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ویرایش: [Third edition.] نویسندگان: Manavjit Singh Sandhu, (Physician) Arun Kumar Gupta, Anju Garg سری: ISBN (شابک) : 9789390595556, 939059555X ناشر: Jaypee Brothers Medical Publishers سال نشر: 2021 تعداد صفحات: [9156] زبان: English فرمت فایل : PDF (درصورت درخواست کاربر به PDF، EPUB یا AZW3 تبدیل می شود) حجم فایل: 203 Mb
در صورت تبدیل فایل کتاب Comprehensive textbook of diagnostic radiology به فرمت های PDF، EPUB، AZW3، MOBI و یا DJVU می توانید به پشتیبان اطلاع دهید تا فایل مورد نظر را تبدیل نمایند.
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Cover Title Page AIIMS-MAMC-PGI's Comprehensive Textbook of Diagnostic Radiology, 3ed Copyright Associate Editors Contributors Preface to the Third Edition Preface to the First Edition Acknowledgments Volume 1 SECTION 1 Genitourinary Imaging CHAPTER 1 Imaging Techniques and Radiological Anatomy of the Upper Urinary Tract ANATOMY OF THE UPPER URINARY TRACT Variants of the Calyceal Anatomy Retroperitoneal Spaces Relations of the Kidneys Vascular Anatomy Ureters IMAGING TECHNIQUES OF THE UPPER URINARY TRACT CONVENTIONAL RADIOGRAPHY INTRAVENOUS UROGRAPHY Normal Physiology Giving Rise to the Appearances on IVU Technique DIGITAL TOMOSYNTHESIS RETROGRADE PYELOGRAPHY Technique ANTEGRADE PYELOGRAPHY NEPHROSTOGRAM GRAYSCALE ULTRASOUND Technique Normal Appearances on Ultrasound Normal Variations DOPPLER EVALUATION Indications Technique Normal Doppler Pattern Ureters on Ultrasound CONTRAST-ENHANCED ULTRASOUND ULTRASOUND ELASTOGRAPHY COMPUTED TOMOGRAPHY OF THE UPPER URINARY TRACT Normal Appearance of the Upper Urinary Tract on CT Examination Technique and Imaging Protocols of MDCT of Kidney Noncontrast Normal CT Nephrogram Pathological CT Nephrogram MDCT in Renal Masses MDCT in Urolithiasis and Acute Flank Pain MDCT in Blunt Renal Trauma MDCT in Renal Infections Image Processing and Postprocessing Techniques on Computed Tomography MULTIDETECTOR CT UROGRAPHY CT HYBRID UROGRAPHY CT—Only CT Urography Split Bolus MDCT Urography with Synchronous NP and EP Enhancement Triple Bolus CT Urography Radiation Dose of CT Urography DUAL ENERGY CT IN THE UPPER URINARY TRACT Characterization of Renal Masses on Dual Energy CT Characterization of Renal Stones by Dual Energy CT Dual Energy CT in CT Urography CT ANGIOGRAM OF RENAL ARTERIES Technique MAGNETIC RESONANCE IMAGING OF THE UPPER URINARY TRACT Technique Normal Appearance of the Upper Urinary Tract on MRI MAGNETIC RESONANCE UROGRAPHY Static Fluid MR Urography Excretory MR Urogram Clinical Applications of MR Urography Limitations of MR Urograms MAGNETIC RESONANCE ANGIOGRAM Functional MRI of the Kidneys Contrast-enhanced MR Renography138 Diffusion Weighted MRI Diffusion Tensor Imaging Blood Oxygen Level Dependent MRI Arterial Spin Labeling: Noncontrast Perfusion Imaging MRI Sodium ( MR Elastography CONCLUSION REFERENCES CHAPTER 2 Current Status of Nuclear Medicine in Urinary Tract Imaging INTRODUCTION RENAL POSITRON EMISSION TOMOGRAPHY RADIOPHARMACEUTICALS L,L Ethylene Dicysteine Mercaptoacetyltriglycine Diethyl Triamine Pentaacetic Acid Dimercaptosuccinic Acid IMAGING TECHNIQUES Renal Dynamic Scintigraphy RENAL CORTICAL SCINTIGRAPHY Imaging Techniques Radionuclide Cystography POSITRON EMISSION TOMOGRAPHY/COMPUTED TOMOGRAPHY Renal Cell Carcinoma Urinary Bladder Cancer REFERENCES CHAPTER 3 Renal Calculus Disease and Obstructive Uropathy UROLITHIASIS INTRODUCTION COMPOSITION ETIOLOGY PRESENTATION DIAGNOSTIC EVALUATION Ultrasonography Sonographic Technique Kidney Ureter and Bladder Radiography Computed Tomography Technical and Dose Considerations Imaging Features Intravenous Urography Magnetic Resonance Imaging OBSTRUCTIVE UROPATHY INTRODUCTION PATHOPHYSIOLOGY CAUSES OF OBSTRUCTION AND DISEASES OF URETER Congenital Ureteric Obstruction Acquired Ureteric Obstruction Extrinsic Causes of Ureteral Obstruction Miscellaneous Diseases of Ureter REFERENCES CHAPTER 4 Renal Parenchymal Disease DEFINITION AND CLASSIFICATION OF KIDNEY DISEASE Acute Kidney Injury Chronic Kidney Disease ROLE OF IMAGING IN RENAL FAILURE Radiological Approach to Renal Parenchymal Disease Imaging Techniques IMAGING IN RENAL PARENCHYMAL DISEASE Acute Renal Parenchymal Disease Acute Tubular Necrosis Acute Cortical Necrosis Leukemia Acute Interstitial Nephritis Amyloidosis Multiple Myeloma Paroxysmal Nocturnal Hemoglobinuria Chronic Renal Parenchymal Disease Renal Papillary Necrosis Benign and Malignant Nephrosclerosis Renal Osteodystrophy CONCLUSION REFERENCES CHAPTER 5 Nontubercular Infections of the Urinary Tract INTRODUCTION IMAGING MODALITIES ACUTE PYELONEPHRITIS Pathology Radiology ACUTE FOCAL BACTERIAL NEPHRITIS RENAL AND PERIRENAL ABSCESSES EMPHYSEMATOUS PYELONEPHRITIS PYONEPHROSIS CHRONIC PYELONEPHRITIS XANTHOGRANULOMATOUS PYELONEPHRITIS MALACOPLAKIA HIV-ASSOCIATED NEPHROPATHY FUNGAL INFECTION PARASITIC INFECTION REFERENCES CHAPTER 6 Tubercular Infection of the Urinary Tract INTRODUCTION PATHOGENESIS CLINICAL PICTURE LABORATORY INVESTIGATIONS CYSTOSCOPY IMAGING EVALUATION Radiographs Intravenous Urography Retrograde Pyelography Ultrasonography Computed Tomography Spectrum of Imaging Findings on Computed Tomography Magnetic Resonance Imaging COMPLICATIONS DIFFERENTIAL DIAGNOSIS GENITOURINARY TUBERCULOSIS IN HUMAN IMMUNODEFICIENCY VIRUS TUBERCULAR INFECTION OF THE GRAFT KIDNEY CONCLUSION REFERENCES CHAPTER 7 Renal Cystic Diseases INTRODUCTION RENAL CYSTS Serous Renal Cysts Atypical Cysts IMAGING MODALITIES Conventional Radiography Ultrasonography Computed Tomography Magnetic Resonance Imaging Angiography Biopsy ADULT RENAL CYSTIC DISEASE: CLASSIFICATION MULTIFOCAL CYSTIC RENAL DISEASE Heritable Multifocal Cystic Renal Disease Acquired Multifocal Cystic Renal Disease Cysts of Renal Pelvis FOCAL CYSTIC RENAL DISEASE Mixed Epithelial and Stromal Tumor Cystic Nephroma Cystic Renal Cell Carcinoma Pyelocalyceal Diverticulum INFECTIOUS CYSTS Pyogenic Abscess Hydatid Cyst Tuberculosis Renal Aspergillosis CONCLUSION SUGGESTED READING CHAPTER 8 Renal Neoplasms INTRODUCTION CLASSIFICATION OF RENAL TUMORS IMAGING OF RENAL MASS: MODALITIES AND TECHNIQUES DIAGNOSTIC CRITERIA Balls versus Beans Renal Pseudotumors RENAL CELL TUMORS Renal Cell Carcinoma Other Subtypes of Renal Cell Carcinoma Imaging of Renal Cell Carcinoma Screening for Kidney Cancer Oncocytoma METANEPHRIC TUMORS Renal Adenomas MIXED EPITHELIAL AND STROMAL TUMORS MESENCHYMAL TUMORS Angiomyolipoma Leiomyosarcoma UROTHELIAL TUMOR Transitional Cell Carcinoma Squamous Cell Carcinoma LYMPHOMA Imaging of Renal Lymphoma PRIMITIVE NEUROECTODERMAL TUMOR/EXTRASKELETAL EWING’S TUMOR RENAL METASTASES RENAL MASS BIOPSY INDETERMINATE RENAL MASS ACKNOWLEDGMENT REFERENCES CHAPTER 9 Renovascular Hypertension HYPERTENSION CAUSES OF HYPERTENSION RENOVASCULAR HYPERTENSION Epidemiology Natural History Pathophysiology Clinical Manifestations of Renovascular Disease MAJOR CAUSES OF RENOVASCULAR HYPERTENSION Atherosclerotic Renal Arterial Disease Fibromuscular Dysplasia Nonspecific Aortoarteritis/Takayasu’s Arteritis14,15 Other Vasculitis Congenital Renal Artery Stenosis Transplant Renal Artery Stenosis Aortorenal Dissection SCREENING FOR RENOVASCULAR HYPERTENSION Indications for Testing for Renovascular Hypertension11,18,19 DIAGNOSTIC MODALITIES Clinical and Biochemical Tests Imaging Modalities for Assessment of Renal Artery Stenosis INDICATIONS OF REVASCULARIZATION AND TREATMENT OPTIONS Atherosclerotic Renal Artery Stenosis Takayasu’s Arteritis/Nonspecific Aortoarteritis Fibromuscular Dysplasia Renal Artery Stenosis in Children49 TRIAL EVIDENCE ENDOVASCULAR TREATMENT: TECHNICAL CONSIDERATIONS CONCLUSION REFERENCES CHAPTER 10 Imaging of Renal Transplant INTRODUCTION TECHNIQUE COMPLICATIONS Vascular Complications Nonvascular Complications Surgical Complications IMAGING TECHNIQUES Radiography Nuclear Imaging Ultrasonography Computed Tomography Dual Energy Computed Tomography Magnetic Resonance Imaging Angiography Percutaneous Interventional Techniques ACKNOWLEDGMENTS REFERENCES CHAPTER 11 Imaging Techniques and Radiological Anatomy of Lower Urinary Tract INTRODUCTION ANATOMY Urinary Bladder Urethra IMAGING MODALITIES Plain Radiographs Voiding Cystourethrography Retrograde Urethrography Cystography Retrograde Pyelography Ultrasonography Computed Tomography Magnetic Resonance Imaging Urodynamic Studies Nuclear Imaging CONCLUSION SUGGESTED READING CHAPTER 12 Urinary Bladder and Urethral Diseases ANATOMY Urinary Bladder Urethra IMAGING MODALITIES Plain Films Retrograde Urethrography Voiding Cystourethrography Cystography Urodynamic Studies of the Lower Urinary Tract Ultrasonography Computed Tomography Magnetic Resonance Imaging Radionuclide Imaging SPECIFIC DISEASES OF THE URINARY BLADDER Bladder Diverticula Urachal Anomalies Exstrophy Other Anomalies Neurogenic Bladder Infections Bladder Tumors SPECIFIC DISEASES OF URETHRA Gonococcal and Nongonococcal Urethritis Condyloma Acuminata (Venereal Warts) Tuberculosis Urethral Strictures Urethral Diverticulum Megalourethra and Urethral Fistula Urethral Calculi Tumors of the Male Urethra Tumors of the Female Urethra Metastatic Tumors of Urethra Role of Contrast-enhanced Ultrasound and Recent Advances in Lower Urinary Tract Imaging Advances in Imaging of Lower Urinary Tract REFERENCES CHAPTER 13 Imaging Techniques and Radiological Anatomy of Female Genital Tract INTRODUCTION PLAIN FILM RADIOGRAPHY HYSTEROSALPINGOGRAPHY Technique ULTRASOUND Indications for Evaluation of Uterus and Adnexa Technique DOPPLER EVALUATION Indications GEL SONOVAGINOGRAPHY THREE-DIMENSIONAL AND FOUR-DIMENSIONAL SONOGRAPHY Indications Technical Considerations SALINE INFUSION SONOHYSTERO-SALPINGOGRAPHY Technique HYSTEROSALPINGO-CONTRAST SONOGRAPHY EXTENDED FIELD-OF-VIEW IMAGING15 ELASTOGRAPHY16 CONTRAST-ENHANCED ULTRASONOGRAPHY MAGNETIC RESONANCE IMAGING Indications Patient Preparation Sequences COMPUTED TOMOGRAPHY Technique PET-CT AND PET-MR Indications Technical Considerations ANATOMY Uterus Adnexae The Menstrual Cycle Imaging in Postmenopausal Period Vascular Anatomy CONCLUSION REFERENCES CHAPTER 14 Benign Adnexal Disease INTRODUCTION OVARIAN DISEASE FUNCTIONAL CYSTS OF THE OVARY Follicular Cyst Corpus Luteum Cyst Hemorrhagic Ovarian Cysts Follow-up Guidelines for Functional Ovarian Cysts ENDOMETRIOMA Pathophysiology Clinical Features Imaging Features Associations Complications Differential Diagnosis BENIGN OVARIAN NEOPLASMS EPITHELIAL TUMORS Serous Cystadenoma Mucinous Cystadenoma Ovarian Cystadenofibroma Brenner Tumor GERM CELL TUMORS Mature Cystic Teratoma SEX CORD-STROMAL TUMORS OVARIAN TORSION Pathophysiology Clinical Features Imaging Features Differential Diagnosis Management MASSIVE OVARIAN EDEMA Imaging Features PELVIC INFLAMMATORY DISEASE Etiopathogenesis Clinical Features Imaging Features Specific Pelvic Inflammatory Disease Complications Differential Diagnosis Management EXTRAOVARIAN DISEASE TUBAL PATHOLOGY Tubal Dilatation/Hydrosalpinx Ectopic Pregnancy Paraovarian and Paratubal Cysts Peritoneal Inclusion Cyst UTERINE LESIONS IMAGING APPROACH TO AN ADNEXAL LESION CONCLUSION REFERENCES CHAPTER 15 Malignant Ovarian and Tubal Disease INTRODUCTION ETIOPATHOGENESIS CLASSIFICATION WHO Histological Classification STAGING ROLE OF IMAGING MODALITIES Ultrasonography Color Doppler IOTA Simple Rules ADNEX Model Computed Tomography Magnetic Resonance Imaging PET-CT KEY IMAGING FEATURES OF OVARIAN MALIGNANCIES Collision Tumors Metastatic Ovarian Tumors Fallopian Tube Malignancies TUMOR MARKERS IN OVARIAN NEOPLASMS RECENT ADVANCES IN IMAGING BIOLOGY High-grade Serous Carcinoma Low-grade Serous Carcinoma Other Subtypes CONCLUSION REFERENCES CHAPTER 16 Benign Diseases of the Uterus and Vagina INTRODUCTION CONGENITAL ANOMALIES Classification European Society of Human Reproduction and Embryology/European Society for Gynaecological Endoscopy (ESGE) Classification System Definitions: Uterine Main Classes and Subclasses—Smaller than ESHRE/ESGE UTERINE LEIOMYOMAS Epidemiology Pathogenesis Pathological Features Clinical Features Classification Imaging Leiomyoma Variants Differential Diagnosis Treatment ADENOMYOSIS OF THE UTERUS Epidemiology Pathogenesis Histopathology Clinical Presentation Imaging Atypical/Unusual Patterns of Adenomyosis Differential Diagnosis OTHER BENIGN MESENCHYMAL TUMORS UTERINE ARTERIOVENOUS MALFORMATION UTERINE INVERSION ENDOMETRIAL PATHOLOGY Endometrial Polyps79- Endometrial Hyperplasia Infection BENIGN VAGINAL LESIONS CONCLUSION ACKNOWLEDGMENT REFERENCES CHAPTER 17 Malignant Diseases of the Uterus and Vagina INTRODUCTION ENDOMETRIAL CANCER Epidemiology Pathogenesis and Histology Molecular Classification Clinical Presentation Diagnosis Imaging Staging Management of Endometrial Cancer Role of MRI in Fertility Preservation in Endometrial Cancer Patients UTERINE SARCOMA Clinical Presentation Mixed Epithelial and Mesenchymal Tumors Smooth Muscle Tumors Stromal Tumors Adenosarcoma CERVICAL CANCER Clinical Presentation Etiopathogenesis Histopathology Detection and Diagnosis Staging Imaging Treatment Complications of Disease and Treatment Treatment Follow-up Computed Tomography Hybrid Imaging (FDG–PET/CT and PET/MRI) ENDOMETRIAL VERSUS CERVICAL ORIGIN OF UTERINE CANCER WHEN BIOPSY FINDINGS ARE INCONCLUSIVE OR INDETERMINATE VAGINAL CANCER CONCLUSION ACKNOWLEDGMENTS REFERENCES CHAPTER 18 Female Infertility INTRODUCTION RISK FACTORS FOR INFERTILITY INITIAL APPROACH History Physical Examination Imaging Modalities THE NORMAL MENSTRUAL CYCLE CERVICAL FACTOR Cervical Stenosis UTERINE FACTOR Endometrial Adhesions or Synechiae Leiomyoma Endometrial Polyps Müllerian Duct Abnormalities Adenomyosis Nontubercular Chronic Endometritis Calcific Endometritis TUBAL FACTOR PERITONEAL FACTOR Endometriosis Genital Tuberculosis OVARIAN FACTOR Gonadal Dysgenesis Polycystic Ovary Syndrome Ovulatory Function Tests Development and Evolution of Ovarian Follicles Follicular Monitoring: Spontaneous Cycles Follicular Monitoring: Induced Cycles Prediction of Ovulation Ovarian Reserve Serum AMH Level Antral Follicle Count TREATING INFERTILITY Follicle Aspiration CONCLUSION REFERENCES CHAPTER 19 Imaging Techniques and Radiological Anatomy of the Male Genital Tract MALE GENITAL TRACT PROSTATE GLAND IMAGING MODALITIES Ultrasound Computed Tomography Magnetic Resonance Imaging SCROTUM AND PENIS IMAGING MODALITIES Ultrasound Doppler Evaluation Magnetic Resonance Imaging REFERENCES CHAPTER 20 Disorders of the Prostate Gland INTRODUCTION BENIGN PROSTATIC HYPERPLASIA Primary Findings in Benign Prostatic Hyperplasia Secondary Findings in Benign Prostatic Hyperplasia PROSTATE CANCER Introduction Clinical Features Pathology Screening Diagnosis ROLE OF VARIOUS IMAGING MODALITIES IN DIAGNOSIS OF PROSTATE CANCER Transrectal Ultrasound Magnetic Resonance Imaging Prostate Imaging-reporting and Data System Assessment Tumor Spread and Staging Nuclear Medicine Active Surveillance and Surveillance after Treatment Prostatic Calcifications PROSTATITIS AND PROSTATIC ABSCESS PROSTATIC CYSTS ACKNOWLEDGEMENT REFERENCES CHAPTER 21 Scrotal Diseases ANATOMY IMAGING MODALITIES Technique of Sonography Magnetic Resonance Imaging of Scrotum CONGENITAL ANOMALIES OF THE TESTIS Cryptorchidism Miscellaneous Congenital Anomalies ACUTE SCROTUM Epididymitis and Orchitis Torsion Scrotal Trauma Testicular Tumors Germ Cell Tumors Teratoma Non-germ Cell Testicular Tumors Staging of Testicular Cancer Serum Tumor Markers CANCER GROUP STAGING Risk Group Classification Imaging in Evaluation of Testicular Cancer BENIGN INTRATESTICULAR LESIONS Cysts Adrenal Rests Calcifications EXTRATESTICULAR PATHOLOGIES Fluid Collections Epididymal Cysts Postorchidectomy Scrotum Extratesticular Tumors Varicocele REFERENCES CHAPTER 22 Male Infertility and Erectile Dysfunction MALE INFERTILITY Etiology IMAGING APPROACH IN MALE INFERTILITY Magnetic Resonance Imaging in Infertility Imaging in Assisted Fertilization ERECTILE DYSFUNCTION Anatomy and Physiology of Penile Erection Evaluation of Erectile Dysfunction CONCLUSION REFERENCES CHAPTER 23 Imaging of the Adrenal Gland INTRODUCTION ANATOMY AND PHYSIOLOGY IMAGING MODALITIES Ultrasound Computed Tomography Magnetic Resonance Imaging Radionuclide Imaging Positron Emission Tomography ADRENAL DISEASES Group I: Adrenal Hyperfunctional Diseases Group II: Adrenal Insufficiency Group III: Adrenal Diseases with Normal Function CONCLUSION REFERENCES CHAPTER 24 The Retroperitoneum INTRODUCTION ANATOMY IMAGING MODALITIES PATHOLOGIES MESODERMAL NEOPLASMS Lipoma Liposarcomas Leiomyosarcomas Malignant Fibrous Histiocytomas Hemangiopericytomas Other Malignancies NEUROGENIC NEOPLASMS Paragangliomas Nerve Sheath Tumors GERM CELL, SEX CORD OR STROMAL NEOPLASMS Teratomas Primary Extragonadal Germ Cell Tumor Growing Teratoma Syndrome LYMPHOID NEOPLASMS Benign Lymphadenopathy Lymphoma HIV Lymphadenopathy Metastatic Lymphadenopathy NON-NEOPLASTIC PATHOLOGIES Retroperitoneal Collections Aorta Aortic Aneurysm Aortic Dissection Inferior Vena Cava Congenital Anomalies Venous Thrombosis Retroperitoneal Fibrosis Iliopsoas Muscle Compartment REFERENCES CHAPTER 25 Urinary Tract Trauma INTRODUCTION RENAL TRAUMA Imaging Work-up in a Patient with Suspected Renal Trauma Radiological Findings Management Follow-up Imaging URETERAL TRAUMA Imaging Work-up Classification Management URINARY BLADDER TRAUMA Cystography Classification Management URETHRAL TRAUMA Radiology Blunt Urethral Trauma Classification Management REFERENCES Management REFERENCES CHAPTER 26 Nonvascular Interventions in the Urinary Tract INTRODUCTION PERCUTANEOUS NEPHROSTOMY Indications Anatomy for Percutaneous Renal Entry Technique Postprocedure Care Results Complications Extended Applications of Percutaneous Nephrostomy SCLEROTHERAPY FOR RENAL CYSTS PERCUTANEOUS CATHETER DRAINAGE BIOPSIES THE COMPLICATED RENAL TRANSPLANT ABLATION OF RENAL TUMORS Indications Patient Selection and Preprocedure Evaluation Technical Considerations: Different Ablation Devices Choice of Ablative Therapy: Clinical Consideration Postprocedure and Follow-up REFERENCES CHAPTER 27 Vascular Interventions in the Genitourinary Tract INTRODUCTION RENAL ARTERY ANGIOPLASTY Imaging the Renal Arteries Technique4- RENAL ARTERY STENTING Outcome Renal Artery Intervention in Renal Transplants Complications RENAL ARTERIAL EMBOLIZATION Technique Transcatheter Embolization of Renal Neoplasms Transcatheter Embolization of Renal Pseudoaneurysms Anatomic/Physiologic Considerations Results of Embolization Complications Embolization of End-stage Kidney UTERINE ARTERY EMBOLIZATION Indications Technique Results Complications VAGINAL ARTERIOVENOUS MALFORMATION EMBOLIZATION SCROTAL ARTERIOVENOUS MALFORMATION AND TESTICULAR TUMOR EMBOLIZATION VARICOCELE EMBOLIZATION (FIGS. 18A TO C) PROSTATIC ARTERY EMBOLIZATION TRANSJUGULAR RENAL BIOPSY (FIGS. 19A TO C) PROPHYLACTIC BALLOON PLACEMENT IN ADHERENT PLACENTA (FIGS. 20A TO D) CONCLUSION REFERENCES SECTION 2 Advances in Imaging Technology CHAPTER 28 Ultrasound Instrumentation: Practical Applications INTRODUCTION PARTS OF AN ULTRASOUND MACHINE CONTROLS OF ULTRASOUND MACHINE TRANSDUCER FREQUENCY OF TRANSDUCERS High Frequency Transducer Medium Frequency Transducer Low Frequency Transducer MODES OF SCANNING Tissue Harmonic Imaging Spatial Compound Imaging Extended Field of View Elastography 3D and 4D Ultrasound Fusion Imaging Therapeutic Applications of Ultrasound Ultrasound-based Molecular Imaging and Oncotherapy Ultrasound Image Artifacts REFERENCES CHAPTER 29 Image Optimization in Ultrasound GRAYSCALE IMAGING Basic Guidelines2- USER ADJUSTABLE PARAMETERS Factory Presets Transducer Selection Overall Gain Time Gain Compensation Depth Setting Focal Zone Setting Zoom Dynamic Range ARTIFACTS IN B MODE IMAGING3,5- Artifacts due to Physical Characteristics of Ultrasound Beam Artifacts Associated with Multiple Echoes Artifacts Associated with Velocity Errors Attenuation Errors Noise Speckle Clutter SPECTRAL AND COLOR DOPPLER EXAMINATION Basic Guidelines7 Optimizing Color Doppler and Spectral Doppler Settings7- DOPPLER ARTIFACTS Anatomically-related Artifacts Artifacts Unrelated to Blood Flow SPECIAL IMAGING MODES1- Tissue Harmonic Imaging Compound Imaging Frequency Compound Imaging Spatial Compound Imaging Coded Pulse Excitation Adaptive Image Processing Photopic Ultrasound Imaging Extended Field of View Imaging B-Mode Flow Imaging CONCLUSION REFERENCES CHAPTER 30 Ultrasound Elastography: Principles and Application INTRODUCTION BASIC PHYSICS Stress Strain Elasticity Viscosity Viscoelasticity Poroelasticity Hooke’s Law DIFFERENT ELASTOGRAPHY METHODS Compression Elastography Dynamic Methods Advances in Shear Wave Imaging Other Advanced Elastography Techniques ELASTOGRAPHY APPLICATIONS Breast Liver Prostate Lymph Nodes Thyroid Gynecology Soft Tissue Masses Musculoskeletal OTHER APPLICATIONS Renal Transplant Assessment Cardiovascular Applications Venous Thrombosis Dermatological Applications Endoscopic Ultrasonography CONCLUSION REFERENCES CHAPTER 31 Computed Tomography Hardware including Dual Energy Computed Tomography: An Update CT HARDWARE BASIC WORKFLOW OF CT SCANNER DETERMINANTS OF AN