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دانلود کتاب Grainger & Allison’s Diagnostic Radiology. A Textbook of Medical Imaging
دانلود کتاب رادیولوژی تشخیصی گرینگر و آلیسون. کتاب درسی تصویربرداری پزشکی
مشخصات کتاب
Grainger & Allison’s Diagnostic Radiology. A Textbook of Medical Imaging
ویرایش: [Volume 1, 7 ed.] نویسندگان: Andreas Adam, Adrian K. Dixon, Jonathan H. Gillard, Cornelia M. Schaefer-Prokop سری: ISBN (شابک) : 9780702075247 ناشر: Elsevier سال نشر: 2021 تعداد صفحات: [2218] زبان: English فرمت فایل : PDF (درصورت درخواست کاربر به PDF، EPUB یا AZW3 تبدیل می شود) حجم فایل: 1 Gb
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فهرست مطالب
Cover Grainger & Allison’s Diagnostic Radiology Copyright Page Table Of Contents Preface List of Section Editors List of Contributors Dedication SECTION A The Chest and Cardiovascular System 1 Current Status of Thoracic Imaging Chapter Outline Chest Radiography Equipment Considerations Radiographic Projections Portable Chest Radiography Novel Radiographic Techniques Computed Tomography of the Thorax Principles From Single-Slice to Multidetector Computed Tomography High-Resolution Computed Tomography Intravenous Contrast Medium Enhancement and Timing of Computed Tomography Acquisition Additional Postprocessing Techniques Dual-Energy Computed Tomography Computed Tomography Dose Considerations Low-Dose Computed Tomography Ultrasound Endoscopic and Endobronchial Ultrasound Magnetic Resonance Imaging Radionuclide Imaging Ventilation–Perfusion Scintigraphy Positron Emission Tomography Further Reading 2 The Normal Chest Chapter Outline The Lungs The Central Airways The Lungs Beyond the Hila The Hila The Mediastinum Computed Tomography and Magnetic Resonance Imaging Radiographic Appearances Junction Lines Right Mediastinum Above the Azygos Vein Left Mediastinum Above the Aortic Arch Trachea and Retrotracheal Area in the Lateral View Supra-Aortic Mediastinum on the Lateral View Right Middle Mediastinal Border Below the Azygos Arch Left Cardiac Border Below the Aortic Arch Paraspinal Lines Retrosternal Line The Diaphragm Further Reading 3 The Chest Wall, Pleura, Diaphragm and Intervention Chapter Outline The Chest Wall Soft Tissues Breasts Muscles Soft-Tissue Calcification Subcutaneous Emphysema Bony Structures Ribs Sternum Clavicles Scapula Spine Chest Wall Tumours Soft-Tissue Tumours Bone Tumours The Pleura Pleural Effusion Imaging Pleural Effusion Chest Radiograph Free pleural fluid. Loculated (encysted, encapsulated) pleural fluid. Pleural effusion in the supine patient. Ultrasound Computed Tomography Magnetic Resonance Imaging Positron-Emission Tomography/Computed Tomography Some Specific Pleural Effusions Exudates and Transudates Empyema Chylothorax Haemothorax Hepatic Hydrothorax Bronchopleural Fistula Pneumothorax Imaging Pneumothorax Chest Radiography Typical Signs. Atypical Signs Ultrasound Computed Tomography Primary Spontaneous Pneumothorax Secondary Spontaneous Pneumothorax Complications Haemopneumothorax Tension Pneumothorax Pyopneumothorax Adhesions Reexpansion Oedema Pleural Thickening and Tumours Imaging Pleural Thickening and Tumours Chest Radiography Ultrasound Computed Tomography Magnetic Resonance Imaging Positron-Emission Tomography/Computed Tomography Pleural Plaques Diffuse Pleural Disease Pleural Tumours Pleural Fibroma Pleural Lipoma Malignant Mesothelioma (Primary Pleural Malignancy) Pleural Metastases (Secondary Pleural Malignancy) Tumour-Like Conditions of the Pleura Pleural Calcification Intervention Chest Wall Intervention Pleural Intervention Pleural Aspiration Chest Drains Pleural Biopsy Complications of Image-Guided Pleural Intervention Intercostal artery injury. Iatrogenic pneumothorax. Iatrogenic infection. Diaphragm Imaging the Diaphragm Chest Radiograph Ultrasound Computed Tomography Magnetic Resonance Imaging Eventration Movement and Paralysis Diaphragmatic Hernias Diaphragmatic Trauma Neoplasms of the Diaphragm Further Reading Classic Books/Articles Recent Journal Articles 4 The Mediastinum, Including the Pericardium Chapter Outline Mediastinal Diseases Mediastinal Masses Incidence Imaging Techniques Radiography Computed Tomography Magnetic Resonance Imaging Ultrasound Radionuclide Examinations Approach to Mediastinal Masses Localise to the Mediastinum Localise Within the Mediastinum Characterise on Computed Tomography or Magnetic Resonance Imaging Thyroid Masses Parathyroid Masses Thymic Tumours Thymomas Thymic Carcinoma Thymic Neuroendocrine Tumour (Thymic Carcinoid) Thymolipomas Lymphofollicular Thymic Hyperplasia and Rebound Thymic Hyperplasia Thymic Cyst Germ-Cell Tumours of the Mediastinum Teratomas Seminoma Non-Seminomatous Germ-Cell Tumours Mediastinal Lymphadenopathy Malignant Lymphoma and Leukaemia Lymph Node Calcification Low-Attenuation Nodes Enhancing Lymph Nodes Lymph Node Enlargement Sarcoidosis. Tuberculosis and histoplasmosis. Metastatic carcinoma. Reactive hyperplasia. Thoracic lymphadenopathy in AIDS. Foregut Duplication Cysts