 Malignant Colonic Neoplasm 52,53 C ONCLUSION Hepatic and Pancreatic Masses in Children Akshay Kumar Saxena, Kushaljit Singh Sodhi, Naveen Kalra IMAGING HEPATIC MASSES Malignant Hepatic Tumors HEPATOBLASTOMA HEPATOCELLULAR CARCINOMA (HCC) F ibrolamellar HCC RHABDOMYOSARCOMA HEPATIC METASTASES Benign Hepatic Neoplasms HEMANGIOMA MESENCHYMAL HAMARTOMA INFANTILE HEMANGIOENDOTHELIOMA FOCAL NODULAR HYPERPLASIA (FNH) AND HEPATIC ADENOMA PELIOSIS HEPATIS INFLAMMATORY LESIONS Pyogenic Hepatic Abscess Amebic Hepatic Abscess F ungal Abscess Granulomatous Lesions Echinococcal Disease (Hydatid Cyst) SIMPLE HEPATIC CYST POLYCYSTIC LIVER DISEASE CAROLI’S DISEASE P ANCREATIC MASSES P ancreatoblastoma ISLET CELL TUMORS SOLID AND PAPILLARY EPITHELIAL NEOPLASM (SPEN) (FRANTZ TUMOR) MESENCHYMAL TUMORS P ANCREATIC ADENOCARCINOMA PSEUDOCYSTS P ANCREATIC TUBERCULOSIS SUMMARY REFERENCES Childhood Biliopathies V eena Chowdhury DEFINITION AND PATHOPHYSIOLOGY OF CHOLESTASIS PHYSIOLOGICAL NEONATAL JAUNDICE ETIOLOGY OF JAUNDICE IN THE NEONATE AND INFANT T r ansient Causes P ersistent Causes C ommon Uncommon Other Causes of Cholestasis DIAGNOSIS OF JAUNDICE IN INFANCY AND CHILDHOOD H e patobiliary scintigraphy (99mTc HIDA scan) is usually required to dif NEONATAL HEPATITIS P a thology Imaging Features BILIARY ATRESIA P a thology Ultrasonography Gallbladder Length and Gallbladder Contraction Biliary Atresia Splenic Malformation Syndrome T riangular Cord Sign Objective Criteria of Triangular Cord Sign in Biliary Atresia on US C olor Doppler US in Biliary Atresia C ontrast Enhanced MR Cholangiography for E v aluation of Biliary Atresia HEPATOBILIARY CYSTIC MALFORMATIONS Choledochal Cyst Kasai Operation Etiopathogenesis Anomalous Junction of the P ancreaticobiliary Duct Imaging Features CAROLI’S DISEASE P a thology Imaging Features C ongenital Hepatic Fibrosis PRIMARY SCLEROSING CHOLANGITIS P a thology Imaging Features CYSTIC FIBROSIS DESTRUCTIVE CHOLANGITIS ASSOCIATED WITH LANGERHANS’ CELL HISTIOCYTOSIS P a thology Imaging Features BILE DUCT PAUCITY SPONTANEOUS PERFORATION OF CBD INSPISSATED BILE SYNDROME JAUNDICE IN OLDER CHILDREN Hepatocellular Causes HEPATITIS Imaging Features CHRONIC ACTIVE HEPATITIS METABOLIC CIRRHOSIS P o rtal Hypertensive Biliopathy BILIARY TRACT NEOPLASMS Embryonal Rhabdomyosarcoma (Sarcoma Botryoides) P a thology Imaging Features DISEASES OF THE GALLBLADDER Cholelithiasis P athogenesis of Gallstones in Infancy and Childhood Imaging Features A cute Acalculus Cholecystitis and A cute Hydrops of the Gallbladder C ongenital Anomalies of the Urinary Tract Smriti Hari, Arun Kumar Gupta IMAGING MODALITIES A n t enatal Sonography Magnetic Resonance Urography Static MRU (Precontrast Imaging) Dynamic MR Urography (Postcontrast Imaging) Limitations V oiding Urosonography CT Angiography (CTA) and CT Urography (CTU) Neonatal Kidney Embryologic Development of the Urinary Tract ABNORMALITIES OF KIDNEY Renal Agenesis Imaging Features Rotational Anomalies A nomalies of Renal Position Ipsilateral/Uncrossed Ectopia Imaging Features C r ossed Renal Ectopia Horseshoe Kidney Imaging Features Ureteropelvic Duplication (Duplex Kidney) Imaging Features Renal Hypoplasia C y stic Renal Dysplasia A utosomal Recessive Polycystic Kidney Disease Imaging Features Multicystic Dysplastic Kidney A utosomal Dominant (Adult Type) Polycystic Kidney Disease (ADPKD) Imaging Features PUJ Obstruction Imaging Features T he Prominent Normal Extrarenal Pelvis P ostoperative Evaluation ANOMALIES OF THE URETER E ctopic Ureter Imaging Features Ureterocele Simple Ureterocele Imaging Features E ctopic Ureterocele Imaging Features P rimary Megaureter ANOMALIES OF THE URINARY BLADDER A genesis C omplete Duplication Bladder Exstrophy Bladder Diverticulae Neurogenic Bladder T ypes of Anomalies Megacystis P rune Belly Syndrome Urachal Anomalies Imaging Features ABNORMALITIES OF THE URETHRA P osterior Urethral Valve P osterior Urethral Polyp P r ostatic Utricle and Mullerian Duct Cyst C o wper’s Duct Cyst Male Hypospadias/Epispadias A n t erior Urethral Diverticulum and Anterior Urethral Valve Urethral Duplication Megalourethra C ongenital Meatal Stenosis Urinary Tract Infections (Including VUR and Neurogenic Bladder) RADIOLOGICAL MODALITIES FOR IMAGING OF UTI R OLE OF ULTRASOUND IN FIRST TIME UTI INCIDENCE V esicoureteral Reflux P A THOPHYSIOLOGY OF VUR AND P Y ELONEPHRITIS IMAGING FINDINGS IN ACUTE P Y ELONEPHRITIS A CUTE FOCAL BACTERIAL NEPHRITIS Grading of VUR Imaging of VUR MICTURATING CYSTOURETHROGRAM PRACTICE AND CONCEPT OF CYCLICAL VOIDING RADIONUCLIDE CYSTOGRAPHY ULTRASOUND IN VUR R OLE OF MRI IN UTI IMAGING MICTURATING CYSTOURETHROGRAM VERSUS VOIDING UROSONOGRAPHY GUIDELINES FOR IMAGING IN UTI: FROM HISTORY TO CURRENT PERSPECTIVE DMSA for Renal Scar: W hen is the Best Time to Scan? TREATMENT GUIDELINES FOR REFLUX NEUROGENIC BLADDER A CKNOWLEDGMENTS REFERENCES Renal and Retroperitoneal Masses IMAGING RENAL MASSES WILMS’ TUMOR (NEPHROBLASTOMA) E tiopathogenesis C linical Features P a thology S taging Imaging Differential Diagnosis F ollow-up and Screening T r eatment and Prognosis NEPHROBLASTOMATOSIS P a thology Imaging Features P a thology MESOBLASTIC NEPHROMA (BOLANDE’S TUMOR) C linical Presentation Imaging CLEAR CELL SARCOMA P a thology Imaging RHABDOID TUMOR C linical Presentation Differential Diagnosis T r eatment and Prognosis P a thology Imaging C linical Presentation P a thology Imaging T r eatment and Prognosis RENAL CELL CARCINOMA MULTILOCULAR CYSTIC RENAL TUMOR P a thology Imaging Differential Diagnosis T r eatment and Follow-up ANGIOMYOLIPOMA C linical Presentation P a thology Screening, Follow-up and Treatment OSSIFYING RENAL TUMOR OF INFANCY Imaging METANEPHRIC ADENOMA (NEPHROGENIC ADENOFIBROMA, EMBRYONAL ADENOMA) L ymphoma C linical Presentation LEUKEMIA PRIMARY NEUROGENIC TUMORS OF THE KIDNEY P rimitive Neuroectodermal Tumor Neuroblastoma CYSTIC DISEASES OF THE KIDNEY ADRENAL MASSES NEUROBLASTOMA Site C linical Features P a thology S taging Imaging Differential Diagnosis Management and Follow-up GANGLIONEUROBLASTOMA GANGLIONEUROMA PHEOCHROMOCYTOMA C linical Presentation Imaging ADRENAL C ORTICAL TUMORS C linical Features ADRENAL HEMORRHAGE C linical Features ADRENAL CYSTS PRIMARY RETROPERITONEAL TUMORS NEUROGENIC TUMORS GERM CELL TUMORS MESENCHYMAL TUMORS Lipomatous Tumors Rhabdomyosarcoma and Undifferentiated Sarcomas RETROPERITONEAL LYMPHANGIOMA L Y MPH NODE MASSES C ONCLUSION RETROPERITONEAL ABSCESS AND HEMATOMA REFERENCES E v aluation of Female Pelvis and T esticular Abnormalities K ushaljit Singh Sodhi, Akshay Kumar Saxena NORMAL US ANATOMY OF GENITAL ORGANS IN INFANTS AND CHILDREN UTERUS O V ARIES O V ARIAN CYSTS ANOMALIES OF THE FEMALE PELVIS Müllerian Anomalies Obstructive Müllerian Anomalies Nonobstructive Müllerian Anomalies P rimary Amenorrhea P olycystic Ovary Syndrome (PCOS) PELVIC MASSES IN CHILDREN Benign Ovarian Neoplasms Malignant Neoplasms Malignant Ovarian Neoplasm Ovarian Torsion C olor Doppler Imaging in Ovarian Torsion T ubo-ovarian Abscess Ectopic Pregnancy NONGYNECOLOGIC PELVIC MASSES Role of MRI in Imaging of Female Pelvis C ongenital Uterine Anomalies Role of MRI in Characterization of Adnexal Lesions C ONCLUSION IMAGING OF TESTICULAR ABNORMALITIES Undescended Testes Inguinal-Scrotal Hernia V aricoceles Hydrocele C y stic Dysplasia of the Testis T esticular Calcification (Microcalcification) A cute Scrotum Epididymo-orchitis T orsion of the Testicular Appendages T esticular Torsion A cute Idiopathic Scrotal Edema Scrotal Tumors T esticular Tumors Nonseminomatous Germ Cell Tumors Other Testicular Tumors EXTRATESTICULAR TUMORS P aratesticular Rhabdomyosarcoma Lipoma F ibrous Pseudotumor ADRENAL RESTS A denomatoid Tumor Epididymal Cystadenoma Scrotal Involvement in Systemic Diseases Scrotal Trauma Role of MRI in Testicular Abnormalities C ONCLUSION REFERENCES Imaging of Intersex Disorders Sanjay Sharma, Arun Kumar Gupta NORMAL SEXUAL DIFFERENTIATION 1 IMAGING OF AN INTERSEX CHILD 2-6 Genitography 2,7 Other Imaging Modalities MR Appearance of Genital Structures CLASSIFICATION OF INTERSEX F emale Pseudohermaphroditism (FPH) 1,2,7,14,15 E tiology T ypes Male Pseudohermaphroditism (MPH) 1,2,7 C ause T rue Hermaphroditism (TH) 1,7 Mixed Gonadal Dysgenesis (MGD) and Dysgenetic Male Pseudohermaphroditism (DM CLUES TO THE DIAGNOSIS C ONCLUSION Skeletal Dysplasias Gaurav S Pradhan TERMINOLOGY Newer Imaging Modalities OSTEOCHONDRODYSPLASIAS Defects of Growth of Tubular Bones, Spine or Both Dysplasias Manifested at Birth Dysplasias Manifested in Later Life Disorganized Development of Cartilage and F ibrous Components of the Skeleton Dysplasia Epiphysealis Hemimelica Multiple Cartilaginous Exostoses Enchondromatosis (Ollier’s Disease) Enchondromatosis with Hemangiomas (Maffucci’s Syndrome) F ibrous Dysplasia A bnormalities of the Density of Cortical Diaphyseal Structure or Metaphyseal Dysplasias with Decreased Bone Density Increased Bone Density without Modification of Bone Shape Increased Bone Density with Diaphyseal Involvement Increased Bone Density with Metaphyseal Involvement D Y SOSTOSES Dysostoses with Cranial and Facial Involvement Craniosynostosis Craniofacial Synostosis Dysostoses with Predominant Axial Involvement Osteo-onychodysostosis Dysostosis with Predominant Involvement of Extremities IDIOPATHIC MULTICENTRIC OSTEOLYSIS PRIMARY DISTURBANCE OF GROWTH C ornelia