Hemorrhage in metastatic neoplasms-CT

Multifocal haemorrhagic ring lesions  with vasogenic edema, possibly haemorrhagic mitotic etiology (likely secondaries).  Note- The incidence of hemorrhage in metastatic neoplasms is highest in melanoma, hypernephroma, bronchogenic carcinoma, and choriocarcinoma. Other metastatic tumours that bleed are breast and thyroid metastasis

Lingual Thyroid-CT

In the first trimester of embryonic development, the thyroid gland originates in the back of the tongue and migrates to the front of the neck.  When migration fails and the gland remains in the base of the tongue, it is called lingual thyroid or ectopic lingual thyroid. Lingual thyroids are four times more common in females than in males. This is a 23 year old female who presented with tongue mass. CT shows an hyperdense ectopic thyroid in the midline base of tongue.

Case by Teleradiology Providers

Ascariasis-CT

Note the linear and rounded cut sections of worm on CT abdomen. Common in our side of the world.

Teleradiology Providers

Giant hiatal hernia-CT

Hiatal hernias may be categorized as paraesophageal or sliding. Paraesophageal hiatal hernias are rare hernias involving migration of the gastric fundus into the thorax while the gastroesophageal junction remains below the diaphragm. Sliding hiatal hernias, by far more common, involve migration of both the gastroesophageal junction and the stomach into the thorax; they place patients at risk for reflux.

Paraduodenal Hernia-CT

Intestinal obstruction is a common clinical condition that is usually suspected on the basis of clinical signs and patient history. Internal hernias are rare cause for intestinal obstruction. Para duodenal hernias constitute approximately 53% of all internal hernias

Retinoblastoma-CT

Note the soft tissue lesion with calcification in the left globe.

Teleradiology Providers

Craniovertebral Tuberculosis-CT

Some CT images showing destruction of the left lateral mass and odontoid tip. Patient is k/c/o of tuberculosis.

Dr.Sumer K Sethi, MD

Sr Consultant Radiologist ,VIMHANS and CEO-Teleradiology Providers

Editor-in-chief, The Internet Journal of Radiology

Director, DAMS (Delhi Academy of Medical Sciences)

Aspergilloma-CT

Note the classical postion shift in supine and prone CT studies.

Dr.Sumer K Sethi, MD

Sr Consultant Radiologist ,VIMHANS and CEO-Teleradiology Providers

Editor-in-chief, The Internet Journal of Radiology

Director, DAMS (Delhi Academy of Medical Sciences)

Multiple Arachnoid Cysts-CT

Arachnoid cysts are CSF-filled intraarachnoidal collections. They are most commonly located in the middle cranial fossa followed by suprasellar and quadrigeminal cisterns, posterior fossa, cerebral convexities, and interhemispheric fissure. This is an exceptional case with the coexistence of multiple arachnoid cysts in three different locations.

Bilateral Subdural hematomas-CT

Bilateral subdural hematomas especially when they are isodense may be missed on CT. A classical sign is "Rabbit Ear Sign" in which frontal horns point posteriorly.

Dr.Sumer K Sethi, MD
Sr Consultant Radiologist ,VIMHANS and CEO-Teleradiology Providers
Editor-in-chief, The Internet Journal of Radiology
Director, DAMS (Delhi Academy of Medical Sciences)

Epidermoid Tumour- Suprasellar location-CT

Here is a case of epidermoid tumour in the suprasellar location and it appeared bright on DWI.

Dr.Sumer K Sethi, MD
Sr Consultant Radiologist ,VIMHANS and CEO-Teleradiology Providers
Editor-in-chief, The Internet Journal of Radiology
Director, DAMS (Delhi Academy of Medical Sciences)

Maxillary SInus Mucocele-CT

Mucoceles are most commonly frontal or frontoethmoid in origin with maxillary sinus mucoceles accounting for less. Often resulting from trauma or ostial obstruction, mucoceles often expand gradually, but their progression can be much more rapid during episodes of infection. Frequently, the surrounding bone demonstrates either thickening as a result of osteitis from chronic inflammation or remodeling with resorption secondary to the chronic expansile forces and osteolytic enzymes.

Dr.Sumer K Sethi, MD

Sr Consultant Radiologist ,VIMHANS and CEO-Teleradiology Providers

Editor-in-chief, The Internet Journal of Radiology

Director, DAMS (Delhi Academy of Medical Sciences)

Early Stroke-CT finding

NCCT done on the day reveals obscuration of the outline of lentiform nucleus, which is a early sign of infarction. CT repeated next day confirms the right MCA territiry infarct.

Hyperdense MCA sign-Hyperacute Stroke

Axial CT images demonstrate increased linear attenuation within the left middle cerebral artery. Hyperacute stroke was suspected. MRI was done and diffusion weighted MRI confirms left MCA territory infarct.

Carcinoma Stomach with Krukenberg Secondaries

Dr.Sumer K Sethi, MD
Sr Consultant Radiologist ,VIMHANS and CEO-Teleradiology Providers
Editor-in-chief, The Internet Journal of Radiology
Director, DAMS (Delhi Academy of Medical Sciences)

Basal Ganglia Calcification-Differential Diagnosis

BASAL GANGLIA CALCIFICATION

Birth anoxia

Idiopathic (most common) bilateral and symmetrical

Toxoplasmosis / CMV - usually not limited to basal ganglia

Hypoparathyroidism / pseudohypoparathyroidism

Fahr syndrome

Cockayne syndrome

Acute Pyelonephritis

This a a young female presented with symptoms of urinary tract infection with CT shwoing bulky right kidney with inhomogenous striated nephrogram, likely acute pyelonephritis.

Dr.Sumer K Sethi, MD
Consultant Radiologist ,VIMHANS and CEO-Teleradiology Providers
Editor-in-chief, The Internet Journal of Radiology
Director, DAMS (Delhi Academy of Medical Sciences

Giant Hemangioma of Liver-Triple Phase CT

Cavernous hemangioma is the most common benign hepatic tumor. It typically occurs in women. Lesions measuring more than 4 cm in diameter are known as "giant hemangiomas" and often cause symptoms such as vague abdominal distention and pain. The constellation of giant hemangioma, thrombocytopenia, and localized consumption coagulopathy is known as the Kasabach–Merritt syndrome. This is a case of 40 year old female with giant hemangioma of liver with triple phase CT showing classical centripetal fill-in.

Dr Jaya Shankar, MD and Dr.Sumer K Sethi, MD
Sr Consultant Radiologist ,VIMHANS and CEO-Teleradiology Providers

Editor-in-chief, The Internet Journal of Radiology

Director, DAMS (Delhi Academy of Medical Sciences

Hydatid Cyst- CT

Imaging--Separation of the laminated membrane from the penicyst produces a split wall or floating membrane appearance.

Dr.Sumer K Sethi, MD

Sr Consultant Radiologist ,VIMHANS and CEO-Teleradiology Providers
Editor-in-chief, The Internet Journal of Radiology
Director, DAMS (Delhi Academy of Medical Sciences

Lissencephaly-CT

Sulci are absent with smooth cortical surface. Sylvian fissures are straight oblique resultinga figure of eight appearance of brain.
Diagnosis : Lissencephaly.

Dr.Sumer K Sethi, MD

Consultant Radiologist ,VIMHANS and CEO-Teleradiology Providers

Editor-in-chief, The Internet Journal of Radiology

Director, DAMS (Delhi Academy of Medical Sciences)