Bronchogenic Cysts Oesophageal Duplication Cysts Neurenteric Cysts Mediastinal Pancreatic Pseudocyst Neurogenic Tumours Peripheral Nerve Sheath Tumours Sympathetic Ganglion Tumours Mediastinal Paragangliomas Lateral Thoracic Meningocele Extramedullary Haematopoiesis Mesenchymal Tumours and Tumour-Like Conditions Lymphangiomas (Cystic Hygromas) Haemangiomas Fatty Lesions in the Mediastinum Mediastinal Lipomatosis Fatty Tumours of the Mediastinum Fat-Containing Hernias Other Mediastinal Lesions Acute Mediastinitis Fibrosing Mediastinitis Mediastinal Haemorrhage Pneumomediastinum Pericardium Imaging Pericardial Disease Developmental Anomalies Congenital Absence of the Pericardium Pericardial Cysts Acquired Pericardial Disease Pericardial Effusion Cardiac Tamponade Pericarditis Constrictive Pericarditis Pericardial Neoplasms Acknowledgement Further Reading 5 Pulmonary Infection in Adults Chapter Outline Types of Pneumonias Community-Acquired Pneumonia (CAP) (Box 5.1) Hospital-Acquired Pneumonia (HAP) Ventilator-Associated Pneumonia (VAP) Health Care–Associated Pneumonia (HCAP) Aspiration Pneumonia Clinical Utility and Limitations of Chest Radiography and Computed Tomography Computed Tomography Patterns of Pulmonary Infection Complications of Pneumonia Integrating Clinical and Imaging Findings Lobar Pneumonia Most Common Organisms Streptococcus pneumoniae. Klebsiella. Legionella sp. Chlamydia. Moraxella catarrhalis. Immunocompromised Host Nocardia sp. Actinomyces sp. Endemic in Certain Geographic Areas Coxiella burnetii (Rickettsial Pneumonia). Francisella tularensis. Bronchopneumonia Most Common Organisms Staphylococcus aureus. Escherichia coli. Pseudomonas aeruginosa. Haemophilus influenzae. Atypical Pneumonia Mycoplasma pneumoniae. Viral Influenza A. Adenovirus. Respiratory syncytial virus (RSV). Epstein–Barr virus (EBV). Varicella-zoster virus. Herpes simplex virus type 1 (HSV 1). Hantaviruses. Cytomegalovirus (CMV). New Emerging Viruses Human metapneumovirus (hMPV). Severe acute respiratory syndrome coronavirus. Middle East respiratory syndrome. Avian flu (H5N1). Swine influenza (H1N1). Changing Spectrum of Human Immunodeficiency Virus Infections: 40 Years Later Mycobacterium tuberculosis Primary Tuberculosis Reactivation and Reinfection Tuberculosis Pulmonary Non-Tuberculous Mycobacteria (NTMB) Fungal Infection Aspergillus Infection Candidiasis Pneumocystis jiroveci Mucormycosis Cryptococcosis Histoplasmosis Coccidioidomycosis Paracoccidioidomycosis (South American Blastomycosis) North American Blastomycosis Parasitic Infections Protozoa Amoebiasis Malaria Nematodes Dirofilariasis Ascariasis Strongyloidiasis Trypanosomiasis Cysticercosis Toxocariasis Cestodes Echinococcosis (Hydatid Disease) Trematodes Paragonimiasis Schistosomiasis Further Reading 6 Large Airway Disease and Chronic Airflow Obstruction Chapter Outline Introduction Tracheal Disorders Post-Traumatic Strictures Infectious Tracheobronchitis Primary Malignant Neoplasms Secondary Malignant Neoplasms Benign Neoplasms Wegener Granulomatosis Relapsing Polychondritis Tracheobronchial Amyloidosis Sarcoidosis Inflammatory Bowel Disease Tracheobronchopathia Osteochondroplastica Sabre-Sheath Trachea Tracheobronchomegaly (Mounier-Kuhn Disease) Tracheobronchomalacia Tracheobronchial Fistula and Dehiscence Bronchiectasis Radiographic Findings Computed Tomographic Findings Accuracy of Computed Tomography Cystic Fibrosis Allergic Bronchopulmonary Aspergillosis Diskinetic Cilia Syndrome Broncholithiasis Obliterative (Constrictive) Bronchiolitis Pathological Features Radiological Findings Computed Tomography Assessment of Air Trapping Chronic Obstructive Pulmonary Disease Pathological Findings Radiographic Findings Computed Tomographic Findings Visually Defined Computed Tomography Pattern of Emphysema Visually Defined Computed Tomography Patterns of Airway Diseases Associated Features Quantitative Computed Tomography Image Analysis Quantitative Analysis of Emphysema Extent Quantitative Computed Tomography Analysis of Gas Trapping Quantitative Analysis of Airway Dimensions Asthma Radiographic Findings Computed Tomography Findings Quantitative Computed Tomography Imaging of Airways in Asthma Further Reading 7 Pulmonary Lobar Collapse Chapter Outline Mechanisms and Causes of Lobar Collapse Radiographic Considerations Direct Signs of Volume Loss Indirect Signs of Volume Loss Ancillary Features of Lobar Collapse Computed Tomography of Lobar Collapse Technique Utility Potential Pitfalls Other Imaging Techniques in Lobar Collapse Patterns of Lobar Collapse Right Upper Lobe Collapse Left Upper Lobe Collapse Right Middle Lobe Collapse Right and Left Lower Lobe Collapse Whole Lung Collapse Combinations of Lobar Collapse Further Reading 8 Pulmonary Neoplasms Chapter Outline Histopathology Treatment-Predictive Biomarkers Epidermal Growth Factor Receptor KRAS Anaplastic Lymphoma Kinase ROS1 BRAF Programmed Cell Death Ligand 1 Re-biopsy Lung Cancer and Other Environmental Factors Smoking