de Lange Syndrome P r ogeria C ONSTITUTIONAL DISEASES OF BONE WITH KNOWN PATHOGENESIS C hromosomal Aberrations P rimary Metabolic Abnormalities C alcium Phosphorus Metabolism (Hypophosphatasia) Mucopolysaccharidoses and Mucolipidoses Bone Abnormalities Secondary to Disturbances of Extraskeleton Systems REFERENCES Skeletal Maturity Assessment MEASUREMENT OF MATURITY S k eletal Maturity Assessment: W h y is it Necessary? Methods to Assess Skeletal Maturity A ppearance and Fusion of Ossification Centers Greulich and Pyle (G–P) Method T anner and Whitehouse Method C omparison of G–P and TW2 Methods T echnique C omputer-assisted Skeletal Age Scores Ultrasound-based Bone Age Calculation Indian Scene REFERENCES Spinal Dysraphism Raju Sharma, Ankur Gadodia EMBRYOLOGY CLASSIFICATION IMAGING MODALITIES OPEN SPINAL DYSRAPHISM Myelocele and Myelomeningocele Chiari II Malformation Hemimyelocele/Hemimyelomeningocele CLOSED SPINAL DYSRAPHISM CSD with Subcutaneous Mass Lipoma with Dural Defect (Lipomyelocele and Lipomyelomeningocele) Meningocele Anterior Sacral Meningocele Myelocystocele CLOSED SPINAL DYSRAPHISM WITHOUT SUBCUTANEOUS MASS P osterior Bony Spina Bifida F ilum Terminale Lipoma Lipoma (Intradural and Intramedullary) T ight Filum Terminale Syndrome P ersistent Terminal Ventricle Neurenteric Cyst SPLIT CORD MALFORMATION DORSAL DERMAL SINUS CAUDAL AGENESIS (CAUDAL REGRESSION SYNDROME, CRS) SEGMENTAL SPINAL DYSGENESIS C ONCLUSION REFERENCES Imaging of Pediatric Hip Normal Anatomy METHODS OF INVESTIGATION C onventional Radiography Normal Sonoanatomy of the Hip Scintigraphy Arthrography C omputed Tomography ( CT ) Magnetic Resonance Imaging (MRI) PEDIATRIC HIP DISORDERS DEVELOPMENTAL DYSPLASIA OF THE HIP Natural History and Pathology Clinical Examination Radiological Diagnosis and Screening of DDH IMAGING IN DEVELOPMENTAL DYSPLASIA OF THE HIP C onventional Radiography Ultrasonography in DDH C OMPUTED TOMOGRAPHY MAGNETIC RESONANCE Differential Diagnosis of DDH T he Painful Hip Septic Arthritis P athology Imaging T uberculosis of the Hip Joint P a thology and Imaging Stage I—Tubercular Synovitis Stage II—Tubercular Arthritis with Damage to Articular Cartilage Stage III—Advanced Arthritis TRANSIENT SYNOVITIS OF HIP LEGG-CALVE-PERTHES’ DISEASE Imaging CT and MRI in Perthes’ Disease P r o ximal Femoral Focal Deficiency (PFFD) Imaging Slipped Capital Femoral Epiphysis Imaging Differential Diagnosis Traumatic SCFE Developmental Coxa Vara P ediatric Hip Trauma Neuromuscular Hip Dysplasia Childhood Idiopathic Chondrolysis of the Hip C alcification of Cartilage and Joints F emoroacetabular Impingement REFERENCES Benign Bone and Soft Tissue T umors and Conditions Mahesh Prakash, Kushaljit Singh Sodhi CARTILAGINOUS TUMORS Osteochondroma Enchondroma C hondroblastoma C hondromyxoid Fibroma OSSEOUS TUMORS Osteoid Osteoma Osteoblastoma FIBROUS TUMORS Nonossifying Fibroma F ibrous Dysplasia Osteofibrous Dysplasia HISTIOCYTOSIS X (LANGERHANS CELL HISTIOCYTOSIS) GIANT CELL TUMOR TUMOR-LIKE LESIONS Simple Bone Cyst A neurysmal Bone Cyst P seudotumor of Hemophilia SOFT TISSUE TUMORS V ascular Lesions Hemangioma V ascular Malformations FIBROBLASTIC/MYOFIBROBLASTIC TUMORS Nodular Fasciitis Myositis Ossificans Myofibroma/Myofibromatosis F ibromatosis Neurogenic Tumor A dipocytic Tumor Lipoma Lipoblastoma P seudotumors F a t Necrosis Hematoma Inflammatory Lesions P eriarticular Cysts C ONCLUSION P ediatric Malignant Bone and Soft Tissue Tumors Manisha Jana, Ashu Seith Bhalla, Deep N Srivastava IMAGING MODALITIES P lain Radiographs Sonography Magnetic Resonance Imaging MRI Techniques for Bone and Soft Tissue Tumors Role of Contrast-enhanced MRI Newer MR Imaging Techniques S taging of Malignant Bone and Soft Tissue Tumors M ALIGNANT BONE TUMORS Osteosarcoma E wing’s Sarcoma C hondrosarcoma L ymphoma Metastases Malignant Fibrous Histiocytoma SOFT TISSUE TUMORS Rhabdomyosarcoma S ynovial Sarcoma Other Non-rhabdomyosarcomatous Tumors C ONCLUSION REFERENCES C ongenital Brain Anomalies Niranjan Khandelwal DISORDERS OF ORGANIZATION Supratentorial Malformations Migrational Disorders Holoprosencephaly Septo-optic Dysplasia Dysgenesis of Corpus Callosum Hydranencephaly Infratentorial Malformations C hiari Malformations Supra- and Infratentorial Malformations DISORDERS OF HISTOGENESIS Neurofibromatosis T uberous Sclerosis S turge–Weber Syndrome Hypoxic–Ischemic Encephalopathy A tin Kumar, Arun Kumar Gupta NEUROIMAGING IN INFANTS WITH HIE BELOW 34 WEEKS GROUP: THE PREMATURE NEONATE Severe, Total Hypoxia Mild-to-moderate Hypoxia Hemorrhage Germinal Matrix Hemorrhage (GMH) Intraventricular Hemorrhage (IVH) P arenchymal Hemorrhage (Periventricular Hemorrhagic Infarction) Grading of Intracranial Hemorrhage Imaging of Intracranial Hemorrhage W hite M a tter I njury of P r ematurity/ P eriventricular Leukomalacia Imaging of Early PVL Imaging of End-stage PVL ABOVE 34 WEEKS GROUP: THE TERM NEONATE Severe, Total Hypoxia P r olonged Partial Hypoxia H Y POXIC–ISCHEMIC INJURY IN POSTNATAL AGE GROUP Severe, Total Hypoxia Mild-to-moderate Hypoxia IMAGING CHOICE FOR EVALUATION OF H Y POXIC–ISCHEMIC INJURY PREDICTION OF CLINICAL OUTCOME Ultrasound E chogenic Thalamus C erebral Artery Doppler MR Imaging C onventional Sequences Reversal Sign Diffuse Decreased Density MR Spectroscopy Cranial Sonography Rashmi Dixit, Veena Chowdhury TECHNIQUE AND NORMAL ANATOMY Cranial Doppler US C ONGENITAL BRAIN ANOMALIES F ailure of Neural Tube Closure Chiari II Malformation Sonographic Appearance A genesis of the Corpus Callosum Dandy–Walker (DW) Complex Disorders of Diverticulation Holoprosencephaly Schizencephaly Lissencephaly P ellucidal Agenesis and Dysgenesis T uberous Sclerosis Sturge–Weber Syndrome V ascular Malformations DESTRUCTIVE BRAIN LESIONS P orencephalic Cyst Hydranencephaly H Y DROCEPHALUS INTRACRANIAL HEMORRHAGE Grade I Grade II Grade III Grade IV H Y POXIC OR ISCHEMIC ENCEPHALOPATHY Mild-to-moderate Hypotension in the P r eterm Neonate Severe Hypotension in the Preterm Neonate Diffuse Cerebral Edema Extracorporeal Membrane Oxygenation (ECMO) P ost-traumatic Injury Intracranial Infection NEONATAL AND ACQUIRED INFECTIONS Pyogenic Meningitis T ubercular Meningitis Neoplasms and Cysts C y sts REFERENCES Inflammatory Diseases of the Brain V ivek Gupta, Niranjan Khandelwal, Paramjeet Singh INVESTIGATIVE MODALITIES BACTERIAL INFECTIONS Brain Abscess Abscesses Evolve in Four Stages CRANIAL TUBERCULOSIS T uberculous Meningitis Basal Exudates Hydrocephalus Infarction P a r enchymal Tuberculous Granulomas C ompound Parenchymal and Me ningeal T uberculosis Clinical Features and Pathology NEUROCYSTICERCOSIS L eptomeningitic Form Intraventricular Form Racemose Cysts (Subarachnoid Form) H Y D A TID DISEASE VIRAL ENCEPHALITIS Herpes Simplex Encephalitis Japanese Encephalitis DWI in Encephalitis C ONGENITAL INFECTIONS C ytomegalovirus T o x oplasmosis Neonatal Herpes Simplex Encephalitis Rubella C ongenital HIV Infection FUNGAL INFECTIONS Aspergillosis Mucormycosis C ONCLUSION REFERENCES P ediatric Brain Tumors Shailesh B Gaikwad, Ajay Garg CLASSIFICATION OF CHILDHOOD TUMORS BASED ON TOPOGRAPHY 3 POSTERIOR FOSSA TUMORS Medulloblastoma P athology P ilocytic Astrocytoma P athology Ependymoma P athology Imaging Brainstem Gliomas P athology Imaging A typical Teratoid/Rhabdoid Tumor P athology Imaging Hemangioblastoma P athology Imaging Epidermoid and Dermoid SUPRATENTORIAL TUMORS C erebral Astrocytoma P athology Imaging Subependymal Giant Cell Astrocytoma Ganglioglioma Imaging Supratentorial Ependymoma P athology P rimitive Neuroectodermal Tumor P athology Imaging Oligodendroglioma Dysembryoplastic Neuroepithelial Tumors Desmoplastic Infantile Ganglioglioma C r aniopharyngioma SELLAR AND SUPRASELLAR TUMORS C hiasmatic/Hypothalamic Gliomas Imaging Hypothalamic Hamartoma Imaging P ituitary Adenomas A r achnoid Cyst PINEAL REGION MASSES Germinomas Imaging T eratomas P athology Imaging Other Germ Cell Tumors P ineal P arenchymal Tumors P ineal Cysts EXTRAPARENCHYMAL TUMORS C horoid P lexus Tumors P athology Imaging Meningiomas and Related Tumors P athology L eukemia and Lymphoma TUMORS OF THE ORBIT AND NECK OCULAR TUMORS Retinoblastoma RETROBULBAR ORBITAL TUMORS V ascular Tumors Orbital Varices P lexiform Neurofibroma Rhabdomyosarcoma Neuroblastoma Juvenile Angiofibroma MR SPECTROSCOPY IN BRAIN T umor Imaging P ositron-emission Tomography (PET ) in Neuro-oncology U ses in Glioma Evaluation NANOTECHNOLOGY Imaging and Nanomedicine for Diagnosis and Therapy of CNS Tumors Diffusion-weighted Imaging N ewly codified glial neoplasms of the 2007 WHO classification of tumors of th C ONCLUSION REFERENCES Metabolic Disorders of the Brain Normal Myelination of the Brain MR Imaging at 1.5 T (Tables 1A and B) Graywhite Matter Differentiation METABOLIC DISORDERS Classification According to C ellular Organelle Dysfunction Classification of Metabolic Disorders on the Basis of Organelle Disorder 9,10 L ysosomal Storage Diseases with White Matter Involvement Mitochondrial Dysfunction with L eukoencephalopathy P eroxisomal Disorders K e arns–Sayre syndrome Disorders of Amino Acid and Organic Acid Metaboli White Matter Disorders with Unknown Metabolic Defect Classification of Metabolic Disorders A c c ording to Brain Substance Involvem L eukodystrophies P oliodystrophies P andystrophies L Y SOSOMAL STORAGE DISORDERS Metachromatic Leukodystrophy Clinical