OPTIMAL IMAGE Spatial Resolution Contrast Resolution Temporal Resolution ADVANCES IN HARDWARE Advances in X-ray Sources (A) CT Tubes (B) Generators Advances in Detectors Advances in Reconstruction SPECIAL CT SCANNERS Cone Beam CT Cone Beam Geometry Portable Systems Navigation Systems DUAL ENERGY CT PRINCIPLE GENERATIONS OF DECT Dual Source DECT Single Source DECT KEY CONCEPTS IN DECT Dual Energy Ratio Spectral Separation Temporal Resolution and Temporal Coherence Spatial Resolution Dose Efficiency PROCESSING OF DATA, IMAGE RECONSTRUCTION AND IMAGE DISPLAY IN DECT Image Display in DECT APPLICATIONS OF DECT Applications in Abdomen Applications in Adrenal DOSE CONSIDERATIONS FUTURE TRENDS IN DECT IMAGING CONCLUSION ACKNOWLEDGMENTS REFERENCES CHAPTER 32 Advanced Computed Tomography Applications and Software INTRODUCTION LUNG NODULE EVALUATION SOFTWARES Clinical Applications LUNG PARENCHYMA EVALUATION SOFTWARES Clinical Applications PULMONARY EMBOLISM DETECTION SOFTWARES Clinical Applications CT PERFUSION ADVANCED SOFTWARES Clinical Applications CONTINUOUS FREE-BREATHING SCANS Clinical Applications ADVANCED CT ANGIOGRAPHY SOFTWARES Clinical Applications ADVANCED CARDIAC APPLICATION SOFTWARES Clinical Applications COMPUTED TOMOGRAPHY VOLUMETRY DENTASCAN Clinical Application COMPUTED TOMOGRAPHY CINEMATIC RENDERING Clinical Applications FUSION IMAGING Clinical Application VERTEBRAL LABELING Clinical Applications SOFTWARE FOR ONCOLOGICAL IMAGING INTERPRETATION Clinical Application 3D PRINTING Major Clinical Applications ITERATIVE RECONSTRUCTION Clinical Applications COMPUTED TOMOGRAPHY COLONOGRAPHY REFERENCES CHAPTER 33 Magnetic Resonance Instrumentation and MRI Safety Issues: An Update THE MAGNET SUBSYSTEM Superconducting Magnet Quench Magnet Geometry Shim Coils GRADIENT SUBSYSTEM Components and Technical Parameters of Gradient Coils Gradient Amplifier Gradient Strength and Slew Rate Gradient Linearity Duty Cycle Gradient-related Problems RADIO FREQUENCY SUBSYSTEM Construction Design of an RF Coil Phased Array Coils Multichannel RF Coils and Parallel Imaging COMPUTER SUBSYSTEM Data Processing and Image Reconstruction INSTALLATION FOOTPRINT OF MRI Magnet Shielding and the Fringe Field Radiofrequency Shielding SPECIAL TYPES OF MRI HARDWARE AND APPLICATIONS Higher Magnet Strengths MR-HIFU (High Intensity Focused Ultrasound) MR Elastography MR Surgical Suite: Interventional MRI MR-PET MR SAFETY MRI Safety Risks Screening by Detection SAR—Limits and Control MEDICAL DEVICE AND IMPLANT COMPATIBILITY MRI SAFETY PROFILE IN SPECIAL GROUPS MR SAFETY GUIDELINES AND REGULATIONS MRI EMERGENCIES REFERENCES CHAPTER 34 Image Optimization in Magnetic Resonance Imaging SIGNAL-TO-NOISE RATIO Field Strength Proton Density Coil Type and Position Repetition Time Echo Time Flip Angle Number of Signal Averages Slice Thickness Receiver Bandwidth CONTRAST-TO-NOISE RATIO Administration of a Contrast Agent Magnetization Transfer Constant Chemical Suppression Echo Train Length Time from Inversion SPATIAL RESOLUTION Voxel Volume, Field of View, Matrix SCAN TIME Repetition Time Number of Excitations Phase Matrix Number of Slice Encodings in 3D Sequences ARTEFACTS MOTION ARTEFACTS (PHASE MISMAPPING) Ghosting and Smearing Pulsatile Flow-related Artefacts ARTEFACTS DUE TO MEASUREMENT TECHNIQUE/PARAMETERS Aliasing Moiré/Fringe Artefact Chemical Shift Artefacts Phase Cancellation Artefact Truncation Artefacts Magnetic Susceptibility Difference Artefacts Section Cross Talk Parallel Imaging Artefact EXTERNAL ARTEFACTS Artefacts Caused by Field Distortions Spike (Herringbone) Artefact Zipper Artefact 3T IMAGING: ADVANTAGES VS LIMITATIONS Advantages Limitations CONCLUSION SUGGESTED READING CHAPTER 35 Diffusion-weighted Magnetic Resonance Imaging INTRODUCTION BASIC PRINCIPLE B VALUE ADC AND EXPONENTIAL IMAGE DWI SEQUENCES AND OPTIMIZATION Echo Planar Imaging Turbo Spin Echo Sequences or Half-fourier-acquisition Single-shot Turbo-spinecho Steady-state Free-precession ARTIFACTS AND PITFALLS T2 Shine Through T2 Washout T2 Blackout Eddy Current Artifacts Susceptibility Artifacts Chemical Shift Artifacts Motion Artifacts Effect of Contrast Media ADVANCED DWI TECHNIQUES Diffusion Tensor Imaging Whole Body Diffusion-weighted Imaging Intravoxel Incoherent Motion Histogram Analysis of ADC Diffusion Kurtosis Imaging Computed DWI CLINICAL APPLICATIONS OF DWI Brain Head and Neck Pediatric Applications Thorax Breast Liver Gallbladder and Biliary Ducts Pancreas Kidneys and Adrenal Prostate Small Bowel and Rectum Bony Spine Female Pelvis CONCLUSION REFERENCES CHAPTER 36 Perfusion MRI INTRODUCTION MR Imaging Techniques and Methods Dynamic Susceptibility Contrast-enhanced MR Perfusion (DSC MRP) Dynamic Contrast-enhanced MR Perfusion (DCE MRP) Arterial Spin Labeling MR Imaging DYNAMIC CONTRAST-ENHANCED MAGNETIC RESONANCE IMAGING NON-NEUROLOGY APPLICATIONS OF DCE-MRI Head and Neck Hematological Disorders Musculoskeletal System Chest Prostate Renal Cell Carcinoma Liver Tumors Gastrointestinal Tract Breast Endometrial and Cervical Cancer Ovarian Tumors REFERENCES CHAPTER 37 Magnetic Resonance Angiography HISTORY AND INTRODUCTION FLOW PHENOMENA AND PHASE EFFECTS IN MRA Flow Phenomena Phase Effects FLOW-RELATED ENHANCEMENT DEPENDENT NONCONTRAST MRA TECHNIQUES Time-of-Flight Angiography: Techniques Inflow Inversion Recovery–Magnetic Resonance Angiography (NC-MRA) Quiescent Interval Single-shot Magnetic Resonance Angiography Arterial Spin-labeled Magnetic Resonance Angiography PHASE DEPENDENT NONCONTRAST MRA TECHNIQUES Phase Contrast Angiography Gated Subtractive Magnetic Resonance Angiography FLOW INDEPENDENT NONCONTRAST MRA TECHNIQUES Strengths Drawbacks Contrast-enhanced MR Angiography Time Resolved/4D CE-MRA Parallel Imaging35 APPLICATIONS OF MRA Neurovascular Imaging Abdominal Vascular Imaging FUTURE PERSPECTIVES ACKNOWLEDGMENTS REFERENCES CHAPTER 38 Magnetic Resonance Imaging Pulse Sequences BASIC TERMINOLOGIES SEQUENCE TYPES The Spin Echo Pulse Sequence Double and Triple IR Prep Sequences Gradient Echo Sequences Fat Suppression Sequences STEADY STATE SEQUENCES Concept of Steady State Incoherent/Spoiled Gradient Echo Sequences Coherent Gradient Echo Sequence CISS/FIESTA-C Dual Echo Steady State Sequence FAST GRADIENT ECHO Echo Planar Imaging MR ELASTOGRAPHY SUGGESTED READING CHAPTER 39 Digital Radiography: An Update Limitations of Film Screen Radiography Advantages of Digital Radiography2,3 EVOLUTION OF DIGITAL RADIOGRAPHY PHYSICS BEHIND DIGITAL RADIOGRAPHY PRINCIPLE OF DIGITAL RADIOGRAPHY DIGITAL RADIOGRAPHY SYSTEMS COMPUTED RADIOGRAPHY Advances in CR Advantages of CR/Storage Phosphor Systems7 Drawbacks of CR/Storage Phosphor Systems DIGITAL RADIOGRAPHY Direct Conversion Advances in DR IMAGE PROCESSING Advances in Image Processing ASPECTS OF IMAGE QUALITY Pixels Detector Size Gray Scale Spatial Resolution Contrast Resolution and Dynamic Range Modulation Transfer Function Detective Quantum Efficiency RADIATION EXPOSURE EXPOSURE INDICATOR FOR DIGITAL RADIOGRAPHY ACR Practice Guideline for Digital Radiography DIGITAL RADIOGRAPHIC ARTIFACTS CONCLUSION REFERENCES CHAPTER 40 Digital Mammography INTRODUCTION DIGITAL MAMMOGRAPHY BASIC PHYSICS OF DIGITAL MAMMOGRAPHY Detectors Spatial Resolution Analog to Digital Units Processing Algorithms Dynamic Range Comparison between Digital Mammograms and Film/Screen Mammograms Storage of Digital Images Display of Digital Images Artifacts APPLICATIONS OF DIGITAL MAMMOGRAPHY Computer-aided Detection and Computer-aided Diagnosis Dual-energy Subtraction Mammography Contrast-enhanced Digital Mammography Digital Breast Tomosynthesis Teleradiology Applications Stereotactic Breast Biopsy CONCLUSION REFERENCES CHAPTER 41 Fluoroscopy and Digital Subtraction Angiography OVERVIEW FLUOROSCOPY Components of Fluoroscopic System Image Intensifier Properties of Image Intensifier Limitations of Image Intensifier System Optical Coupling and Video System Digital Fluoroscopy DIGITAL SUBTRACTION ANGIOGRAPHY Types of Subtraction Flat Panel Detector Advanced Features of FPD Systems Fusion Imaging Other Advanced Softwares Hybrid Labs Automatic Exposure Control Recording Fluoroscopic Images Types of Fluoroscopic Equipment Factors Affecting Image Quality Radiation Safety in Fluoroscopy SUMMARY REFERENCES CHAPTER 42 Tools and Drugs in Interventional Radiology PUNCTURE NEEDLES DILATORS (FIG. 3) SHEATHS (FIG. 4) CATHETERS Parts of Catheter (Fig. 5) Materials Sizes Shapes and Holes Balloon Catheters GUIDEWIRE Selection of Guidewires FNAC AND BIOPSY NEEDLE STENT Vascular Stent Biliary Stent Ureteral Stents (Fig. 12) EMBOLIZING AGENTS Permanent Proximal Occluders Permanent Distal Occluders Temporary Proximal Occluders Temporary Distal Occluders DRUGS IN INTERVENTIONAL RADIOLOGY Vasodilators Vasoconstrictors Prothrombotics Anticoagulants Thrombolytics Antiplatelets REFERENCES CHAPTER 43 Magnetic Resonance Contrast Media INTRODUCTION BASIC PRINCIPLES OF MR CONTRAST AGENTS CLASSIFICATION OF MR CONTRAST AGENTS Magnetic Properties Image Enhancement Biodistribution GADOLINIUM-BASED CONTRAST AGENTS Interaction between Extracellular MRI Contrast Agents with Clinical Tests Dose of GBCAs Adverse Effects of GBCAs Guidelines on GBCA Usage GBCA Administration in Children GBCAs During Pregnancy and Lactation Gadolinium Presence in Brain and Body MANGANESE-BASED CONTRAST AGENTS IRON OXIDE-BASED CONTRAST AGENTS ORAL CONTRAST AGENTS Low-low Intensity (Dark Lumen) Agents High-high Intensity (Bright Lumen) Agents High-low Intensity Agents Low-high Intensity Agents ONGOING RESEARCH AND FUTURE TRENDS CONCLUSION REFERENCES CHAPTER 44 Ultrasound Contrast Agents INTRODUCTION EVOLUTION OF UCAs TECHNIQUE OF CEUS SAFETY OF UCAs Advantages of CEUS Over CT/MRI DIAGNOSTIC APPLICATIONS OF UCA HEPATIC APPLICATIONS CEUS of the Liver CEUS LI-RADS NON-HEPATIC APPLICATIONS Applications in Pancreatic Imaging Applications in Renal Imaging Application in Abdominal Trauma Applications in Gastrointestinal Tract Application in Peripheral Vascular System and Aorta Miscellaneous Intravascular Applications Intracavitary Applications Upcoming Non-hepatic Applications FUTURE DIRECTIONS ACKNOWLEDGMENTS REFERENCES CHAPTER 45 Iodinated Contrast Media: An Update (To Include Reactions and Management) INTRODUCTION DESIRABLE PROPERTIES OF AN IDEAL CONTRAST AGENT HISTORY OF DEVELOPMENT OF IODINATED CONTRAST MEDIA BASIC CHEMISTRY OF ICM TYPES OF ICM ICM PHARMACOKINETICS DOSAGE OF IODINATED CONTRAST MEDIA ADMINISTRATION ADVERSE REACTIONS Risk Factors for Adverse Reactions to ICM Other Preprocedure Considerations1 Pretesting ACUTE ALLERGIC LIKE REACTION Mechanism24 Prevention1 Specific Recommended Premedication Regimens1 Premedication in Patients Undergoing Chronic Corticosteroid Therapy Risks of Premedication Breakthrough Contrast Reactions MANAGEMENT1 ACUTE PHYSIOLOGIC POSTCONTRAST ACUTE KIDNEY INJURY Pathophysiology of CIN Risk Factors Risk Thresholds Screening Renal Dialysis Patients and the Use of Iodinated Contrast Medium1 SAFE INJECTION Technique AIR EMBOLISM EXTRAVASATION Clinical Features Treatment of Contrast Extravasation DELAYED ADVERSE REACTIONS TO CONTRAST MEDIA Treatment and Prophylaxis CONTRAST MEDIA WARMING CONTRAS ADMINISTRATION IN PATIENTSON METFORMIN SPECIAL CONSIDERATIONS AND RISK FACTORS Contrast Administration and Pregnancy Contrast Administration and Lactation RECOMMENDATIONS FOR THE DEPARTMENTS PERFORMING CONTRASTRELATED INVESTIGATIONS CONCLUSION FUTURE DIRECTIONS REFERENCES CHAPTER 46 Radiology Information System and Picture Archiving and Communication System INTRODUCTION INDUSTRY STANDARDS Health Level 7 Digital Imaging and Communications in Medicine RADIOLOGY INFORMATION SYSTEM PICTURE ARCHIVING AND COMMUNICATION SYSTEM Acquisition Workstation Network Storage Related Applications CONCLUSION REFERENCES CHAPTER 47 Evidence-based Radiology and a Primer on Biostatistics INTRODUCTION BACKGROUND Why Evidence-based Practice? Forms of Evidence-based Practice The ‘Bottom-up’ Evidence-based Practice BIOSTATISTICS PRIMER Measures of Central Tendency and Variation Sample Size Calculation Measures of Effect Choice of Statistical Test CONCLUSION REFERENCES CHAPTER 48 Radiation Hazards and Radiation Units THE BIOLOGICAL EFFECTS OF RADIATION DAMAGE TO DNA BY THE RADIATION THE EFFECT OF RADIATION Oxygen Enhancement Ratio Stochastic and Nonstochastic (Deterministic) Effects Dose and Dose-rate Effects Lethal Dose Radiation Effect on Embryo Diagnostic Radiography in Women: Ten Day Rule to Twenty Eight Day Rule Radiation Dose to Eye Lens and Dose Limit Protection of Patient, Staff, and Public from Radiation Radioactivity Radiation Units Computed Tomography Dose Index Size Specific Dose Estimate in CT Imaging SUGGESTED READING CHAPTER 49 Radiation Protection HISTORICAL PERSPECTIVE REGULATORY BODIES FOR RADIATION PROTECTION Functions of Atomic Energy Regulatory Board4 Radiation Protection Survey and Program PROTECTION AGAINST RADIATION HAZARD CARDINAL PRINCIPLES OF RADIATION PROTECTION Source Shielding/Shielding of the X-ray Tube Room Shielding Shielding of the X-ray Control Room Shielding of the Patient Fluoroscopy X-ray Equipment RADIATION PROTECTION IN INTERVENTIONAL RADIOLOGY Pulsed Fluoroscopy Last Image Hold (LIH) Road Mapping Dose Spreading Techniques Ultra Low Dose Fluoroscopy (ULD) SAFETY OF RADIOGRAPHIC IMAGING DURING PREGNANCY 28 Day Rule Recommended Dose Limits to Pregnant Women3,4 PERSONNEL DOSIMETRY Types of Dosimeter COMPUTED TOMOGRAPHY (RADIATION EXPOSURE AND DOSE MODULATIONS) Radiation Dose Measures: CT Specific Typical Dose Measurements FACTORS AFFECTING RADIATION DOSE AND QUALITY Patient Factors Scanning Factors Tube Voltage Detector Configuration Gantry Rotation Time and Pitch TECHNIQUES FOR CONTROLLING RADIATION DOSE AT CT Using Automated Exposure Control (AEC) Modifying the Acquisition Parameters Optimum Tube Potential Iterative Reconstruction (IR) KEY FEATURES OF PEDIATRIC CT PROTOCOLS STEPS TO ENSURE MINIMUM CT RADIATION CONCLUSION REFERENCES CHAPTER 50 Planning Modern Imaging Department with Regulatory Requirements in Radiology Practice PLANNING AND ORGANIZATION DIVISIONS OF THE RADIOLOGY DEPARTMENT LOCATION LAYOUT REGULATORY REQUIREMENTS Safety Code Radiation Testing Facility for Demonstration of Type Approval Radiation Protection Devices Quality Assurance Program Radiological Safety Officer Quality Assurance Equipment EQUIPMENTS Conventional Radiography Digital Radiography Regulatory Requirements in the Use of X-ray Equipment MAMMOGRAPHY Computer-aided Detection Systems DUAL-ENERGY X-RAY ABSORPTIOMETRY COMPUTED TOMOGRAPHY ULTRASOUND MAGNETIC RESONANCE IMAGING DIGITAL SUBTRACTION ANGIOGRAPHY Combined Angio-CT NUCLEAR IMAGING SYSTEMS PICTURE ARCHIVING AND COMMUNICATION SYSTEMS TELERADIOLOGY PRE-CONCEPTION AND PRE-NATAL DIAGNOSTIC TECHNIQUE (PC-PNDT) ACT REGISTRATION48,49 REQUIREMENTS AT THE ULTRASOUND CENTER48,49 RECORD KEEPING48,49 REFERENCES CHAPTER 51 Recent Advances in PET/ CT and PET/MR INTRODUCTION POSITRON EMISSION TOMOGRAPHY/COMPUTED TOMOGRAPHY RECENT ADVANCES IN THE CLINICAL APPLICATIONS OF PET/CT Oncology Neurology Miscellaneous POSITRON EMISSION TOMOGRAPHY/MAGNETIC RESONANCE CLINICAL APPLICATIONS OF PET/MR Oncology Neurology Cardiology ACKNOWLEDGMENT REFERENCES CHAPTER 52 Ethical and Legal Issues in Radiology ETHICAL ISSUES Doctor-patient Relationship Radiation Issues LEGAL ISSUES Image Interpretation and Reporting LAWS/LEGAL ACTS APPLICABLE TO MEDICINE The Pre-natal Diagnostic Techniques (Regulation and Prevention of Misuse) Act (1994) and The Consumer Protection Act (1986) Radiologist as a Defendant Radiologist as a Witness TELERADIOLOGY: WHO IS RESPONSIBLE? CONCLUSION REFERENCES CHAPTER 53 Basics of Radiomics, Texture Analysis and Radiogenomics INTRODUCTION BACKGROUND AND WORKFLOW IN RADIOMICS Image Acquisition Segmentation of Region of Interest Feature Extraction Building Radiomics Classifiers and Data Sharing CLINICAL APPLICATIONS OF RADIOMICS AND TEXTURE ANALYSIS Oncological Applications Tools for Texture Analysis Radiogenomics Evolution of Radiogenomics Applications of Radiogenomics Translation into Clinical Practice Data Sharing CHALLENGES CONCLUSION REFERENCES CHAPTER 54 Artificial Intelligence in Radiology INTRODUCTION Historical Perspective ARTIFICIAL INTELLIGENCE AND RADIOLOGY ARTIFICIAL INTELLIGENCE: CHARACTERISTICS AND IMPORTANCE Machine Learning: A Tool of Artificial Intelligence Deep Learning Assessment Parameters of AI Algorithms APPLICATIONS OF AI IN IMAGING Imaging Logistics Image Acquisition and Optimization Image Transformation Pathology Detection, Feature Extraction and Postprocessing Image Management (Display, Archiving and Retrieval) Image Quality Analytics Radiology Reporting and Analytics Automated Radiation Dose Estimation CHALLENGES/ETHICAL ISSUES OF AI IN MEDICINE AND RADIOLOGY ARTIFICIAL INTELLIGENCE: EXISTENTIAL DILEMMA FOR A RADIOLOGIST? CONCLUSION REFERENCES CHAPTER 55 Structured Reporting in Radiology INTRODUCTION STEPS OF RADIOLOGY REPORTING TYPES OF REPORTS COMPONENTS OF A RADIOLOGY REPORT COMPONENTS/CRITERIA OF A GOOD STRUCTURED REPORT ERRORS IN RADIOLOGY REPORTS Types of Radiology Errors STRUCTURED VERSUS PROSE REPORTS Pros of Structured Reporting Cons of Structured Reporting STEPS TO IMPLEMENTING STRUCTURED REPORTING FORMATS COMMON STRUCTURED REPORTING FORMATS IN USE/AVAILABLE RESOURCES CONCLUSION REFERENCES Volume 2 SECTION 3 Paediatric Imaging CHAPTER 56 Technical Considerations in Pediatric Imaging INTRODUCTION MINIMIZING HEAT LOSS IMMOBILIZATION SEDATION Nonpharmacological Methods Preanesthetic Evaluation Nil per Orally (NPO) Status Monitoring and Ensuring Safety Sedative Agents Risks of Anesthesia Radiation versus Sedation (Computed Tomography versus Magnetic Resonance Imaging) REDUCTION OF RADIATION DOSAGE Radiography and Fluoroscopy Computed Tomography REDUCING EXAMINATION TIMES IN COMPUTED TOMOGRAPHY AND MAGNETIC RESONANCE IMAGING Reducing Computed Tomography Scan Time Reducing Magnetic Resonance Scan Time USE OF CONTRAST MEDIA Intravenous Contrast Use Oral Use of Contrast Media CONCLUSION REFERENCES CHAPTER 57 Recent Advances in Pediatric Radiology INTRODUCTION ULTRASOUND Contrast-enhanced Ultrasound Shear Wave Elastography COMPUTED TOMOGRAPHY Dual-energy Computed Tomography FLUOROSCOPY Percutaneous Transhepatic Cholecystocholangiography MAGNETIC RESONANCE IMAGING Lung Magnetic Resonance Imaging Functional Magnetic Resonance Imaging Whole-body Magnetic Resonance Imaging CONCLUSION REFERENCES CHAPTER 58 Frontiers in Research: Genomics, Radiogenomics, Texture Analysis, Safety of Gadolinium-based Contrast, etc. INTRODUCTION BASICS OF GENOMICS TEXTURE ANALYSIS, RADIOMICS, AND RADIOGENOMICS Image Acquisition Segmentation Feature Extraction Building Radiomics Classifiers and Data Sharing ARTIFICIAL INTELLIGENCE RECENT ADVANCES IN COMPUTED TOMOGRAPHY AND MAGNETIC RESONANCE IMAGING MAGNETIC RESONANCE IMAGING CONTRAST SAFETY CONCLUSION REFERENCES CHAPTER 59 Vascular Interventions in Children INTRODUCTION SPECIAL CONSIDERATIONS FOR THE PEDIATRIC PATIENT Patient Preparation TECHNIQUES Access PROCEDURES Embolization Angioplasty Thrombolysis Foreign Body Removal CONCLUSION REFERENCES CHAPTER 60 Nonvascular Interventions in Children INTRODUCTION PATIENT EVALUATION AND PREPROCEDURE CARE SEDATION AND ANESTHESIA BASIC PROCEDURES Fine-needle Aspiration/Biopsy Abscess Drainage THORACIC INTERVENTIONS GASTROINTESTINAL INTERVENTIONS Salivary Gland Interventions Esophageal Interventions Gastric Interventions Hepatic Interventions Biliary Intervention Pancreatic Interventions GENITOURINARY INTERVENTIONS Renal Biopsy Percutaneous Nephrostomy Ureteric Dilatation and Stenting MUSCULOSKELETAL INTERVENTIONS CONCLUSION REFERENCES CHAPTER 61 Imaging of Pediatric Trauma INTRODUCTION ANATOMIC DIFFERENCES IN CHILDREN FROM ADULTS: EFFECT ON PEDIATRIC TRAUMA MANAGEMENT3 (TABLE 1) PHYSIOLOGICAL DIFFERENCES IN CHILDREN FROM ADULTS3- IMAGING METHODS6 Potential Benefits of the Focused Abdominal Sonography for Trauma Examination8 Abdominal Trauma11- Chest Trauma Musculoskeletal Injuries7,10 Imaging15 Types of Injuries Head Trauma16 Spinal Injuries CONCLUSION REFERENCES CHAPTER 62 Neonatal Respiratory Distress INTRODUCTION MEDICAL CAUSES OF NEONATAL RESPIRATORY DISTRESS Hyaline Membrane Disease Transient Tachypnea of the Newborn (TTNB) Neonatal Pneumonia Meconium Aspiration Syndrome Pneumothorax SURGICAL CAUSES OF NEONATAL RESPIRATORY DISTRESS Congenital Lobar Overinflation Congenital Pulmonary Airway Malformation Congenital Diaphragmatic Hernia Esophageal Atresia with Tracheoesophageal Fistula MISCELLANEOUS CAUSES REFERENCES CHAPTER 63 Childhood Pulmonary Infections INTRODUCTION PNEUMONIA Epidemiology Imaging Viral Pneumonia Coronavirus Disease 2019 Pneumonia Bacterial Pneumonia Round Pneumonia Exclusion of Other Pathologies Progressive or Fulminant Pneumonia Nonresolving or Recurrent Pneumonia Evaluation of Associated Complications Chronic Effects of Pneumonia TUBERCULOSIS Primary Pulmonary Tuberculosis Postprimary Tuberculosis Role of Computed Tomography Signs of Disease Inactivity in Tuberculosis FUNGAL INFECTIONS Aspergillosis Histoplasmosis Coccidioidomycosis