Passive Smoking General Environmental Pollutants Asbestos Radon Lung Cancer Screening Chest Radiographic Screening Computed Tomography Screening Radiation Dose Considerations The Future of Screening Pulmonary Nodules Management of Small Pulmonary Nodules Nodule Size and Growth Rate Location, Shape and Morphology Nodule Contour Nodule Density Subsolid Nodules Pericystic Tumours Other Forms of Nodule Assessment Nodule Enhancement Positron Emission Tomography/Computed Tomography Tissue Sampling Lung Cancer Staging—the 8Th Edition of the TNM Staging System Additional Pulmonary Nodules in the Presence of Lung Cancer N Descriptors M Descriptors Small Cell Lung Cancer Bronchopulmonary Carcinoid Tumour Summary Imaging Protocols for Lung Cancer Staging The Current Standards of Computer Tomography Technology Imaging Features of Bronchogenic Carcinoma Peripheral Tumours Tumour Shape and Margins Cavitation Calcification Other Findings Central Tumours Collapse/Consolidation in Association With Central Tumours Staging Intrathoracic Spread of Bronchial Carcinoma Hilar Enlargement Mediastinal Invasion Chest Wall Invasion Pleural Involvement Summary Extrathoracic Staging of Lung Cancer Pulmonary Sarcoma and Other Primary Malignant Neoplasms Benign Pulmonary Tumours Hamartoma Other Benign Pulmonary Neoplasms Leiomyoma Inflammatory Myofibroblastic Tumour Sclerosing Haemangioma Squamous Papillomas Benign Lymphoproliferative Disorders Lymphocytic Interstitial Pneumonia Follicular Bronchiolitis Malignant Lymphoproliferative Disorders Lymphoma Other Findings in Pulmonary Lymphoma Leukaemia Metastases Lymphangitic Carcinomatosis Unusual Patterns of Metastatic Cancer Endobronchial Metastases Miliary Metastases Tumour Emboli Further Reading 9 High-Resolution Computed Tomography of Interstitial and Occupational Lung Disease Chapter Outline High-Resolution Computed Tomography Patterns of Diffuse Lung Disease Reticular Pattern Nodular Pattern Mosaic Attenuation Pattern Cystic Pattern Idiopathic Interstitial Pneumonias Usual Interstitial Pneumonia/Idiopathic Pulmonary Fibrosis Classical HRCT Findings Non-Specific Interstitial Pneumonia Classical HRCT Findings Cryptogenic Organising Pneumonia Respiratory Bronchiolitis–Interstitial Lung Disease and Desquamative Interstitial Pneumonia Classical HRCT Findings Acute Interstitial Pneumonia/Diffuse Alveolar Damage Classical HRCT Findings Lymphoid Interstitial Pneumonia Classical HRCT Findings Idiopathic Pleuroparenchymal Fibroelastosis Classical HRCT Findings Sarcoidosis Lymphadenopathy Parenchymal Changes High-Resolution Computed Tomography Features Classical HRCT Findings Hypersensitivity Pneumonitis Classical HRCT Findings Langerhans Cell Histiocytosis Classical HRCT Findings Lymphangioleiomyomatosis Classical HRCT Findings Connective Tissue Diseases Rheumatoid Disease Classical HRCT Findings Sjögren Syndrome Classical HRCT Findings Progressive Systemic Sclerosis (Scleroderma) Classical HRCT Findings Polymyositis/Dermatomyositis Classical HRCT Findings Systemic Lupus Erythematosus Classical HRCT Findings Systemic Vasculitides Eosinophilic Granulomatosis With Polyangiitis (Formerly Churg–Strauss Syndrome) Classical HRCT Findings Microscopic Polyangiitis Classical HRCT Findings Drug-Induced Lung Disease Diffuse Alveolar Damage Interstitial Pneumonia Organising Pneumonia Eosinophilic Pneumonia Classical HRCT Findings Occupational Lung Disease The International Labour Office Classification Silicosis/Coal Worker’s Pneumoconiosis Classical HRCT Findings Asbestos-Related Disease Benign Pleural Effusions Pleural Plaques Diffuse Pleural Thickening Round Atelectasis Asbestosis Classical HRCT Findings Further Reading 11 Airspace Diseases Chapter Outline Introduction Suggested Approach to the Radiological Diagnosis of Airspace Diseases Anatomical Considerations Radiological Signs of Airspace Disease Pulmonary Oedema Chest Radiography in Pulmonary Oedema Vascular Alterations Interstitial Oedema Alveolar Oedema Radiographic Differentiation of Cardiogenic and Non-Cardiogenic Oedema Computed Tomography in Pulmonary Oedema Diffuse Pulmonary Haemorrhage Idiopathic Pulmonary Haemosiderosis Antibasement Membrane Antibody Disease (Goodpasture’s Syndrome) Granulomatosis With Polyangiitis (GPA; Formerly Wegener’s Granulomatosis) Organising Pneumonia Eosinophilic Lung Disease Simple Pulmonary Eosinophilia (Löffler’s Syndrome) Acute Eosinophilic Pneumonia (AEP) Chronic Eosinophilic Pneumonia Pulmonary Alveolar Proteinosis Alveolar Microlithiasis Further Reading 12 Cardiac Anatomy and Imaging Techniques Chapter Outline Normal Chest Radiography Cardiac Magnetic Resonance Cardiac Axis Imaging Planes Body Axes Imaging Planes Normal Anatomy on Cardiac Magnetic Resonance Images Computed Tomography Imaging Techniques Computed Tomography Imaging of Ventricles and Myocardial Tissue Coronary Arteries by Computed Tomography Valves Pulmonary Veins Other Structures Echocardiography Valves Acknowledgement Further Reading 13 Congenital Heart Disease