Features P athologic Findings Krabbe Disease/Globoid Cell L eukodystrophy (GLD) Clinical Features P athologic Findings Sphingolipidosis Clinical Features Imaging Features P athologic Findings Imaging Features Gaucher’s Disease F abry Disease Clinical Features PEROXISOMAL DISORDERS Clinical Features Imaging Mucopolysaccharidoses X -linked Adrenoleukodystrophy Clinical Features P athologic Findings A drenomyeloneuropathy Z ellweger Syndrome MR imaging reveals diffuse demyelination with abnormal gyration that is most Refsum Disease P athologic Findings C erebrotendinous Xanthomatosis Rhizomelic Chondrodysplasia C alcificans Punctata UNCLASSIFIED LEUKODYSTROPHIES C anavan Disease Clinical Features Imaging Features Alexander Disease P athologic Findings Clinical Features Imaging Features V an der Knaap Disease/Megaloencephalic L eukodystrophy with Subcortical Cyst V anishing White Matter Disease/Childhood A taxia with CNS Hypomyelination P athologic Findings Clinical Features Imaging Features Aicardi–Goutieres Syndrome P elizaeus–Merzbacher Disease Mitochondrial Encephalomyopathy: Lactic A cidosis and Stroke-like Symptoms Clinical Features P athologic Findings C ockayne Syndrome MR Spectroscopy MITOCHONDRIAL DISORDERS/ DEFECTS OF THE RESPIRATORY CHAIN Imaging Features Myoclonic Epilepsy with Ragged Red Fibers (MERRF) P athologic Findings K earns–Sayre Syndrome Clinical Features Imaging Features Subacute Necrotizing Encephalomyopathy (Leigh Disease) P athologic Features Imaging Features LEBER’S HEREDITARY OPTIC NEUROPATHY DISORDERS OF AMINO ACID METABOLISM/AMINOACIDOPATHIES Urea Cycle Defects Phenylketonuria Clinical Features Imaging Findings Malignant Form of Phenylketonuria Maple Syrup Urine Disease Imaging Findings Classic Homocystinuria Clinical Features Imaging Nonketotic Hyperglycinemia Imaging 5, 10 Methylene-tetrahydrofolate Reductase Deficiency ORGANIC ACIDEMIAS Methylmalonic Acidemia Imaging Findings during Metabolic Crisis Imaging Findings after Metabolic Crisis P r opionic Acidemia Imaging Findings Ethylmalonic Acidemia Methylglutaconic Aciduria Imaging Finding 3-Hydroxy-3-methylglutaryl (HMG)- C oenzyme a Lyase Deficiency Glutaric Aciduria Type 1 METABOLIC DISORDERS PRIMARILY AFFECTING GRAY MATTER Hallervorden–Spatz Disease Neuronal Ceroid Lipofuscinosis (NCL) Rett Syndrome DISORDERS OF METAL METABOLISM W ilson’s Disease (Hepatolenticular Degeneration) Imaging Findings Imaging Menkes’ Disease C ONCLUSION REFERENCES C hest and Cardiovascular Imaging Chest X-ray: Techniques and Anatomy Mahesh Prakash, Manavjit Singh Sandhu TECHNICAL ADVANCES High kV Technique C ONVENTIONAL CHEST RADIOGRAPHY New Screen Film Combinations Beam Equalization Radiography Digital Radiography Digital Radiography and Chest RADIOGRAPHIC PROJECTIONS P osteroanterior View P atient Positioning P atient Respiration F ilm Exposure Kilovoltage Grids and Filters Lateral View A n t eroposterior View Decubitus View L ordotic View Oblique View SPECIAL RADIOGRAPHIC TECHNIQUES Inspiratory–Expiratory Radiography V alsalva and Müller Maneuvers Bedside/Portable Radiography NORMAL ANATOMY ON CHEST X-RAY T r achea T r acheobronchial Divisions L ungs Bronchopulmonary Segments Hilum and Pulmonary Vasculature P leura Mediastinum Mediastinal Lines and Interfaces REFERENCES Heart Diaphragm C ONCLUSION Multidetector Computed T omography of Chest: T echniques and Anatomy Deep N Srivastava, Atin Kumar, Shivanand Gamanagatti C OMPUTED TOMOGRAPHY Indications for CT of the Chest Definition of Spiral Pitch Dose Considerations Intravenous Contrast Medium Enhancement W indow Settings HIGH-RESOLUTION COMPUTED T OMOGRAPHY Sequential HRCT Protocol V olumetric HRCT Protocol V olumetric Standard CT Protocol V olumetric Low-dose CT Protocol P ediatric MDCT Chest ANATOMY T r acheobronchial Tree L ungs Mediastinum Esophagus L ymph Nodes Mediastinal Spaces Basic Patterns of Lung Diseases Sumedha Pawa, Sapna Singh P A TTERN RECOGNITION High-resolution CT Patterns of Disease L UNG DISEASES THAT INCREASE RADIOGRAPHIC DENSITY P r edominantly Airspace Disease P arenchymal Consolidation Radiographic Criteria of Airspace Disease Airspace Nodule C oalescence Distribution Characteristics Margination Air Bronchogram T ime Factor P arenchymal Atelectasis Maintenance of Lung Volume Resorption Atelectasis RADIOGRAPHIC SIGNS OF ATELECTASIS Direct Signs Indirect Signs L ocal Increase in Density Elevation of the Hemidiaphragm Mediastinal Displacement P assive Atelectasis A dhesive Atelectasis C ompensatory Overinflation Displacement of the Hila Changes in the Chest Wall P r edominantly Interstitial Disease Radiographic Patterns of Diffuse Interstitial Disease Reticular Pattern Nodular Pattern Reticulonodular Pattern Linear Pattern C ombined Airspace and Interstitial Disease General Signs in Diseases that Increase Radiographic Density Characteristics of the Border of a Pulmonary Lesion C avitation C alcification and Ossification Changes in Position of Interlobar Fissures Bullae and Cysts Distribution of Disease within the Lungs ( A natomic Basis) Radiologic Localization of Pulmonary Disease (The Silhouette’s Sign) Line Shadows T ubular Shadows (Bronchial Wall Shadows) Horizontal or Obliquely Oriented Linear Opacities of Unknown Nature HIGH-RESOLUTION CT SCAN FINDINGS MANIFESTING AS INCREASED LUNG OPACITY P arenchymal Scarring Line Shadow of Pleural Origin Nodules Linear Abnormalities Interlobular Septal Thickening P arenchymal Bands Subpleural Lines Reticular Abnormalities Ground-glass Opacity C onsolidation L UNG DISEASES THAT DECREASE RADIOGRAPHIC DENSITY Increased Air with Unchanged Blood and Tissue Increased Air with Decreased Blood and Tissue Normal Amount of Air but Decreased Blood and Tissue Reduction in All Three Components RADIOGRAPHIC SIGNS Alteration in Lung Volume General Excess of Air in the Lungs L ocal Excess of Air Static Signs Dynamic Signs L ocal Reduction in Vasculature P ulmonary Air Cysts Alteration in Vasculature General Reduction in Vasculature HIGH-RESOLUTION CT SCAN FINDINGS MANIFESTING AS DECREASED OPACITY Areas of Decreased Attenuation with Walls Bronchiectasis Honeycomb Pattern C ystic Pattern Areas of Decreased Attenuation without Walls Emphysema Mosaic Perfusion and Inhomogeneous L ung Opacity Normal Inspiratory Scans with Air Trapping on Expiratory Imaging Multidetector CT in Assessment of Diffuse Lung Disease C ONCLUSION REFERENCES R adiographic Manifestations of P ulmonary Tuberculosis Mandeep Kumar Garg, Naveen Kalra NEW CONCEPT OF RADIOLOGIC M ANIFESTATIONS OF PULMONARY TUBERCULOSIS RADIOLOGICAL PATTERNS OF PULMONARY TUBERCULOSIS T ypical Radiological Patterns of P rimary Tuberculosis P ostprimary TB or Phthisis Radiological Patterns Encountered in Both P rimary and/or Postprimary TB Miliary TB Exudative Pleuritis T r acheobronchial TB T uberculoma C omplications and Sequelae of Pulmonary TB A typical Patterns PET/CT IN TUBERCULOSIS Nontubercular Pulmonary Infections Anju Garg IMAGING MODALITIES RADIOGRAPHIC PATTERN ETIOPATHOGENESIS OF PULMONARY INFECTIONS SPECIFIC PNEUMONIAS Bacterial Pneumonias P neumococcal P neumonia Staphylococcal Pneumonia Gram-negative Pneumonias Chlamydia pneumoniae Anaerobic Pneumonias A ctinomycosis Mycoplasma Pneumonia V iral Pneumonia Influenza Virus Respiratory Syncytial Virus V aricella A denovirus FUNGAL INFECTIONS Opportunistic Invaders Aspergillosis P rimary Pathogens Histoplasmosis Cryptococcosis C occidioidomycosis P ARASITIC INFECTIONS P r otozoal Infections Metazoal Infestations Roundworm, Hookworm and Strongyloides Infections F ilariasis E chinococcus Infection/Hydatid Disease C OMPLICATIONS OF PNEUMONIA P leural Effusion and Empyema Hydropneumothorax P neumatoceles A bscess Bronchiectasis Miscellaneous Complications Delayed Resolution of Pneumonia INTERVENTIONAL PROCEDURES IN THE P A TIENTS WITH PNEUMONIA C ONCLUSION REFERENCES Imaging of the Tracheobronchial Tree Ashu Seith Bhalla, Raju Sharma IMAGING MODALITIES Chest Radiograph Computed Tomography Acquisition Axial CT Images Advanced Reconstruction Techniques NORMAL AIRWAY ANATOMY Anatomic Variants TRACHEOBRONCHIAL LESIONS Central Airways Strictures Inflammatory Tracheal Stenosis due to Tuberculosis Tracheobronchomalacia Fungal Infections Postintubation Stenosis Neoplasms of Tracheobronchial Tree Malignant Tumors Miscellaneous Mucous Plug/Mucoid Pseudotumor Benign Tumors Broncholithiasis T r acheopathia Osteoplastica T r acheoesophageal Fistulas Diffuse Diseases Involving T r acheobronchial Tree Amyloidosis Relapsing Polychondritis Sarcoidosis W egener Granulomatosis Saber Sheath Trachea P eripheral Airways Bronchiectasis C ongenital Airway Wall Abnormality T r acheobronchomegaly (Mounier–Kuhn Disease) W illiams–Campbell Syndrome C ongenital Bronchial Atresia A c quired Wall Abnormalities Mucociliary Clearance Abnormalities Hyperimmune Response Small Airway Disease/Bronchiolitis C ellular Bronchiolitis Bronchiolitis Obliterans with Intraluminal Polyps Obliterative or Constrictive Bronchiolitis Asthma Chronic Obstructive Pulmonary Disease C ONCLUSION Imaging of Interstitial Lung Disease Smriti Hari, Sanjay Sharma, Deep N Srivastava PLAIN RADIOGRAPHY High-resolution CT A natomy of the Secondary Pulmonary Lobule SARCOIDOSIS C ONNECTIVE TISSUE DISEASE ASSOCIATED INTERSTITIAL LUNG DISEASE RHEUMATOID ARTHRITIS-ASSOCIATED INTERSTITIAL LUNG DISEASE SYSTEMIC LUPUS ERYTHEMATOSUS PROGRESSIVE SYSTEMIC SCLEROSIS