PARASITIC INFESTATIONS Hydatid Disease of the Lung Others PULMONARY INFECTIONS IN IMMUNOCOMPROMISED CHILDREN Bacterial Pneumonias Mycobacterial Pneumonias Fungal Pneumonias Viral Pneumonias Lymphocytic Interstitial Pneumonitis CONCLUSION REFERENCES CHAPTER 64 Imaging of Pediatric Chest Masses INTRODUCTION LUNG MASSES Congenital Pulmonary Airway Malformation Pulmonary Sequestration Bronchogenic Cyst Vascular Lesions Lung Abscess Hydatid Cysts Pulmonary Metastasis Primary Lung Tumors MEDIASTINAL MASSES Anterior Mediastinal Masses Middle and Posterior Mediastinal Masses CHEST WALL MASSES Chest Wall Infections Lymphangioma Hemangioma Neurofibroma Benign Osseous Masses Primitive Neuroectodermal Tumor Rhabdomyosarcoma Miscellaneous Malignant Chest Wall Masses CONCLUSION REFERENCES CHAPTER 65 Pediatric Airway INTRODUCTION IMAGING MODALITIES Challenges of Imaging Plain Radiographs Fluoroscopy Barium Swallow Multidetector Computed Tomography Magnetic Resonance Imaging UPPER AIRWAY OBSTRUCTION Normal Anatomy (Figs. 1A to C) Acute Obstruction Chronic Obstruction LOWER AIRWAY OBSTRUCTION Central Airways Peripheral Airways REFERENCES CHAPTER 66 Pediatric Interstitial Lung Diseases TERMINOLOGY AND BACKGROUND CLASSIFICATION1 I. Diseases More Prevalent in Infancy II. Disorders not Specific to Infancy B. Disorders related to Systemic Diseases C. Disorders of Immunocompromised Host D. Disorders Masquerading as Interstitial Lung Diseases (Box 3) III. Unclassified Disorders PATTERN APPROACH (TABLE 5) REFERENCES CHAPTER 67 Developmental Anomalies of Gastrointestinal Tract INTRODUCTION ANATOMICAL FUNCTIONAL COMBINED ANATOMICAL-FUNCTIONAL IMAGING MODALITIES Plain Film Radiography ESOPHAGUS Esophageal Atresia and Tracheoesophageal Fistula STOMACH Microgastria DEVELOPMENTAL OBSTRUCTIVE DEFECTS Gastric Atresia Prepyloric Membrane or Antral Web/Diaphragm Hypertrophic Pyloric Stenosis Adult Idiopathic Hypertrophic Pyloric Stenosis (AIHPS) Ectopic Pancreas SMALL BOWEL Duodenum Duodenal Atresia and Stenosis Duodenal Web/Intraluminal Duodenal Diaphragm Annular Pancreas Preduodenal Portal Vein Anomalies of Rotation and Fixation Jejunoileal Atresia and Stenosis Meconium Ileus Megacystis-microcolon-intestinal Hypoperistalsis Syndrome (Berdon Syndrome) LARGE BOWEL Colonic Obstruction Colonic Atresia Hirschsprung’s Disease/Aganglionosis of the Colon/Congenital Megacolon Functional Immaturity of the Colon/Neonatal Functional Colonic Obstruction CONCLUSION ACKNOWLEDGEMENTS REFERENCES CHAPTER 68 Imaging of Anorectal Anomalies INTRODUCTION EMBRYOLOGY OF THE CLOACA RELATED TO ANORECTAL ANOMALIES Internal Cloaca External Cloaca CLASSIFICATION INFORMATION REQUIRED IN A PATIENT OF ANORECTAL ANOMALY CLINICAL CLUES Males Females IMAGING WORKUP Invertography Contrast Studies ANORECTAL ANOMALY IN MALES High Anomalies Intermediate Anomalies Low Anomalies ANORECTAL ANOMALY IN FEMALES High Anomalies Intermediate Anomalies Low Anomalies UNCOMMON ANORECTAL ANOMALY: POUCH COLON INVESTIGATIONS OTHER INVESTIGATIONS (BOTH FOR MALE AND FEMALE ANORECTAL ANOMALIES) Ultrasound Computed Tomography Scan Magnetic Resonance Imaging Scan RELATIONSHIP OF SACRAL DEVELOPMENT AND LEVATOR MUSCLE DEVELOPMENT ASSOCIATED ANOMALIES DIAGNOSTIC ALGORITHM REFERENCES CHAPTER 69 Gastrointestinal Masses and Inflammatory Conditions of Gastrointestinal Tract in Children PART A: CONGENITAL AND NEOPLASTIC LESIONS INTRODUCTION PLAIN RADIOGRAPHS CONTRAST STUDIES ULTRASONOGRAPHY COMPUTED TOMOGRAPHY MAGNETIC RESONANCE IMAGING ESOPHAGEAL MASSES IN CHILDREN Congenital Masses Neoplasms GASTRIC MASSES IN CHILDREN Congenital Acquired Outlet Obstruction of Stomach Ultrasonography5- Barium Study NEOPLASTIC MASSES Benign Masses12 Malignant Gastric Tumors Bezoars24 SMALL BOWEL MASSES IN CHILDREN Congenital NEOPLASTIC MASSES Benign Malignant Small Bowel Masses Intussusception (Fig. 13B) MESENTERIC MASSES IN CHILDREN Mesenteric and Omental Tumors COLONIC MASSES IN CHILDREN Congenital Neoplasms CONCLUSION PART B: BOWEL IMAGING IN CHILDREN: INFLAMMATORY AND INFECTIVE LESIONS INTRODUCTION INFECTIVE DISEASES Tuberculosis Acute Appendicitis Neutropenic Enterocolitis Meckel Diverticulitis INFLAMMATORY DISEASES Necrotizing Enterocolitis Eosinophilic Gastroenteritis Crohn’s Disease Ulcerative Colitis Celiac Disease CONCLUSION REFERENCES CHAPTER 70 Hepatic and Pancreatic Masses in Children INTRODUCTION IMAGING HEPATIC MASSES Malignant Hepatic Tumors Benign Hepatic Neoplasms PELIOSIS HEPATIS INFLAMMATORY LESIONS Pyogenic Hepatic Abscess Amebic Hepatic Abscess Fungal Abscess Granulomatous Lesions Echinococcal Disease (Hydatid Cyst) SIMPLE HEPATIC CYST POLYCYSTIC LIVER DISEASE CAROLI’S DISEASE PANCREATIC MASSES Pancreatoblastoma Islet Cell Tumors Solid and Papillary Epithelial Neoplasm (Frantz Tumor) Mesenchymal Tumors Pancreatic Adenocarcinoma Pseudocysts Pancreatic Tuberculosis SUMMARY REFERENCES CHAPTER 71 Imaging and Interventions in Pediatric Budd–Chiari Syndrome INTRODUCTION PATHOPHYSIOLOGY ETIOLOGY AND CLINICAL PRESENTATION MORPHOLOGICAL CLASSIFICATION IMAGING MODALITIES IMAGING DIAGNOSIS OF PEDIATRIC BUDD–CHIARI SYNDROME Ultrasonography Computed Tomography Magnetic Resonance Imaging Venography MANAGEMENT OF PEDIATRIC BUDD–CHIARI SYNDROME Radiological Interventions CONCLUSION REFERENCES CHAPTER 72 Childhood Biliopathies INTRODUCTION IMAGING MODALITIES1- NORMAL ANATOMY9- Normal Bile Ducts Normal Gallbladder CHOLESTATIC PROCESSES13- Biliary Atresia18- Neonatal Hepatitis1,53,54 Bile Duct Paucity12,37 Progressive Familial Intrahepatic Cholestasis19,54,56 Gestational Alloimmune Liver Disease and Neonatal Hemochromatosis54,57- Inspissated Bile Syndrome12,37,54 Spontaneous Perforation of Common Bile Duct Choledochal Cyst12,37,60- Caroli’s Disease and Caroli’s Syndrome12,37,69,75- BILIARY CHANGES ASSOCIATED WITH SYSTEMIC DISEASES Biliary Changes in Cystic Fibrosis12,37,79 Sclerosing Cholangitis12,37 Immunoglobulin G4-related Disease12,80 Portal Hypertensive Biliopathy81- CHOLELITHIASIS AND CHOLEDOCHOLITHIASIS12,54,84- MISCELLANEOUS GALLBLADDER PATHOLOGY Acalculous Cholecystitis87,88 Gallbladder Dyskinesia86 Gallbladder Hydrops88- BILIARY NEOPLASMS12,37 BILIARY COMPLICATIONS OF PEDIATRIC LIVER TRANSPLANTATION37 CONCLUSION ACKNOWLEDGEMENT REFERENCES CHAPTER 73 Congenital Anomalies of the Urinary Tract INTRODUCTION IMAGING MODALITIES Antenatal Sonography Magnetic Resonance Urography Voiding Ultrasonography CT Angiography and CT Urography Neonatal Kidney Embryologic Development of the Urinary Tract ABNORMALITIES OF KIDNEY Renal Agenesis Rotational Anomalies Anomalies of Renal Position Ipsilateral/Uncrossed Ectopia Crossed Renal Ectopia Horseshoe Kidney Ureteropelvic Duplication (Duplex Kidney) Renal Hypoplasia Cystic Renal Dysplasia Autosomal Recessive Polycystic Kidney Disease Multicystic Dysplastic Kidney Autosomal Dominant (Adult Type) Polycystic Kidney Disease Pelviureteric Junction Obstruction ANOMALIES OF THE URETER Ectopic Ureter Ureterocele Primary Megaureter ANOMALIES OF THE URINARY BLADDER Complete Duplication Bladder Exstrophy Bladder Diverticulae Neurogenic Bladder Prune Belly Syndrome Urachal Anomalies Bladder Exstrophy Bladder Diverticulae Neurogenic Bladder Prune Belly Syndrome Urachal Anomalies ABNORMALITIES OF THE URETHRA Posterior Urethral Valve Male Hypospadias/Epispadias Anterior Urethral Diverticulum and Anterior Urethral Valve Urethral Duplication Megalourethra REFERENCES CHAPTER 74 Urinary Tract Infections (Including Vesicoureteral Reflux and Neurogenic Bladder) INTRODUCTION INCIDENCE RADIOLOGICAL MODALITIES FOR IMAGING OF URINARY TRACT INFECTION Role of Ultrasound in First-time Urinary Tract Infection VESICOURETERAL REFLUX Pathophysiology of Vesicoureteral Reflux and Pyelonephritis Imaging Findings in Acute Pyelonephritis Grading of Vesicoureteral Reflux Imaging of Vesicoureteral Reflux GUIDELINES FOR UROLOGIC IMAGING IN URINARY TRACT INFECTION: FROM HISTORY TO CURRENT PERSPECTIVE TREATMENT GUIDELINES FOR REFLUX NEUROGENIC BLADDER ACKNOWLEDGMENTS REFERENCES CHAPTER 75 Renal and Retroperitoneal Masses INTRODUCTION IMAGING RENAL MASSES WILMS’ TUMOR (NEPHROBLASTOMA) Etiopathogenesis Clinical Features Pathology Imaging Management Differential Diagnosis Follow-up and Screening NEPHROBLASTOMATOSIS Pathology Imaging Features MESOBLASTIC NEPHROMA (BOLANDE’S TUMOR) Clinical Presentation Pathology Imaging Differential Diagnosis Treatment and Prognosis CLEAR CELL SARCOMA Pathology Imaging Treatment RHABDOID TUMOR Clinical Presentation Pathology Imaging Treatment and Prognosis RENAL CELL CARCINOMA Clinical Presentation Pathology Imaging Differential Diagnosis MULTILOCULAR CYSTIC RENAL TUMOR Clinical Presentation Pathology Imaging Differential Diagnosis Treatment and Follow-up ANGIOMYOLIPOMA Clinical Presentation Pathology Imaging Screening, Follow-up, and Treatment OSSIFYING RENAL TUMOR OF INFANCY Imaging METANEPHRIC ADENOMA (NEPHROGENIC ADENOFIBROMA and EMBRYONAL ADENOMA) Imaging LYMPHOMA Clinical Presentation Imaging LEUKEMIA PRIMARY NEUROGENIC TUMORS OF THE KIDNEY Primitive Neuroectodermal Tumor Neuroblastoma CYSTIC DISEASES OF THE KIDNEY ADRENAL MASSES NEUROBLASTOMA Site Clinical Features Pathology Imaging Staging Imaging Strategy Differential Diagnosis Management and Follow-up GANGLIONEUROBLASTOMA GANGLIONEUROMA PHEOCHROMOCYTOMA Clinical Presentation Imaging ADRENAL CORTICAL TUMORS Clinical Features Imaging Features ADRENAL HEMORRHAGE Clinical Features Imaging Features ADRENAL CYSTS PRIMARY RETROPERITONEAL TUMORS NEUROGENIC TUMORS GERM-CELL TUMORS Imaging MESENCHYMAL TUMORS Lipomatous Tumors Rhabdomyosarcoma and Undifferentiated Sarcomas RETROPERITONEAL LYMPHATIC MALFORMATION LYMPH NODE MASSES RETROPERITONEAL ABSCESS AND HEMATOMA CONCLUSION REFERENCES CHAPTER 76 Evaluation of Female Pelvis and Testicular Abnormalities FEMALE PELVIS NORMAL ULTRASOUND ANATOMY OF GENITAL ORGANS IN INFANTS AND CHILDREN Uterus Ovaries Ovarian Cysts ANOMALIES OF THE FEMALE PELVIS Müllerian Duct Anomalies Primary Amenorrhea Polycystic Ovary Syndrome PELVIC MASSES IN CHILDREN Benign Ovarian Neoplasms Malignant Neoplasms Malignant Ovarian Neoplasms Ovarian Torsion Tubo-ovarian Abscess Ectopic Pregnancy NONGYNECOLOGIC PELVIC MASSES IMAGING OF TESTICULAR ABNORMALITIES Undescended Testes Inguinal-scrotal Hernia Hydrocele Cystic Dysplasia of the Testis Testicular Calcification (Microcalcification) Acute Scrotum Scrotal Tumors Testicular Tumors Other Testicular Tumors EXTRATESTICULAR TUMORS Paratesticular Rhabdomyosarcoma Adenomatoid Tumor Epididymal Cystadenoma Lipoma Fibrous Pseudotumor ADRENAL RESTS SCROTAL INVOLVEMENT IN SYSTEMIC DISEASES Scrotal Trauma REFERENCES CHAPTER 77 Imaging of Disorders of Sex Differentiation INTRODUCTION NORMAL SEXUAL DIFFERENTIATION1,2 IMAGING OF A CHILD WITH DISORDERS OF SEX DIFFERENTIATION3- Genitography3,8 Other Imaging Modalities Magnetic Resonance Appearance of Genital Structures CLASSIFICATION OF DISORDERS OF SEX DIFFERENTIATION 46,XX DSD (Earlier Known as Female Pseudohermaphroditism) 46,XY DSD (Earlier Known as Male Pseudohermaphroditism) Ovotesticular Disorders of Sex Differentiation (Earlier Known as True Hermaphroditism) CLUES TO THE DIAGNOSIS NEOPLASMS IN DISORDERS OF SEX DIFFERENTIATION CONCLUSION REFERENCES CHAPTER 78 Skeletal Dysplasias INTRODUCTION NOSOLOGY AND CLASSIFICATION OF SKELETAL DYSPLASIA CLINICAL PRESENTATION OF SKELETAL DYSPLASIAS RADIOLOGICAL EVALUATION Skeletal Survey CROSS-SECTIONAL IMAGING MODALITIES PRENATAL DIAGNOSIS OF SKELETAL DYSPLASIA Practical Approach to Skeletal Dysplasia Epiphyseal Dysplasias Metaphyseal Dysplasia Dysplasia with Predominant Involvement of Diaphyses Frontometaphyseal Dysplasia Dysplasia with Major Involvement of the Spine Kniest Dysplasia Diastrophic Dysplasia Group Spondylometaphyseal Dysplasias Metaphoric Dysplasia Dysostosis Multiplex DYSPLASIA WITH ALTERED BONE DENSITY: OSTEOPENIC OR SCLEROSING DYSPLASIAS Dysplasias with Decreased Bone Density (Osteopenic Dysp Dysplasias with Increased Bone Density (Sclerosing or Osteosclerotic Dysplasia) Progressive Diaphyseal Dysplasia (Camurati–Engelmann Disease) Craniodiaphyseal Dysplasia Craniometaphyseal Dysplasia Dysplasia with Single Site or Segment Involvement SKELETAL DYSPLASIAS WITH MULTIPLE DISLOCATIONS Disorganized Development of Cartilage and Fibrous Components of the Skeleton DYSOSTOSES Dysostoses with Cranial and Facial Involvement Dysostoses with Predominant Axial Involvement Dysostosis with Predominant Involvement of Extremities Bone Abnormalities Secondary to Disturbances of Extraskeleton Systems CONCLUSION REFERENCES CHAPTER 79 Short Stature and Skeletal Maturity Assessment INTRODUCTION MEASUREMENT OF MATURITY SKELETAL MATURITY ASSESSMENT: WHY IS IT NECESSARY? METHODS TO ASSESS SKELETAL MATURITY Appearance and Fusion of Ossification Centers Greulich and Pyle Method Tanner and Whitehouse II Method Comparison of Greulich and Pyle and Tanner and Whitehouse II Methods Automated Bone Age Estimation Ultrasound-based Bone Age Calculation Magnetic Resonance-based Bone Age Assessment Indian Scene ACCELERATED AND DELAYED BONE AGE CAUSES OF SHORT STATURE IMAGING EVALUATION IN SHORT STATURE IMAGING FINDINGS IN SPECIFIC DISEASE ENTITIES Hypopituitarism37- Hypothyroidism Cushing Syndrome Precocious Puberty REFERENCES CHAPTER 80 Spinal Dysraphism INTRODUCTION CLASSIFICATION EMBRYOLOGY IMAGING MODALITIES OPEN SPINAL DYSRAPHISM Myelocele and Myelomeningocele Hemimyelocele/Hemimyelomeningocele CLOSED SPINAL DYSRAPHISM Closed Spinal Dysraphism with Subcutaneous Mass Closed Spinal Dysraphism without Subcutaneous Mass CONCLUSION REFERENCES CHAPTER 81 Imaging of Pediatric Joint Pathology INTRODUCTION IMAGING MODALITIES Radiographs Ultrasound CT MRI Nuclear Scan JUVENILE IDIOPATHIC ARTHRITIS Etiopathogenesis Classification of Juvenile Idiopathic Arthritis Imaging in Juvenile Idiopathic Arthritis Specific Joint Involvement in Juvenile Idiopathic Arthritis Role of Imaging in Treatment IMAGING OF JUVENILE SPONDYLOARTHRITIS Juvenile Ankylosing Spondylitis (Box 3) Juvenile Psoriatic Arthritis (Box 4) Arthritis Associated with Inflammatory Bowel Disease in Children Reactive Arthritis INFECTIOUS ARTHROPATHIES IN CHILDREN Pyogenic/Septic Arthritis Tuberculous Arthritis Transient Synovitis of Hip Hemophilic Arthropathy Neuropathic Arthropathy DEVELOPMENTAL/MISCELLANEOUS ABNORMALITIES OF THE IMMATURE JOINT Developmental Dysplasia of the Hip Proximal Femoral Focal Deficiency Legg–Calvé–Perthes Disease Slipped Capital Femoral Epiphysis (Box 6) Blount’s Disease Tarsal Coalition Pseudoarthritis CONCLUSION REFERENCES CHAPTER 82 Benign Bone and Softtissue Tumors and Conditions INTRODUCTION CARTILAGINOUS TUMORS Osteochondroma Enchondroma Chondroblastoma Chondromyxoid Fibroma OSSEOUS TUMORS Osteoid Osteoma Osteoblastoma FIBROUS TUMORS Nonossifying Fibroma Fibrous Dysplasia Osteofibrous Dysplasia HISTIOCYTOSIS X (LANGERHANS CELL HISTIOCYTOSIS) GIANT CELL TUMOR TUMOR-LIKE LESIONS Simple Bone Cyst Aneurysmal Bone Cyst Pseudotumor of Hemophilia SOFT-TISSUE TUMORS Vascular Lesions FIBROBLASTIC/MYOFIBROBLASTIC TUMORS Nodular Fasciitis Myositis Ossificans Myofibroma/Myofibromatosis Fibromatosis Neurogenic Tumor Adipocytic Tumor Lipoma Lipoblastoma Pseudotumors Fat Necrosis Hematoma Inflammatory Lesions Periarticular Cysts Advance Magnetic Resonance Imaging CONCLUSION REFERENCES CHAPTER 83 Pediatric Malignant Bone and Soft-tissue Tumors INTRODUCTION IMAGING MODALITIES Plain Radiographs Sonography Computed Tomography Magnetic Resonance Imaging STAGING OF MALIGNANT BONE AND SOFT-TISSUE TUMORS MALIGNANT BONE TUMORS Osteosarcoma Ewing’s Sarcoma Chondrosarcoma Lymphoma Metastases Other Rare Bone Sarcomas SOFT-TISSUE TUMORS Rhabdomyosarcoma Synovial Sarcoma Infantile/Congenital Fibrosarcoma Other Malignant Soft-tissue Pediatric Tumors MIMICS OF SOFT-TISSUE SARCOMAS CONCLUSION REFERENCES CHAPTER 84 Congenital Brain Anomalies INTRODUCTION ANOMALIES OF DORSAL PROSENCEPHALON DEVELOPMENT Commissural Anomalies Malformations of Cortical Development ANOMALIES OF VENTRAL PROSENCEPHALON DEVELOPMENT Holoprosencephaly CONGENITAL ANOMALIES OF THE POSTERIOR FOSSA Anomalies of Midbrain-hindbrain Development CONCLUSION REFERENCES CHAPTER 85 Hypoxic-ischemic Encephalopathy INTRODUCTION NEUROIMAGING IN INFANTS WITH HYPOXIC-ISCHEMIC ENCEPHALOPATHY BELOW 36 WEEKS GROUP—The premature neonate Severe, Total Hypoxia Mild-to-moderate Hypoxia ABOVE 36 WEEKS GROUP—THE TERM NEONATE Severe, Total Hypoxia Prolonged, Partial Hypoxia HYPOXIC-ISCHEMIC INJURY IN POSTNATAL AGE GROUP Severe, Total Hypoxia Mild-to-moderate Hypoxia IMAGING CHOICE FOR EVALUATION OF HYPOXIC-ISCHEMIC INJURY Technique and Timing of Magnetic Resonance Imaging PREDICTION OF CLINICAL OUTCOME Ultrasound Computed Tomography Magnetic Resonance Imaging CONCLUSION REFERENCES CHAPTER 86 Craniospinal Sonography PART A: CRANIAL SONOGRAPHY INTRODUCTION INDICATIONS OF CRANIAL SONOGRAPHY3 EQUIPMENT TECHNIQUE AND NORMAL ANATOMY Standard Views Supplemental Windows CRANIAL DOPPLER SONOGRAPHY NORMAL ANATOMIC VARIANTS Cavum Septum Pellucidum and Cavum Vergae Cavum Veli Interpositi Frontal Horn Variants (Cysts) Choroid Plexus Variants Hyperechoic White Matter Pseudolesion or Periventricular Halo INTRACRANIAL HEMORRHAGE Hemorrhage in Preterm Neonate Hemorrhage in Term Neonate HYPOXIC-ISCHEMIC INJURY Hypoxic-ischemic Injury in Preterm Neonates Hypoxic-ischemic Injury in Term Neonates HYDROCEPHALUS Detection of Hydrocephalus and Ultrasound Measurement of Lateral Ventricles Level of Obstruction Doppler Imaging Follow-up with Ultrasonography Benign Enlargement of Subarachnoid Space in Infancy CONGENITAL BRAIN ANOMALIES Disorders of Organogenesis Disorders of Diverticulation Disorders of Sulcation and Migration Disorders of Histogenesis DESTRUCTIVE BRAIN LESIONS Porencephalic Cyst Hydranencephaly INTRACRANIAL INFECTION Congenital Infections Acquired Infections NEOPLASMS AND CYSTS Neoplasms Cysts EXTRACORPOREAL MEMBRANE OXYGENATION POST-TRAUMATIC INJURY MINERALIZING LENTICULOSTRIATE VASCULOPATHY LIMITATIONS OF CRANIAL SONOGRAPHY AND RECOMMENDATIONS FOR MRI FUTURE PERSPECTIVES CONCLUSION ACKNOWLEDGMENT PART B: PEDIATRIC SPINAL SONOGRAPHY INTRODUCTION INDICATIONS EQUIPMENT TECHNIQUE DETERMINATION OF VERTEBRAL LEVEL NORMAL ANATOMY NORMAL VARIATIONS DISEASE ENTITIES Spinal Dysraphism Complex Dysraphism Tethered Cord Syndrome Subdural Hematoma Infection Other Indications CONCLUSION REFERENCES CHAPTER 87 Infectious and Inflammatory Diseases of the Brain INTRODUCTION NEUROINFECTIONS Investigative Modalities BACTERIAL INFECTIONS Meningitis Cerebritis and Brain Abscess Cranial Tuberculosis Neurocysticercosis Hydatid Disease VIRAL INFECTIONS Herpes Simplex Encephalitis Japanese Encephalitis CONGENITAL INFECTIONS Congenital Cytomegalovirus Congenital Toxoplasmosis Neonatal Herpes Simplex Encephalitis Rubella Congenital Human Immunodeficiency Virus Infection FUNGAL INFECTIONS Aspergillosis Mucormycosis INFLAMMATORY DISEASES Multiple Sclerosis Acute Disseminated Encephalomyelitis Neuromyelitis Optica Spectrum Disorder Anti-myelin Oligodendrocyte Glycoprotein Syndromes Autoimmune Encephalitis CONCLUSION REFERENCES CHAPTER 88 Pediatric Brain Tumors INTRODUCTION CLASSIFICATION OF CHILDHOOD TUMORS BASED ON TOPOGRAPHY2 INFRATENTORIAL TUMORS Medulloblastoma Cerebellar Pilocytic Astrocytoma Ependymoma Atypical Teratoid Rhabdoid Tumor Brainstem Gliomas Hemangioblastoma SUPRATENTORIAL TUMORS Cerebral Hemisphere Sellar and Suprasellar Tumors Pineal Region Masses Extraparenchymal Tumors Tumors of the Orbit and Neck Ocular Tumors CONCLUSION REFERENCES CHAPTER 89 Metabolic Disorders of the Brain INTRODUCTION MYELIN COMPOSITION PROGRESSION OF MYELINATION GRAY-WHITE MATTER DIFFERENTIATION Delayed Myelination Hypomyelination Demyelination Dysmyelination CLASSIFICATION OF METABOLIC DISORDERS (A) Classification of Metabolic Disorders According to Brain Substance Involvement (B) Classification of Metabolic Disorders on the Basis of Organelle Disorder9,10 Disorders of Amino Acid Metabolism/Aminoacidopathies Organic Acidemias112 DIFFERENTIATING FEATURES Metabolic Disorders Primarily Affecting Gray Matter Disorders of Metal Metabolism CONCLUSION REFERENCES CHAPTER 90 Pediatric Neck Lesions INTRODUCTION CONGENITAL Branchial Cleft Anomalies Thyroid Anomalies Thymic Anomalies Dermoid and Epidermoid Cysts Ranula Vascular Lesions INFECTIOUS/INFLAMMATORY LESIONS Lymphoid Hyperplasia Lymph Node Enlargement Deep Space Infections NEOPLASMS Teratomas Lipoma Lipoblastoma Neurogenic Tumors Cervical Neuroblastoma Rhabdomyosarcoma Inflammatory Myofibroblastic Tumor Juvenile Nasopharyngeal Angiofibroma Lymphoma Epithelial Malignancies MISCELLANEOUS Desmoid Infantile Fibromatosis NEONATAL NECK MASSES Fibromatosis Colli Melanotic Neuroectodermal Tumor of Infancy CONCLUSION REFERENCES SECTION 4 Gastrointestinal and Hepatobiliary Imaging CHAPTER 91 Imaging Techniques for Abdomen INTRODUCTION CONVENTIONAL TECHNIQUES BARIUM STUDIES ULTRASONOGRAPHY EVALUATION OF THE LIVER Technique Sonographic Anatomy Intraoperative Ultrasonography Endosonography USG Elastography USG Contrast Agents USG Image Fusion and Navigation CT EXAMINATION OF THE ABDOMEN AND PELVIS CT Evaluation