Chapter Outline Introduction Clinical Presentation Later Clinical Presentation Morphological Description and Sequential Segmental Analysis Sequential Segmental Analysis Step 1—Atrial Situs Step 2—Ventricular Morphology Step 3—Ventriculo-Arterial Connection Step 4—Identification of Other Abnormalities Physiological and Functional Assessment Non-Invasive Imaging Techniques Echocardiography Magnetic Resonance Imaging Computed Tomography Conventional Radiology Diagnostic Features The Pulmonary Vasculature Heart Size, Shape and Position Specific Lesions Acyanotic Lesions Septal Defects Atrial Septal Defects Key imaging goals Atrioventricular Septal Defects Key imaging goals Ventricular Septal Defects Key imaging goals Abnormalities of the Great Vessels Patent Ductus Arteriosus Key imaging goals Coarctation of the Aorta Key imaging goals Interrupted Aortic Arch Key imaging goals Abnormalities of the Aortic Arch and Vascular Rings Key imaging goals Valvular Heart Disease Aortic Valve Disease Key imaging goals Pulmonary Valve Disease Key imaging goals Ebstein Anomaly of the Tricuspid Valve Key imaging goals Coronary Artery Abnormalities Anomalous Coronary Arteries Key imaging goals Cyanotic Congenital Heart Disease Tetralogy of Fallot Key imaging goals Transposition of the Great Arteries Key imaging goals Congenitally Correct Transposition of the Great Arteries Key imaging goals Pulmonary Atresia Pulmonary atresia with a ventricular septal defect. Key imaging goals Pulmonary atresia with an intact ventricular septum. Double Outlet Right Ventricle Key imaging goals Common Arterial Trunk Key imaging goals Anomalous Pulmonary Venous Connection/Drainage Key imaging goals Single Ventricles Systemic to Pulmonary Artery Shunt Key imaging goals following stage 1: pre-bidirectional cavopulmonary connection (pre-BCPC) Bidirectional Glenn Circulation Key imaging goals following stage 2: pre-total cavopulmonary connection (pre-TCPC) Fontan Circulation Key imaging goals following stage 3: post-total cavopulmonary connection (post-TCPC) Recent Developments in Cardiac Magnetic Resonance Imaging Hybrid Catheter/Cardiac Magnetic Resonance Imaging Laboratory Fetal Cardiac Magnetic Resonance Imaging Post-Mortem Cardiac Magnetic Resonance Imaging Three-Dimensional Printing Conclusion Further Reading 14 Nonischaemic Acquired Heart Disease Chapter Outline Role of Imaging Chest Radiography (CXR) Echocardiography Magnetic Resonance Imaging Computed Tomography Cardiomyopathies Hypertrophic Pattern Dilated Phenotype Restrictive Phenotype Arrhythmogenic Right Ventricular Cardiomyopathy Unclassified Cardiomyopathy Myocarditis Valvular Heart Disease Mitral Valve Disease Mitral Valve Prolapse Chordal Rupture Functional Mitral Regurgitation Mitral Stenosis Rheumatic Mitral Valve Disease Tricuspid Valve Disease Aortic Valve Disease Aortic Stenosis Aortic Regurgitation New Magnetic Resonance Imaging Techniques Prosthetic Cardiac Valves Complications of Prosthetic Valves Structure Fracture Porcine Bioprosthesis Infective Endocarditis Valve Regurgitation Thromboembolism Tumours of the Heart Metastasis Primary Cardiac Tumours Benign Cardiac Tumours Cardiac Myxoma Lipomas Rhabdomyomas Fibroma Papillary Fibroelastoma Haemangioma Hydatid Disease Malignant Cardiac Tumours Primary Malignant Tumours of the Heart Sarcomas Sarcomas with myofibroblastic differentiation. Rhabdomyosarcoma. Lymphoma Pericardial Diseases Anatomy Pericardial Cysts Pericardial Defects Pericardial Diverticulum Pericardial Effusion Pericardial Inflammation Constrictive Pericarditis Pericardial Masses Further Reading 16 Pulmonary Circulation and Pulmonary Thromboembolism Chapter Outline Pulmonary Circulation Pulmonary Circulation Anatomy Pulmonary Arteries Pulmonary Veins Bronchial Arteries Pulmonary Circulation Physiology Pulmonary Vascular Patterns Pulmonary Venous Hypertension Vascular Redistribution (Grade 1) Interstitial Oedema (Grade 2) Alveolar Oedema (Grade 3) Pulmonary Arterial Hypertension Vascular Signs Cardiac Signs Parenchymal Signs Pulmonary Arteriovenous Malformations Pulmonary Thomboembolic Disease Acute Pulmonary Thromboembolism Background Diagnosis Clinical (Pre-Test) Probability Estimate and D-Dimer Testing Imaging Findings Plain Chest Radiography Transthoracic or Transoesophageal Ultrasound (Echocardiography) Conventional Pulmonary Angiography Compression Ultrasound of the Legs Ventilation–Perfusion Scintigraphy Computed Tomography Pulmonary Angiography Computed tomography pulmonary angiography protocol. Combined protocols: one-stop-shop procedure. Computed tomography pulmonary angiography during pregnancy. Computed tomography pulmonary angiography assessment. Computed tomography perfusion. Magnetic Resonance Imaging Diagnostic Strategies Chronic Pulmonary Thromboembolism Conclusion Acknowledgements Further Reading 15 Ischaemic Heart Disease Chapter Outline Introduction Pathophysiology of Ischaemic Heart Disease Coronary Artery Imaging Functional Imaging Stress Imaging Myocardial Infarct