H Y PERSENSITIVITY PNEUMONITIS SILICOSIS AND COAL-WORKER PNEUMOCONIOSIS ASBESTOSIS L Y MPHANGIOLEIOMYOMATOSIS LANGERHANS CELL HISTIOCYTOSIS PULMONARY ALVEOLAR PROTEINOSIS IDIOPATHIC INTERSTITIAL PNEUMONIAS IDIOPATHIC PULMONARY FIBROSIS NONSPECIFIC INTERSTITIAL PNEUMONITIS CRYPTOGENIC ORGANIZING PNEUMONIA RESPIRATORY BRONCHIOLITIS-ASSOCIATED INTERSTITIAL LUNG DISEASE DESQUAMATIVE INTERSTITIAL PNEUMONIA L Y MPHOID INTERSTITIAL PNEUMONIA A CUTE INTERSTITIAL PNEUMONIA P ulmonary Manifestations in Immunocompromised Host (HIV and Solid Organ Tra Mandeep Kang HIV/AIDS S y stematic Approach to Imaging Diagnosis Imaging Methods Radiological Pattern Approach to Diagnosis Normal C hest R adiograph Ground-glass O pacities C onsolidation Multiple P ulmonary N odules L ymphadenopathy P leural E ffusion NON-HIV IMMUNOCOMPROMISED HOSTS Imaging Approach B A CTERIAL INFECTIONS PNEUMOCYSTIS JIROVECI PNEUMONIA MYCOBACTERIAL INFECTIONS HIV/AIDS Patients HIV Negative Immunocompromised Patients VIRAL INFECTIONS FUNGAL INFECTIONS L ymphoma L ymphocystic Interstitial Pneumonitis P ost-transplant Lymphoproliferative Disorder NONINFECTIOUS MANIFESTATIONS OF AIDS Kaposi’s Sarcoma Chest in Immunocompromised Host (Hematological Infections and Bone Marrow Sanjay Sharma, Sanjay Thulkar C OMPLICATIONS NOT SPECIFIC TO HSCT Infections Bacterial Pneumonia P neumocystis jirovecii Pneumonia F ungal Infections T uberculosis Drug Toxicity P ulmonary Hemorrhage C OMPLICATIONS SPECIFIC TO HSCT Infections C ytomegalovirus Pneumonia P ulmonary Edema Idiopathic Pneumonia Syndrome Bronchiolitis Obliterans Bronchiolitis Obliterans Organizing Pneumonia R adiation Injury Spontaneous Pneumothorax REFERENCES Imaging the Mediastinum Raju Sharma, Ashu Seith Bhalla, Arun Kumar Gupta IMAGING MODALITIES Chest Radiograph C omputed Tomography Magnetic Resonance Imaging DIFFERENTIAL DIAGNOSIS OF MEDIASTINAL MASSES ANTERIOR MEDIASTINUM L esions of Thymus Thymic Rebound Thymoma Thymic Hyperplasia Germ Cell Tumors Thyroid Mass P arathyroid Adenoma L ymphangioma (Cystic Hygroma) P ericardial Cyst Other Vascular Tumors MIDDLE MEDIASTINUM Bronchogenic Cyst Esophageal Duplication Cyst Esophageal Lesions POSTERIOR MEDIASTINUM Neurenteric Cyst P eripheral Nerve Tumors Lateral Thoracic Meningocele T umors from Sympathetic Ganglia P araganglioma P a r aspinal Infection Extramedullary Hemopoiesis Mediastinal Varices MULTICOMPARTMENT MEDIASTINAL MASSES/LESIONS Mediastinal Lymphadenopathy T u berculosis Sarcoidosis L ymphoma Metastasis V ascular Lesions A ortic Aneurysm A o rtic Dissection Superior Vena Cava Obstruction A bnormalities of the Mediastinal Fat Mediastinal Lipomatosis Herniation of Abdominal Fat MISCELLANEOUS LESIONS OF THE MEDIASTINUM Mediastinal Hemorrhage P neumomediastinum A cute Mediastinitis F ibrosing Mediastinitis C ONCLUSION REFERENCES Imaging of Solitary and Multiple Pulmonary Nodules MORPHOLOGICAL CHARACTERISTICS OF SPN Size Shape L ocation Edge Characteristics INTERNAL CHARACTERISTICS OF SPN C alcification C alcification in a Benign Nodule Indeterminate Calcification Fat Nodule Attenuation C alcification in Tumor C a vitation Air Bronchograms and Pseudocavitation Air Crescent Sign AIR FLUID LEVEL Satellite Nodules F eeding Vessel Sign P ositive Bronchus Sign INDETERMINATE SOLITARY PULMONARY NODULE C ontrast-enhancement/Hemodynamic Characteristics on Dynamic Helical CT F or Benign Nodules Growth Rate Assessment V OLUME QUANTIFICATION ON CT/THREE– DIMENSIONAL EVALUATION C OMPUTER-AIDED DIAGNOSIS IMAGE REGISTRATION Bayesian Analysis Decision Analysis FDG Positron Emission Tomography Biopsy T r ansthoracic Needle Aspiration Biopsy (TNAB) F iberoptic Bronchoscopy (FOB) V ideo Assisted Thoracic Surgery NEWER TECHNIQUES FOR THE EVALUATION OF SPN Dynamic MR Imgaing Diffusion Weighted MRI Imaging Infective Causes Inflammatory (Noninfectious) Airway and Inhalational Disease Dual Energy CT in the Evaluation of SPN DIFFERENTIAL DIAGNOSIS OF SOLITARY PULMONARY NODULE 72 Malignant Neoplasm Septic embolism C ongenital Lesions Sequestration Idiopathic/Miscellaneous Benign Neoplasm and Neoplasm Like C ondition MORPHOLOGICAL CHARACTERISTICS IN SPECIFIC LESIONS Malignant Lesions L ung Malignancies L ymphoma Metastatic Neoplasm C arcinoid Tumor Benign Neoplasms P ulmonary Hamartoma Other Benign Tumors Infective Causes Granuloma Mycetoma Hydatid Cyst Round Pneumonia L ung Abscess Inflammatory (Noninfectious) Rheumatoid Nodules Airway or Inhalational Disease Lipoid Pneumonia V ascular Lesions P ulmonary Artery Aneurysm P ulmonary Vein Varix Arteriovenous Malformation (AVM) P ulmonary Infarction C ongenital Lesions P ulmonary Bronchogenic Cyst Sequestration Miscellaneous Round Atelectasis MULTIPLE PULMONARY NODULES MORPHOLOGICAL CHARACTERISTICS IN SPECIFIC CAUSES Metastatic Lung Nodules Kaposi’s Sarcoma Rheumatoid Nodules and Caplan Syndrome P r ogressive Massive Fibrosis W egener’s Granulomatosis Sarcoidosis Septic Emboli with Infarction Arteriovenous Malformation Amyloidosis Bronchiolitis Obliterans Organizing Pneumonia (BOOP) C ONCLUSION L ung Malignancies Sanjay Thulkar, Smriti Hari, Arun Kumar Gupta P A THOLOGY CLINICAL FEATURES IMAGING FEATURES P eripheral Tumors C entral Tumors Methods to Establish Tissue Diagnosis Imaging Work-up for the Staging of NSCLC Mediastinal Invasion STAGING OF NSCLC CHEST WALL INVASION P ancoast Tumor L ymph Node Staging A dditional Lung Nodules Pleural Effusion Distant Metastases PET in Management of Lung Cancer Bronchoalveolar Carcinoma TREATMENT OF NSCLC F ollow-up Imaging Recurrent Lung Cancer SCREENING FOR LUNG CANCER NEUROENDOCRINE TUMORS OF THE L UNG Bronchial Carcinoid Small-cell Lung Cancer T r eatment of Neuroendocrine Tumors RARE LUNG MALIGNANCIES L UNG METASTASES L ymphangitis Carcinomatois Detection of Lung Metastases T r eatment of Lung Metastases L Y MPHOMA OF THE LUNG REFERENCES Intensive Care Chest Radiology Akshay Kumar Saxena, Kushaljit Singh Sodhi, Madhu Gulati A t electasis CHEST X-RAY IN IMAGING OF ICU PATIENTS A spiration Pneumonitis P neumonia Hydrostatic Pulmonary Edema CT in Hydrostatic Pulmonary Edema Noncardiogenic Pulmonary Edema P ulmonary Embolism Barotrauma P ulmonary Interstitial Emphysema P neumomediastinum P neumothorax Subcutaneous Emphysema Support and Monitoring Apparatus Respiratory Support Endotracheal and Tracheostomy Tube Intravascular Catheters C entral Venous Line S w an-Ganz Catheter ULTRASOUND IN IMAGING OF ICU PATIENTS CT SCAN IN IMAGING OF ICU PATIENTS Imaging in Pulmonary T hromboembolism PLAIN RADIOGRAPHS PULMONARY ANGIOGRAPHY E chocardiography D-dimer Scintigraphy Duplex Ultrasound and Compression Ultrasound of Lower Limbs C OMPUTED TOMOGRAPHY Spiral CT V ASCULAR FINDINGS T echnique P ARENCHYMAL FINDINGS A cute Thromboembolism C hronic Thromboembolism A cute Versus Chronic Thromboembolism PITFALLS IN DIAGNOSIS OF PULMONARY EMBOLISM EFFICACY AND ACCURACY OF MULTIDECTOR C OMPUTED TOMOGRAPHY ISOLATED SUBSEGMENTAL PULMONARY EMBOLISM C OMPUTED TOMOGRAPHY VENOGRAPHY M A GNETIC RESONANCE IMAGING MR Venography IMAGING-GUIDED INTERVENTION IN THE MANAGEMENT OF PULMONARY THROMBOEMBOLISM P ulmonary Embolism in Pregnancy A CKNOWLEDGMENTS Imaging in Thoracic Trauma Atin Kumar, Shivanand Gamanagatti PULMONARY PARENCHYMAL INJURIES P ulmonary Contusion P ulmonary Laceration Aspiration Pneumonitis A t electasis T r aumatic Lung Herniation PLEURAL INJURIES P neumothorax Hemothorax INJURIES OF THE MEDIASTINUM T r acheobronchial Injury Esophageal Injury P neumomediastinum V ascular Injury INJURY OF DIAPHRAGM C ardiac and Pericardial Injury Injury of Chest Wall C ONCLUSION REFERENCES Imaging of Pleura IMAGING MODALITIES Layers of Pleura PLEURAL EFFUSION T ypes of Effusion: Exudates and Transudates Exudates T r ansudate F ibrin Body IMAGING IN PLEURAL EFFUSION Plain Radiographs ULTRASONOGRAPHY OF PLEURAL EFFUSION C OMPUTED TOMOGRAPHY PLEURAL EFFUSION OR ASCITIS L oculated Pleural Fluid (Encysted/ Encapsulated) MAGNETIC RESONANCE IMAGING OF PLEURAL EFFUSION Specific Causes of Pleural Effusion P arapneumonic Effusion with Empyema 9-14 Organization Stage (Pleural Peel) Empyema Necessitans T ube Drainage of Empyema BRONCHOPLEURAL FISTULA P ostsurgical BPF Infective BPF PLEURAL THICKENING V isceral Pleural Thickening Pleural Apical Cap and Fibrous Thickening Pleural Thickening Mimics PLEURA AND ASBESTOSIS 1 8-19 ASBESTOSIS PSEUDOTUMOR (ROUND ATELECTASIS) PLEURAL CALCIFICATION PNEUMOTHORAX Spontaneous Pneumothorax P rimary Spontaneous Pneumothorax Secondary Spontaneous Pneumothorax P neumothorax Ex Vacuo T r aumatic Pneumothorax C a tamenial Pneumothorax IMAGING FINDINGS X-ray Upright Patient Supine Patients Ultrasonography C omputed Tomography T ension Pneumothorax SIZE OF PNEUMOTHORAX 21 PLEURAL NEOPLASM Pleural Thickening MESOTHELIOMA (MALIGNANT PLEURAL MESOTHELIOMA) 2 3-24 Pleural or Extrapleural Masses Pleural Effusion Radiographic Findings Ultrasonography C omputed Tomography Magnetic Resonance Imaging P ositron Emission Tomography L ocalized Fibrous Tumor Pleural Metastasis REFERENCES Pleural Lymphoma Imaging of the Diaphragm and Chest Wall Sameer Vyas, Anupam Lal DIAPHRAGM Anatomy Imaging Modalities P lain Radiograph Ultrasonography (USG) C omputed Tomography (CT ) Magnetic Resonance Imaging (MRI) R adionuclide Scan Normal Variants A c c essory Diaphragm Elevated Hemidiaphragm Unilateral Elevation Bilateral Elevation L o w Lying Diaphragm Inversion of the