of Hepatic Pathology VOLUME ESTIMATION MULTIDETECTOR COMPUTED TOMOGRAPHY EVALUATION OF PANCREATIC PATHOLOGY BOWEL EVALUATION CT Enteroclysis MAGNETIC RESONANCE IMAGING MRI of the Liver MRI of Pancreatic Pathology MAGNETIC RESONANCE ENTEROGRAPHY NUCLEAR IMAGING ANGIOGRAPHY Technique Anatomy CONCLUSION REFERENCES CHAPTER 92 Imaging a Patient with Dysphagia INTRODUCTION EPIDEMIOLOGY PHYSIOLOGY OF SWALLOWING Oropharyngeal Stage Esophageal Stage PATHOGENESIS OF DYSPHAGIA Clinical Presentation CAUSES OF DYSPHAGIA IMAGING TECHNIQUES IN THE EVALUATION OF DYSPHAGIA Examination Technique Evaluation of Pharynx Evaluation of the Esophagus, Gastroesophageal Junction and Cardia The Tailored Examination7 Videofluoroscopic Swallowing Study Nasopharyngoscopy Pharyngeal/Esophageal Manometry Upper Gastrointestinal Endoscopy Esophageal Scintigraphy Intraesophageal pH Monitoring Endoscopic Ultrasound Cross-sectional Imaging Studies FUNCTIONAL OROPHARYNGEAL ABNORMALITIES Laryngeal Penetration Aspiration Postswallow Residue in the Pharynx Cricopharyngeal Bar or Prominent Cricopharyngeus Muscle STRUCTURAL OROPHARYNGEAL ABNORMALITIES Postcricoid Webs Pharyngeal Diverticula and Pouches Oropharyngeal Tumors and their Surgery Postradiation Stricture Retropharyngeal Abscess Pharyngeal Foreign Bodies ESOPHAGEAL MOTILITY DISORDERS PRIMARY MOTILITY DISORDER Nonspecific Esophageal Motility Disorder Diffuse Esophageal Spasm Achalasia SECONDARY MOTILITY DISORDER Scleroderma STRUCTURAL ESOPHAGEAL DYSPHAGIA Esophagitis Gastroesophageal Reflux Disease and Barrett's Esophagus Lower Esophageal Ring (Schatzki Ring) Congenital Esophageal Stenosis INFECTIOUS ESOPHAGITIS Esophagitis Imaging Features Viral Esophagitis Tuberculosis INFLAMMATORY ESOPHAGITIS Corrosive/Caustic Esophagitis Drug-induced or Pill Esophagitis Eosinophilic Esophagitis Intramural Pseudodiverticulosis ESOPHAGEAL NEOPLASMS Benign Esophageal Neoplasms Leiomyoma Gastrointestinal Stromal Tumors Fibrovascular Polyp MALIGNANT ESOPHAGEAL NEOPLASMS Esophageal Carcinoma: Squamous Cell Carcinoma and Adenocarcinoma LEIOMYOSARCOMA Clinical Presentation Imaging Features LYMPHOMA Clinical Presentation Imaging Features Treatment SPINDLE CELL CARCINOMA Imaging Features PRIMARY MALIGNANT MELANOMA Imaging Features SMALL CELL CARCINOMA Imaging Features STAGING OF ESOPHAGEAL CANCER CT for Esophageal Cancer Endoscopic Ultrasound for Esophageal Cancer PET-CT for Esophageal Cancer Treatment EXTRINSIC NARROWING Foreign Bodies Vascular Ring Enlarged Thyroid Gland Enlarged Cervical Osteophytes CONCLUSION REFERENCES CHAPTER 93 Tumors of Stomach and Duodenum INTRODUCTION GASTRIC POLYPS Epithelial Polyps Hamartomatous Polyps Mesenchymal Polyps MALIGNANT GASTRIC NEOPLASMS GASTRIC ADENOCARCINOMAS Pathophysiology EARLY GASTRIC CANCER ADVANCED GASTRIC CANCER Staging of Gastric Cancer Imaging Features of Advanced Gastric Cancer CT Features of Gastric Cancer Endoscopic Ultrasonography Nuclear Imaging Treatment and Prognosis Differential Diagnosis Gastric Lymphoma Metastatic Disease Gastric and Duodenal Carcinoids GASTROINTESTINAL STROMAL TUMOR Etiopathogenesis Clinical Features Imaging Features Duodenal GIST Gastric Lipomas (Table 3) Liposarcoma/Leiomyoma/Leiomyosarcoma Neurogenic Tumors of Stomach Glomus Tumor Hemangioma Plasmacytoma Other Focal Gastric Lesions Mimicking Tumor DUODENAL FOCAL LESIONS Introduction BENIGN DUODENAL TUMORS Adenomas Adenomatous Polyps Lipomas Other Benign Tumors Malignant Duodenal Tumors Adenocarcinoma Lymphoma Villous Adenoma Secondary Involvement and Metastasis CONCLUSION REFERENCES CHAPTER 94 Small Bowel Tumors INTRODUCTION SMALL BOWEL CARCINOGENESIS–PATHOGENESIS DIAGNOSTIC TECHNIQUES BENIGN TUMORS AND POLYPS Adenoma Lipoma Leiomyoma Hemangioma Neurogenic Tumor POLYPOSIS SYNDROMES INVOLVING THE SMALL BOWEL Peutz-Jeghers Syndrome Cowden's Disease4,21 Familial Adenomatous Polyposis1,4,21 Cronkhite-Canada Syndrome21 Juvenile Polyposis22 MALIGNANT TUMORS Adenocarcinoma Etiopathogenesis Clinical Presentation Imaging Features Staging and Prognosis Treatment Carcinoid Tumors or Neuroendocrine Tumors Etiopathogenesis Clinical Features Imaging Imaging of Metastatic Lesions Differential Diagnosis Future Directions16 Treatment and Prognosis GASTROINTESTINAL STROMAL TUMORS Clinical Features Etiopathogenesis IMAGING APPEARANCES STAGING AND PROGNOSIS Treatment RESPONSE EVALUATION AND SURVEILLANCE LYMPHOMA ETIOPATHOGENESIS AND CLASSIFICATION Clinical Presentation Imaging Infiltrative Form Polypoid Form Endoexoenteric Form Mesenteric Invasive Form Radiological Appearances of Some Specific Lymphoma Types Burkitt's Lymphoma STAGING AND PROGNOSTICATION Treatment Kaposi's Sarcoma Leiomyosarcoma Metastatic Neoplasms CONCLUSION REFERENCES CHAPTER 95 Colorectal Tumors INTRODUCTION EPIDEMIOLOGY RISK FACTORS PATHOGENESIS CLINICAL FEATURES PATHOLOGY ROUTE OF SPREAD STAGING Primary Tumor (T) Regional Lymph Node (N) Distant Metastasis (M) Stage Grouping ROLE OF RADIOLOGY Screening for Colorectal Cancer DIAGNOSTIC METHODS Plain Radiographs Barium Enema Ultrasound Computed Tomography Computed Tomography Colonography Magnetic Resonance Imaging Magnetic Resonance Colonography Arteriography Immunoscintigraphy Positron Emission Tomography RECENT ADVANCES ACR RECOMMENDATIONS FOR COLORECTAL CANCER STAGING OTHER EPITHELIAL TUMORS OF COLON NONEPITHELIAL TUMORS OF COLON SECONDARY TUMORS OF COLON POSTOPERATIVE COLON AND RECURRENT CANCER POLYPOSIS SYNDROMES Familial Adenomatous Polyposis Syndrome Peutz–Jeghers Syndrome Cowden Disease (Multiple Hamartoma Syndrome) Juvenile Polyposis Cronkhite–Canada Syndrome CONCLUSION REFERENCES CHAPTER 96 Ulceroconstrictive Diseases of the Gut INTRODUCTION Plain Radiograph Barium Studies CECT and CT Enteroclysis/CT Enterography MRI/MR Enterography Ultrasonography and Contrast-enhanced Ultrasonography ABDOMINAL TUBERCULOSIS Gastrointestinal Tuberculosis INFLAMMATORY BOWEL DISEASE Crohn's Disease Imaging Features to Differentiate Intestinal TB from CD Ulcerative Colitis MISCELLANEOUS DISEASES CONCLUSION REFERENCES CHAPTER 97 Imaging of Ischemic Bowel Disease INTRODUCTION ANATOMY OF SPLANCHNIC CIRCULATION Arterial Supply Collateral System ETIOLOGY PATHOPHYSIOLOGY OF ISCHEMIC BOWEL DISEASE ACUTE MESENTERIC ISCHEMIA Superior Mesenteric Artery Thromboembolism Venous Mesenteric Ischemia Nonocclusive Mesenteric Ischemia Imaging Modalities Technical Aspects Treatment of Acute Mesenteric Ischemia CHRONIC MESENTERIC ISCHEMIA Imaging Modalities Treatment COLONIC ISCHEMIA Diagnosis Treatment ACKNOWLEDGMENTS REFERENCES CHAPTER 98 Gastrointestinal Hemorrhage: Imaging and Intervention INTRODUCTION CLASSIFICATION Clinical Presentation Etiology Evaluation IMAGING MODALITIES Indications Radionuclide Studies Computed Tomography Angiography Ultrasonography Magnetic Resonance Imaging RADIOLOGICAL INTERVENTIONS IN GASTROINTESTINAL HEMORRHAGE Endovascular Approach Percutaneous Approach Embolic Materials SPECIFIC SITUATIONS IN GASTROINTESTINAL HEMORRHAGES Upper Gastrointestinal Hemorrhage Hemobilia Lower Gastrointestinal Hemorrhage Angiodysplasia CONCLUSION REFERENCES CHAPTER 99 Imaging of Appendix INTRODUCTION NORMAL IMAGING APPEARANCE ACUTE APPENDICITIS Pathophysiology Clinical Picture Imaging WHICH MODALITY AND WHEN? TUBERCULOSIS OF THE APPENDIX MUCOCELE OF APPENDIX PRIMARY APPENDICEAL INTUSSUSCEPTION POSTOPERATIVE APPENDICEAL DEFECTS TUMORS OF THE APPENDIX REFERENCES CHAPTER 100 Diffuse Liver Diseases INTRODUCTION HEPATIC STEATOSIS (FATTY LIVER) NAFLD-NASH Continuum VIRAL HEPATITIS USG CT MRI ALCOHOLIC HEPATITIS RADIATION HEPATITIS HEMOCHROMATOSIS AND HEMOSIDEROSIS USG CT MRI AMYLOIDOSIS WILSON’S DISEASE GRANULOMATOUS DISEASES CIRRHOSIS USG CT MRI MALIGNANT DIFFUSE LIVER DISEASES CONCLUSION REFERENCES CHAPTER 101 Clinical Aspects of Liver Cirrhosis: A Perspective for the Radiologist INTRODUCTION EPIDEMIOLOGY CAUSES AND RISK FACTORS OF CIRRHOSIS NATURAL HISTORY AND PROGNOSIS PATHOLOGY TYPES OF CIRRHOSIS CLINICAL PRESENTATION SEVERITY OF CIRRHOSIS DIAGNOSIS OF CIRRHOSIS ENDOSCOPY IMAGING IN CIRRHOSIS COMPLICATIONS OF CIRRHOSIS CIRRHOSIS AND HEPATOCELLULAR CARCINOMA Screening Tests Surveillance Intervals Diagnosis of HCC and Protocol for HCC Surveillance Cost Effectiveness TREATMENT OF CIRRHOSIS TREATMENT OF COMPLICATIONS CONCLUSION REFERENCES CHAPTER 102 Benign Focal Lesions of Liver INTRODUCTION HEPATIC CYSTS Pathology Clinical Features Imaging Features Computed Tomography Magnetic Resonance Imaging POLYCYSTIC LIVER DISEASE CILIATED HEPATIC FOREGUT CYST PERIBILIARY CYST BILIARY DUCT HAMARTOMAS Pathology Clinical Features Imaging Features Differential Diagnosis BILIARY CYSTADENOMA Pathology Clinical Features Imaging Features MR Imaging Differential Diagnosis HEMANGIOMA Pathology Clinical Features Imaging Features FOCAL NODULAR HYPERPLASIA Pathogenesis Pathology Clinical Features Imaging Features HEPATOCELLULAR ADENOMA/HEPATIC ADENOMA Pathogenesis Pathology Clinical Features Imaging Features NODULAR REGENERATIVE HYPERPLASIA Pathogenesis Clinical Features Imaging Features ADENOMATOUS HYPERPLASTIC NODULE PEDIATRIC LIVER TUMORS Mesenchymal Hamartoma Pathology Clinical Features Imaging Features INFANTILE HEPATIC HEMANGIOMA Pathogenesis Pathology Clinical Features Imaging Features UNUSUAL BENIGN TUMORS OF THE LIVER Lipomatous Tumors LEIOMYOMAS Imaging Features Paraganglioma INFECTIVE LESIONS Bacterial (Pyogenic) Liver Abscess Clinical Features Imaging Features AMOEBIC ABSCESS Pathology Imaging Features Complications FUNGAL HEPATIC ABSCESSES Imaging Features HYDATID DISEASE Structure of Hydatid Cyst Clinical Features Imaging Features COMPLICATIONS OF HYDATID CYSTS Intrahepatic Complications Peritoneal Seeding/Peritoneal Hydatidosis Biliary Communication Other Complications HEPATIC ALVEOLAR ECHINOCOCCOSIS HEPATIC TUBERCULOSIS Pathology Clinical Features Imaging Features Micronodular Form Macronodular Form Serohepatic Tuberculosis Tubercular Cholangitis HEPATIC SARCOIDOSIS HEPATIC SCHISTOSOMIASIS MISCELLANEOUS LESIONS Fatty Infiltration Hematoma Biloma Peliosis Hepatis Inflammatory Pseudotumor CONCLUSION REFERENCES CHAPTER 103 Malignant Focal Lesions of Liver INTRODUCTION IMAGING TECHNIQUES AND ADVANCES PRIMARY MALIGNANT FOCAL LESIONS HEPATOCELLULAR CARCINOMA Clinical Presentation Imaging in HCC Ultrasonography Computed Tomography Magnetic Resonance Imaging Differential Diagnosis of HCC Liver Imaging Reporting and Data System FIBROLAMELLAR HEPATOCELLULAR CARCINOMA Interventional Techniques INTRAHEPATIC CHOLANGIOCARCINOMA Imaging HEPATOCHOLANGIOCARCINOMA BILIARY CYSTADENOCARCINOMA HEPATOBLASTOMA Imaging EPITHELIOID HEMANGIOENDOTHELIOMA Imaging ANGIOSARCOMA SECONDARY MALIGNANCIES METASTATIC DISEASE Ultrasonography Computed Tomography Magnetic Resonance Imaging Differential Diagnosis LYMPHOMA PITFALLS IN THE DIAGNOSIS OF FOCAL LIVER LESIONS CONCLUSION REFERENCES CHAPTER 104 Interventional Radiology in Treatment of Liver Tumors INTRODUCTION TREATMENT OF MALIGNANT TUMORS Hepatocellular Carcinoma Pretreatment Assessment for Locoregional Therapy TREATMENT OF METASTATIC DISEASES OF LIVER TREATMENT OF BENIGN LIVER TUMORS CONCLUSION REFERENCES CHAPTER 105 Imaging in Liver Transplant INTRODUCTION INDICATIONS AND CONTRAINDICATIONS FOR LIVER TRANSPLANTATION HOW TO SELECT PATIENTS? HEPATOCELLULAR CARCINOMA TYPES OF LIVER TRANSPLANTATION LIVING DONOR LIVER TRANSPLANTATION PREOPERATIVE IMAGING MODALITIES Multidetector Computed Tomography MR Imaging Preoperative Imaging Evaluation Vascular Anatomy Hepatic Arteries Hepatic Veins Portal Veins Biliary Anatomy Liver Parenchyma POSTOPERATIVE EVALUATION Imaging of Post-transplant Complications CONCLUSION ACKNOWLEDGMENTS REFERENCES CHAPTER 106 Imaging and Interventions in Hepatic Venous Outflow Tract Obstruction INTRODUCTION CLINICAL PRESENTATION ETIOPATHOGENESIS DIAGNOSTIC TECHNIQUES EVALUATION OF HEPATIC VEINS IN BUDD-CHIARI SYNDROME EVALUATION OF INFERIOR VENA CAVA IN BUDD-CHIARI SYNDROME ASSESSMENT OF LIVER PARENCHYMA IN BUDD-CHIARI SYNDROME MANAGEMENT OF BUDD-CHIARI SYNDROME REFERENCES CHAPTER 107 Imaging Approach to Obstructive Biliopathy IMAGING MODALITIES Ultrasound Computed Tomography COMPUTED TOMOGRAPHY INTRAVENOUS CHOLANGIOGRAPHY Magnetic Resonance Cholangiopancreatography CONTRAST-ENHANCED MAGNETIC RESONANCE CHOLANGIOGRAPHY ENDOSCOPIC ULTRASOUND FUNCTIONAL IMAGING DIRECT CHOLANGIOGRAPHY Percutaneous Transhepatic Cholangiography PET-CT INTRADUCTAL ULTRASOUND IMAGING ALGORITHM IN OBSTRUCTIVE JAUNDICE CONCLUSION REFERENCES CHAPTER 108 Inflammatory Pathologies of the Biliary Tract INFLAMMATORY CONDITIONS OF THE GALLBLADDER Chronic Cholecystitis Xanthogranulomatous Cholecystitis INFLAMMATORY CONDITIONS OF THE BILIARY TREE FIRST ASPECT: ENTITIES WHICH WERE COMMON IN THE PAST AND NOW RARELY SEEN AIDS-related Cholangiopathy DISEASES KNOWN IN THE PAST WITH INCREASED DETECTABILITY IN THE PRESENT ERA Primary Sclerosing Cholangitis Secondary Processes Simulating PSC NEW CONCEPTS Primary Biliary Cirrhosis Autoimmune Hepatitis and Overlap Syndromes IgG4-related Biliary Involvement Eosinophilic Cholangitis CONCLUSION REFERENCES CHAPTER 109 Malignant Pathologies of Biliary Tree INTRODUCTION GALLBLADDER CARCINOMA Epidemiology Risk Factors Pathological Features, Staging and Prognosis IMAGING MODALITIES Radiological Findings OTHER MALIGNANT GALLBLADDER NEOPLASMS Cholangiocarcinoma Intrahepatic Cholangiocarcinoma Hilar Cholangiocarcinoma (Klatskin's tumor) Distal Cholangiocarcinoma Periampullary Carcinoma Malignant Cystic Bile Duct Neoplasms: Cystadenocarcinoma OTHER MALIGNANT NEOPLASMS OF THE BILE DUCTS CONCLUSION REFERENCES CHAPTER 110 Biliary Interventions INTRODUCTION PERCUTANEOUS TRANSHEPATIC CHOLANGIOGRAPHY Preprocedure Evaluation and Preparation Technique PERCUTANEOUS TRANSHEPATIC BILIARY DRAINAGE Indications for Biliary Drainage PATIENT PREPARATION Preprocedure Imaging Technique Fluoroscopic Guidance Internal and External Drainage Postprocedure Management Follow-up of Biliary Catheters Biliary Stenting Results and Complications of Biliary Drainage INTRALUMINAL PROCEDURES THROUGH PERCUTANEOUS TRANSHEPATIC BILIARY DRAINAGE Percutaneous Transhepatic Cholangioplasty PERCUTANEOUS CHOLECYSTOSTOMY Technique Complications CONCLUSION REFERENCES CHAPTER 111 Acute Pancreatitis: Imaging and Interventions INTRODUCTION PATHOPHYSIOLOGY ETIOLOGY REVISED ATLANTA CLASSIFICATION Diagnosis Types of Acute Pancreatitis Phases of Acute Pancreatitis Nomenclature Classification of Severity IMAGING TECHNIQUES Indications (Table 2) Plain Radiography Ultrasonography Computed Tomography Magnetic Resonance Imaging IMAGING APPEARANCE Acute Interstitial Edematous Pancreatitis Acute Necrotizing Pancreatitis SEVERITY ASSESSMENT SCORES COMPLICATIONS Nonvascular Complications Vascular Complications MANAGEMENT Radiological Interventions RADIATION EXPOSURE ADVANCES IN IMAGING SUMMARY REFERENCES CHAPTER 112 Chronic Pancreatitis and its Variants INTRODUCTION ETIOPATHOGENESIS CLASSIFICATION OF CHRONIC PANCREATITIS Large Duct Pancreatitis versus Small Duct Pancreatitis DIAGNOSIS Imaging Modalities Abdominal Radiographs Endoscopic Retrograde Cholangio-pancreatography Ultrasonography Computed Tomography Magnetic Resonance Imaging MISCELLANEOUS TYPES OF CHRONIC PANCREATITIS Autoimmune Pancreatitis Groove Pancreatitis Chronic Pancreatitis in Cystic Fibrosis Hereditary Pancreatitis Tropical Chronic Pancreatitis Chronic Pancreatitis and Pancreatic Adenocarcinoma ACKNOWLEDGMENT REFERENCES CHAPTER 113 Pancreatic Cancer Imaging INTRODUCTION IMAGING MODALITIES Sonography Multidetector Computed Tomography Magnetic Resonance Imaging Endoscopic Techniques Positron Emission Tomography–Computed Tomography Recent Advances IMAGING FINDINGS (TABLE 1) PANCREATIC CANCER VARIANTS DIFFERENTIAL DIAGNOSES STAGING OF PANCREATIC CANCER SAMPLING BIOMARKERS FOLLOW-UP IMAGING STRUCTURED REPORTING CONCLUSION REFERENCES CHAPTER 114 Cystic Pancreatic Tumors and Neuroendocrine Tumors of Pancreas CYSTIC PANCREATIC TUMORS Imaging Modalities Clinical Presentation Classification Morphological Classification UNCOMMON CYSTIC PANCREATIC TUMORS Endoscopic Ultrasound (EUS)/EUS-guided Fluid Characteristics of Cystic Lesions Management Guidelines PANCREATIC NEUROENDOCRINE TUMORS (TABLE 7) Specific Features of Various pNETs (Table 8) CONCLUSION REFERENCES CHAPTER 115 Nontraumatic Acute Abdomen INTRODUCTION COMPUTED TOMOGRAPHY TECHNIQUE Plain Radiographs in Evaluation of the Acute Abdomen Perforation Intestinal Obstruction MISCELLANEOUS CONDITIONS ROLE OF CROSS-SECTIONAL IMAGING IN SPECIFIC DISEASE ENTITIES Acute Appendicitis Acute Cholecystitis Acute Pancreatitis Intra-abdominal Abscess Intestinal Obstruction Bowel Perforation Mesenteric Ischemia Vascular Causes Pelvic Disease MISCELLANEOUS Diverticulitis Toxic Megacolon Acute Pyelonephritis Acute Urinary Colic Acute Epiploic Appendagitis, Omental Infarction Acute Abdomen in Neutropenic Patients REFERENCES CHAPTER 116 Imaging in Abdominal Trauma INTRODUCTION PLAIN RADIOGRAPHY ULTRASONOGRAPHY COMPUTED TOMOGRAPHY Computed Tomography Technique MAGNETIC RESONANCE IMAGING DIGITAL SUBTRACTION ANGIOGRAPHY IMAGING AND MANAGEMENT PROTOCOLS DIAGNOSTIC IMAGING CT Signs in Blunt Abdominal Trauma Computed Tomography Staging of Abdominal Injuries Computed Tomography Signs for Operative/Angiographic Intervention SPLEEN LIVER AND BILIARY TRACT PANCREAS URINARY TRACT Adrenal HOLLOW VISCUS, OMENTAL AND MESENTERIC INJURY DIAPHRAGM RETROPERITONEUM ABDOMINAL WALL INJURY PENETRATING ABDOMINAL TRAUMA CONCLUSION TAKE HOME KEY POINTS REFERENCES CHAPTER 117 Imaging of Peritoneum and Mesentery EMBRYOLOGY ANATOMY OF THE PERITONEUM4- Ligaments of Stomach Ligaments of the Liver and Spleen Ligaments Attached to Small Bowel Ligaments Attached to Large Bowel Ligaments of the Pelvis PERITONEAL SPACES4,5,7 Pelvic Peritoneal Spaces PERITONEAL FLUID DYNAMICS ASCITES PNEUMOPERITONEUM INTERNAL HERNIAS PERITONEAL INFECTIONS AND INFLAMMATION Peritonitis Tuberculous Peritonitis PERITONEAL HYDATIDOSIS SECONDARY INFLAMMATORY PROCESSES SCLEROSING ENCAPSULATING PERITONITIS/ABDOMINAL COCOON SCLEROSING MESENTERITIS (MESENTERIC PANNICULITIS, MESENTERIC LIPODYSTROPHY, RETRACTILE MESENTERITIS) Imaging Findings ACUTE EPIPLOIC APPENDAGITIS OMENTAL INFARCTION MESENTERIC LYMPHADENOPATHY Tuberculous Lymphadenitis Primary Mesenteric Adenitis Neoplastic Lymphadenopathy PRIMARY PERITONEAL NEOPLASMS PERITONEAL MALIGNANT MESOTHELIOMA MULTICYSTIC MESOTHELIOMA/PERITONEAL INCLUSION CYST/ MULTILOCULAR INCLUSION CYST PRIMARY PERITONEAL SEROUS CARCINOMA DESMOPLASTIC SMALL ROUND CELL TUMOR DESMOID TUMOR/MESENTERIC FIBROMATOSIS INFLAMMATORY MYOFIBROBLASTIC PSEUDOTUMOR LEIOMYOMATOSIS PERTONEALIS DISSEMINATA/DIFFUSE PERITONEAL LEIOMYOMATOSIS MISCELLANEOUS MESENCHYMAL TUMORS LYMPHATIC MALFORMATION/LYMPHANGIOMA SECONDARY PERITONEAL NEOPLASMS PERITONEAL CARCINOMATOSIS PSEUDOMYXOMA PERITONEI PERITONEAL LYMPHOMATOSIS PERITONEAL SARCOMATOSIS MESENTERIC CARCINOID (NEUROENDOCRINE TUMOR) CONCLUSION REFERENCES CHAPTER 118 Imaging of Spleen INTRODUCTION AND ANATOMY IMAGING MODALITIES Plain Abdominal Radiographs Ultrasonography (USG) Computed Tomography Magnetic Resonance Imaging Scintigraphy Positron Emission Tomography/Computed Tomography (PET/CT) Angiography SPLENIC SIZE NORMAL VARIANTS/DEVELOPMENTAL ANOMALIES Splenunculus/Accessory Spleen Wandering Spleen Polysplenia Asplenia CYSTIC LESIONS OF SPLEEN Congenital Cysts False Cyst (Pseudocyst) Echinococcal Cyst INFECTIOUS DISEASES OF SPLEEN Splenic Infarcts Trauma Splenic Rupture SPLENIC NEOPLASMS Benign Neoplasms Malignant Neoplasms SPLENIC INTERVENTIONS FNAC AND BIOPSY OF SPLEEN Drainage Splenic Artery Aneurysm and Intervention Miscellaneous Conditions ACKNOWLEDGMENTS REFERENCES CHAPTER 119 Imaging of the Postoperative Abdomen INTRODUCTION IMAGING MODALITIES CT PROTOCOL NORMAL RADIOLOGICAL FINDINGS IN THE POSTOPERATIVE ABDOMEN POSTOPERATIVE COMPLICATIONS Anastomotic Leak Postoperative Abscess Postoperative Bleeding Anastomotic Strictures Postoperative Bowel Obstruction Wound Complications Incisional Hernia Retained Surgical Foreign Material NORMAL POSTOPERATIVE ANATOMY AND COMPLICATIONS SPECIFIC TO PROCEDURE Esophageal Surgeries Surgeries of the Stomach and Duodenum Bariatric Surgery Small Bowel Blind Pouch Syndrome Ileal Pouch-Anal Anastomoses (IPAA) Large Bowel Diversion Colitis HEPATOBILIARY SURGERIES Surgical Procedures Normal Postoperative Imaging Features Late Postoperative Period EARLY POSTOPERATIVE COMPLICATIONS Vascular Thrombosis Biliary Injuries Intraoperative Diaphragmatic Injury LATE POSTOPERATIVE COMPLICATIONS Laparoscopic Cholecystectomy Normal Appearances after Laparoscopic Cholecystectomy Complications Biliary Injury Biliary Obstruction Stone Retention Dropped Gallstones Vascular Injury Pancreatic Surgeries NORMAL POSTOPERATIVE FINDINGS COMPLICATIONS CONCLUSION REFERENCES CHAPTER 120 Portal Hypertension: Imaging and Intervention IMAGING OF PORTAL HYPERTENSION INTRODUCTION CAUSES OF PORTAL HYPERTENSION4 ANATOMY OF PORTAL SYSTEM5 Work-up6,7 Normal Doppler Findings of Portal Vein Technique of Doppler of Portal System Optimization of Sonographic Technique Pathophysiology of Doppler Findings in Portal Hypertension Ultrasound