Imaging Myocardial Viability Imaging Imaging of Complications Related to Ischaemic Heart Disease Prognosis Assessment in Ischaemic Heart Disease Role of Conventional Chest Radiography in Ischaemic Heart Disease Differential Diagnosis in Ischaemic Heart Disease Further Reading 17 The Thoracic Aorta Chapter Outline The Normal Aorta Diagnostic Aspects Chest X-Ray and Echocardiography Angiography Computed Tomography and Magnetic Resonance Imaging Acute Diseases Chronic Diseases Acquired Aortic Abnormalities Acute Aortic Syndrome Aortic Dissection Classification Imaging Magnetic resonance imaging. Computed tomography. Intramural Haematoma Magnetic Resonance Imaging Computed Tomography Penetrating Atherosclerotic Ulcer Traumatic Aortic Injury Imaging Magnetic resonance imaging. Computed tomography. Aortic Aneurysms Atherosclerotic Aortic Aneurysms Thoracic Aneurysms Magnetic resonance imaging. Computed tomography. Abdominal Aneurysms Inflammatory Aneurysms Computed tomography. Magnetic resonance imaging. Mycotic Aneurysms Aortic Sinus Aneurysms Preoperative Evaluation of Acute Aortic Syndromes Impending Aortic Rupture Visceral Malperfusion Preoperative or Preinterventional Evaluation Postoperative Evaluation Management of Aortic Diseases Traumatic Aortic Injury Aortic Dissection Type A dissection. Type B dissection. Endovascular treatment of type B dissection. Inflammatory Diseases of the Aorta and Midaortic Syndrome Midaortic Syndrome Granulomatous vasculitis (Takayasu disease). Imaging. Prognosis and treatment. Von Recklinghausen disease (type 1 neurofibromatosis). Aortic Occlusive Disease Chronic Aortic Occlusive Disease Investigation and management. Acute Aortic Occlusive Disease Imaging and management. Congenital Aortic Abnormalities Vascular Rings Double Aortic Arch Other Vascular Rings Associated With Aortic Arch Abnormalities Right aortic arch with aberrant left subclavian artery and left ligamentum arteriosum. Right aortic arch with mirror-image branching and retro-oesophageal ligamentum arteriosum. Vascular Rings Associated With Left Aortic Arch Aortic Arch Abnormalities Without an Anatomical Ring Anomalous innominate artery. Retro-oesophageal right subclavian artery with an otherwise normal left arch. Imaging Coarctation of the Aorta Chest X-Ray Magnetic Resonance Imaging Computed Tomography Management Pseudocoarctation Aortic Atresia Further Reading SECTION B Abdominal Imaging 18 Current Status of Imaging of the Gastrointestinal Tract Chapter Outline Plain Abdominal Radiograph and Interpretation Abnormal Gas Distribution Pneumoperitoneum Gas in Bowel Wall Gas in Retroperitoneum Gas in Other Organs Dilatation of Bowel Gastric Dilatation Distinction Between Small- and Large-Bowel Dilatation Small-Bowel Dilatation Large-Bowel Dilatation Pseudo-Obstruction Large-Bowel Obstruction Abnormal Bowel Wall Pattern Small-Bowel Ischaemia Large-Bowel Ischaemia Inflammatory Bowel Disease Pseudomembranous Colitis Acute Abdominal Inflammatory Conditions Ultrasound in Appendicitis Computed Tomography in Appendicitis Other Inflammatory Conditions Imaging the Abdomen With Computed Tomography: Radiation Issues Automatic Tube Current Modulation Iterative Reconstruction Algorithms Role of MRI in the Acute Abdomen Radiation Dose Reduction in Clinical Practice Further Reading 19 The Oesophagus Chapter Outline Anatomy and Function Anatomy (Table 19.1) Embryology Function Examination Plain Radiography Ultrasound Fluoroscopy Endoscopy Computed Tomography Magnetic Resonance Imaging Endoscopic Ultrasound Radionuclide Radiology Including Positron-Emission Tomography–Computed Tomography Pathological Features Oesophageal Cancer Computed Tomography for Oesophageal Cancer Endoscopic Ultrasound for Oesophageal Cancer Positron-Emission Tomography–Computed Tomography for Oesophageal Cancer Treatment of Oesophageal Cancer Other Oesophageal Neoplasms Benign Lesions Malignant Lesions Hiatus Hernia Gastro-Oesophageal Reflux Disease Complications of Gastro-Oesophageal Reflux Disease Reflux oesophagitis. Columnar-lined oesophagus. Other Varieties of Oesophagitis Oesophageal Diverticula Motility Disorders Achalasia Jackhammer Oesophagus Systemic Disorders Neuromuscular Disorders Miscellaneous Conditions Oesophageal Diverticula Oesophageal Varices Schatzki Ring Dysphagia Lusoria Dysphagia Aortica Trauma Congenital Conditions Further Reading 20 The Stomach Chapter Outline Anatomy Radiological Techniques Fluoroscopy Cross-Sectional Imaging Multidetector Computed Tomography Magnetic Resonance Imaging FDG-PET and FDG-PET-CT Gastric Pathology Inflammatory Disease and Infiltrative Diseases Helicobacter pylori and Diseases of the Stomach Gastric Ulcer Gastric Erosions Gastritis Atrophic Gastritis Infectious Gastritis Crohn and Other Granulomatous Diseases Hypertrophic Gastritis Ménétrier Disease Zollinger-Ellison Syndrome Eosinophilic Gastroenteritis Corrosive Ingestion Amyloidosis Neoplastic Diseases Mucosal Polyps Mesenchymal Tumours Gastric Carcinoma Early Gastric