Diaphragm P eridiaphragmatic Collections DIAPHRAGMATIC MOVEMENTS Diaphragmatic Hernias Bochdalek Hernia Morgagni Hernia Intrapericardial Hernia Diaphragmatic Injury T umors of the Diaphragm CHEST WALL C ongenital and Developmental Anomalies Inflammatory and Infectious Diseases T umors of the Chest Wall Malignant C hest Wall Tumors REFERENCES Bronchial Artery Embolization Shivanand Gamanagatti, Ashu Seith Bhalla P A THOPHYSIOLOGY AND ETIOLOGY C auses of Hemoptysis (Figs 1A to D) DIAGNOSTIC WORK-UP Idiopathic pulmonary hemosiderosis C onventional Radiography (Figs 2A to C) C omputed Tomography (CT) (Figs 1 and 3) F iberoptic Bronchoscopy (FB) BRONCHIAL ARTERY ANATOMY NONBRONCHIAL SYSTEMIC ARTERY ANATOMY TECHNIQUE OF BRONCHIAL ARTERY EMBOLIZATION Embolic Agents (Figs 9A to D) RESULTS C OMPLICATIONS C ONCLUSION Diagnostic and Therapeutic Interventions in Chest Naveen Kalra, Mandeep Kang, Anupam Lal IMAGE GUIDANCE MODALITIES Nonvascular Interventions T r ansthoracic Needle Biopsy of P ulmonary Lesions Indications P atient Evaluation C ontraindications Image Guidance Biopsy Technique Results C omplications T r ansthoracic Needle Biopsy from Other Sites P ercutaneous Needle Biopsy of the Pleura L ocalization of a Nodule for T horacoscopic Resection Diagnostic Thoracocentesis PERCUTANEOUS DRAINAGE OF PLEURAL SPACE FLUID COLLECTIONS Pleural Sclerotherapy or Pleurodesis P neumothorax Drainage L ung Abscess Drainage SECONDARY PULMONARY ASPERGILLOMA Endoluminal Tracheobronchial S t enting Mediastinal Abscess Drainage P ericardial Effusion Drainage P neumatocele and Bulla Drainage RADIOFREQUENCY ABLATION OF LUNG LESIONS V ASCULAR INTERVENTIONS P ulmonary Artery Embolization Endovascular Therapy of SVC Obstruction P ercutaneous Vascular Foreign Body Retrieval C ONCLUSION REFERENCES Chest X-ray Evaluation in C ardiac Disease Sanjiv Sharma, Gurpreet Singh Gulati, Priya Jagia CARDIAC SILHOUETTE C ardiac Shape C ardiac Contour P osteroanterior (PA) View C ardiac Size C ardiac Volume Right Anterior Oblique View L eft Anterior Oblique View L ateral View A ssessment of Chamber Enlargement Right Atrium L eft Ventricle Right Ventricle L eft Atrium A orta N ormal Radiographic Anatomy PULMONARY VASCULATURE Increased Pulmonary Blood Flow (Pulmonary Plethora) Decreased Pulmonary Blood Flow (Pulmonary Oligemia) R adiological Signs (Fig. 7) R adiological Signs of Plethora (Fig. 6) P ulmonary Arterial Hypertension (Fig. 8) P ulmonary Venous Hypertension Stage 1: Redistribution/Cephalization of the Blood Flow (Fig. 9) Stage 2: Interstitial Edema (Fig. 10) Stage 3: Alveolar Edema (Fig. 11) A symmetrical Pulmonary Blood Flow (Fig. 12) Orientation of Pulmonary Outflow Tract Imaging in Ischemic Heart Disease Gurpreet Singh Gulati, Sanjiv Sharma, Priya Jagia P A THOPHYSIOLOGY OF ISCHEMIC HEART DISEASE Myocardial Ischemia Myocardial Viability and Myocardial Infarction (MI) Rationale for Ischemia and Viability Imaging Imaging Modalities E chocardiography Nuclear Imaging C ardiac Magnetic Resonance Imaging Sequences Stress Cardiac Magnetic Resonance C ardiac Magnetic Resonance for Viability CMR for Myocardial Mass and Function Other Useful Sequences Multidetector Computed Tomography Limitations of MDCT E v aluation of Various Components of IHD C oronary Artery Imaging P laque Imaging Detection of Myocardial Ischemia Myocardial Viability Myocardial Function FUTURE DIRECTIONS A ppropriateness Criteria for use of Cardiac MDCT and CMR in the Investigatio C ONCLUSION REFERENCES Imaging Approach in Children with C ongenital Heart Disease P riya Jagia, Sanjiv Sharma, Gurpreet Singh Gulati PHYSICAL EXAMINATION RADIOLOGICAL APPROACH C hest Radiograph L eft-to-Right (L–R) Shunt P r etricuspid Shunt L arge Aorta Normal Aorta P ost-tricuspid L–R Shunt Right-to-Left (R–L) Shunt Large Aorta with Decreased Lung Vascularity Small Aorta with Increased Vascularity L arge Pedicle with Increased Vascularity Normal Aorta with Decreased L ung Vascularity Other Conditions MULTISLICE CARDIAC CT CARDIAC MRI A nalyzing CT or MRI Images Anatomy CARDIAC CATHETERIZATION REFERENCES Normal Connections C ardiac Tumors F ollow-up after Surgery or after Endovascular Intervention Imaging in Cardiomyopathies P riya Jagia, Gurpreet Singh Gulati, Sanjiv Sharma CLASSIFICATION DIAGNOSTIC TECHNIQUES DILATED CARDIOMYOPATHY Hypertrophic Cardiomyopathy Restrictive Cardiomyopathy Amyloidosis Sarcoidosis Siderotic (or Iron Overload) Cardiomyopathy Endomyocardial Fibrosis Anderson–Fabry Disease T uberculosis Miscellaneous Myocardial Diseases BIBLIOGRAPHY C ONCLUSION Imaging Evaluation of Cardiac Masses Gurpreet Singh Gulati, Priya Jagia, Sanjiv Sharma CLINICAL FEATURES Imaging Techniques Angiocardiography ECHO MDCT MRI MR Imaging Sequences for Evaluation of Cardiac Masses Spin Echo (SE) Sequences Gradient Echo (GRE) and Steady-state Free P r ecession Sequences C ontrast-enhanced Imaging Other Techniques C lassification (Table 1) NEOPLASTIC LESIONS OF THE HEART P rimary Benign Tumors Malignant Tumors Sarcoma Secondary Neoplasms P aracardiac and Extracardiac Tumors NON-NEOPLASTIC LESIONS T hrombus A neurysm of Sinus of Valsalva (SOV ) A trial Septal Aneurysm P leuropericardial Cyst Infective Lesions V alvular Vegetation Hydatid Cyst T uberculoma V ARIANT AND NORMAL ANATOMICAL STRUCTURES SIMULATING A CARDIAC MASS P ericardium L eft Atrium L eft Ventricle Right Atrium Right Ventricle C ONCLUSION REFERENCES Imaging Diagnosis of V alvular Heart Disease P riya Jagia, Sanjiv Sharma, Gurpreet Singh Gulati INTRODUCTION A ORTIC VALVULAR DISEASE MITRAL VALVULAR DISEASE TRICUSPID VALVULAR DISEASE HEMODYNAMIC EFFECTS ON PULMONARY VASCULATURE A ssociated Pulmonary Pathologies E ff ects of Treatment during Follow-up Heart Size L eft Atrial Size Other Changes ECHOCARDIOGRAPHY V alvular Stenosis V alvular Regurgitation Infective Endocarditis P r osthetic Valves CARDIAC MAGNETIC RESONANCE IMAGING V alve Leaflet Morphology V alvular Stenosis V alvular Regurgitation V alve Endocarditis and Tumors P r osthetic Valve C OMPUTED TOMOGRAPHY ANGIOCARDIOGRAPHY C ONCLUSION BIBLIOGRAPHY Imaging of the Pericardium ANATOMY T r ansverse Sinus Superior Aortic Recess Inferior Aortic Recess Right and Left Pulmonic Recesses Oblique Sinus Recesses of the Pericardial Cavity Proper Right and Left Pulmonary Venous Recesses P ostcaval Recess PHYSIOLOGY C ONGENITAL PERICARDIAL ANOMALIES P ericardial Cysts C ONGENITAL ABSENCE OF THE PERICARDIUM PERICARDIAL EFFUSION C ardiac Tamponade P ericarditis Nonconstrictive Pericarditis C onstrictive Pericarditis P neumopericardium PERICARDIAL TUMORS Metastases P rimary P ericardial Tumors C ONCLUSION Nuclear Medicine in CVS and Chest Chetan D Patel, Madhavi Chawla MYOCARDIAL PERFUSION IMAGING Radiopharmaceuticals Rationale of Myocardial Perfusion Imaging S tudy Protocol for Stress MPI C linical Indications of Myocardial P erfusion Imaging Detection of Coronary Artery Disease Assessment of Prognosis and Risk Stratification E v aluation of Myocardial Perfusion after Revascularization Detection of Myocardial Viability RADIONUCLIDE VENTRICULOGRAPHY P a tient Preparation Data Acquisition Interpretation C linical Application Chemotherapy Toxicity C oronary Artery Disease C ardiomyopathy CARDIAC POSITRON EMISSION T OMOGRAPHY C linical Application of Cardiac PET Diagnosis of CAD Assessment of Myocardial Viability NEW DIRECTIONS IN NUCLEAR CARDIOLOGY L UNG VENTILATION: PERFUSION IMAGING L ung Perfusion Scan V entilation Scan Interpretation of V-Q Scan for P ulmonary Embolism C urrent Status and Future Developments in V-Q Imaging POSITRON EMISSION TOMOGRAPHY IN L UNG CANCER P a tient Preparation for F-18 FDG Study PET-CT in Solitary Pulmonary Nodules (SPN) PET-CT in Staging Lung Cancer Restaging and Assessment of Response t o Therapy PET in Radiotherapy Planning Imaging of Aorta ANGIOGRAPHIC ANATOMY Abdominal Aorta Measurement (Diameter) of Aorta Normal Anatomic Variations Indications for Imaging the Aorta IMAGING MODALITIES Intravascular Ultrasound (IV US) C omputed Tomography ( CT ) C onventional Technique Spiral/Helical Technique Ultrasound (US) T r ansesophageal Echocardiography (TEE) Limitations Magnetic Resonance Imaging (MRI) and MR Angiography Black-blood Imaging White-Blood Imaging C ontrast MR Angiography C a theter Angiography T echnique C omplications of Angiography Radiological Findings C onventional X-ray Chest C ONGENITAL AORTIC ANOMALIES A ortic Arch Anomalies C oarctation of Aorta Associated Anomalies Hemodynamics in Adults Noninvasive Imaging A C QUIRED AORTIC DISEASES A ortic Aneurysms Incidence Classification Objectives of Imaging Plain Radiography Growth Rates of Aneurysm and Risk of Rupture Ultrasound (US) C omputed Tomography and Magnetic Resonance Imaging C a theter Angiography A ORTIC DISSECTION Classification A o rtography Imaging C omputed Tomography P r econtrast Images T AKAYASU’S ARTERITIS P ostcontrast Images T ypes 31 Magnetic Resonance Imaging Imaging Findings A ORTIC TRAUMA Grading of Aortic Injuries 37 Imaging C omputed Tomography Magnetic Resonance Imaging A THEROSCLEROSIS P a thology Imaging C ONCLUSION REFERENCES P ostoperative Aorta Imaging of Peripheral V ascular Disease EVALUATION OF THE PERIPHERAL ARTERIAL SYSTEM Imaging Modalities Ultrasound and Doppler Scanning Arterial Flow Patterns on Spectral Doppler CT Angiography MR Angiography C o n v entional Angiography/DSA 9,10 PERIPHERAL ARTERIAL OCCLUSIVE