Criteria for Detecting Portal Hypertension Splenomegaly and Ascites Portosystemic Venous Collaterals Computed Tomography12,13 Oral Contrast Display Technique13 Magnetic Resonance Imaging14- MR Technique MR Protocol HEMODYNAMIC MEASUREMENT OF PORTAL PRESSURE17 Procedures (Figs. 10A and B) Interpretation (Table 4) MORPHOLOGIC SIGNS OF PORTAL HYPERTENSION Divided into Direct and Associated Signs Collateral Pathways18,19 VARICES Esophageal and Paraesophageal Varices Gastric and Perigastric Varices Ectopic Varices Associated Findings Splenomegaly SPECIFIC SITUATIONS Intrahepatic Portal Hypertension PREHEPATIC CAUSES Extrahepatic Portal Vein Obstruction23,24 Treatment and Prognosis Portal Vein Thrombosis24,26,27 Left-sided Portal Hypertension Splanchnic Arterioportal Fistula Posthepatic Causes RADIOLOGICAL INTERVENTIONS IN PORTAL HYPERTENSION INTRODUCTION Interventions in Portal Hypertension Transjugular Intrahepatic Portosystemic Shunts Complications of TIPS Recanalization of Hepatic Venous Outflow (Budd-Chiari Syndrome) Partial Splenic Embolization Recanalization of Occluded/Thrombosed Portal Veins or Tributaries Occlusion of Arterioportal Shunts (Congenital/Acquired) Revision of Occluded Surgical or Radiological Shunts Percutaneous Transhepatic (or Trans-splenic) Variceal Embolization Balloon-occluded Retrograded Transvenous Obliteration of Gastric Varices (BRTO) Occlusion of Surgical or Radiologic Shunts in Refractory Encephalopathy REFERENCES CHAPTER 121 Percutaneous Nonvascular Gastrointestinal Tract Interventions PERCUTANEOUS GASTROSTOMY Indications Other Indications Contraindications Hardwares Technique (Figs. 1A to E) Technical Difficulty Complications PERCUTANEOUS JEJUNOSTOMY Indications Technique (Figs. 2A to D) Complications ESOPHAGEAL STENTING Indications Types of Stents Stent Designs Stent Selection Technique (Figs. 4 and 5) Postprocedure Care Complications Guidelines for Esophageal Stenting MDCT in Esophageal Stent Evaluation GASTRODUODENAL STENTING Indications Contraindications Available Devices Endoscopic versus Fluoroscopic Placement Technique (Figs. 6A to D) Postprocedure Care Guidelines for Duodenal Stents20 MDCT in Duodenal Stent Evaluation20 Complications COLORECTAL STENTING Indications Contraindications Technical Considerations Postprocedure Follow-up Complications Guidelines for Colonic Stents MDCT in Colonic Stent Evaluation20 PERCUTANEOUS ENTEROCUTANEOUS FISTULA CLOSURE WITH NBUTYL2-CYANOACRYLATE Mechanism of Action of the Glue (N-butyl-2-cyanoacrylate) Prerequisites Technical Consideration Preparation Technique (Figs. 7A to D) REFERENCES Volume 3 SECTION 5 Chest and Cardiovascular Imaging CHAPTER 122 Chest Radiography and Sonography: Techniques and Anatomy INTRODUCTION CONVENTIONAL CHEST RADIOGRAPHY TECHNICAL ADVANCES High kV Technique New Screen Film Combinations Beam Equalization Radiography Digital Chest Radiography RADIOGRAPHIC PROJECTIONS Posteroanterior View Lateral View Anteroposterior View Decubitus View Lordotic View Oblique View SPECIAL RADIOGRAPHIC TECHNIQUES Inspiratory–Expiratory Radiography Bedside/Portable Radiography NORMAL ANATOMY ON CHEST X-RAY Trachea Tracheobronchial Divisions Lungs Bronchopulmonary Segments Hilum and Pulmonary Vasculature Pleura Mediastinum Mediastinal Lines and Interfaces Heart Diaphragm Sonography of Chest Ultrasound Technique Normal Anatomy CONCLUSION ACKNOWLEDGMENT REFERENCES CHAPTER 123 MDCT and MRI Thorax: Techniques and Normal Anatomy MDCT THORAX CT TECHNOLOGY CT ACQUISITION AND RECONSTRUCTION PROTOCOLS Use of Iodinated Contrast Medium Window Settings and Reconstruction Algorithms1,7 HIGH-RESOLUTION COMPUTED TOMOGRAPHY Modifications in Scanning Technique for HRCT7,10,11 ACQUISITION PROTOCOL AND CONTRAST OPACIFICATION FOR CT PULMONARY ANGIOGRAPHY1,8,12 EVALUATION OF THE AORTA AND CORONARY ARTERIES EVALUATION OF PULMONARY VEINS EXTENDED CHEST PAIN PROTOCOL OR TRIPLE RULE OUT CT POST-PROCESSING TECHNIQUES1,11,15,16 Multiplanar and Curved Multiplanar Reconstruction or Curved Planar Reconstruction (MPR and CMPR) Maximum Intensity Projection Minimum Intensity Projection (MinIP) Shaded Surface Display Volume-rendering Virtual Bronchoscopy ADVANCED APPLICATIONS Dual Energy CT: Thoracic Applications1 4D Scanning18,19 Computer-aided Detection DOSE CONSIDERATIONS AND DOSE REDUCTION TECHNIQUES IN THORACIC CT1,2,20 Dose Reduction Strategies MAGNETIC RESONANCE IMAGING TECHNICAL CONSIDERATIONS Magnet Strength and Coils Respiratory Motion Cardiac Gating PROTOCOL AND SEQUENCES MR PULMONARY ANGIOGRAPHY MR PERFUSION IMAGING OTHER ADVANCED/NEWER IMAGING TECHNIQUES Ultrashort Echo Time Imaging Novel Contrast Methods and Ventilation MR CLINICAL APPLICATIONS OF MR THORAX Mediastinum Pulmonary Embolism and Pulmonary Hypertension Lung Cancer Detection and Characterization of Pulmonary Nodule Pneumonitis Emphysema and Chronic Obstructive Pulmonary Disease Cystic Fibrosis Interstitial Lung Disease Pleura, Chest Wall and Diaphragm NORMAL ANATOMY MEDIASTINUM Axial Sections (Cranial to Caudal) Thymus Lymph Nodes Mediastinal Divisions on Cross-sectional Imaging36,37 TRACHEOBRONCHIAL TREE38,39 LUNG SEGMENTS, FISSURES AND PLEURA1,38,39 CONCLUSION REFERENCES CHAPTER 124 Basic Radiographic Pattern of Lung Diseases PATTERN RECOGNITION Airspace Disease Atelectasis Interstitial Pattern Combination of Airspace Opacities and Interstitial Pattern Ring Shadows Line and Band Shadows Position of Fissures and Hila Characteristics of the Lesion Itself Anatomical Basis of Disease The Silhouette Sign DECREASED DENSITY ON CHEST RADIOGRAPH CONCLUSION REFERENCES CHAPTER 125 Basic Patterns of Lung Disease on CT HIGH RESOLUTION CT PATTERNS OF LUNG DISEASE HIGH RESOLUTION CT SCAN FINDINGS MANIFESTING AS INCREASED LUNG OPACITY Nodular Pattern: Nodules and Nodular Opacities Linear and Reticular Pattern Opacities Ground-glass Opacity Consolidation HIGH RESOLUTION CT SCAN FINDINGS MANIFESTING AS DECREASED LUNG OPACITY Area of Decreased Attenuation with Walls Bronchiectasis Cystic Lung Disease DECREASED LUNG OPACITY WITHOUT DISCERNIBLE WALL Emphysema HRCT Findings Manifesting as Inhomogeneous Lung Opacity CONCLUSION REFERENCES CHAPTER 126 Imaging of Pulmonary Tuberculosis INTRODUCTION CHANGING CONCEPTS OF RADIOLOGIC MANIFESTATIONS OF PULMONARY TB ROLE OF IMAGING IN PULMONARY TUBERCULOSIS RADIOLOGICAL PATTERNS OF PULMONARY TB Typical Radiological Patterns of Primary TB Postprimary TB or Phtysis Radiological Patterns Seen in Both Primary and/or Postprimary TB Complications and Sequelae of Pulmonary TB Atypical Patterns MRI in Pulmonary Tuberculosis PET/CT in Tuberculosis REFERENCES CHAPTER 127 Nontubercular Pulmonary Infections INTRODUCTION IMAGING MODALITIES RADIOGRAPHIC PATTERN ETIOPATHOGENESIS OF PULMONARY INFECTIONS SPECIFIC PNEUMONIAS Bacterial Infections Viral Infections Fungal Infections Parasitic Infections COMPLICATIONS OF PNEUMONIA Pleural Effusion and Empyema Hydropneumothorax Pneumatoceles Bronchiectasis Pulmonary Abscess, Necrotizing Pneumonia and Pulmonary Gangrene Miscellaneous Complications DELAYED RESOLUTION OF PNEUMONIA Diagnostic Algorithm in Patients Suspected with Pneumonia CONCLUSION REFERENCES CHAPTER 128 Pulmonary Manifestations in Immunocompromised Host INTRODUCTION HIV/AIDS Systematic Approach to Imaging Diagnosis Imaging Methods Radiological Pattern Approach to Diagnosis NON-HIV IMMUNOCOMPROMISED HOSTS Imaging Approach BACTERIAL INFECTIONS PNEUMONIA MYCOBACTERIAL INFECTIONS HIV/AIDS Patients HIV Negative Immunocompromised Patients VIRAL INFECTIONS FUNGAL INFECTIONS NONINFECTIOUS MANIFESTATIONS OF AIDS Kaposi's Sarcoma Lymphoma Lymphocystic Interstitial Pneumonitis Post-transplant Lymphoproliferative Disorder NONINFECTIOUS MANIFESTATIONS IN HSCT PRE-ENGRAFTMENT PERIOD Idiopathic Pulmonary Syndrome Pulmonary Edema Diffuse Alveolar Hemorrhage Peri-engraftment Respiratory Distress Syndrome EARLY POST-TRANSPLANT PERIOD Drug-induced Lung Injury Acute GVHD Acute Radiation Pneumonitis Pulmonary Cytolytic Thrombi LATE PULMONARY COMPLICATIONS Chronic GVHD Bronchiolitis Obliterans Bronchiolitis Obliterans Organizing Pneumonia Air-leak Syndrome Pulmonary Veno-occlusive Disease Pleuroparenchymal Fibroelastosis CONCLUSION REFERENCES CHAPTER 129 Pattern Approach to Interstitial Lung Disease and Imaging of Idiopathic Interstitial Pneumonias IMAGING Plain Radiography High Resolution Computed Tomography ANATOMY OF THE SECONDARY PULMONARY LOBULE (MILLER’S) Increased Lung Attenuation Decreased Lung Attenuation Nodules and Nodular Opacities Linear and Reticular Opacities IDIOPATHIC INTERSTITIAL PNEUMONIAS CHRONIC FIBROSING IDIOPATHIC INTERSTITIAL PNEUMONIAS Idiopathic Pulmonary Fibrosis Nonspecific Interstitial Pneumonia SMOKING-RELATED INTERSTITIAL PNEUMONIAS Respiratory Bronchiolitis-associated Interstitial Lung Disease Desquamative Interstitial Pneumonia ACUTE AND SUBACUTE INTERSTITIAL PNEUMONIAS Cryptogenic Organizing Pneumonia Acute Interstitial Pneumonia RARE INTERSTITIAL PNEUMONIAS Lymphoid Interstitial Pneumonia Idiopathic Pulmonary Fibroelastosis REFERENCES CHAPTER 130 Imaging of Interstitial Lung Disease of Known Etiology INTRODUCTION PLAIN RADIOGRAPHY HIGH-RESOLUTION CT Anatomy of Secondary Pulmonary Lobule SARCOIDOSIS Imaging Features CONNECTIVE TISSUE DISEASE (CTD) ASSOCIATED INTERSTITIAL LUNG DISEASE RHEUMATOID ARTHRITIS (RA) ASSOCIATED INTERSTITIAL LUNG DISEASE Imaging Features PROGRESSIVE SYSTEMIC SCLEROSIS (PSS) Imaging Features SYSTEMIC LUPUS ERYTHEMATOSUS Imaging Features POLYMYOSITIS AND DERMATOMYOSITIS HYPERSENSITIVITY PNEUMONITIS Imaging Features SILICOSIS AND COAL WORKERS’ PNEUMOCONIOSIS Imaging Features ASBESTOSIS LYMPHANGIOLEIOMYOMATOSIS Imaging Features LANGERHANS CELL HISTIOCYTOSIS Imaging Features PULMONARY ALVEOLAR PROTEINOSIS Imaging Features CONCLUSION REFERENCES CHAPTER 131 Miscellaneous Interstitial Lung Diseases INTRODUCTION DIFFUSE LUNG DISEASES PRESENTING WITH GROUND-GLASS OPACITY INFECTIONS Severe Acute Respiratory Syndrome Swine Influenza (H1N1) Pneumonia ACUTE RESPIRATORY DISTRESS SYNDROME Acute (Exudative) Phase Subacute (Proliferative) Phase Chronic (Fibrotic) Phase HYDROSTATIC PULMONARY EDEMA DIFFUSE ALVEOLAR HEMORRHAGE EOSINOPHILIC LUNG DISEASE Acute Eosinophilic Pneumonia (Figs. 6A and B) Chronic Eosinophilic Pneumonia Idiopathic Hypereosinophilic Syndrome LIPOID PNEUMONIA Acute Exogenous Lipoid Pneumonia Chronic Exogenous Lipoid Pneumonia Endogenous Lipoid Pneumonia PULMONARY ALVEOLAR PROTEINOSIS SEPTAL THICKENING PREDOMINANT DIFFUSE LUNG DISEASES PULMONARY LEUKOSTASIS PULMONARY VENO-OCCLUSIVE DISEASE AND PULMONARY CAPILLARY HEMANGIOMATOSIS PULMONARY AMYLOIDOSIS Diffuse Alveolar Septal Amyloidosis DIFFUSE LUNG DISEASES PRESENTING WITH NODULES DIFFUSE LUNG DISEASES PRESENTING WITH CYSTS EMPHYSEMA Centrilobular Emphysema Panlobular Emphysema Paraseptal Emphysema COMBINED PULMONARY FIBROSIS AND EMPHYSEMA PULMONARY LANGERHANS’ CELL HISTIOCYTOSIS Imaging LYMPHANGIOLEIOMYOMATOSIS Differential Diagnosis TUBEROUS SCLEROSIS BIRT-HOGG-DUBÉ SYNDROME CONCLUSION REFERENCES CHAPTER 132 Mediastinum INTRODUCTION DIVISIONS OF THE MEDIASTINUM IMAGING MODALITIES Chest Radiograph Computed Tomography (CT) Magnetic Resonance Imaging DIFFERENTIAL DIAGNOSIS OF MEDIASTINAL MASSES ANTERIOR MEDIASTINUM Lesions of Thymus Germ-cell Tumors MIDDLE MEDIASTINUM Bronchogenic Cyst Esophageal Duplication Cyst Neurenteric Cyst Esophageal Lesions POSTERIOR MEDIASTINUM Neurogenic Tumors Paraspinal Infection MULTICOMPARTMENT MEDIASTINAL MASSES/LESIONS Mediastinal Lymphadenopathy Aortic Aneurysm Aortic Dissection Abnormalities of the Mediastinal Fat MISCELLANEOUS LESIONS OF THE MEDIASTINUM Mediastinal Hemorrhage Pneumomediastinum Acute Mediastinitis Fibrosing Mediastinitis CONCLUSION REFERENCES CHAPTER 133 Imaging of Solitary Pulmonary Nodule INTRODUCTION SPURIOUS SPN MORPHOLOGICAL CHARACTERISTICS OF SPN Size Shape Location Edge Characteristics Presence of a Halo INTERNAL CHARACTERISTICS Calcification Fat Cavitation Air Bronchiolograms and Pseudocavitation Air Crescent Sign Air-fluid Level OTHER CHARACTERISTICS OF SPN Satellite Nodules Feeding Vessel Sign Positive Bronchus Sign NODULE ATTENUATION Solid Nodule Ground-glass Nodule (GGN)/Ground-glass Attenuation Nodule (GGAN) Subsolid Nodules (SSNs) Association of Nodule Attenuation with Adenocarcinoma ASSESSMENT OF MALIGNANT POTENTIAL OF A SPN Nodule Growth Nodule Enhancement Bayesian Analysis Fluorodeoxyglucose Positron Emission Tomography Transthoracic Needle Aspiration Biopsy (TNAB) Fiberoptic Bronchoscopy NEWER IMAGING TECHNIQUES FOR THE EVALUATION OF SPN Dynamic MR Imaging Diffusion-weighted MRI Imaging Dual Energy CT in the Evaluation of SPN MANAGEMENT OF A SOLITARY PULMONARY NODULE MORPHOLOGICAL CHARACTERISTICS IN SPECIFIC LESIONS Lung Malignancies Metastasis Carcinoid Tumor Lymphoma Benign Neoplasms Infective Causes Inflammatory Nodules Airway or Inhalational Disease Vascular Lesions Congenital Lesions Miscellaneous CONCLUSION REFERENCES CHAPTER 134 Imaging of Pulmonary Neoplasms INTRODUCTION WHO CLASSIFICATION5 CLINICAL FEATURES IMAGING MODALITIES Magnetic Resonance Imaging21 IMAGING FEATURES Peripheral Tumors Central Tumors RADIOLOGICAL CHARACTERISTICS BY CELL TYPE Adenocarcinoma Squamous Cell Carcinoma Small Cell Lung Cancer Large Cell Carcinoma SAMPLING FOR SUSPECTED LUNG CANCER STAGING OF LUNG CANCER Imaging Modalities for the Staging of Lung Cancers Salient Points TREATMENT OF LUNG CANCER SCREENING FOR LUNG CANCER FOLLOW-UP IMAGING RECURRENT LUNG CANCER RARE LUNG MALIGNANCIES PULMONARY LYMPHOMA Primary Pulmonary Lymphoma Secondary Pulmonary Lymphoma (SPL) Acquired Immune Deficiency Syndrome-Related Lymphoma (ARL) Post-transplantation Lymphoproliferative Disorder PULMONARY NEUROENDOCRINE NEOPLASMS Carcinoid Tumors Large Cell Neuroendocrine Carcinoma Small Cell Lung Carcinoma Diffuse Idiopathic Pulmonary Neuroendocrine Cell Hyperplasia (DIPNECH) PULMONARY METASTASES PULMONARY HAMARTOMA CONCLUSION REFERENCES CHAPTER 135 Imaging of the Tracheobronchial Tree INTRODUCTION ROLE OF IMAGING (BOX 1) IMAGING MODALITIES Chest Radiograph Multidetector Computed Tomography Endoscopic Ultrasound Magnetic Resonance Imaging NORMAL AIRWAY ANATOMY ANATOMIC VARIANTS TRACHEOBRONCHIAL TREE PATHOLOGIES CENTRAL AIRWAYS EXTRINSIC INTRINSIC MURAL Congenital Inflammatory/Infective Miscellaneous INTRALUMINAL Inflammatory/Infective Masses MISCELLANEOUS PERIPHERAL AIRWAYS BRONCHIECTASIS Definition and Pathophysiology Clinical Features Imaging Findings (Figs. 1 and 32) Etiology SMALL AIRWAYS ROLE OF IMAGING IN EVALUATION OF SAD CT SIGNS OF SMALL AIRWAY DISEASE CLASSIFICATION Inflammatory/Cellular Bronchiolitis Constrictive/Obliterative Bronchiolitis Asthma CHRONIC OBSTRUCTIVE PULMONARY DISEASE CONCLUSION REFERENCES CHAPTER 136 Intensive Care Chest Radiology INTRODUCTION CHEST RADIOGRAPH ULTRASOUND COMPUTED TOMOGRAPHY IMAGING OF CARDIOPULMONARY COMPLICATIONS IN ICU PATIENTS Atelectasis Aspiration Pneumonitis Pneumonia Hydrostatic Pulmonary Edema Noncardiogenic Pulmonary Edema Pulmonary Embolism Barotrauma IMAGING OF SUPPORT AND MONITORING APPARATUS Endotracheal and Tracheostomy Tube Chest Tube Venous Catheter Swan-Ganz Catheter REFERENCES CHAPTER 137 Imaging in Thoracic Trauma INTRODUCTION ROLE OF IMAGING The Chest Radiograph Ultrasound Multidetector Computed Tomography PULMONARY PARENCHYMAL INJURIES Pulmonary Contusion Pulmonary Laceration Aspiration Pneumonitis Atelectasis Traumatic Lung Herniation PLEURAL INJURIES Pneumothorax Hemothorax INJURIES OF THE MEDIASTINUM Tracheobronchial Injury Esophageal Injury Pneumomediastinum Vascular Injury Cardiac and Pericardial Injury INJURY OF DIAPHRAGM INJURY OF CHEST WALL CONCLUSION REFERENCES CHAPTER 138 Imaging of Pleura INTRODUCTION IMAGING MODALITIES PLEURAL PATHOLOGY PLEURAL EFFUSION Specific Causes of Pleural Effusion IMAGING IN PLEURAL EFFUSION Plain Radiographs Loculated Pleural Fluid (Encysted/Encapsulated) Ultrasound of Pleural Effusion Computed Tomography of Pleural Effusion PLEURAL EFFUSION OR ASCITIS MRI of Pleural Effusion Parapneumonic Effusion with Empyema Empyema Necessitans Tube Drainage of Empyema BRONCHOPLEURAL FISTULA Postsurgical BPF Infective BPF PLEURAL THICKENING PLEURA AND ASBESTOSIS23,24 ASBESTOSIS PSEUDOTUMOR (ROUND ATELECTASIS) PLEURAL CALCIFICATION PNEUMOTHORAX Spontaneous Pneumothorax IMAGING FINDINGS OF PNEUMOTHORAX Radiograph Ultrasonography in Pneumothorax Technique of Ultrasound to Detect Pneumothorax27,28 Sonographic Signs of Pneumothorax Computed Tomography Tension Pneumothorax PLEURAL NEOPLASM Pleural Effusion Pleural Thickening MESOTHELIOMA (MALIGNANT PLEURAL MESOTHELIOMA) Radiographic Findings of MPM Ultrasonography Computed Tomography Magnetic Resonance Imaging Positron Emission Tomography Pleural Metastasis Pleural Lymphoma Localized Fibrous Tumor TUMOR-LIKE CONDITIONS OF THE PLEURA REFERENCES CHAPTER 139 Imaging of the Diaphragm and Chest Wall EMBRYOLOGY AND ANATOMY FUNCTIONS IMAGING MODALITIES Plain Radiograph Fluoroscopy Ultrasonography Computed Tomography Magnetic Resonance Imaging Radionuclide Scan NORMAL VARIANTS Scalloping Eventration Accessory Diaphragm Elevated Hemidiaphragm Low Lying Diaphragm Inversion of the Diaphragm Peridiaphragmatic Collections DIAPHRAGMATIC MOVEMENTS DIAPHRAGMATIC WEAKNESS AND PARALYSIS DIAPHRAGMATIC HERNIAS Hiatal Hernia Bochdalek Hernia Morgagni Hernia Intrapericardial Hernia DIAPHRAGMATIC INJURY TUMORS OF THE DIAPHRAGM CHEST WALL CONGENITAL AND DEVELOPMENTAL ANOMALIES Funnel Chest (Pectus Excavatum or Depressed Sternum) Pigeon Chest (Pectus Carinatum) Poland Syndrome Cervical Rib Clavicles INFLAMMATORY AND INFECTIOUS DISEASES Cellulitis and Necrotizing Fasciitis Pyogenic Osteomyelitis Tuberculosis Fungal Infections TUMORS OF THE CHEST WALL Benign Osseous Tumors Malignant Osseous Tumors Soft Tissue Tumors METASTATIC DISEASE CHEST WALL INVASION BY THORACIC MALIGNANCY REFERENCES CHAPTER 140 Bronchial Artery Embolization INTRODUCTION PATIENT SELECTION MANAGEMENT APPROACH PATHOPHYSIOLOGY INDICATIONS OF BAE PRE-PROCEDURE DIAGNOSTIC WORK-UP RELEVANT ARTERIAL ANATOMY Bronchial Arteries Non-bronchial Systemic Collaterals TECHNIQUE OF BAE COMPLICATIONS CONCLUSION KEY MESSAGES REFERENCES CHAPTER 141 Diagnostic and Therapeutic Interventions in Chest INTRODUCTION IMAGE GUIDANCE MODALITIES NONVASCULAR INTERVENTIONS Transthoracic Needle Biopsy of Pulmonary Lesions Transthoracic Needle Biopsy from Other Sites Percutaneous Needle Biopsy of the Pleura Localization of a Nodule for Thoracoscopic Resection Diagnostic Thoracocentesis Percutaneous Drainage of Pleural Space Fluid Collections Pleural Sclerotherapy or Pleurodesis Pneumothorax Drainage Lung Abscess Drainage Mediastinal Abscess Drainage Pericardial Effusion Drainage Pneumatocele and Bulla Drainage Secondary Pulmonary Aspergilloma Endoluminal Tracheobronchial Stenting THERMAL ABLATION OF LUNG LESIONS VASCULAR INTERVENTIONS Pulmonary Artery Embolization Endovascular Therapy of SVC Obstruction Percutaneous Vascular Foreign Body Retrieval CONCLUSION REFERENCES CHAPTER 142 Chest X-ray Evaluation in Cardiac Disease INTRODUCTION CARDIAC SILHOUETTE Cardiac Shape Cardiac Contour Cardiac Size Cardiac Volume Assessment of Chamber Enlargement Aorta PULMONARY VASCULATURE Normal Radiographic Anatomy Increased Pulmonary Blood Flow (Pulmonary Plethora) Decreased Pulmonary Blood Flow (Pulmonary Oligemia) Pulmonary Venous Hypertension Asymmetrical Pulmonary Blood Flow (Fig. 12) Orientation of Pulmonary Outflow Tract REFERENCES CHAPTER 143 Imaging Approach in Children with Congenital Heart Disease INTRODUCTION PHYSICAL EXAMINATION RADIOLOGICAL APPROACH Chest Radiograph Large Aorta with Decreased Lung Vascularity Normal Aorta with Decreased Lung Vascularity MULTISLICE CARDIAC CT CARDIAC MRI Analyzing CT or MRI Images Anatomy CARDIAC CATHETERIZATION BIBLIOGRAPHY CHAPTER 144 Imaging in Ischemic Heart Disease INTRODUCTION PATHOPHYSIOLOGY OF ISCHEMIC HEART DISEASE Myocardial Ischemia Myocardial Viability and Myocardial Infarction Rationale for Ischemia and Viability Imaging IMAGING MODALITIES Echocardiography Nuclear Imaging Cardiovascular Magnetic Resonance Imaging (CMR) IMAGING SEQUENCES Stress CMR CMR for Viability CMR for Myocardial Mass and Function OTHER USEFUL SEQUENCES EVALUATION OF VARIOUS COMPONENTS OF IHD Coronary Artery Imaging Plaque Imaging Detection of Myocardial Ischemia Myocardial Viability Myocardial Function RECENT ADVANCES ON CT FOR ASSESSMENT OF CORONARY ARTERY STENOSIS FUTURE DIRECTIONS Appropriateness Criteria for Use of Cardiac MDCT and CMR in the Investigation of IHD CONCLUSION REFERENCES CHAPTER 145 Imaging in Cardiomyopathies INTRODUCTION CLASSIFICATION DIAGNOSTIC TECHNIQUES DILATED CARDIOMYOPATHY Hypertrophic Cardiomyopathy Restrictive Cardiomyopathy CONCLUSION BIBLIOGRAPHY CHAPTER 146 Imaging Evaluation of Cardiac Masses INTRODUCTION CLINICAL FEATURES Imaging Techniques Other Techniques Classification (Table 1) NEOPLASTIC LESIONS OF THE HEART Primary Secondary Neoplasms Paracardiac and Extracardiac Tumors NON-NEOPLASTIC LESIONS Thrombus Aneurysm of Sinus of Valsalva Atrial Septal Aneurysm Pleuropericardial Cyst Infective Lesions VARIANT AND NORMAL ANATOMICAL STRUCTURES SIMULATING