Cancer Advanced Gastric Cancer Staging of Gastric Cancer Gastric Lymphoma Carcinoid Metastatic Disease Miscellaneous Conditions Positional Abnormalities Hiatus Hernia Gastric Volvulus Gastric Pneumatosis Prepyloric Web (Antral Mucosal Diaphragm) Diverticula Hypertrophic Pyloric Stenosis Varices Gastric Distention Gastroparesis Ectopic Pancreas Bariatric Surgery The Postoperative Stomach Complications of Bariatric Surgery Non-Bariatric Gastric Surgeries Complications of Non-Bariatric Gastric Surgery Advances in Gastric Imaging Further Reading 21 The Small Intestine, Mesentery and Peritoneal Cavity Chapter Outline The Duodenum Anatomy and Normal Appearances Radiological Investigation Disorders of the Duodenum Peptic Ulceration Postbulbar Ulceration Complications of Peptic Ulceration Diverticula Neoplasms Benign Neoplasms Malignant Neoplasms Primary Carcinoma Secondary Involvement Other Conditions Pancreatitis Crohn Disease Progressive Systemic Sclerosis Intramural Haematoma Vascular Conditions The Small Intestine Anatomy and Normal Appearances Radiological Investigation Plain Radiographs Barium Studies Computed Tomography Ultrasound Magnetic Resonance Imaging Angiography Nuclear Medicine Studies Disorders of the Small Intestine Crohn Disease Radiological Appearances Coeliac Disease Neoplasms Malignant Neoplasms Carcinoid Tumour Adenocarcinoma Lymphoma Gastrointestinal Stromal Tumours Secondary Neoplasms Benign Neoplasms Infections and Infestations Tuberculosis Yersiniosis Actinomycosis Acquired Immune Deficiency Syndrome Whipple Disease Mechanical Small-Bowel Obstruction Vascular Disease Acute Mesenteric Ischaemia Vasculitis Occult Gastrointestinal Bleeding Chronic Radiation Enteritis Miscellanous Conditions Diverticula and Blind Loops Jejunal Diverticula Meckel Diverticulum Blind Loops Ileal Diverticula Neuromuscular Disorders Eosinophilic Gastroenteritis Mastocytosis Angio-oedema Amyloidosis Behçet Disease Graft-Versus-Host Disease Non-Steroidal Anti-Inflammatory Drug Enteritis The Peritoneal Cavity, Mesentry and Omentum Anatomical Considerations Introduction Peritoneal Spaces Supramesocolic Space Inframesocolic Space Peritoneal Reflections The Mesenteries The Omentum Developmental/Congenital Anomalies Rotational Anomaly Developmental Defects Mesenteric Cysts Manifestations of Inflammation and Infection Peritonitis Tuberculosis Peritonitis Sclerosing Peritonitis Hydatid Disease of the Peritoneum Mesenteric Lymphadenitis Mesenteric Panniculitis–Sclerosing Mesenteritis Non-Inflammatory Mesenteric Oedema Epiploic Appendagitis Omental Infarction Neoplastic Diseases Secondary Carcinoma Mechanisms and Pathways of Tumour Spread Direct Invasion and Along Mesenteric– Ligamentous Attachments Intraperitoneal Seeding and Peritoneal Carcinomatosis Embolic Metastases Lymphatic Dissemination Cytoreductive Surgery Mesenteric Carcinoid Primary Neoplasms: Benign and Malignant Peritoneum Mesentery Omentum Further Reading 22 The Large Bowel Chapter Outline Anatomy Radiological Investigation Tumours Polyps Polyposis Syndromes Familial adenomatous polyposis. Hereditary non-polyposis colorectal cancer (Lynch syndrome). Peutz–Jeghers syndrome. Rare polyposes. Radiographic Features of Polyps Computed tomography colonography. Magnetic resonance colonography. Double-contrast barium enema. Colorectal Cancer Colon Cancer Rectal Cancer Anal Cancer Appendix Tumours Lymphoma Secondary Cancers Diverticulitis Epiploic Appendagitis Colitis Imaging Features of Colitis Inflammatory Bowel Disease Differential Features Disease Activity in Inflammatory Bowel Disease Carcinoma in Colitis Other Common Causes of Colitis Ischaemic Colitis Radiation Colitis Behçet’s Syndrome Infectious Colitis Pseudomembranous Colitis Neutropenic Colitis Parasitic Colitis Tuberculosis Amoebiasis Acquired Immunodeficiency Syndrome Defunctioned Colon Acute Fulminant Colitis Perforation Miscellaneous Conditions Large-Bowel Strictures Pseudodiverticula Appendicitis Lipomatous Disorders of the Large Bowel Pneumatosis Coli Volvulus Intussusception Endometriosis Retrorectal Lesions Functional Disorders of the Anorectum Anal Fistula Further Reading 24 The Biliary System Chapter Outline Biliary Anatomy Gallbladder Anatomical Variants Methods of Investigation Ultrasound Computed Tomographic Cholangiography Magnetic Resonance Cholangiopancreatography Endoscopic Retrograde Cholangiopancreatography Percutaneous Transhepatic Cholangiography Intraoperative Cholangiography T-Tube Cholangiography Hepatobiliary Scintigraphy Endoscopic Ultrasound Disorders of the Gallbladder Gallbladder Stones Low Phospholipid-Associated Cholelithiasis Sludge Milk of Calcium Bile Cholecystitis Acute Calculous Cholecystitis Gangrenous Cholecystitis Emphysematous Cholecystitis Acalculous Cholecystitis Xanthogranulomatous Cholecystitis Gallbladder Mucocele Gallbladder Fistulae Porcelain Gallbladder Adenomyomatous Hyperplasia Gallbladder Polyps Gallbladder Carcinoma Gallbladder Metastases and Lymphoma Role of Radiology in