DISEASE Clinical Features Radiological Evaluation Angiography L O WER LIMB ARTERIOGRAPHY 9 Arteritis 9,10 Upper Extremities 20,21 E v aluation of Bypass Grafts 10,22-24 T r eatment Etiology Clinical Features Imaging A cute Limb Ischemia 9,10,20,25 Angiography Clinical Features T horacic Outlet Syndrome 20,22,24 Imaging Aneurysms P seudoaneurysms V enous Malformations V ascular Malformations 9,20,26,29 C apillary Malformations Arteriovenous Malformations Arteriovenous Fistulae 23,24 Dialysis Fistulae EVALUATION OF THE PERIPHERAL VEINS L o w er Extremity A cute Deep Venous Thrombosis Sonography and Color Doppler Flow Imaging C olor Doppler Flow Imaging Upper Extremity DVT 20,24,32,33 A cute Versus Chronic DVT CT Venography 33,34 MR and MR Venography 33-36 V enography 30,31,35 Chronic Venous Disease 30,37,38 Imaging Sonography P erforating Veins V enography V enous Mapping O THER DISORDERS V enous Aneurysms 30,31 C ONCLUSION Basic Principles and Current C oncepts of Musculoskeletal Magnetic Resonan R aju Sharma, Shivanand Gamanagatti HARDWARE ISSUES 3 T IMAGING SEQUENCES F ast Spin-echo Sequences Gradient-recalled Echo Sequences F a t Suppressed Sequences Role of Contrast Reduction of Metallic Artifact from Orthopedic Hardware NORMAL APPEARANCE OF MUSCULOSKELETAL TISSUES IMAGING OF ARTICULAR CARTILAGE MORPHOLOGICAL ASSESSMENT OF CARTILAGE C OMPOSITIONAL ANALYSIS OF CARTILAGE T1ρ Mapping T2 Mapping MUSCULOSKELETAL TUMORS d-GEMRIC USE OF ADVANCED MR TECHNIQUES IN TUMOR EVALUATION P r oton Spectroscopy Diffusion-weighted Imaging Dynamic Perfusion Imaging M ARROW IMAGING MUSCULOSKELETAL INFECTIONS INFLAMMATORY ARTHRITIS INTERVENTIONAL MR IMAGING Nuclear Medicine Imaging for Musculoskeletal Disorders BONE SCINTIGRAPHY SPECT AND SPECT-CT PET AND PET-CT MUSCULOSKELETAL TUMOR IMAGING Metastasis P rimary Malignant Tumors Benign Tumors INFECTION IMAGING A cute and Chronic Osteomyelitis Diabetic Foot P r osthetic Infection FDG PET-CT for Musculoskeletal Infection MUSCULOSKELETAL TRAUMA S tress Fractures S hin Splints F r actures in Childhood Sport Injuries METABOLIC BONE DISEASE IMAGING P aget’s Disease Hyperparathyroidism Renal Osteodystrophy Osteoporosis and Osteomalacia Bone Dysplasias A v ascular Necrosis C omplex Regional Pain Syndrome (Reflex Sympathetic Dystrophy) JOINT IMAGING FUTURE DIRECTION REFERENCES Angiography and Interventions in Musculoskeletal Lesions Deep N Srivastava TECHNIQUE Diagnostic Angiography Angioembolization ANGIOGRAPHY IN BONE TUMORS Osteochondroma Osteoid Osteoma Osteosarcoma Giant Cell Tumor Aneurysmal Bone Cyst ANGIOGRAPHY IN BONE AND SOFT TISSUE LESIONS OF VASCULAR ORIGIN Hemangioma Hemangiopericytoma Angiosarcoma ANGIOGRAPHY IN METASTATIC TUMORS IN BONE AND SOFT TISSUES ANGIOGRAPHY IN PERIPHERAL TRAUMA IMAGE-GUIDED INTERVENTIONS IN BONE AND SOFT TISSUE LESIONS Aspiration Cytology and Biopsy Embolization P r eprocedural Preparations Indications Embolizing Materials C omplications P ercutaneous Vertebroplasty T echnique C ontraindications Intra-arterial Chemotherapy Results C omplications P ercutaneous Treatment of Disk Herniation F uture Directions PERCUTANEOUS ABLATION OF BONE TUMORS T uberculosis of Bones and Joints Gaurav S Pradhan, Veena Chowdhury ETIOPATHOGENESIS C linical Features Radiological Features TUBERCULOSIS OF JOINTS T ubercular Arthritis Hip Knee Ankle and Foot Shoulder Elbow W rist and Carpus Sacroiliac Joints TUBERCULOSIS OF LONG AND FLAT BONES T ubercular Osteomyelitis T uberculosis of Long Bones F lat Bones Ribs P athology Scapula Sternum Skull P elvis Sternoclavicular Joint T uberculosis of Tendon Sheaths and Bursae A cromioclavicular Joint TUBERCULOSIS OF SHORT BONES T ubercular Infection of Prosthetic Joint C ONCLUSION REFERENCES A typical Mycobacterial Infection Nontubercular Bone and Joint Infections Manphool Singhal, Niranjan Khandelwal IMAGING MODALITIES A CUTE OSTEOMYELITIS C linical Features Radiologic Features L OCALIZED OSTEOMYELITIS (BRODIE’S ABSCESS) CHRONIC OSTEOMYELITIS SCLEROSING OSTEOMYELITIS OF GARRE SYPHILIS OF BONE C ongenital (Infantile) Syphilis Late Congenital Syphilis A c quired Syphilis R UBELLA OSTEOMYELITIS A CTINOMYCOSIS OF BONE M ADURAMYCOSIS LEPROSY OF BONE DIABETIC FOOT H Y D A TID DISEASE SEPTIC ARTHRITIS T uberculosis of the Spine R ashmi Dixit PATHOPHYSIOLOGY CLINICAL FEATURES LABORATORY INVESTIGATIONS 21-24 IMAGING MODALITIES Conventional Radiographs Nuclear Medicine Scintigraphy Computed Tomography Magnetic Resonance Imaging Central Anterior Subperiosteal IMAGING APPEARANCES CONVENTIONAL RADIOGRAPHS Paradiskal Appendiceal or Neural Arch Tuberculosis Computed Tomography Cord Changes ATYPICAL SPINAL TUBERCULOSIS 21 Post-treatment Follow-up Conventional Radiographs PET/CT 65 Computed Tomography Magnetic Resonance Imaging 40,48,57 DIFFERENTIAL DIAGNOSIS Noninfective Inflammatory Arthritis Mandeep Kang, Mahesh Prakesh RHEUMATOID ARTHRITIS Pathophysiology Radiographic Features Late Changes Axial Skeleton Involvement OTHER IMAGING MODALITIES Ultrasonography Computed Tomography Radionuclide Scanning Magnetic Resonance Imaging Synovial Imaging Bone Marrow Edema Erosions Large Joints SCORING SYSTEMS FOR RA Tendons and Ligaments JUVENILE IDIOPATHIC ARTHRITIDES Juvenile-onset Adult Type (Seropositive) Rheumatoid Arthritis Seronegative Chronic Arthritis Radiologic Features SERONEGATIVE SPONDYLOARTHROPATHIES ANKYLOSING SPONDYLITIS Pathophysiology Radiologic Features Sacroiliac Joints Spine Peripheral Joints PSORIATIC ARTHROPATHY REITER’S SYNDROME ENTEROPATHIC SPONDYLOARTHROPATHY CRYSTAL DEPOSITION ARTHROPATHY Gout CALCIUM PYROPHOSPHATE DIHYDRATE CRYSTAL DEPOSITION DISEASE Nontubercular Infections of the Spine Sameer Vyas, Manavjit Singh Sandhu P A THOGENESIS OF SPINAL INFECTIONS IMAGING OF SPINAL INFECTIONS P lain Radiography Radioisotope Scanning C omputed Tomography TYPES OF INFECTIONS Myelography/CT Myelography Pyogenic Bacterial Infections Pyogenic Disc Space Infections Spinal Infections in Children Childhood Disc Infection or Discitis Differential Diagnosis of Spinal Infection P ostoperative Spondylodiscitis Epidural Space Infections Nonpyogenic Bacterial Infections Brucellosis A ctinomycosis Nocardiosis V iral Infections Spinal Infections in AIDS C occidioidomycosis Cryptococcosis ( T orulosis) F ungal Infections Aspergillosis Blastomycosis C andidiasis (Moniliasis) P arasitic Infections E chinococcosis or Hydatid C ysticercosis REFERENCES Degenerative Disease of the Spine and Joints Jyoti Kumar, Sumedha Pawa DEGENERATIVE DISORDERS OF THE SPINE Imaging Modalities Pathophysiology Anatomy of Intervertebral Disk Degenerative Disk Changes Disk Herniation Endplate Changes Disease of Facets, Uncovertebral Joints and Ligaments Spondylosis Deformans and Intervertebral Osteochondrosis Complications of Degenerative Spinal Disease Spinal and Foraminal Stenosis Scoliosis and Kyphosis Segmental Instability Clinical Implications DEGENERATIVE DISEASE OF JOINTS Prevalence and Incidence of Osteoarthritis Imaging Modalities Pathogenesis Systemic Risk Factors Local Joint Vulnerabilities Extrinsic Factors Acting on the Joint Joint Overuse from Occupations and Athletics Radiographic–Pathologic Correlation HIP OSTEOARTHRITIS Radiographic Views Radiographic Appearance Superior Migration Pattern Medial Migration Pattern Axial Migration Pattern Rapid Destructive Osteoarthritis KNEE OSTEOARTHRITIS Radiographic Views Cartilage Space Osteophytes Subchondral Sclerosis Radiographic Findings Malalignment Differential Diagnosis Radiographic Grading of Osteoarthritis SHOULDER OSTEOARTHRITIS ROTATOR CUFF TEAR ARTHROPATHY HAND AND WRIST OSTEOARTHRITIS Interphalangeal Joints Thumb Base Metacarpophalangeal Joints Erosive (Inflammatory) Osteoarthritis FOOT AND ANKLE OSTEOARTHRITIS SECONDARY OSTEOARTHRITIS CONCLUSION REFERENCES Skeletal Disorders of Metabolic and Endocrine Origin Alpana Manchanda, Arun Kumar Gupta DISORDERS OF METABOLIC ORIGIN RICKETS AND OSTEOMALACIA C auses Biochemical Findings P a thology of Rickets and Osteomalacia Clinical Features Radiological Features RICKETS Signs of Healing Rickets Sequelae Etiologic Considerations of Rickets ABNORMALITIES OF VITAMIN D METABOLISM Renal Osteodystrophy Hereditary Vitamin D-dependent Rickets X -linked Hypophosphatemia T y pe I VDDR Biochemical Findings Radiological Features T y pe II VDDR RICKETS AND OSTEOMALACIA SECONDARY TO PHOSPHATE LOSS Renal Tubular A cidosis T y pe I (Distal) RTA T y pe II (Proximal) RTA T umor-associated Rickets and Osteomalacia Chemotherapeutic Drug-induced Rickets SYNDROMES WITH THE RADIOGRAPHIC APPEARANCE OF RICKETS OR OSTEOMALACIA BUT W Hypophosphatasia Metaphyseal Chondrodysplasia (Schmid Type) A typical Axial Osteomalacia OSTEOMALACIA Radiological Changes H Y PERPARATHYROIDISM P rimary HPT Secondary HPT T ertiary HPT P a thophysiology Clinical Features Biochemical Findings Radiological Approach Radiological Findings BONE RESORPTION Subperiosteal Resorption Intracortical Bone Resorption Endosteal Bone Resorption Subchondral Bone Resorption Subphyseal Bone Resorption Subligamentous and Subtendinous Bone Resorption T r abecular Bone Resorption BROWN TUMORS RENAL OSTEODYSTROPHY JOINT DISORDERS OSTEOSCLEROSIS RENAL LESIONS NEPHROCALCINOSIS P ARATHYROID LOCALIZATION Surgical Treatment P arathyroid Imaging PREOPERATIVE LOCALIZATION TECHNIQUES ANATOMICAL AND PATHOLOGICAL C ONSIDERATION IMPORTANT FOR LOCALIZATION Embryology and Anatomy Sonographic