A CARDIAC MASS Pericardium Left Atrium Left Ventricle Right Atrium Right Ventricle CONCLUSION REFERENCES CHAPTER 147 Imaging Diagnosis of Valvular Heart Disease INTRODUCTION AORTIC VALVULAR DISEASE MITRAL VALVULAR DISEASE TRICUSPID VALVULAR DISEASE HEMODYNAMIC EFFECTS ON PULMONARY VASCULATURE Associated Pulmonary Pathologies Effects of Treatment during Follow-up Heart Size Left Atrial Size Other Changes ECHOCARDIOGRAPHY Valvular Stenosis Valvular Regurgitation Infective Endocarditis Prosthetic Valves CARDIAC MAGNETIC RESONANCE IMAGING Valve Leaflet Morphology Valvular Stenosis Valvular Regurgitation Valve Endocarditis and Tumors Prosthetic Valve COMPUTED TOMOGRAPHY ANGIOCARDIOGRAPHY CONCLUSION BIBLIOGRAPHY CHAPTER 148 Imaging of the Pericardium INTRODUCTION ANATOMY Transverse Sinus and Recesses Oblique Sinus and Recess Recesses of the Pericardial Cavity Proper PHYSIOLOGY CONGENITAL PERICARDIAL ANOMALIES Pericardial Cysts (Box 2) CONGENITAL ABSENCE OF THE PERICARDIUM (BOX 3) PERICARDIAL EFFUSION CARDIAC TAMPONADE (BOX 4) PERICARDITIS Nonconstrictive Pericarditis (Box 5) Constrictive Pericarditis (Box 6) PNEUMOPERICARDIUM PERICARDIAL TUMORS Metastases (Box 7) Primary Pericardial Tumors CONCLUSION REFERENCES CHAPTER 149 Imaging and Interventions of Aorta INTRODUCTION SEGMENTATION ANATOMY OF AORTA IMAGING OF AORTA: BASICS Angiographic Anatomy The Measurement (Diameter) of Aorta Normal Anatomic Variations IMAGING MODALITIES Ultrasound Computed Tomography CT Angiography Technique Magnetic Resonance Imaging and MR Angiography 18F-fluorodeoxyglucose (18F-FDG) with either CT or MRI Catheter Angiography Technique Complications of Angiography INDICATIONS FOR IMAGING THE AORTA CONGENITAL AORTIC ANOMALIES Aortic Arch Anomalies Associated Anomalies Hemodynamics in Adults Radiological Findings Noninvasive Imaging Management of Aortic Coarctation ACQUIRED AORTIC DISEASES AORTIC ANEURYSMS Incidence Classification Etiology Growth Rates of Aneurysm Risk of Rupture Diagnostic Imaging Plain Radiography Ultrasound CT and MRI Important Aneurysmal Features to be Assessed with CT or MRI22,38,39 Catheter Angiography Management of Aortic Aneurysms Aneurysms of the Infrarenal Abdominal Aorta ACUTE AORTIC SYNDROME AORTIC DISSECTION Classification IMAGING Computed Tomography Magnetic Resonance Imaging Aortography Management of AD INTRAMURAL HEMATOMA PENETRATING AORTIC ULCER Management of IMH and PAU AORTITIS Takayasu's Arteritis Types69 (Fig. 40) Imaging Findings Management of TA Immunoglobulin G4 (IgG4)-related Aortitis AORTIC TRAUMA Grading of Aortic Injuries86 Imaging Management of Thoracic Aortic Injury ATHEROSCLEROSIS Pathology Imaging Postoperative Aorta CONCLUSION ACKNOWLEDGMENTS REFERENCES CHAPTER 150 Imaging in Pulmonary Vascular Disease ANATOMY ACUTE PULMONARY EMBOLISM Imaging Techniques Imaging Features of Acute PE CHRONIC THROMBOEMBOLIC DISEASE PULMONARY HYPERTENSION Classification Imaging Modalities Etiologies of Pulmonary Hypertension VASCULITIS PULMONARY ARTERY ANEURYSMS AND PSEUDOANEURYSMS PULMONARY ARTERIOVENOUS MALFORMATIONS CONGENITAL ANOMALIES MALIGNANT TUMORS REFERENCES CHAPTER 151 Peripheral Vascular Diseases: Imaging and Interventions INTRODUCTION IMAGING MODALITIES Digital Subtraction Angiography Ultrasonography Computed Tomography Magnetic Resonance Imaging IMAGING FEATURES CLINICAL ENTITIES Atherosclerosis Atheroembolism and Thromboembolism Peripheral Arterial Aneurysm Arteritis Popliteal Artery Entrapment Syndrome Cystic Adventitial Disease Imaging Strategy Treatment Decision Types of Procedures Results Follow-up and Surveillance Technique of Angioplasty Stenting Preprocedure Work-up Day of Procedure Vascular Access Crossing of the Lesion19 Balloon Angioplasty (Figs. 11A to C and Table 3) How to Decide the Endpoint? Subintimal Angioplasty (Figs. 14A to D) Stents19,22,25 Complications19,22 Arterial Rupture Distal Plaque Embolization Stent-related Complications Restenosis Teaching Points REFERENCES SECTION 6 Musculoskeletal and Breast Imaging CHAPTER 152 Current Concepts in Cross-sectional Imaging of Musculoskeletal Diseases INTRODUCTION ULTRASONOGRAPHY COMPUTED TOMOGRAPHY MAGNETIC RESONANCE IMAGING Hardware Issues 3T Imaging Sequences Normal Appearance of Musculoskeletal Tissues Imaging of Articular Cartilage Musculoskeletal Tumors Use of Advanced Magnetic Resonance Techniques Magnetic Resonance Neurography Whole Body Magnetic Resonance Imaging Zero Echo Time Magnetic Resonance Imaging New Rapid Acquisition Sequences Marrow Imaging Musculoskeletal Infections Inflammatory Arthritis Interventional Magnetic Resonance Imaging CONCLUSION REFERENCES CHAPTER 153 Nuclear Medicine Imaging for Musculoskeletal Disorders INTRODUCTION BONE SCINTIGRAPHY SPECT AND SPECT/CT PET AND PET/CT MUSCULOSKELETAL TUMOR IMAGING Metastasis Primary Malignant Tumors Benign Tumors INFECTION IMAGING Acute and Chronic Osteomyelitis Diabetic Foot Prosthetic Infection FDG-PET-CT for Musculoskeletal Infection MUSCULOSKELETAL TRAUMA Stress Fractures Shin Splints Fractures in Childhood Sport Injuries METABOLIC BONE DISEASE IMAGING Paget's Disease Hyperparathyroidism Renal Osteodystrophy Osteoporosis and Osteomalacia Bone Dysplasias Avascular Necrosis Complex Regional Pain Syndrome (Reflex Sympathetic Dystrophy) JOINT IMAGING FUTURE DIRECTION AND THERANOSTICS CONCLUSION REFERENCES CHAPTER 154 Angiography and Interventions in Musculoskeletal Lesions INTRODUCTION 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 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 Intra-arterial Chemotherapy Percutaneous Vertebral Body Augmentation Procedures Percutaneous Treatment of Disc Herniation PERCUTANEOUS ABLATION OF BONE TUMORS REFERENCES CHAPTER 155 Tuberculosis of Bones and Joints INTRODUCTION ETIOPATHOGENESIS CLINICAL FEATURES RADIOLOGICAL FEATURES TUBERCULOSIS OF JOINTS (ARTHRITIS) Hip Joint Knee Joint Ankle and Foot Shoulder Elbow Wrist and Carpus Sacroiliac Joints BCG OSTEITIS TUBERCULOSIS OF LONG AND FLAT BONES Tuberculosis of Long Bones Flat Bones TUBERCULOSIS OF SHORT BONES Tuberculosis of Tendon Sheaths and Bursae Atypical Mycobacterial Infection Tubercular Infection of Prosthetic Joint CONCLUSION REFERENCES CHAPTER 156 Nontubercular Bone and Joint Infections INTRODUCTION IMAGING MODALITIES ACUTE OSTEOMYELITIS Clinical Features Radiologic Features LOCALIZED OSTEOMYELITIS (BRODIE’S ABSCESS) CHRONIC OSTEOMYELITIS SCLEROSING OSTEOMYELITIS OF GARRE SYPHILIS OF BONE Congenital (Infantile) Syphilis Late Congenital Syphilis Acquired Syphilis RUBELLA OSTEOMYELITIS ACTINOMYCOSIS OF BONE MADUROMYCOSIS LEPROSY OF BONE DIABETIC FOOT HYDATID DISEASE SEPTIC ARTHRITIS TRANSIENT SYNOVITIS CHRONIC RECURRENT MULTIFOCAL OSTEOMYELITIS FUNGAL OSTEOMYELITIS PERIPROSTHETIC INFECTIONS REFERENCES CHAPTER 157 Tuberculosis of the Spine INTRODUCTION PATHOPHYSIOLOGY CLINICAL FEATURES LABORATORY INVESTIGATIONS19- IMAGING MODALITIES Conventional Radiographs Computed Tomography Magnetic Resonance Imaging Nuclear Medicine Scintigraphy30,32- IMAGING APPEARANCES CONVENTIONAL RADIOGRAPHS Paradiscal Central Anterior Subperiosteal Appendiceal or Neural Arch Tuberculosis Computed Tomography Magnetic Resonance Imaging Cord Changes ATYPICAL SPINAL TUBERCULOSIS21 Post-treatment Follow-up DIFFERENTIAL DIAGNOSIS REFERENCES CHAPTER 158 Nontubercular Infections of the Spine INTRODUCTION PATHOGENESIS OF SPINAL INFECTIONS Vascular Anatomy of Vertebrae Routes of Spread of the Spinal Infections Anatomic Sites of the Spinal Infections IMAGING MODALITIES OF SPINAL INFECTIONS Plain Radiography Computed Tomography Magnetic Resonance Imaging Nuclear Medicine Imaging Studies TYPES OF INFECTIONS Pyogenic Bacterial Infections Nonpyogenic Bacterial Infections17,18 Epidural Space Infections Fungal Infections20- Parasitic Infections DIFFERENTIAL DIAGNOSIS OF SPINAL INFECTION23,24 CONCLUSION REFERENCES CHAPTER 159 Imaging in Rheumatological Disorders INTRODUCTION RHEUMATOID ARTHRITIS Pathophysiology Imaging Radiographic Features Axial Skeleton Involvement Other Imaging Modalities Scoring Systems for Rheumatoid Arthritis JUVENILE IDIOPATHIC ARTHRITIDES Radiologic Features SERONEGATIVE SPONDYLOARTHROPATHIES ANKYLOSING SPONDYLITIS Pathophysiology Radiologic Features PSORIATIC ARTHROPATHY Radiologic Features REITER’S SYNDROME ENTEROPATHIC SPONDYLOARTHROPATHY CRYSTAL DEPOSITION ARTHROPATHY Gout Calcium Pyrophosphate Dihydrate Crystal Deposition Disease SYSTEMIC LUPUS ERYTHEMATOSUS IDIOPATHIC INFLAMMATORY MYOPATHY SYSTEMIC SCLEROSIS (SCLERODERMA) FIBROMYALGIA SYNDROME BURSITIS TENDINITIS AND TENOSYNOVITIS BEHÇET’S DISEASE REFERENCES CHAPTER 160 Degenerative Disease of the Spine INTRODUCTION IMAGING MODALITIES PATHOPHYSIOLOGY ANATOMY OF INTERVERTEBRAL DISC MAGNETIC RESONANCE APPEARANCE OF INTERVERTEBRAL DISC DEGENERATIVE CHANGES OF THE SPINE Structural Disc Changes Annular Fissures Disc Herniation Endplate Changes Facet Osteoarthritis Uncovertebral Joint Degeneration Spondylosis Deformans and Intervertebral Osteochondrosis Complications of Degenerative Spinal Disease CLINICAL IMPLICATIONS REFERENCES CHAPTER 161 Skeletal Disorders of Metabolic and Endocrine Origin INTRODUCTION DISORDERS OF METABOLIC ORIGIN RICKETS AND OSTEOMALACIA Causes Clinical Features Etiologic Considerations Rickets HYPERPARATHYROIDISM Primary Hyperparathyroidism Secondary Hyperparathyroidism Tertiary Hyperparathyroidism Pathophysiology Clinical Features Biochemical Findings Radiological Approach Parathyroid Localization Parathyroid Imaging Percutaneous Aspiration/Biopsy Contrast-enhanced Computed Tomography Four-dimensional Computed Tomography Magnetic Resonance Imaging Parathyroid Scintigraphy Single-photon Emission Computed Tomography HYPOPARATHYROIDISM Clinical Presentation Biochemical Findings Radiological Findings PSEUDOHYPOPARATHYROIDISM Clinical Findings Biochemical Findings Radiological Findings PSEUDOPSEUDOHYPOPARATHYROIDISM DISORDERS OF ENDOCRINE ORIGIN HYPERCORTISOLISM Radiological Findings HYPOPITUITARISM Radiological Findings HYPOTHYROIDISM Clinical Findings Radiological Findings HYPERTHYROIDISM Clinical Findings Biochemical Findings Radiological Findings HYPERGONADISM HYPOGONADISM Radiological Findings GROWTH HORMONE DISORDERS Acromegaly Clinical Findings Definitive Diagnosis Radiological Findings SCURVY Clinical Findings Biochemical Findings Pathophysiology Radiological Findings Diagnosis Ultrasound Evaluation Magnetic Resonance Imaging Treatment FLUOROSIS Clinical Findings Radiographical Findings CONCLUSION REFERENCES CHAPTER 162 Osteoporosis INTRODUCTION PATHOGENESIS ETIOLOGY Primary 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 Standard Radiography Radiogrammetry Photodensitometry Neutron Activation Analysis Compton Scattering Single-energy Photon Absorptiometry Dual-energy Photon Absorptiometry Dual-energy X-ray Absorptiometry Quantitative Computed Tomography Quantitative Ultrasound High-resolution Bone Imaging Multidetector Computed Tomography MACHINE-BASED ARTIFICIAL INTELLIGENCE IN PREDICTING BONE MINERAL DENSITY INTERVENTIONAL MANAGEMENT OF OSTEOPOROTIC COMPRESSION FRACTURES—PERCUTANEOUS VERTEBROPLASTY Indications Procedure Postprocedure Care Complications REFERENCES CHAPTER 163 Diagnostic Approach to Focal Bone Lesions INTRODUCTION GENERAL PRINCIPLES OF FOCAL BONE LESION EVALUATION AGE OF THE PATIENT LOCATION OF LESION (FIG. 1) PATTERNS OF BONE DESTRUCTION Geographic Bone Destruction Moth-eaten Bone Destruction Permeative Bone Destruction Combination and Changing Pattern MARGIN OF THE LESION AND RATE OF GROWTH CORTICAL RESPONSE MATRIX MINERALIZATION Osseous Matrix Cartilage Matrix PERIOSTEAL REACTION Continuous Periosteal Reaction Interrupted Periosteal Reaction Complex Periosteal Reaction SOFT TISSUE EXTENSION MULTIPLICITY MISCELLANEOUS Septations (Table 2) Saucerization Floating Fragment Sign BENIGN VERSUS MALIGNANT ULTRASONOGRAPHY COMPUTED TOMOGRAPHY ANALYSIS OF BONE LESIONS Computed Tomography Grading System of Bone Lesions MAGNETIC RESONANCE IMAGING OF BONE LESIONS11,12 CONCLUSION REFERENCES CHAPTER 164 Benign Bone Tumors and Tumor-like Conditions INTRODUCTION IMAGING MODALITIES Radiography Computed Tomography Magnetic Resonance Imaging BONE-FORMING TUMORS Enostosis Osteoma Osteoid Osteoma Osteoblastoma CARTILAGE-FORMING TUMORS Osteochondroma Enchondroma Chondroblastoma Chondromyxoid Fibroma FIBROUS TUMORS/LESIONS Fibrous Cortical Defects and Nonossifying Fibroma Fibrous Dysplasia Osteofibrous Dysplasia Desmoplastic Fibroma VASCULAR AND CONNECTIVE TISSUE TUMORS Hemangioma Lipoma OTHER TUMORS Giant Cell Tumor TUMOR-LIKE LESIONS Simple Bone Cyst Aneurysmal Bone Cyst Eosinophilic Granuloma Pseudotumor of Hemophilia Brown Tumor of Hyperparathyroidism ROLE OF ADVANCE MAGNETIC RESONANCE IMAGING CONCLUSION REFERENCES CHAPTER 165 Malignant Bone Tumors CLASSIFICATION OF PRIMARY MALIGNANT BONE TUMORS GENERAL PRINCIPLES OF DIAGNOSIS STAGING OF BONE TUMORS Grade Local Extent Metastases IMAGING MODALITIES Conventional Radiography Magnetic Resonance Imaging Computed Tomography Fluoroscopy Nuclear Medicine Angiography Ultrasonography TREATMENT FOR PRIMARY MALIGNANT BONE TUMORS Limb Salvage Considerations Image Fusion for Computer-assisted Bone Tumor Surgery OSTEOGENIC ORIGIN Osteosarcoma CHONDROGENIC ORIGIN Chondrosarcoma Other Varieties of Chondrosarcoma FIBROGENIC TUMORS Spindle Cell Sarcoma (Fibrosarcoma) SMALL ROUND BLUE CELL TUMORS EWING SARCOMA FAMILY OF TUMORS Ewing Sarcoma Primitive Neuroectodermal Tumor of Bone NOTOCHORDAL ORIGIN Chordoma VASCULAR TUMORS OF THE BONE Angiosarcoma Hemangioendothelioma Epithelioid Hemangioendothelioma MYOGENIC, LIPOGENIC, AND EPITHELIAL TUMORS Liposarcoma Adamantinoma of Long Bones UNDIFFERENTIATED PLEOMORPHIC SARCOMA (MALIGNANT FIBROUS HISTIOCYTOMA) Clinical Presentation Imaging Features MALIGNANT GIANT CELL TUMOR METASTATIC BONE DISEASE Clinical Presentation Imaging Features Differential Diagnosis CONCLUSION REFERENCES CHAPTER 166 Imaging in Marrow Disorders: Benign and Malignant INTRODUCTION MAGNETIC RESONANCE APPEARANCE OF NORMAL MARROW NORMAL DISTRIBUTION OF MARROW MAGNETIC RESONANCE IMAGING TECHNIQUES T1-weighted Sequence T2-weighted Sequence STIR Sequence Chemical Shift Imaging Diffusion-weighted Imaging Proton Magnetic Resonance Spectroscopy Contrast Enhancement Dynamic Contrast-enhanced Magnetic Resonance Studies MAGNETIC RESONANCE PROTOCOL FOR SURVEY OF MARROW WHOLE BODY MAGNETIC RESONANCE IMAGING BONE MARROW PATHOLOGY MARROW PROLIFERATIVE DISORDERS Reconversion of Yellow Marrow to Red Marrow Myelofibrosis Leukemia Multiple Myeloma Plasmacytoma POEMS Syndrome, also known as Takatsuki Disease or Crow–Fukase Syndrome Langerhans Cell Histiocytosis MARROW REPLACEMENT DISORDERS Benign Marrow Replacement Disorder Malignant Marrow Replacement Disorder MARROW DEPLETION Aplastic Anemia VASCULAR ABNORMALITIES (HYPEREMIA AND ISCHEMIA) Trauma MISCELLANEOUS MARROW DISEASES Gaucher's Disease Iron Overload (Hemosiderosis) Paget's Disease MAGNETIC RESONANCE APPROACH TO MARROW DISEASE CONCLUSION REFERENCES CHAPTER 167 Magnetic Resonance Imaging of Shoulder and Temporomandibular Joints SHOULDER JOINT INTRODUCTION MAGNETIC RESONANCE IMAGING PROTOCOLS MAGNETIC RESONANCE ARTHROGRAPHY NORMAL ANATOMY Osseous Structures Ligaments MUSCULOTENDINOUS ANATOMY Bursae NORMAL MAGNETIC RESONANCE APPEARANCE Axial Sections (Figs. 1 and 4) Coronal Sections (Figs. 2 and 4) Sagittal Sections (Figs. 3 and 4) SHOULDER IMPINGEMENT SYNDROME Primary Extrinsic Impingement Secondary Extrinsic Impingement Internal Impingement ROTATOR CUFF TENDINOPATHY AND TEARS Magnetic Resonance Appearance Instability Pitfalls 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 AVASCULAR NECROSIS NEOPLASMS ADVANCE MAGNETIC RESONANCE TECHNIQUES IN SHOULDER JOINT TEMPOROMANDIBULAR JOINT INTRODUCTION MAGNETIC RESONANCE IMAGING TECHNIQUE NORMAL ANATOMY AND MAGNETIC RESONANCE APPEARANCE (FIGS. 39 TO 42) Normal Magnetic Resonance Appearance MOVEMENTS DISEASES OF TEMPOROMANDIBULAR JOINT Internal Derangement Disc Displacements Disc Deformity and Osteoarthritis Stuck Disc Open Lock Jaw Osteonecrosis and Osteochondritis Dissecans POSTOPERATIVE IMAGING EVALUATION OF MANDIBULAR ASYMMETRY INFECTIONS AND ARTHRITIDES TUMORS AND TUMOR-LIKE CONDITIONS REFERENCES CHAPTER 168 Magnetic Resonance Imaging of Wrist INTRODUCTION BONES AND JOINTS Ulnar Variance or Hulten Variance Ligaments of Wrist Triangular Fibrocartilage Complex (Fig. 3) Extensor Compartment (Fig. 5) Flexor Compartment (Figs. 6A to C) Carpal Tunnel (Figs. 6A to C) IMAGING TECHNIQUE OF WRIST Magnetic Resonance Imaging Cartilage Imaging Magnetic Resonance Arthrography of Wrist Fractures of Other Carpal Bones Kienböck's Disease Triangular Fibrocartilage Complex Lesions Radioulnar Ligament Lesions Ulnar Impaction Syndrome (Ulnocarpal Abutment) Ulnar Styloid Impaction Syndrome Ulnar Impingement Syndrome Hamatolunate Impingement Carpal Instability Distal Radioulnar Joint Tendon Disorders De Quervain's Tenosynovitis Intersection Syndrome Distal Intersection Syndrome Extensor Carpi Ulnaris Tenosynovitis Flexor Tenosynovitis Carpal Tunnel Syndrome Guyon's Canal Syndrome Wartenberg's Syndrome Inflammatory Arthritis Seronegative Spondyloarthropathies Infections Degenerative Arthritis Tumors Osseous Lesions Ulnar-sided Wrist Pain Radial-sided Wrist Pain REFERENCES CHAPTER 169 Magnetic Resonance Imaging of the Hip and Pelvis INTRODUCTION NORMAL ANATOMY MAGNETIC RESONANCE IMAGING TECHNIQUE Conventional Magnetic Resonance Imaging Radial Imaging Magnetic Resonance Arthrography MAGNETIC RESONANCE APPEARANCES OF NORMAL HIP Pathological Conditions of the Hip Imaging Staging MAGNETIC RESONANCE IMAGING AND PROGNOSTIC INDICATORS Treatment Pitfalls in Diagnosis1 Minimal Avascular Necrosis ACUTE BONE MARROW EDEMA SYNDROME Imaging Labrum FEMOROACETABULAR IMPINGEMENT Cam Impingement Pincer Impingement Imaging Radiography in Femoroacetabular Impingement Magnetic Resonance Imaging Herniation Pits HIP TRAUMA Stress Fractures Salter Fracture Traumatic Musculotendinous Injury Gluteus Medius Tendon Tear—Greater Trochanteric Pain Syndrome Morel-Lavallée Lesion Snapping Hip Syndrome ATHLETIC PUBALGIA ARTHRITIS SACROILIITIS INFECTION BURSAE NERVES PIRIFORMIS SYNDROME MAGNETIC RESONANCE IMAGING IN POSTARTHROPLASTY HIP HIP AND PELVIS-BONE TUMORS CONCLUSION REFERENCES CHAPTER 170 Magnetic Resonance Imaging of the Knee INTRODUCTION IMAGING PROTOCOLS/TECHNICAL FACTORS Patient Positioning Slice Thickness Imaging Planes and Pulse Sequences MR EVALUATION OF THE KNEE MENISCI Microanatomy of the Menisci Macroanatomy and MRI Appearance Medial Meniscus Lateral Meniscus Anatomic Variants Abnormal Meniscus MR Grading of Meniscal Tears Abnormal Morphology Classification of Meniscal Tears Meniscocapsular Separation Indirect Signs of the Meniscal Tear Imaging Challenges Potential Pitfalls Surgical Considerations in Meniscal Tear Accuracy of MR in the Diagnosis of the Meniscal Tears CENTRAL STRUCTURES OF THE KNEE Anterior Cruciate Ligament Posterior Cruciate Ligament MEDIAL STRUCTURES OF THE KNEE Anatomy Magnetic Resonance Imaging MCL Injury CORNER-BASED ANATOMY OF THE KNEE Posterolateral Corner of the Knee Posteromedial Corner of the Knee Anterolateral Corner of the Knee POSTERIOR STRUCTURES OF THE KNEE Anatomy Magnetic Resonance Imaging KNEE DISLOCATIONS Magnetic Resonance Imaging ANTERIOR STRUCTURES OF THE KNEE OR THE EXTENSOR MECHANISM OF THE KNEE Anatomy Patellar Tendonitis (Jumper's Knee) Acute Patellar Tendon Disruption Patellar Tendon-lateral Femoral Condyle Friction Syndrome PATELLOFEMORAL JOINT AND KINEMATIC MRI Patellofemoral Joint Anatomy MRI of Patellar Instability Kinematic MRI Weight-bearing MRI of the Knee MRI OF THE ARTICULAR CARTILAGE MRI Assessment of Articular Cartilage Injury Chondromalacia Patellae Osteoarthritis NOVEL SEQUENCES AND TECHNIQUES FOR DETECTION OF EARLY OSTEOARTHRITIS Biochemical MR Imaging of Knee Articular Cartilage/Composit Quantitative Cartilage Imaging—Delayed Gadolinium-enhanced MRI of Cartilage Sodium Imaging Glycosaminoglycan Chemical Exchange Saturation Transfer Imaging Ultrashort Echo Time Imaging of Articular Cartilage In Vivo Diffusion MRI Hybrid MRI EVALUATION OF THE SYNOVIUM Rheumatoid Arthritis Tuberculosis of the Knee Juvenile Rheumatoid Arthritis Pigmented Villonodular Synovitis Hemophilia Synovial Chondromatosis of the Knee Deferiprone-induced Arthropathy TRAUMATIC BONE MARROW ABNORMALITIES OF THE KNEE Acute and Chronic Avulsive Injuries Fatigue and Insufficiency Fractures Stress Fractures OSTEOCHONDRAL LESIONS OF THE KNEE Spontaneous Osteonecrosis Juvenile and Adult Osteochondritis Dissecans91 Transient Bone Marrow Edema Syndrome (Transient Osteoporosis) MISCELLANEOUS LESIONS Bursae1 Medullary Infarction Reflex Sympathetic Dystrophy BONE INFECTIONS BONE NEOPLASMS MR ARTHROGRAPHY Technique POSTOPERATIVE EVALUATION OF THE KNEE Imaging of the ACL Graft Graft Rupture Graft Impingement Arthrofibrosis Postoperative Meniscus Postoperative Articular Cartilage ARTIFICIAL INTELLIGENCE IN THE EVALUATION OF KNEE PATHOLOGY106 CONCLUSION REFERENCES CHAPTER 171 Magnetic Resonance Imaging of Ankle INTRODUCTION IMAGING PROTOCOLS/TECHNICAL FACTORS Patient Positioning and