Investigation of Jaundice Benign Bile Duct Pathology Choledocholithiasis Ultrasound Unenhanced CT Cholangiography Hepatolithiasis Benign Biliary Strictures Postoperative Strictures Primary Sclerosing Cholangitis IgG4-Related Disease Mirizzi Syndrome Pancreatitis HIV Cholangiopathy Acute Bacterial Cholangitis Recurrent Pyogenic Cholangitis Parasitic Infections Ascaris lumbricoides Hydatid Fascioliasis Biliary Leaks and Bile Duct Injuries Biliary Cystic Disease Neoplastic Bile Duct Pathology Cholangiocarcinoma Intraductal Papillary Mucinous Neoplasm of the Bile Duct Metastases and Lymphoma Pancreatic and Ampullary Tumours Lobar or Segmental Duct Obstruction Haemobilia Interventional Techniques Percutaneous Cholecystostomy Percutaneous Transhepatic Biliary Catheterisation Malignant Disease Hilar Strictures—Special Considerations Benign Disease Percutaneous Transjejunal Biliary Intervention Biopsy Techniques Further Reading 23 The Liver and Spleen Chapter Outline Liver Anatomy Subdivisions (Fig. 23.2) Lobar Agenesis/Atrophy (Figs 23.3 and 23.4) Vascular Anatomy Variation (Fig. 23.5) Liver Imaging Techniques Plain Radiography Ultrasound Technique Normal (Fig. 23.6) Computed Tomography Technique (Fig. 23.9) Normal Magnetic Resonance Imaging Techniques (Fig. 23.11) Intravenous Contrast Agents (Fig. 23.12) Normal Scintigraphy Technique Normal Angiography Diffuse Disease Benign Diffuse Disease Hepatic Steatosis Cirrhosis Viral Hepatitis Haemochromatosis and Iron Overload Wilson Disease Malignant Diffuse Disease Focal Disease Calcification Pneumobilia Portal Vein Gas Parenchymal Gas Benign Cystic Lesions Cysts Hydatid Disease Abscess Malignant Cystic Lesions Metastases Benign Solid Lesions Haemangioma Atypical Haemangiomas Focal Nodular Hyperplasia Hepatic Adenoma Focal Fat Focal Confluent Fibrosis Biliary Hamartomas (Fig. 23.44) Atypical Regenerative Nodules Malignant Solid Lesions Hepatocellular Carcinoma Fibrolamellar Carcinoma (Fig. 23.53) Hepatoblastoma Epithelioid Haemangioendothelioma Hepatic Lymphoma Angiosarcoma (Fig. 23.55) Metastases Vascular Lesions Budd–Chiari Syndrome Veno-occlusive Disease Portal Venous Hypertension Portal Vein Thrombosis Arterioportal Shunts Intrahepatic Portosystemic Shunts Arteriovenous Shunts Hepatic Trauma Liver Transplantation Background and Indications Recipient Assessment Living Donor Assessment Perioperative Imaging Graft Failure Liver Biopsy Liver Biopsy, Aspiration and Drainage Devices Approach Routes Practical Procedural Issues Complications and Safety Spleen Anatomy Congenital Variations Accessory Spleen or Splenunculus (Fig. 23.74) Polysplenia and Asplenia (Fig. 23.75) Acquired Diseases Trauma (Fig. 23.76) Infections (Fig. 23.77) Infarction (Figs 23.78 and 23.79) Benign Lesions Cysts (Fig. 23.80) Haemangioma (Fig. 23.81) Hamartomas and Lymphangiomas (Fig. 23.82) Malignant Lesions Angiosarcoma (Fig. 23.83) Lymphoma (Fig. 23.84) Metastases (Fig. 23.85) Leukaemia Other Problems Portal Hypertension/Splenic Vein Thrombosis Sarcoidosis Amyloidosis Haemosiderosis Extramedullary Haematopoiesis Gaucher Disease Further Reading 25 The Pancreas Chapter Outline Embryology The Normal Pancreas Congenital Anomalies Pancreas Divisum Annular Pancreas Pancreatic Agenesis, Hypoplasia and Ectopic Pancreas Pancreatitis Acute Pancreatitis Imaging in Acute Pancreatitis Interstitial Oedematous Pancreatitis Pseudocyst Necrotising Pancreatitis Walled-Off Necrosis Complications of Acute Pancreatitis Chronic Pancreatitis Paraduodenal Pancreatitis Autoimmune Pancreatitis Pancreatic Neoplasms Ductal Adenocarcinoma Imaging Investigations Imaging Appearances Local Staging Lymph Node and Distant Metastases Follow-Up Neuroendocrine Tumours Functioning Tumours Non-Functioning Neuroendocrine Tumours Cystic Masses What to Do With Small Incidental Cystic Lesions? Pancreatic Metastases Rare Pancreatic Neoplasms Tumour-Simulating Conditions Multisystem Diseases With Involvement of the Pancreas Cystic Fibrosis Autosomal Dominant Polycystic Kidney Disease Von Hippel–Lindau Disease Osler–Weber–Rendu Disease Trauma Pancreatic Transplant Imaging Interventional Radiology Biopsy of Solid Pancreatic Lesions and Fine-Needle Aspiration of Cystic Pancreatic Lesions Drainage of Pancreatic/Peripancreatic Fluid Collections Further Reading 26 Common Uroradiological Referrals Chapter Outline Haematuria Renal Tract Calcifications Imaging of Renal and Ureteric Stones Imaging of Renal and Ureteric Tumours Risk Stratification of Patients With Haematuria for Triage to Computed Tomography Imaging Features of Urothelial Tumours on Computed Tomography Loin Pain Imaging of Patients With Loin Pain Computed Tomography Useful Signs on Unenhanced Computed Tomography and Potential Pitfalls Intravenous Urography Ultrasound Radiography Magnetic Resonance Urography Renal Failure Chronic Renal Failure Autosomal Dominant Polycystic Kidney Disease (Adult Polycystic Kidney Disease) Tuberous Sclerosis Acquired Cystic Kidney Disease (ACKD) Renovascular Disease Iodinated