Evaluation P itfalls in Interpretation P ercutaneous Aspiration/Biopsy C ontrast-enhanced Computed Tomography Magnetic Resonance Imaging P arathyroid Scintigraphy Clinical Presentation Biochemical Findings RADIOLOGICAL FINDINGS Single Photon Emission Computed T omography H Y POPARATHYROIDISM PSEUDOHYPOPARATHYROIDISM Clinical Findings Biochemical Findings Radiological Findings PSEUDOPSEUDOHYPOPARATHYROIDISM DISORDERS OF ENDOCRINE ORIGIN ⁄ ) ZQFSHPOBEJTN H Y PERCORTISOLISM Clinical Findings Radiological Findings H Y POPITUITARISM H Y POTHYROIDISM H Y PERTHYROIDISM Clinical Findings Biochemical Findings Radiological Findings H Y PERGONADISM H Y POGONADISM T urner’s Syndrome GROWTH HORMONE DISORDERS A CROMEGALY Clinical Findings Definitive Diagnosis Radiological Findings GIGANTISM SCURVY Clinical Findings Biochemical Findings P a thophysiology Radiological Findings FLUOROSIS Clinical Findings Radiographical Findings REFERENCES Osteoporosis Mukesh Kumar Yadav, Vivek Gupta, Niranjan Khandelwal DEFINITION P A THOGENESIS CLASSIFICATION P rimary Osteoporosis Juvenile Osteoporosis Endocrine Causes Malignant Diseases Immobilization Drugs Genetic Abnormalities in Bone Collagen Synthesis Gastrointestinal Diseases Organ Transplantation CLINICAL FEATURES INVESTIGATIONS Bone Mineral Analysis S tandard Radiography Radiogrammetry P hotodensitometry Neutron Activation Analysis C ompton Scattering Single Energy Photon Absorptiometry Dual Energy Photon Absorptiometry Dual Energy X-ray Absorptiometry Quantitative C omputed Tomography Quantitative Ultrasound High-resolution Bone Imaging T r abecular Bone Assessment Using C ortical Bone Assessment Using MRI C linical Applications High-resolution Peripheral Quantitative C omputed Tomography (HR-pQCT ) Multidetector CT (MDCT ) M ANAGEMENT OF OSTEOPOROTIC C OMPRESSION FRACTURES: PERCUTANEOUS VERTEBROPL Indications P r ocedure P ostprocedure Care C omplications Benign Bone Tumors and T umor-like Conditions Mahesh Prakash, Niranjan Khandelwal IMAGING MODALITIES Radiography C omputed Tomography Magnetic Resonance Imaging BONE-FORMING TUMORS Enostosis Osteoma Osteoid Osteoma Osteoblastoma CARTILAGE-FORMING TUMORS Osteochondroma Enchondroma C hondroblastoma C hondromyxoid Fibroma FIBROUS TUMORS/LESIONS F ibrous Cortical Defects and Nonossifying Fibroma F ibrous Dysplasia Osteofibrous Dysplasia Desmoplastic Fibroma V ASCULAR AND CONNECTIVE TISSUE TUMORS Hemangioma Lipoma O THER TUMORS Giant C ell Tumor A neurysmal Bone Cyst TUMOR-LIKE LESIONS Simple Bone Cyst E osinophilic Granuloma P seudotumor of Hemophilia Brown Tumor of Hyperparathyroidism C ONCLUSION Malignant Bone Tumors CLASSIFICATION OF PRIMARY M ALIGNANT BONE TUMORS General Principles of Diagnosis S taging of Bone Tumors IMAGING MODALITIES C onventional Radiography Magnetic Resonance Imaging C omputed Tomography A ngiography Ultrasonography Nuclear Medicine OSTEOSARCOMA Intraosseous Osteosarcoma C linical Presentation Surface Osteosarcomas P eriosteal Osteosarcoma 20 Juxtacortical/Parosteal Osteosarcoma High-grade Surface Osteosarcoma Extraosseous Osteosarcoma P rimary Multifocal Osteosarcoma 24 CHONDROSARCOMA Secondary Osteosarcoma Imaging Features 27,28 Other Varieties of Chondrosarcoma FIBROSARCOMA C linical Presentation Imaging Features 32 M ALIGNANT FIBROUS HISTIOCYTOMA 12 C linical Presentation M ALIGNANT ROUND CELL TUMORS (MRCT) EWING’S SARCOMA 33 C linical Presentation Imaging Features 34 P rimitive Neuroectodermal T umor of Bone (PNET ) 12 Non-Hodgkin’s Lymphoma of Bone 38 (Lymphosarcoma, Reticulum Cell Sarcoma) C linical Presentation Hodgkin’s Lymphoma of Bone Imaging Features LIPOSARCOMA V ASCULAR TUMORS OF THE BONE A ngiosarcoma CHORDOMA C linical Presentation Imaging Features ADAMANTINOMA OF LONG BONES 41 C linical Presentation Hemangioendothelioma M ALIGNANT GIANT CELL TUMOR Imaging Features MULTIPLE MYELOMA C linical Presentation Imaging Features POEMS Syndrome PLASMACYTOMA (SOLITARY MYELOMA) C linical Presentation METASTATIC BONE DISEASE Imaging Features Differential Diagnosis C ONCLUSION REFERENCES Magnetic Resonance Imaging of the Knee Sapna Singh IMAGING PROTOCOLS/TECHNICAL FACTORS P a tient Positioning Slice Thickness Imaging Planes and Pulse Sequences Microanatomy of the Menisci MENISCI Normal Anatomy Macroanatomy and MRI Appearance Lateral Meniscus Anatomic Variants Discoid Meniscus Medial Meniscus Meniscus Flounce (Buckled Meniscus) Meniscal Ossicle ABNORMAL MENISCUS Meniscal Degenerations and Tears MR Grading of Meniscal Tears Abnormal Morphology CLASSIFICATION OF MENISCAL TEARS Horizontal Tears Radial/Free Edge Tears L ongitudinal Tears P eripheral Tear Meniscocapsular Separation IMAGING CHALLENGES P otential Pitfalls T r ansverse Intrameniscal Ligament Meniscofemoral Ligaments P opliteus Tendon Magic Angle Effect P ulsation Artifact from the Popliteal Artery Surgical Considerations in Meniscal Tear T ear Location T ear Morphology and Length A c curacy of MR in the Diagnosis of Meniscal Tears LIGAMENTS AND TENDONS OF THE KNEE CENTRAL STRUCTURES OF THE KNEE Anatomy of Anterior Cruciate Ligament MR Appearance of ACL A CL Tears Indirect Signs of ACL Tear A c curacy of MR in ACL Tears P osterior Cruciate Ligament Anatomy of the PCL MR Appearance of PCL MEDIAL STRUCTURES OF THE KNEE Anatomy Magnetic Resonance Imaging MCL Injury POSTEROMEDIAL STRUCTURES OF THE KNEE Anatomy POSTEROLATERAL CORNER OF THE KNEE Anatomy Magnetic Resonance Imaging POSTERIOR STRUCTURES OF THE KNEE Anatomy KNEE DISLOCATIONS ANTEROLATERAL CORNER OF THE KNEE Normal Anatomy Iliotibial Band Injury Segond Fracture Iliotibial Band Friction Syndrome ANTERIOR STRUCTURES OF THE KNEE OR THE EXTENSOR MECHANISM OF THE KNEE Anatomy P a t ellar Tendinosis (Jumper’s Knee) A cute Patellar Tendon Disruption F emoral Trochlear Groove P a t ellar Tendon–Lateral F emoral C ondyle Friction Syndrome P a t ella Alta and Patella Baja KINEMATIC MR IMAGING T echniques Incremental, Passive Positioning Technique P A TELLOFEMORAL JOINT P a t ellofemoral Joint Anatomy A ctive Movement or Dynamic Technique Motion Triggered Cine Technique A ctive Movement, Loaded Technique MR IMAGING OF THE ARTICULAR CARTILAGE Articular Cartilage Structure and Damage MRI of Articular Cartilage MRI Assessment of Articular Cartilage Injury QUANTITATIVE CARTILAGE MR IMAGING Chondromalacia Patellae Osteoarthritis EVALUATION OF THE SYNOVIUM Rheumatoid Arthritis T uberculosis of the Knee Juvenile Rheumatoid Arthritis P igmented Villonodular Synovitis Hemophilia S ynovial Chondromatosis of the Knee Deferiprone-induced Arthropathy MR IMAGING OF BONE MARROW ABNORMALITIES OF THE KNEE T r auma A cute and Chronic Avulsive Injuries F a tigue and Insufficiency Fractures Stress Fractures Spontaneous Osteonecrosis Medullary Infarction Osteochondritis Dissecans T r ansient Bone Marrow Edema S yndrome (Transient Osteoporosis) Reflex Sympathetic Dystrophy Infection Bone Neoplasms MR ARTHROGRAPHY T echnique Meniscal Lesions C artilage Lesions Osteochondritis Dissecans Intra-articular Bodies Plica Synovialis POSTOPERATIVE EVALUATION OF THE KNEE Imaging of the ACL Graft Graft Rupture Graft Impingement Arthrofibrosis P ostoperative Meniscus P ostoperative Articular Cartilage C ONCLUSION REFERENCES Magnetic Resonance Imaging of Hip and Pelvis NORMAL ANATOMY TECHNIQUE HIP AND PELVIS: EVALUATION OF STRUCTURES C oronal (Figs 7A and B) Osseous Structures Nonosseous Structures Axial (Figs 8A to C) Osseous Structures Nonosseous Structures Sagittal A V ASCULAR NECROSIS C ause and Pathogenesis P r esentation MRI OF AVN Magnetic Resonance Imaging and P r ognostic Indicators P itfalls in Diagnosis 20 Study Choice and Work-up Staging BONE MARROW EDEMA SYNDROME P r ognosis MONITORING OF TREATMENT MINIMAL AVN Insufficiency or Stress Fractures of the Femoral Head F emoral Head Osteonecrosis and BMEs FEMOROACETABULAR IMPINGEMENT C am Impingement P incer Impingement HERNIATION PITS FRACTURE Magnetic Resonance Imaging STRESS FRACTURES OSTEOCHONDRAL INJURY 41,42 Muscle Contusions Muscle Strain—Myotendinous Strain TRAUMATIC MUSCULOTENDINOUS INJURIES 43,44 A vulsion Injury Gluteus Medius Tendon Tear—Greater T r ochanteric Pain Syndrome LABRUM BURSAE PIRIFORMIS SYNDROME MAGNETIC RESONANCE IN POSTARTHROPLASTY ARTHRITIS INFECTION P igmented Villonodular Synovitis (PVNS) Magnetic Resonance Imaging P rimary Synovial Chondromatosis Magnetic Resonance Imaging Amyloid Arthropathy NERVES MARROW REPLACEMENT PROCESSES Chondroblastoma Magnetic Resonance Imaging Chondrosarcoma TUMORS Osteoid Osteoma Magnetic Resonance Imaging Chordomas Magnetic Resonance Imaging C ONCLUSION REFERENCES Magnetic Resonance Imaging of Shoulder and T emporomandibular Joints Mahesh Prakash, Paramjeet Singh SHOULDER JOINT MR IMAGING PROTOCOLS MR ARTHROGRAPHY NORMAL ANATOMY OSSEOUS STRUCTURES LIGAMENTS MUSCULOTENDINOUS ANATOMY BURSAE NORMAL MR APPEARANCE Axial Sections (Figs 1 and 4) C oronal Sections (Figs 2 and 4) Sagittal Sections (Figs 3 and 4) SHOULDER IMPINGEMENT SYNDROME P rimary Extrinsic Impingement Secondary Extrinsic Impingement Internal Impingement ROTATOR CUFF TENDINOPATHY AND TEARS MR Appearance INSTABILITY Imaging Techniques for Labral Tears MR Findings in Patients with Instability P itfalls ABNORMALITIES OF BICEPS TENDON Bicipital Tendinopathy/Rupture Bicipital Tendon Dislocations NERVE ENTRAPMENT SYNDROMES Quadrilateral Space Compression Syndrome Suprascapular Nerve Entrapment ADHESIVE