Coils Slice Thickness Imaging Planes and Pulse Sequences MAGNETIC RESONANCE ANATOMY Joints (Figs. 1 and 10) Achilles Tendon Pathologies Peroneal Tendon Pathologies Ligament Injuries—Lateral Ligament Injuries—Medial (Figs. 20A to C) Ankle Impingement Tarsal Coalitions (Figs. 23A to C) Adult-acquired Flat Foot10 Bones Osteochondral Lesions of Talus Degenerative Nerve Entrapment-Tarsal Tunnel Syndrome Sinus Tarsi Syndrome Infections Inflammatory Arthritis Plantar Fasciitis (Figs. 30A and B) Tumors REFERENCES CHAPTER 172 Radiological Evaluation of Appendicular Trauma INTRODUCTION CLINICAL EVALUATION RADIOLOGICAL EVALUATION Definitions and Classification Osseous Evaluation Soft-tissue Evaluation FRACTURE HEALING COMPLICATIONS OF FRACTURE Immediate Complications Intermediate Complications Delayed Complications IMAGING MODALITIES UPPER LIMB TRAUMA Dislocation of the Shoulder Fracture of the Neck of Humerus Fracture of the Shaft of Humerus Fracture of the Distal Humerus Dislocation of the Elbow Fracture of the Head and Neck of Radius Fracture of the Upper End of Ulna Fractures of the Shaft of Radius and Ulna Fractures of the Distal End of Radius Fractures of the Carpal Bones Dislocation of the Wrist Fractures and Dislocations of the Hand LOWER LIMB TRAUMA Dislocations of the Hip Fractures of the Proximal Femur Fractures of the Shaft of Femur Fractures of the Patella Dislocation of the Patella Fractures of the Proximal Tibia Fractures of the Shaft of Tibia and Fibula Fractures of the Distal Tibia and Fibula Fractures of the Talus Fractures of the Calcaneum Dislocations of the Foot CONCLUSION REFERENCES CHAPTER 173 Imaging of Soft Tissue Tumors INTRODUCTION CLASSIFICATION Immune Histochemistry Molecular Studies ADIPOCYTIC TUMORS Lipoma Lipoblastoma Other Benign Tumors FIBROBLASTIC OR MYOFIBROBLASTIC TUMORS Myositis Ossificans Desmoid Fibromatosis Inflammatory Myofibroblastic Tumor FIBROHISTIOCYTIC TUMORS Tenosynovial Giant Cell Tumor SMOOTH MUSCLE TUMORS PERICYTIC (PERIVASCULAR) TUMORS SKELETAL MUSCLE TUMORS Rhabdomyosarcoma VASCULAR TUMORS Infantile Hemangioma Congenital Hemangioma Kaposiform Hemangioendothelioma Angiosarcoma CHONDRO-OSSEOUS TUMORS GASTROINTESTINAL STROMAL TUMORS PERIPHERAL NERVE SHEATH TUMORS Benign Peripheral Nerve Sheath Tumors Malignant Peripheral Nerve Sheath Tumors TUMORS OF UNCERTAIN DIFFERENTIATION Synovial Sarcoma UNDIFFERENTIATED/UNCLASSIFIED SARCOMAS Staging of Soft Tissue Sarcomas Tumor Grades Steps of Staging (Flowchart 5) IMAGING MODALITIES AND APPROACH Ultrasonography MRI CT Scan Radiographs Biopsy STRUCTURED REPORTING FORMAT REFERENCES CHAPTER 174 Imaging of Peripheral Nerves INTRODUCTION ANATOMY OF PERIPHERAL NERVOUS SYSTEM CURRENT IMAGING IN PERIPHERAL NERVOUS SYSTEM Conventional Radiography Computed Tomography Ultrasound Magnetic Resonance Imaging Specific Peripheral Nerve Pathologies Systemic Etiologies of Neuropathy RECENT ADVANCES IN PERIPHERAL NERVE IMAGING Microneurography Dedicated Contrast Media Contrast-enhanced Ultrasound Elastography Spinal Ganglion Morphometry MR Spectroscopy REFERENCES CHAPTER 175 Imaging in Prosthetic Joints INTRODUCTION BASIC CONCEPTS PROSTHETIC MATERIALS IMAGING MODALITIES Radiographs Computed Tomography Ultrasound Magnetic Resonance Imaging Nuclear Medicine Scans COMMON ARTHROPLASTIES: INDICATIONS, TERMINOLOGY, AND MEASUREMENT Hip Arthroplasty Knee Arthroplasty Shoulder Arthroplasty COMPLICATIONS Polyethylene Wear Osteolysis Infection Instability Fracture/Dislocation Metallosis/Pseudotumors Heterotopic Ossification Soft Tissue Injury CONCLUSION REFERENCES CHAPTER 176 A Systematic Approach to Imaging of Breast Lesions INTRODUCTION IMAGING TECHNIQUES MAMMOGRAPHY Mammography Equipment Mammography Projections Indications for Mammography Normal Mammographic Anatomy Interpretation and Reporting of Mammograms Breast Imaging—Reporting and Data System ACR BI-RADS Assessment Categories Digital Mammography BREAST ULTRASOUND Technique Indications for Breast Ultrasound Normal Anatomy ACR BI-RADS Ultrasound Lexicon Descriptors Challenges in Assigning Final Assessment Categories and the Influence of Clinical Factors Contrast-enhanced Ultrasound Ultrasound Elastography BREAST MAGNETIC RESONANCE IMAGING Indications of Breast Magnetic Resonance Imaging Technique Kinetic Analysis Normal Magnetic Resonance Imaging Appearances Interpretation of Breast Magnetic Resonance Imaging Associated Findings Kinetic Curve Assessment Diffusion-weighted Imaging Sensitivity and Specificity of Magnetic Resonance Imaging NUCLEAR MEDICINE IN BREAST IMAGING Breast-specific Gamma Imaging Positron Emission Tomography Positron Emission Mammography CONCLUSION REFERENCES CHAPTER 177 Benign and Malignant Lesions of the Breast INTRODUCTION PROLIFERATIVE BENIGN LESIONS OF THE BREAST Fibrocystic Disease Adenosis Fibroadenoma Cysts Intraductal Papilloma Duct Ectasia Ductal Epithelial Hyperplasia MISCELLANEOUS BENIGN BREAST CONDITIONS Lipoma Fat Necrosis Galactocele Radial Scar Hamartoma Desmoid Tumor Diabetic Mastopathy Superficial Thrombophlebitis (Mondor's Disease) Breast Infections Granulomatous Mastitis Breast Implants MALIGNANT LESIONS OF THE BREAST Risk Factors for Breast Cancer Diagnosis of the Breast Cancer BREAST CANCER SCREENING Mammography Screening Magnetic Resonance Imaging Screening Ultrasound Screening Breast Cancer Screening in Developing Countries IMAGING FEATURES OF BREAST CANCER Preinvasive Breast Lesions Ductal Carcinoma In Situ Lobular Carcinoma In Situ Invasive Breast Cancer Invasive Ductal Carcinoma Invasive Lobular Carcinoma Medullary Carcinoma Mucinous Carcinoma Tubular Carcinoma Papillary Carcinoma Triple Negative Breast Cancer STAGING AND TREATMENT OF BREAST CANCER Preoperative Breast Imaging Breast Conservation Therapy Mastectomy Management of Axilla Perioperative Breast Imaging Adjuvant Treatment ADVANCED BREAST CANCER Locally Advanced Breast Cancer Inflammatory Breast Cancer Neoadjuvant Chemotherapy Metastatic Breast Cancer Occult Primary Breast Cancer POST-TREATMENT BREAST IMAGING AND FOLLOW-UP MISCELLANEOUS MALIGNANT LESIONS OF THE BREAST Paget's Disease Phyllodes Tumor Sarcoma Metastases to Breast Male Breast Cancer REFERENCES CHAPTER 178 Breast Interventions INTRODUCTION BREAST BIOPSY BREAST BIOPSY TECHNIQUES Surgical Biopsy Fine Needle Aspiration Cytology Core Needle Biopsy Vacuum-assisted Biopsy Lesion Selection for Breast Biopsy Selection of Guiding Modality Prebiopsy Assessment Ultrasound-guided Breast Biopsy Stereotactic Breast Biopsy Tomosynthesis-guided Core Biopsy Specimen Radiography Postbiopsy Care COMPLICATIONS OF BREAST BIOPSY Magnetic Resonance Imaging-guided Breast Biopsy Histopathological Correlation PREOPERATIVE HOOKWIRE LOCALIZATION Equipment Technique Other Localization Techniques Specimen Radiography Complications Special Techniques of Localization Ultrasound-guided Intraoperative Excision MISCELLANEOUS BREAST INTERVENTIONS Ductography Cyst Aspiration Ultrasound-guided Axillary Lymph Node FNAC ABLATIVE PROCEDURES FOR BREAST CANCER REFERENCES CHAPTER 179 Advances in Breast Imaging INTRODUCTION DIGITAL BREAST TOMOSYNTHESIS Digital Breast Tomosynthesis Technology Digital Breast Tomosynthesis in a Screening Setting Use of Digital Breast Tomosynthesis in Diagnostic Workup CONTRAST-ENHANCED MAMMOGRAPHY Contrast-enhanced Mammography Acquisition and Image Analysis Contrast-enhanced Mammography in Screening Diagnostic Performance of Contrast-enhanced Mammography Contrast-enhanced Mammography as an Alternative to Magnetic Resonance Imaging AUTOMATED BREAST VOLUME SCAN BREAST ELASTOGRAPHY Strain Elastography Shear-wave Elastography CONTRAST-ENHANCED ULTRASOUND Ultrasound Contrast Agent and Basic Principles Contrast-enhanced Ultrasound Acquisition and Evaluation THERMAL IMAGING ARTIFICIAL INTELLIGENCE IN BREAST IMAGING CONCLUSION REFERENCES CHAPTER 180 Male Breast Imaging INTRODUCTION IMAGING METHODS ANATOMY NORMAL IMAGING APPEARANCE Gynecomastia BENIGN NEOPLASMS OF THE MALE BREAST Angiolipoma Schwannoma Intraductal Papilloma Lipomas Benign Spindle Cell Neoplasms BENIGN NON-NEOPLASTIC LESIONS OF MALE BREAST Pseudogynecomastia Intramammary Lymph Nodes Epidermal Inclusion Cyst Duct Ectasia Diabetic Mastopathy Post-traumatic Hematoma/Fat Necrosis Mastitis Subareolar Abscess Tuberculosis of the Breast Pseudoangiomatous Stromal Hyperplasia Hamartomas Augmented Male Breasts Venous Malformation Secondary Syphilis Nodular Fasciitis MALE BREAST CANCER OTHER MALIGNANT NEOPLASMS OF THE MALE BREAST Primary Lymphoma Dermatofibrosarcoma Multiple Myeloma Glomus Tumors Inflammatory Myofibroblastic Tumor Metastasis CONCLUSION REFERENCES Volume 4 SECTION 7 Neuroradiology Including Head and Neck Imaging CHAPTER 181 Evaluation of Plain X-ray Skull: A Systematic Approach INTRODUCTION LATERAL VIEW OF SKULL FRONTAL VIEW (FIG. 2) TOWNE’S VIEW BASAL VIEW WATERS’ VIEW CALDWELL’S VIEW Abnormal Density Abnormal Contour of the Skull Abnormal Intracranial Volume Radiolucent Areas in Skull Sclerotic Areas of the Skull Intracranial Calcification REFERENCES CHAPTER 182 Normal Anatomy of Brain on CT and MRI INTRODUCTION 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) DIENCEPHALON MIDBRAIN AND BRAINSTEM (PONS AND MEDULLA (FIG. 3A) CEREBELLUM WHITE MATTER OF BRAIN (FIGS. 8A TO J) VENTRICLES AND CISTERNS BASAL GANGLIA AND ADJACENT STRUCTURES SUGGESTED READING CHAPTER 183 Normal Cerebral Angiography CEREBRAL ANGIOGRAPHY TECHNIQUE INTRODUCTION Historical Background Definition Six Vessel Angiography Patient Preparation Requirements Catheterization Equipment Site of the Puncture Preparation Local Anesthesia Artery Puncture Puncture Technique Procedure Important Points to Remember Postprocedural Management Complications CEREBRAL ANGIOGRAPHIC ANATOMY ARTERIAL ANATOMY Venous Anatomy (Fig. 14) Dural Sinuses Cerebral Veins CONCLUSION REFERENCES CHAPTER 184 Advances in Neuroimaging Techniques: Computed Tomography INTRODUCTION RECENT ADVANCES IN CT TECHNOLOGY Multidetector Computed Tomography Dual Energy Computed Tomography Cone Beam CT Portable CT Phase Contrast CT Advances in Image Reconstruction Algorithms COMPUTED TOMOGRAPHY IN NEUROIMAGING NONCONTRAST CT OF HEAD CT ANGIOGRAPHY Applications of CT Angiography Intracranial Vasculature COMPUTED TOMOGRAPHY PERFUSION Clinical Applications COMPUTED TOMOGRAPHY IMAGING OF ACUTE ISCHEMIC STROKE COMPUTED TOMOGRAPHY VENOGRAPHY Clinical Applications of CT Venography MULTIDETECTOR COMPUTED TOMOGRAPHY OF SPINE Clinical Applications RADIATION CONCERNS 3D PRINTING CONCLUSION REFERENCES CHAPTER 185 Advances in Neuroimaging Techniques: Magnetic Resonance Imaging IMPROVEMENTS IN MR HARDWARE RAPID IMAGE ACQUISITION TECHNIQUES Echo-planar Imaging (EPI) Fast Spin Echo Imaging Gradient and Spin Echo Imaging (GRASE) Steady State Imaging Methods Partial Fourier Acquisitions Parallel Imaging Compressed SENSE (CSENSE) Multiband or Multiplexed Imaging ADVANCED MR IMAGING TECHNIQUES SUSCEPTIBILITY WEIGHTED IMAGING (SWI) Quantitative Susceptibility Mapping (QSM) Susceptibility Tensor Imaging (STI) DIFFUSION IMAGING Diffusion Weighted Imaging (DWI) Diffusion Tensor Imaging Diffusion Spectrum Imaging q-Ball Imaging Diffusion Kurtosis Imaging (DKI) Readout Segmented EPI-based Diffusion (RESOLVE Diffusion) Contiguous-slice Zonally Oblique Multislice (CO-ZOOM) Diffusion PERFUSION WEIGHTED IMAGING Clinical Applications of MRP MAGNETIC RESONANCE NEUROGRAPHY (MRN) Role of MRN in Diagnosis of Peripheral Neuropathy54 Interpretation of MRN54 MAGNETIC RESONANCE ANGIOGRAPHY VESSEL WALL MR IMAGING (VW-MR IMAGING) Intracranial Vessel Wall Imaging Extracranial Vessel Wall Imaging MAGNETIC RESONANCE ELASTOGRAPHY (MRE) MAGNETIC RESONANCE FINGERPRINTING CHEMICAL EXCHANGE SATURATION TRANSFER (CEST) MRI Magnetization Transfer Amide Proton Transfer POSITRON EMISSION TOMOGRAPHY AND MRI (PET/MRI) ARTIFICIAL INTELLIGENCE IN NEURORADIOLOGY Deep Learning Major Applications of AI in Neuroimaging ACKNOWLEDGMENTS REFERENCES CHAPTER 186 Magnetic Resonance Spectroscopy INTRODUCTION PRINCIPLE Spectrum Spectrum and Echo Time Observable Biochemicals on MRS MRS) Hydrogen 1 ( Phosphorus 31 ( MRS) LOCALIZATION TECHNIQUES B1 Field Gradient Methods B0 Field Gradient Methods Slice-selective B0-gradient Techniques 3D Localization Methods Single Voxel Versus Multivoxel Spectroscopy Quantitative Spectroscopy Data Acquisition and Analysis CLINICAL APPLICATIONS OF MRS OF BRAIN Brain Tumors Differentiation of Intracranial Ring Enhancing Lesions (Table 7) MRS IN PEDIATRICS Prematurity and Birth Asphyxia Metabolic Disorders and Leukodystrophies MAGNETIC RESONANCE SPECTROSCOPY IN EPILEPSY Lateralization in Temporal Lobe Epilepsy MRS in Neurodegenerative Diseases Amyotrophic Lateral Sclerosis (ALS) Idiopathic Parkinson's Disease (IPD) versus Other Parkinsonian Syndromes Huntington's Disease (HD) MAGNETIC RESONANCE SPECTROSCOPY IN DEMYELINATING DISEASES Multiple Sclerosis MAGNETIC RESONANCE SPECTROSCOPY IN HEAD TRAUMA MAGNETIC RESONANCE SPECTROSCOPY IN STROKE MAGNETIC RESONANCE SPECTROSCOPY IN PSYCHIATRIC DISEASES MAGNETIC RESONANCE SPECTROSCOPY IN HIV/AIDS CLINICAL SUCCESS Artefacts in MR Spectroscopy Field Inhomogeneity Inadequate Water and Lipid Suppression Incorrect Voxel Placement Incorrect Protocol Out-of-voxel Magnetization Chemical Shift Displacement Effects Fast MR Spectroscopy Techniques including Whole Brain MR Spectroscopy Whole Brain MRSI FUTURE DEVELOPMENTS REFERENCES CHAPTER 187 Functional MRI INTRODUCTION PRINCIPLE OF FMRI AND BOLD CONTRAST ADVANTAGES OF BOLD FMRI LIMITATIONS OF BOLD TECHNIQUE Susceptibility effects Geometric Distortions Venous Effects Physiologic Noise and Motion Neurovascular Uncoupling IMAGING ACQUISITION fMRI EXAMINATION DESIGN fMRI EXAMINATION TASK PARADIGM POST-PROCESSING AND DATA ANALYSIS CURRENT CLINICAL APPLICATIONS OF FMRI Neurosurgical Planning Epilepsy Dementia Defining Disease Based on Patterns of Brain Function Psychiatric Disorders ADVANCES IN FMRI TECHNIQUE Real-time fMRI Neurofeedback Resting State fMRI CONCLUSION REFERENCES CHAPTER 188 Imaging and Interventions in Cerebral Ischemia INTRODUCTION Pathophysiological Considerations Significance of a Penumbra Etiology IMAGING IN ISCHEMIC STROKE Computed Tomography CT Angiography CT Perfusion Imaging Magnetic Resonance Imaging Magnetic Resonance Angiography Combination of DWI and Perfusion in Evaluation of Acute Stroke Carotid Ultrasound Catheter Angiography RECANALIZATION STRATEGIES IN ACUTE STROKE Intravenous TPA Intra-arterial Therapy Technique Acute Stroke Imaging Protocol (Flowchart 1) VASCULOPATHIES Atherosclerotic Vascular Disease (ASVD) Arterial Dissection Aortoarteritis Fibromuscular Dysplasia Other Vasculopathies RECANALIZATION STRATEGIES IN ATHEROSCLEROTIC VESSEL DISEASE Carotid Artery Stenting Preparation Technique Complications CONCLUSION REFERENCES CHAPTER 189 Imaging of Subarachnoid Hemorrhage INTRODUCTION INCIDENCE CLINICAL FEATURES GRADING SYSTEM OF SUBARACHNOID HEMORRHAGE DIAGNOSIS Lumbar Puncture (LP) Computed Tomography Magnetic Resonance Imaging Cerebral Angiography CT Angiography (CTA) Dual Energy CT Magnetic Resonance Angiography Transcranial Doppler Ultrasound ANEURYSMS Clinical Presentation Location Multiple Aneurysms Unruptured Aneurysms Thrombosed Aneurysms Giant Aneurysms Mycotic Aneurysms Flow-related Aneurysms VASCULAR MALFORMATIONS Parenchymal AVMs Dural AVMs Mixed Pial and Dural AVMs CAPILLARY TELANGIECTASIAS CAVERNOUS ANGIOMAS VENOUS ANGIOMAS TRAUMATIC SUBARACHNOID HEMORRHAGE Subarachnoid Hemorrhage of Unknown Etiology Non-aneurysmal SAH SUMMARY REFERENCES CHAPTER 190 Endovascular Management of Intracranial Aneurysms PATHOGENESIS Hemodynamic Factors TYPES OF ANEURYSMS CLINICAL PRESENTATION DIAGNOSTIC EVAUATION PREPROCEDURE MANAGEMENT ENDOVASCULAR TREATMENT SIMPLE COILING Anesthesia Access Angiogram Microcatheterization of Aneurysm Coiling BALLOON-ASSISTED COILING STENT-ASSISTED COILING Technique of Coiling with Stent Assistance (Figs. 4A to H) PROTOCOL FOR ANTIPLATELET ADMINISTRATION IN CASES OF INTRACRANIAL STENTING FLOW DIVERTERS PARENT ARTERY OCCLUSION COMPLICATIONS OF ENDOVASCULAR COILING AND THEIR MANAGEMENT Coil Migration/Malposition Stretched Coil Intraprocedural Rupture of Aneurysm Rupture of Vessel Intraprocedural Thromboembolism ANEURYSM TREATMENT COILING VS CLIPPING: WHERE DO WE STAND? International Subarachnoid Aneurysm Trial (ISAT) Barrow Ruptured Aneurysm Trial (BRAT) ENDOVASCULAR TREATMENT OF CEREBRAL VASOSPASM Prophylaxis and Medical Treatment for Cerebral Vasospasm INTRA-ARTERIAL VASODILATOR INFUSION Calcium Channel Antagonists Inodilators TRANSLUMINAL BALLOON ANGIOPLASTY FOLLOW-UP AND MONITORING CONCLUSION ACKNOWLEDGMENT REFERENCES CHAPTER 191 Endovascular Management of Arteriovenous Malformations INTRODUCTION ANGIOARCHITECTURE/COMPONENTS OF BRAIN ARTERIOVENOUS MALFORMATION GRADING/CLASSIFICATION OF BRAIN ARTERIOVENOUS MALFORMATION IMAGING EVALUATION OF BRAIN ARTERIOVENOUS MALFORMATIONS Computed Tomography Magnetic Resonance Imaging Digital Subtraction Angiography THERAPEUTIC OPTIONS Microsurgery Radiosurgery ENDOVASCULAR INTERVENTION Curative Embolization Preoperative Embolization Pre-radiosurgery Embolization Palliative Embolization Staging Embolization ENDOVASCULAR HARDWARE Flow-dependent Catheters Guidewire Dependent Catheters Detachable Tip Microcatheters EMBOLIC AGENTS Acrylic Glue Onyx/Squid Precipitating Hydrophobic Injectable Liquid (PHIL) Other Embolic Agents Complications of AVM Embolization DURAL ARTERIOVENOUS FISTULAE Classification Radiological Evaluation Therapeutic Options Compression Therapy Transarterial Embolization Transvenous Embolization Preoperative Embolization CONCLUSION ACKNOWLEDGMENTS REFERENCES CHAPTER 192 Carotid-cavernous Fistulas INTRODUCTION AND HISTORICAL PERSPECTIVE ETIOLOGY AND PATHOGENESIS CLINICAL SYMPTOMATOLOGY ANATOMY OF INTRACAVERNOUS INTERNAL CAROTID ARTERY AND CAVERNOUS SINUS CLASSIFICATION RADIOLOGICAL EVALUATION CT Scan MRI Digital Subtraction Angiogram (DSA) INDICATIONS OF TREATMENT TREATMENT OPTIONS ENDOVASCULAR MANAGEMENT Tools and Hardware Transarterial Embolization Transvenous Embolization Parent Artery Reconstruction Follow-up CONCLUSION ACKNOWLEDGEMENT REFERENCES CHAPTER 193 Central Nervous System Infections INTRODUCTION CRANIAL MENINGES AND EXTRA-AXIAL SPACES BACTERIAL/PYOGENIC INFECTIONS Causative Organisms Pathophysiology PYOGENIC MENINGITIS Clinical Features Imaging COMPLICATIONS OF BACTERIAL MENINGITIS Hydrocephalus Extra-axial Fluid and Pus Collections Cerebritis and Abscess Imaging Central Nervous System Infarction Cranial Nerve Involvement Ventriculitis Recurrent Meningitis GRANULOMATOUS INFECTION TUBERCULOSIS Pathogenesis Tuberculous Meningitis (TBM) Clinical Manifestations Imaging COMPLICATIONS OF TUBERCULAR MENINGITIS Hydrocephalus Vasculitis Cranial Neuropathies TUBERCULAR PACHYMENINGITIS PARENCHYMAL TUBERCULOSIS TUBERCULOMAS MT Imaging Disseminated Tuberculomas (Miliary TB) TUBERCULOUS ABSCESS TB ENCEPHALOPATHY FOCAL TUBERCULOUS CEREBRITIS CNS TB AND AIDS NEUROSARCOIDOSIS FUNGAL INFECTIONS OF THE CENTRAL NERVOUS SYSTEM ASPERGILLOSIS Vasculitis/Vasculopathy CRYPTOCOCCAL INFECTION Imaging MUCORMYCOSIS Imaging CANDIDIASIS Imaging COCCIDIOIDOMYCOSIS HISTOPLASMOSIS NOCARDIOSIS PARASITIC INFECTIONS NEUROCYSTICERCOSIS Clinical Features Parenchymal Cysticercosis Intraventricular Cysticercosis Subarachnoid Cysticercosis Spinal Cysticercosis Orbital Disease TOXOPLASMOSIS Imaging Differentiation of Toxoplasmosis from CNS Lymphoma HYDATID DISEASE Imaging CEREBRAL MALARIA GRANULOMATOUS AMOEBIC ENCEPHALITIS PRIMARY AMOEBIC MENINGOENCEPHALITIS VIRAL INFECTIONS HERPES SIMPLEX ENCEPHALITIS (HSV-1) ENCEPHALITIS/ACUTE INFECTIVE ENCEPHALITIS Imaging Differential Diagnosis MOLLARET MENINGITIS VARICELLA ZOSTER ENCEPHALITIS JAPANESE ENCEPHALITIS (JE) Imaging MEASLES ENCEPHALITIS Acute Measles Encephalitis (AME) Subacute Sclerosing Panencephalitis (SSPE) Subacute Measles Encephalitis RABIES ENCEPHALOMYELITIS RASMUSSEN’S ENCEPHALITIS PRION INFECTIONS—CREUTZFELDT-JAKOB DISEASE Imaging Findings ACQUIRED IMMUNODEFICIENCY SYNDROME (AIDS) AND ITS RELATED CNS INFECTIONS HIV ENCEPHALITIS Imaging PROGRESSIVE MULTIFOCAL LEUKOENCEPHALOPATHY (PML) Imaging NEUROSYPHILIS Imaging CYTOMEGALOVIRUS ENCEPHALITIS/CMV ENCEPHALITIS Imaging IMMUNE RECONSTITUTION INFLAMMATORY SYNDROME (IRIS) Imaging DIFFERENTIAL DIAGNOSIS OF RING ENHANCING LESIONS IN THE BRAIN CONGENITAL INFECTIONS TOXOPLASMOSIS SYPHILIS RUBELLA Imaging CYTOMEGALOVIRUS (CMV) Imaging HERPES SIMPLEX VIRUS (HSV) HIV Imaging CONCLUSION REFERENCES CHAPTER 194 Imaging of White Matter Disease INTRODUCTION Demyelinating Disease: Classification based on Etiology IMAGING OF WHITE MATTER DISEASES Multiple Sclerosis Diagnosis of Multiple Sclerosis MR Imaging of Multiple Sclerosis Acute or Chronic MS 7T MRI—Ultra-high Field MR Imaging Diagnostic Criteria for Diagnosis of MS Dissemination in Space on MRI Dissemination in Time Primary Progressive Multiple Sclerosis Differential Diagnosis of MS Lesion on MR Idiopathic Inflammatory Demyelinating Disorders (IIDDs) Imaging Differential Diagnosis Neuromyelitis Optica (Devic Disease) Epidemiology Clinical Presentation Imaging Differential Diagnosis