CAPSULITIS CALCIFIC TENDINITIS ARTHRITIS OSTEOARTHRITIS INFECTIVE ARTHRITIS RHEUMATOID ARTHRITIS A V ASCULAR NECROSIS TEMPOROMANDIBULAR JOINT MR Imaging Technique NEOPLASMS NORMAL ANATOMY AND MR APPEARANCE (FIGS 34 TO 37) Normal MR Appearance Movements DISEASES OF TEMPOROMANDIBULAR JOINT INTERNAL DERANGEMENT DISK DISPLACEMENTS DISK DEFORMITY AND OSTEOARTHRITIS STUCK DISK OPEN LOCK JAW OSTEONECROSIS AND OSTEOCHONDRITIS DISSECANS POSTOPERATIVE IMAGING EVALUATION OF MANDIBULAR ASYMMETRY INFECTIONS AND ARTHRITIDES TUMORS AND TUMOR-LIKE CONDITIONS REFERENCES Magnetic Resonance Imaging in Bone Marrow Disorders DISTRIBUTION OF NORMAL BONE MARROW AND NORMAL CONVERSION MR IMAGING TECHNIQUES FOR EVALUATION OF NORMAL BONE MARROW RECENT ADVANCES IN MR IMAGING OF BONE MARROW Dynamic Contrast-enhanced MR Imaging and Bone Marrow Perfusion C ONTRAST-ENHANCED MR IMAGING OF THE BONE MARROW USING IRON OXIDE P ARTICLES MR SPECTROSCOPY WHOLE BODY MRI 3T MRI C OMBINED PET AND MR IMAGING NORMAL MR APPEARANCES OF BONE MARROW IMAGING OF BONE MARROW DISORDERS Reconversion of Fatty Marrow to Hematopoietic Marrow Marrow Replacement or Infiltration Myeloid Depletion Depletion of Myeloid Elements with Fibrosis Differential Diagnosis of Gaucher’s Disease and Hemosiderosis Deposition of Metabolic Products MR IMAGING OF THERAPY-INDUCED CHANGES OF BONE MARROW CHANGES IN MARROW SIGNAL DUE TO CHEMOTHERAPY NEW THERAPY REGIMENS BONE MARROW TRANSPLANTATION FOCAL DISORDERS OF THE BONE MARROW C ONCLUSION REFERENCES R adiological Evaluation of Appendicular Trauma A tin Kumar, Arun Kumar Gupta CLINICAL EVALUATION RADIOLOGICAL EVALUATION Definitions and Classification Osseous Evaluation P r esence or Absence of Bony Injury Anatomic Location and Extent of the Fracture T ypes of Fracture Direction of Fracture Line Spatial Relationship of the Fragments P r esence of Special Features P r esence of Associated Abnormalities of the Adjacent Joints Involvement of Growth Plate/Physis: Seen in Children Soft-tissue Evaluation FRACTURE HEALING P r esence of Special Types of Fractures C OMPLICATIONS OF FRACTURE Immediate Complications Intermediate Complications Delayed Complications Imaging Modalities UPPER LIMB TRAUMA Dislocation of the Shoulder F r acture of Neck of Humerus F r acture of Shaft of Humerus F r acture of Distal Humerus Dislocation of the Elbow F r acture of the Head and Neck of Radius F r acture of Upper End of Ulna F r actures of the Shaft of the Radius and Ulna F r actures of Distal End of Radius F r actures of the Carpal Bones Dislocation of the Wrist Single Carpal Dislocations Multiple Carpal Dislocations F r actures and Dislocations of the Hand L O WER LIMB TRAUMA Dislocations of the Hip P osterior Dislocation Anterior Dislocation F r actures of the Proximal Femur Intracapsular Fractures Extracapsular Fractures F r actures of the Shaft of Femur F r actures of the Proximal Tibia F r actures of the Patella Dislocation of the Patella F r actures of the Calcaneum F r actures of Shaft of Tibia and Fibula F r actures of the Distal Tibia and Fibula F r actures of the Talus Dislocations of the Foot C ONCLUSION Imaging of Soft Tissue Lesions Ashu Seith Bhalla, Sanjay Thulkar Ultrasonography Magnetic Resonance Imaging Plain Radiography MR Spectroscopy Staging Location Computed Tomography PET-CT SOFT TISSUE LESIONS ARTIFACTS CALCIFICATION AND OSSIFICATION IN SOFT TISSUES Metastatic Calcification Parasitic Infestations Vascular Calcification Dystrophic Calcification Metabolic Diseases Collagen Vascular Diseases Dermatomyositis Idiopathic Calcification Idiopathic Calcinosis Universalis Calcinosis Circumscripta Tumoral Calcinosis OSSIFICATION Myositis Ossificans Myositis Ossificans Progressiva (Fibrodysplasia Ossificans Progressiva) Soft Tissue Masses with Calcification/Ossification AREAS OF DECREASED DENSITY Air in the Soft Tissues Air Leaks (Surgical Emphysema) Air Formed within the Soft Tissues Air Introduced from Outside FAT IN THE SOFT TISSUES SOFT TISSUE MASSES Cystic Soft Tissue Lesions Bursae Cystic Masses around the Knee Inflammatory Lesions Soft Tissue Tumors Adipocytic Tumors Hemangioma Vascular Lesions Soft Tissue Angiosarcoma Vascular Malformations High-flow Vascular Malformations Low-flow Vascular Malformations Fibroblastic/Myofibroblastic Tumors Fibrohistiocytic Tumors Dermatofibrosarcoma Protuberans Malignant Fibrous Histiocytoma Smooth Muscle Tumors Leiomyoma Leiomyosarcoma Skeletal Muscle Tumors Rhabdomyosarcoma Pericytic Tumors Chondro-osseous Tumors Mesenchymal Chondrosarcoma Extraskeletal Osteosarcoma Tumors of Uncertain Origin Synovial Sarcoma Miscellaneous Neurogenic Tumors EXTRASKELETAL EWIN G’S SARCOMA AND PRIMITIVE NEUROECTODERMAL TUMOR SUMMARY ACKNOWLEDGMENT REFERENCES A Systematic Approach to Imaging of Breast Lesions Smriti Hari, Sanjay Thulkar, Arun Kumar Gupta IMAGING TECHNIQUES Mammography (Basic Physics, Equipment and Technique) RADIATION DOSE Mammography Projections Supplementary Views NORMAL MAMMOGRAPHIC ANATOMY Interpretation and Reporting of Mammograms Mass C alcification ARCHITECTURAL DISTORTION FOCAL ASYMMETRY BREAST EDEMA Abnormal Axillary Lymph Nodes AMERICAN COLLEGE OF RADIOLOGY BI-RADS ASSESSMENT CATEGORIES C ategory 3 Mammographic Assessment is Incomplete C ategory 0 Mammographic Assessment is Complete: F inal Categories C ategory 1 C ategory 2 Management of Probably Benign Lesions C ategory 4 C ategory 5 C ategory 6 Indications for Mammography DIGITAL MAMMOGRAPHY FULL FIELD DIGITAL IMAGING A dvantages and Applications of the Digital Mammography C omputer-aided Detection Digital Breast Tomosynthesis C ONTRAST-ENHANCED DIGITAL MAMMOGRAPHY BREAST ULTRASOUND Normal Anatomy Indications for Breast Ultrasound A CR BI-RADS Ultrasound Lexicon Descriptors Challenges in Assigning Final Assessment C a t egories and the Influence of Cl C ontrast-enhanced Ultrasound Ultrasound Elastography C oils and Patient Positioning MR Field Strength D Y NAMIC CONTRAST-ENHANCED BREAST MRI Basic MR Technique for Breast Cancer Imaging Imaging Protocols Plane of Imaging F at Suppression Nongadolinium-enhanced Sequences Kinetic Analysis Normal MRI Appearances Interpretation of Breast MRI Mass Nonmass like Enhancement Internal Enhancement Pattern FOCUS ASSOCIATED FINDINGS Distribution Kinetic Curve Assessment Sensitivity and Specificity of MRI Indications for MRI PROTON MR SPECTROSCOPY DIFFUSION-WEIGHTED IMAGING NUCLEAR MEDICINE IN BREAST IMAGING Breast-specific Gamma Imaging P ositron Emission Tomography Limitations P ositron Emission Mammography Benign and Malignant Lesions of the Breast Smriti Hari, Ashu Seith Bhalla, Sanjay Thulkar PROLIFERATIVE BENIGN LESIONS OF THE BREAST A denosis F ibroadenoma F ibrocystic Disease C y sts Intraductal Papilloma Duct Ectasia Ductal Epithelial Hyperplasia MISCELLANEOUS BENIGN BREAST C ONDITIONS Lipoma F a t Necrosis Galactocele Radial Scar Hamartoma P seudoangiomatous Stromal Hyperplasia Breast Tuberculosis Desmoid Tumor Diabetic Mastopathy Superficial Thrombophlebitis (Mondor’s Disease) Breast Infections Breast Implants M ALIGNANT LESIONS OF THE BREAST Risk Factors for Breast Cancer Diagnosis of the Breast Cancer BREAST CANCER SCREENING Mammography Screening MRI Screening Ultrasound Screening Breast Cancer Screening in Developing Countries IMAGING FEATURES OF BREAST CANCER P r einvasive Breast Lesions Ductal Carcinoma in Situ L obular Carcinoma in Situ Invasive Ductal Carcinoma Invasive Lobular Carcinoma Invasive Breast Cancer Medullary Carcinoma T ubular Carcinoma P apillary Carcinoma Mucinous Carcinoma T riple Negative Breast Cancer STAGING AND TREATMENT OF BREAST CANCER P r eoperative Breast Imaging Breast C onservation Therapy Mastectomy Management of Axilla P erioperative Breast Imaging A djuvant Treatment ADVANCED BREAST CANCER L ocally Advanced Breast Cancer Inflammatory Breast Cancer Neoadjuvant Chemotherapy Metastatic Breast Cancer POST-TREATMENT BREAST IMAGING AND FOLLOW-UP Occult Primary Breast Cancer MISCELLANEOUS MALIGNANT LESIONS OF THE BREAST P aget’s Disease P h yllodes Tumor Sarcoma Metastases to Breast Male Breast Cancer REFERENCES Breast Interventions Smriti Hari, Sanjay Thulkar BREAST BIOPSY BREAST BIOPSY TECHNIQUES Surgical Biopsy F ine Needle Aspiration Cytology C ore Needle Biopsy V acuum-assisted Biopsy A dvantages of VAB Marker Clip Placement with VAB Disadvantages of VAB C omplete Lesion Removal with VAB L esion Selection for Breast Biopsy Selection of Guiding Modality P r ebiopsy Assessment Ultrasound-guided Breast Biopsy T echnique Stereotactic Breast Biopsy Equipment T echnique Specimen Radiography P ostbiopsy Care C OMPLICATIONS OF BREAST BIOPSY Histopathological Correlation MRI-guided Breast Biopsy PREOPERATIVE HOOKWIRE LOCALIZATION Equipment T echnique Specimen Radiography C omplications Special Techniques of Localization MISCELLANEOUS BREAST INTERVENTIONS Ductography C y st Aspiration Ultrasound-guided Axillary Lymph Node FNAC ABLATIVE PROCEDURES FOR BREAST CANCER REFERENCES PET-CT in Management of Breast Cancer PRIMARY MALIGNANCY POSITRON EMISSION MAMMOGRAPHY LOCOREGIONAL STAGING FDG-PET-CT for Axillary Disease FDG-PET-CT for Other Regional Lymph Nodes SYSTEMIC STAGING Distant Metastasis Bone Metastasis 18 F-Fluoride PET-CT for Bone Metastasis RESPONSE TO CHEMOTHERAPY Neoadjuvant Chemotherapy Adjuvant Chemotherapy in Metastatic Disease RESTAGING Prognostication RECEPTOR IMAGING FUTURE DIRECTIONS CONCLUSION REFERENCES