Treatment and Prognosis White Matter Diseases Associated with Infections ACUTE DEMYELINATING ENCEPHALOMYELITIS Epidemiology Pathology Clinical Diagnosis Imaging Treatment Differential Diagnosis ACUTE HEMORRHAGIC LEUKOENCEPHALITIS Epidemiology Pathology Imaging Treatment and Prognosis Differential Diagnosis Subacute Sclerosing Panencephalitis Imaging Progressive Rubella Panencephalitis Progressive Multifocal Leukoencephalopathy (PML) Epidemiology Pathology Imaging Differential Diagnosis Human Immunodeficiency Virus Encephalopathy103– LYME DISEASE/LYME NEUROBORRELIOSIS (LNB) Imaging Differential Diagnosis White Matter Diseases Associated with Vascular Causes Differential Diagnosis SYSTEMIC LUPUS ERYTHEMATOSUS125– Imaging BEHÇET DISEASE Imaging WHITE MATTER DISEASES ASSOCIATED WITH TOXIC METABOLIC CAUSES Osmotic Demyelination Syndrome (ODS) Acute Hypertensive Encephalopathy/Posterior Reversible Encephalopathy Syndrome (PRES) Ethanol-related Diseases Wernicke Encephalopathy139,140 Marchiafava-Bignami Disease Subacute Combined Degeneration of the Spinal Cord White Matter Diseases Associated with Physical/Chemical Agents or Therapeutic Procedures RADIATION INJURY145- Solvent Vapor Abuse Leukoencephalopathy-Toluene Chemotherapy Cocaine Methanol Poisoning Carbon Monoxide Poisoning Heavy Metal Poisoning Amphetamine and Derivatives CONCLUSION REFERENCES CHAPTER 195 Imaging of Epilepsy INTRODUCTION MRI PROTOCOLS Structural Lesions in Chronic Epilepsy Mesial Temporal Lobe Epilepsy MRI IN MALFORMATIONS OF CORTICAL DEVELOPMENT Focal Cortical Dysplasia Other Disorders of Neuronal Migration and Cortical Organization TUMORS Vascular Malformations Other Lesions Associated with Epilepsy ADVANCES IN EPILEPSY IMAGING AND MANAGEMENT Reformatted Images Quantitative MR Imaging Magnetic Resonance Spectroscopy T2 Relaxometry (Mapping) Diffusion Tensor Imaging Tractography Functional MR Positron Emission Tomography Single-photon Emission Computed Tomography (SPECT) Magnetoencephalography CONCLUSION REFERENCES CHAPTER 196 Imaging of Supratentorial Brain Tumors INTRODUCTION CLASSIFICATION OF SUPRATENTORIAL BRAIN TUMORS (2016) DIFFUSE ASTROCYTIC AND OLIGODENDROGLIAL TUMORS Diffuse Astrocytoma, IDH-mutant/IDH-wildtype/NOS Anaplastic Astrocytoma, IDH-mutant/IDH-wildtype/NOS Glioblastoma, IDH-mutant/IDH-wildtype/NOS Diffuse Midline Glioma, H3 K27M-mutant Oligodendroglioma, IDH-mutant and 1p/19q-codeleted/NOS Anaplastic Oligodendroglioma, IDH-mutant and 1p/19q-codeleted/ NOS OTHER ASTROCYTIC TUMORS Pilocytic Astrocytoma Subependymal Giant Cell Astrocytoma Pleomorphic Xanthoastrocytoma (Noninvasive, WHO Grade II) EPENDYMAL TUMORS Subependymoma Ependymoma CHOROID PLEXUS TUMORS Choroid Plexus Papilloma Choroid Plexus Carcinoma NEURONAL AND MIXED NEURONAL-GLIAL TUMORS Dysembryoplastic Neuroepithelial Tumor Ganglioglioma Central Neurocytoma PINEAL REGION TUMORS Pineal Germinoma and Teratoma Pineal Cell Tumors TUMORS OF CRANIAL AND PARASPINAL NERVE Schwannoma (Cellular/Plexiform) Neurofibroma (Atypical/ Plexiform) TUMORS OF THE MENINGES Meningioma MESENCHYMAL, NON-MENINGOTHELIAL TUMORS Solitary Fibrous Tumor/Hemangiopericytoma Ewing's Sarcoma LYMPHOMA Primary Lymphoma of the CNS Immunodeficiency-associated CNS lymphoma METASTATIC TUMORS Parenchymal Metastases Leptomeningeal Metastases Dural Metastases Calvarial Metastases CONCLUSION REFERENCES CHAPTER 197 Imaging of Infratentorial Tumors INTRODUCTION CLASSIFICATION OF INFRATENTORIAL TUMORS BASED ON TOPOGRAPHY CEREBELLAR HEMISPHERE AND VERMIS Medulloblastoma Ependymoma Cerebellar Pilocytic Astrocytoma Atypical Teratoid/Rhabdoid Tumor Hemangioblastoma Metastases Dysplastic Cerebellar Gangliocytoma Embryonal Tumor with Multilayered Rosettes C19MC-altered BRAINSTEM AND CERVICOMEDULLARY JUNCTION Brainstem Gliomas Ganglioglioma CEREBELLOPONTINE ANGLE AND INTERNAL AUDITORY CANAL Vestibular Schwannomas Meningiomas Epidermoid and Dermoid Arachnoid Cyst Facial Nerve Schwannomas Cerebellopontine Angle/Internal Auditory Canal Lipomas Metastatic Disease Primary Parenchymal Neoplasms Endolymphatic Sac Tumor FOURTH VENTRICLE Choroid Plexus Papillomas Subependymoma Rosette-forming Glioneuronal Tumor (RGNT) CONCLUSION REFERENCES CHAPTER 198 Sellar and Parasellar Lesions INTRODUCTION NORMAL ANATOMY AND APPLIED PHYSIOLOGY IMAGING MODALITIES Plain Radiography Computed Tomography Magnetic Resonance Imaging PATHOLOGY OF THE SELLAR AND PARASELLAR REGION TUMORS Pituitary Adenoma Types of Adenomas Imaging of Adenomas Atypical Presentations of Adenomas Postoperative Sella Craniopharyngioma Pituicytoma Meningioma Germinoma and Teratoma Dermoid and Epidermoid Tumors Chiasmatic/Hypothalamic Glioma Schwannoma SKULL BASE LESIONS Chordoma Metastasis CONGENITAL AND METABOLIC ABNORMALITIES OF PITUITARY GLAND Developmental Anomalies of Pituitary Gland Pituitary Hypoplasia and Congenital Pituitary Deficiency Disorders Empty Sella Diabetes Insipidus Hemochromatosis TUMOR-LIKE LESIONS Pituitary Hyperplasia Arachnoid Cysts Rathke's Cleft Cysts Tuber Cinereum Hamartoma INFECTIVE CONDITIONS Fungal Infection INFLAMMATORY/GRANULOMATOUS CONDITIONS Langerhans Cell Histiocytosis Lymphocytic Hypophysitis Sarcoidosis Tolosa–Hunt Syndrome VASCULAR LESIONS Aneurysms and Vascular Loops Carotid Cavernous Fistula and Vascular Malformations Sheehan's Syndrome CONCLUSION REFERENCES CHAPTER 199 Intraventricular Lesions INTRODUCTION IMAGING MODALITIES ANATOMY AND PHYSIOLOGY OF VENTRICULAR SYSTEM Lateral Ventricular Lesions Third Ventricular Masses Anterior Third Ventricular Masses Fourth Ventricular Masses CONCLUSION REFERENCES CHAPTER 200 Imaging of the Temporal Bone INTRODUCTION COMPUTED TOMOGRAPHY TECHNIQUE MAGNETIC RESONANCE IMAGING CONGENITAL ANOMALIES OF THE TEMPORAL BONE Anomalies of the External and Middle Ear Inner Ear Abnormalities Temporal Bone Fractures COMPLICATIONS Acquired Cholesteatomas OTHER COMPLICATIONS RADIOLOGICAL EVALUATION OF VASCULAR TINNITUS AND VASCULAR TYMPANIC MEMBRANE Causes of Pulsatile Tinnitus33 Normal Vascular Variants Pathological Vascular Causes Venous Tinnitus Otosclerosis DYSPLASTIC CONDITIONS OF THE TEMPORAL BONE Tumors of the Temporal Bone REFERENCES CHAPTER 201 Imaging of the Globe and Orbit INTRODUCTION NORMAL ANATOMY Radiographic Views Ultrasound Computed Tomography Magnetic Resonance Imaging PATHOLOGICAL CONDITIONS OCULAR LESIONS Ocular Detachments Vitreous Hemorrhage Retinoblastoma Persistent Hyperplastic Primary Vitreous Coats’ Disease Uveal Malignant Melanoma Choroidal Metastases Foreign Body Parasitic Infestation Congenital Anomalies ORBITAL LESIONS ORBITAL TUMORS Hemangioma Lymphangioma Lacrimal Gland Tumors Optic Nerve Glioma Meningioma Rhabdomyosarcoma Lymphoma Schwannoma/Neurofibroma Orbital Metastases Developmental Cysts INFLAMMATORY LESIONS Pseudotumor IgG4-related Orbital Disease Endocrine Orbitopathy Parasitic Cysts VASCULAR LESIONS Caroticocavernous Fistula Orbital Varices Osseous Lesions Trauma REFERENCES CHAPTER 202 Imaging of the Paranasal Sinuses INTRODUCTION PARANASAL SINUS EMBRYOLOGY IMAGING MODALITIES AND TECHNIQUE OF EVALUATION Conventional Radiography Computed Tomography MAGNETIC RESONANCE IMAGING NORMAL ANATOMY AND ANATOMIC VARIATIONS12- Normal Anatomy Anatomic Variations SINONASAL REPORTING INFLAMMATORY SINUS DISEASE Acute Sinusitis Chronic Sinusitis GRANULOMATOUS DISEASES Polyps and Cysts NEOPLASTIC LESIONS OF THE PARANASAL SINUSES Epithelial Tumors of the PNS NONEPITHELIAL TUMOR OF PARANASAL SINUSES Angiofibroma Lymphomas Plasmacytoma Olfactory Neuroblastoma (Olfactory Neuroepithelioma/Esthesioneuroblastoma) Neurogenic Tumors Neurofibromas FIBROSSEOUS LESIONS OF CRANIOFACIAL BONES47,48 Osteoma Ossifying Fibroma Osteoma Ossifying Fibroma Paget's Disease REFERENCES CHAPTER 203 Imaging of the Neck Spaces IMAGING MODALITIES FASCIAL LAYERS OF THE NECK MASTICATOR SPACE Infratemporal Fossa Versus Masticator Space PAROTID SPACE SUBMANDIBULAR SPACE SUBLINGUAL SPACE Floor of the Mouth versus Sublingual Space PHARYNGEAL MUCOSAL SPACE PARAPHARYNGEAL SPACE BUCCAL SPACE RETROPHARYNGEAL SPACE CAROTID SPACE PERIVERTEBRAL SPACE INFRAHYOID NECK VISCERAL SPACE ANTERIOR CERVICAL SPACE POSTERIOR CERVICAL SPACE LESIONS COMMON TO DIFFERENT NECK SPACES Branchial Cleft Anomalies LESIONS OF VASCULAR ORIGIN Capillary Malformations Venous Malformations (VM) Lymphatic Malformations (LM) Arteriovenous Malformations VASCULAR TUMORS Hemangiomas MASSES OF MESENCHYMAL ORIGIN CERVICAL LYMPHADENOPATHY MORPHOLOGICAL CHARACTERISTICS OF LYMPH NODES Reactive Lymphadenopathy Necrotic Lymphadenopathy Calcified Lymphadenopathy Matted Lymphadenopathy Diffuse Lymphadenopathy CONCLUSION REFERENCES CHAPTER 204 Thyroid Imaging INTRODUCTION EMBRYOLOGY ANATOMY ENDOCRINOLOGY CLINICAL MANIFESTATIONS OF THYROID DISEASE IMAGING Plain Radiographs Nuclear Scintigraphy Ultrasonography Technique Appearance US Elastography Cross-sectional Imaging PATHOLOGY OF THE THYROID GLAND Developmental Anomalies Lingual Thyroid Thyroglossal Duct Cyst (TDC) DIFFUSE THYROID DISEASE Diffuse Nontoxic Goiter Graves’ Disease (Diffuse Toxic Goiter) Chronic Autoimmune Lymphocytic (Hashimoto's) Thyroiditis Silent Painless Thyroiditis and Postpartum Thyroiditis Acute Suppurative Thyroiditis Subacute Granulomatous Thyroiditis (de Quervain's disease) Invasive Fibrous Thyroiditis (Riedel's Struma) Miscellaneous Thyroid Conditions NODULAR THYROID DISEASE Multinodular Goiter BENIGN NEOPLASMS Thyroid Adenoma MALIGNANT NEOPLASMS Papillary Carcinoma Follicular Carcinoma Hurthle Cell Neoplasms of the Thyroid Medullary Carcinoma Anaplastic Carcinoma Primary Lymphoma Metastatic Disease Preoperative Staging of Thyroid Carcinoma Evaluation of Nodal Metastasis on CT/MRI Recurrent Thyroid Cancer DIFFERENTIATION OF BENIGN AND MALIGNANT THYROID NODULES High Resolution Gray Scale Ultrasonography US Elastography Contrast-enhanced Ultrasound for Evaluation of Thyroid Nodules Diffusion-weighted MR Imaging (DWMRI) Approach to Incidental Thyroid Nodules Detected on Imaging Approach to a Patient with Thyroid Nodule/Nodules THYROID ULTRASOUND REPORTING LEXICON = THYROID IMAGING REPORTING AND DATA SYSTEM (TIRADS) REFERENCES CHAPTER 205 Malignancies of Upper Aerodigestive Tract ORAL CAVITY Floor of Mouth Oral Tongue Lip Gingivo-alveolus Buccal Mucosa Hard Palate Retromolar Trigone Staging of Oral Cavity Cancers Imaging Modalities Treatment NASOPHARYNX Nasopharyngeal Carcinoma Staging of Nasopharyngeal Carcinoma Imaging Features Treatment OROPHARYNX Carcinoma of Tonsil Carcinoma of Soft Palate Carcinoma of Base of Tongue Staging and Treatment of Carcinoma of Oropharynx HYPOPHARYNX Carcinoma of Posterior Wall of Hypopharynx Carcinoma of the Pyriform Sinus Carcinoma of the Postcricoid Treatment LARYNX Supraglottic Carcinoma Glottic Carcinoma Subglottic Carcinoma Imaging Protocol Cartilage Invasion Treatment CERVICAL LYMPH NODES Imaging Management Cervical Lymphadenopathy with Carcinoma of Unknown Primary Site (CUPS) Distant Metastases and Second Primary Tumors POSITRON EMISSION TOMOGRAPHY-COMPUTED TOMOGRAPHY MISCELLANEOUS TUMORS Minor Salivary Gland Tumors Rhabdomyosarcoma Lymphoma POST-TREATMENT IMAGING Post-radiotherapy Neck Late Effects of Radiotherapy Postoperative Neck REFERENCES CHAPTER 206 Imaging of Skull Base Lesions INTRODUCTION ANATOMICAL DIVISION2 IMAGING TECHNIQUES AND THEIR ROLE ANTERIOR SKULL BASE Anatomy Pathology Lesions Arising from Below Lesions Arising from Above Lesions of the Proper Skull Base MIDDLE SKULL BASE Anatomy Pathology POSTERIOR SKULL BASE Anatomy Pathology DIFFUSE/NON-SITE-SPECIFIC SKULL BASE LESIONS CONCLUSION REFERENCES CHAPTER 207 Maxillofacial Imaging: Imaging of Cysts, Tumors and Tumor-like Conditions of the Jaw IMAGING MODALITIES Plain Radiography Computed Tomography Magnetic Resonance Imaging CLASSIFICATION CLINICAL FEATURES RADIOLOGICAL FEATURES/APPROACH ANATOMICAL LOCATION Site Relation to Dentition Relation to Mandibular Canal SIZE SHAPE DENSITY AND INTERNAL ARCHITECTURE OF LESION OUTLINE/DEFINITION/MARGINATION EFFECT ON SURROUNDING STRUCTURES Teeth Surrounding Bone Surrounding Soft Tissues WELL-DEFINED RADIOLUCENT LESIONS Jaw Cysts Tumors or Tumor-like Conditions RADIOLUCENT LESIONS WITH ILL-DEFINED MARGINS Osteomyelitis Malignant Tumors Primary Tumors MIXED-DENSITY LESIONS Odontogenic Lesions Non-odontogenic Lesions RADIOPAQUE LESIONS Odontogenic Lesions Non-odontogenic Lesions CONCLUSION REFERENCES CHAPTER 208 Craniovertebral Junction Anomalies INTRODUCTION ANATOMY AND EMBRYOLOGY Skeletal Anatomy (Figs. 1A to D) Ligamentous Anatomy (Figs. 2A and B) Embryology BIOMECHANICS CLINICAL PRESENTATION CRANIOMETRY (TABLES 1 AND 2) CLASSIFICATION OF CVJ ANOMALIES11,12 Congenital Anomalies and Malformations of the Craniovertebral Junction Developmental and Acquired Abnormalities of the CVJ INCIDENCE NEURORADIOLOGIC INVESTIGATIONS SPECIFIC CONDITIONS Basilar Invagination Assimilation of Atlas Atlas Arch Anomalies Dens Dysplasias Os Terminale Os Odontoideum Atlantoaxial Instability Classification of AAI Inflammatory, Arthritic and Infectious Disorders TRAUMA SYNDROMES INVOLVING THE CVJ35 Klippel-Feil Syndrome Down Syndrome Arnold-Chiari Malformation Achondroplasia Mucopolysaccharidoses Osteogenesis Imperfecta SUMMARY REFERENCES CHAPTER 209 Endovascular Management of Craniofacial Vascular Lesions INTRODUCTION Embolization Techniques EMBOLIC AGENTS PRETHERAPEUTIC EVALUATION IMPORTANT ANATOMIC CONSIDERATIONS POSTEMBOLIZATION CARE NASOPHARYNGEAL ANGIOFIBROMAS PARAGANGLIOMA CRANIOFACIAL VASCULAR ANOMALIES Vascular Tumor Vascular Malformations Aneurysms MISCELLANEOUS LESIONS Epistaxis SUMMARY REFERENCES CHAPTER 210 Imaging of Head Trauma TBI CLASSIFICATION Broad Classification According to Location of Lesions According to Mechanism According to Clinical Severity (According to Glasgow Coma Scale) Marshall CT Classification of Head Injury (HI) Categories GOALS OF NEUROIMAGING IMAGING TECHNIQUES Plain Radiographs Advanced Neuroimaging Techniques Summary of Imaging Recommendations Evidence-based Guidelines for Imaging Patients with Head Injury Imaging Guidelines for Pediatric Head Injury IMAGING FINDINGS Scalp Injury Skull Fractures Recommendations Temporal Bone Fractures Types of Temporal Bone Fractures22 (Figs. 8A and B) PRIMARY HEAD INJURY LESIONS Extra-axial Injury9,23 Traumatic Subarachnoid Hemorrhage Subcortical (Deep Brain) Injury SECONDARY HEAD INJURY Acute Secondary Changes Chronic Secondary Changes CONCLUSION REFERENCES CHAPTER 211 Imaging of Facial Trauma INTRODUCTION IMAGING TECHNIQUES FACIAL BUTTRESSES AND REGIONAL CLASSIFICATION OF INJURIES5,6 Importance of Facial Buttresses20 CLASSIFICATION OF MAXILLOFACIAL FRACTURES Regional Facial Fractures Nasal Fractures Mandibular Fractures Skull Base Fractures PEDIATRIC FACIAL FRACTURES CLINICAL ASPECTS OF MAXILLOFACIAL IMAGING ACKNOWLEDGMENTS REFERENCES CHAPTER 212 Imaging of Acute Spinal Trauma INTRODUCTION IMAGING INDICATIONS OF THE TRAUMATIC SPINE IMAGING MODALITIES Plain Radiography Computed Tomography Magnetic Resonance Imaging Advances in Magnetic Resonance Imaging CLASSIFICATION OF SPINAL TRAUMA Level of Injury Severity of Injury Mechanism of Injury Stable versus Unstable Fracture RADIOLOGICAL INTERPRETATION OF SPINAL TRAUMA (ABCS) NEW RADIOLOGICAL CLASSIFICATION SYSTEMS CERVICAL SPINE INJURY Upper Cervical Spine Injuries Lower Cervical Spine Injury (C3-C7) THORACOLUMBAR SPINE INJURY Compression or Wedge Fracture Burst Fracture Lap Seat-belt Type Fracture or Chance Fracture Fracture Dislocation NONOSSEOUS INJURY Spinal Cord Injuries Intervertebral Disk Injury Ligamentous Injury Epidural and Subdural Hemorrhage Nerve Root Avulsion Vascular Injury SUBACUTE AND CHRONIC INJURIES SPINAL CORD INJURY WITHOUT RADIOGRAPHIC ABNORMALITY Whiplash Injury OSSEOUS VARIANTS THAT MAY SIMULATE INJURY33 Variants of the Atlas (C1) Variants of the Axis (C2) Anterior Subluxation of C2 on C3 Variants of C3 through L5 Verterba SUMMARY ACKNOWLEDGMENT REFERENCES CHAPTER 213 Spinal Neoplasm INTRODUCTION CLASSIFICATION OF LESIONS Intramedullary Tumors Intradural-extramedullary Tumors Extradural Tumors INTRAMEDULLARY TUMORS Ependymomas Myxopapillary Ependymoma Subependymoma Astrocytomas Gangliogliomas Atypical Teratoid/Rhabdoid Tumors Hemangioblastomas Paraganglioma Intramedullary Lymphoma Intramedullary Metastases INTRADURAL EXTRAMEDULLARY TUMORS Meningiomas Nerve Sheath Tumors Intradural Metastases (Leptomeningeal Metastases) EXTRADURAL TUMORS Multiple Lesions Multiple Myeloma Lymphoma Vertebral Hemangiomas Typical Vertebral Hemangiomas Atypical Vertebral Hemangiomas Aggressive Vertebral Hemangiomas Solitary Lesions Giant Cell Tumor Osteoid Osteoma Osteoblastoma Osteochondromas Chordoma Chondrosarcoma Fibrous Dysplasia EPIDURAL LESIONS Angiolipoma Epidural Lipomatosis CONCLUSION REFERENCES CHAPTER 214 Spinal Vascular Malformations INTRODUCTION Classification EXTRADURAL ARTERIOVENOUS FISTULAE (EPIDURAL FISTULAE) DORSAL INTRADURAL ARTERIOVENOUS FISTULA (SPINAL DURAL ARTERIOVENOUS FISTULA) VENTRAL INTRADURAL AVF (SPINAL CORD AVF, SCAVF, PERIMEDULLARY AVF) EXTRADURAL-INTRADURAL ARTERIOVENOUS MALFORMATIONS (JUVENILE/METAMERIC AVM) INTRAMEDULLARY AVM (GLOMUS AVM) CONUS MEDULLARIS AVM CAVERNOUS ANGIOMAS (CAVERNOMA) OF SPINAL CORD OTHER LESIONS CONCLUSION ACKNOWLEDGMENT SUGGESTED READING CHAPTER 215 Imaging of Low Backache IMAGING OF LOW BACK PAIN When to Image? CONDITIONS CAUSING BACK PAIN IMAGING MODALITIES Radiographs Magnetic Resonance Imaging, Computed Tomography, Myelography and Myelography/CT Magnetic Resonance Imaging COMPUTED TOMOGRAPHY Myelography/CT Discography and CT Discography Isotope Bone Scan TRANSITION VERTEBRA SPONDYLOLYSIS AND SPONDYLOLISTHESIS Imaging Scheuermann's Disease DEGENERATIVE DISEASES OF LUMBAR SPINE Degenerative Changes in the Anterior Elements Degenerative Changes in the Posterior Elements Complications of Degenerative Spinal Disease Presentation DEGENERATIVE CHANGE OF THE NUCLEUS PULPOSUS Normal Disk MR Appearance of Normal Disk Abnormal Nucleus Annular Fissures Disk Herniation (Abnormalities in Disk Morphology) Location of Focal Disk Abnormalities Significance of Disk Contour Abnormalities Intraosseous Disk Herniations OSSEOUS DEGENERATIVE CHANGES Vertebral Bodies Osteophytes Endplates Facet Joints Posterior Spinous Processes Spinal Stenosis Central Canal Stenosis Lateral Recess Stenosis Neural Foramen Stenosis Postoperative Changes Failed Back Syndrome Postoperative Imaging after Intervertebral Fusion and Instrumentation Seronegative Spondyloarthropathy INFECTIONS Tubercular Infection Pyogenic Infection TUMORS Benign Tumors MALIGNANT TUMORS Chordoma Chondrosarcoma Metastases Osteoporotic Collapse versus Neoplastic Collapse Multiple Myeloma Lymphoma REFERENCES CHAPTER 216 Localization in Clinical Neurology LOCALIZATION IN CLINICAL NEUROLOGY Clinical Diagnosis and Lesion Localization APPROACH TO NEUROLOGICAL DISORDER DISORDERS OF CRANIAL NERVES OLFACTORY NERVE (CRANIAL NERVE I) Anosmia OPTIC NERVE (CRANIAL NERVE II) Visual 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) FACIAL NERVE (CRANIAL NERVE VII) Localization of Facial Nerve Lesions (Fig. 3) VESTIBULOCOCHLEAR NERVE (CRANIAL NERVE VIII) GLOSSOPHARYNGEAL AND VAGUS NERVE (CRANIAL NERVE IX, X) SPINAL ACCESSORY NERVE (CRANIAL NERVE XI) HYPOGLOSSAL NERVE (CRANIAL NERVE XII) DISORDERS OF MOTOR SYSTEM Muscle Bulk Power Testing Muscle Tone Spasticity Reflexes Abnormalities of Tendon Reflexes Superficial Reflexes Other Important Reflexes Coordination Sensory System Gait DISORDERS OF HIGHER MENTAL FUNCTION DISORDERS OF SPEECH Dysarthria Dysphasia APRAXIA AGNOSIA Visual Agnosia Tactile Agnosia Auditory Agnosia PARIETAL LOBE DYSFUNCTIONS CONCLUSION SUGGESTED READING CHAPTER 217 Basic Neuropathology REMOVAL OF THE BRAIN FROM SKULL REMOVAL OF VENOUS SINUS, CAVERNOUS SINUS AND MIDDLE EAR EXAMINATION EXAMINATION OF THE BRAIN Slicing of Brain Appearance of the Ventricles Choice of Blocks for Histology INFECTIONS Routes of Infection Leptomeningitis Subdural Empyema Brain Abscess Purulent Encephalitis Associated with Subacute Bacterial Endocarditis Viral Encephalitis (Fig. 10) NEUROVASCULAR DISEASES Arterial Infarcts or Territorial Infarcts Practical Considerations Demyelinating Disease and Multiple Sclerosis Inherited Metabolic Diseases TUMORS Postmortem Examination of Brain with Tumor WHO Classification of CNS Tumors 2016 Update SUGGESTED READING Appendices APPENDIX A: HUNT-HESS GRADING OF SAH APPENDIX B: GLASGOW COMA SCALE APPENDIX C: WFNS SCALE APPENDIX D: COOPERATIVE ANEURYSM STUDY NEUROLOGICAL STATUS SCALES APPENDIX E: COGNARD CLASSIFICATION OF DURAL ARTERIOVENOUS SHUNTS APPENDIX F: BORDEN CLASSIFICATION OF CRANIAL DURAL AVF APPENDIX G: FISHER GRADE OF CEREBRAL VASOSPASM RISK IN SUBARACHNOID HEMORRHAGE APPENDIX H: MODIFIED FISHER CT SAH RATING SCALE APPENDIX I: SPETZLER-MA RTIN INTRAC RANIAL AVM GRADING SCALE APPENDIX J: WHO CLASSIFICA TION OF TUMORS OF THE CENTRAL NERVOUS SYSTEM APPENDIX K: WHO GRADES OF SELECT CNS TUMORS APPENDIX L APPENDIX M: INTERNATIONAL LEAGUE AGAINST EPILEPSY (ILAE) CLASSIFICATION OF EPILEPSY APPENDIX N: NIH STROKE SCALE APPENDIX O: MODIFIED RANKIN SCALE (MRS) Index A B C D E F G H I J K L M N O P Q R S T U V W X Y Z