Contrast Agents Nephrogenic Systemic Fibrosis Infection Acute Pyelonephritis Imaging of Acute Pyelonephritis Ultrasound. Computed tomography. Magnetic resonance imaging. Intravenous urography. Renal scintigraphy. Renal and Perirenal Abscess Imaging of Renal and Perirenal Abscess Emphysematous Pyelonephritis Imaging of Emphysematous Pyelonephritis Xanthogranulomatous Pyelonephritis Imaging of Xanthogranulomatous Pyelonephritis Pyonephrosis Imaging of Pyonephrosis Chronic Pyelonephritis Imaging of Chronic Pyelonephritis Renal Tuberculosis Imaging of Renal Tuberculosis Cystitis Imaging of Cystitis Prostatitis Acute Bacterial Prostatitis and Prostatic Abscess Imaging of acute prostatitis and prostatic abscess. Chronic Prostatitis Imaging of chronic prostatitis. Further Reading 27 Current Status of Imaging of the Urinary Tract Chapter Outline Introduction Anatomy of the Urinary Tract Embryology Normal Urinary Tract Anatomy Congenital Abnormalities of the Urinary Tract Renal Ureter and Pelvis Bladder and Urethra Techniques Conventional Radiography Intravenous Urography/Excretory Urography Retrograde Urography Retrograde Urethrography and Voiding Cystourethrogram Ultrasound Nuclear Medicine Computed Tomography Magnetic Resonance Imaging Radiation Issues Radiation Exposure From Medical Imaging Conventional Radiography Intravenous Urography Computed Tomography Conclusion Further Reading 28 Benign Upper Urinary Tract Conditions Chapter Outline Congenital Anomalies Normal Development Ectopy and Fusion Anomalies Renal Ectopy Crossed Renal Ectopy Horseshoe Kidney Renal Agenesis and Hypoplasia Renal Agenesis Hypoplasia Calyceal Anomalies Diverticulum Congenital Megacalyces Pelvis and Ureter Anomalies Duplicated Collecting System (Ureteral Duplication) Ureteropelvic Junction Obstruction Congenital Megaureter Circumcaval Ureter Congenital Cystic Renal Disease Autosomal Recessive Polycystic Kidney Disease Autosomal Dominant Polycystic Kidney Disease Multicystic Dysplastic Kidney Obstructive Cystic Renal Dysplasia Cysts Bosniak Renal Cyst Classification System Cystic Nephroma Mixed Epithelial and Stromal Tumour of the Kidney Lithium-Induced Renal Disease Renal Cysts Associated With von Hippel–Lindau Syndrome (vHL) Renal Cysts Associated With Tuberous Sclerosis Acquired Cystic Disease of the Kidney Calculi Dual-Energy Computed Tomography Nephrocalcinosis Further Reading 29 Renal Masses Chapter Outline Methods of Analysis Plain Abdominal Radiography Ultrasound Computed Tomography Magnetic Resonance Imaging Renal Arteriography Intravenous Urography Radionuclide Imaging Needle Aspiration and Biopsy Benign Renal Masses Renal Cysts Serous Renal Cyst (See Renal Cyst Summary Box) Complicated Cysts Parapelvic and Peripelvic Cysts Adult Polycystic Kidney Disease (ADPKD) Multicystic Renal Dysplasia Localised Cystic Disease of the Kidney Hydatid (Echinococcal) Cysts of the Kidney Inflammatory Masses Renal Abscesses Acute Focal Pyelonephritis Malacoplakia Vascular Masses Haematomas Intrarenal Vascular Masses Angiomyolipomas Focal Hydronephrosis Renal Sinus Lipomatosis Non-Renal Masses Neoplastic Renal Masses Benign Adenoma and Oncocytoma Haemangioma Multilocular Cystic Nephroma Malignant Parenchymal See Renal Cancer Summary Box Renal cell carcinoma. Staging of renal cancer. Wilms, tumour in the adolescent and adult. Sarcoma. Lymphoma and leukaemia. Tumours metastatic to the kidney. Non-Parenchymal Urothelial tumours Transitional cell carcinoma (Fig. 29.23). Squamous cell carcinoma. Further Reading 30 Renal Transplantation Chapter Outline History of Transplantation Surgical Technique Radiological Techniques Ultrasound Computed Tomography Magnetic Resonance Imaging Catheter-Based Angiography and Fluoroscopy Vascular Complications: Early Renal Artery and Vein Thrombosis Vascular Complications: Intermediate to Late Renal Artery Stenosis Arteriovenous Malformations and Pseudoaneurysm Nephrogenic Complications Acute Rejection Acute Tubular Necrosis Chronic Rejection Urological Complications Urinoma Lymphocele Ureteric Strictures Renal Calculi Infection and Renal Transplantation Cancer and Transplant Renal Transplant Biopsy Use of Isotope Studies and Renal Transplant Radiological Evaluation of Potential Donor Kidneys Further Reading 31 Urothelial Cell Cancer, Upper Tract and Lower Tract Chapter Outline Upper Tract Urothelial Carcinoma Definition Epidemiology Risk Factors Histological Classification Identification of Prognostic Factors Management Biopsy Imaging Upper Tract Urothelial Carcinoma Indications and Contraindications for Computed Tomography Urography Optimisation of Computed Tomography Urography Technique Quality Control Radiation Dose Optimisation Strategies Imaging Findings in Upper Tract Urothelial Carcinoma Magnetic Resonance Urography Conclusions and Summary Bladder Cancer Introduction Classification of Urothelial Cancers By Growth Pattern By Histology By Grade Clinical Detection Imaging Detection Technique of Computed Tomography Urography and Magnetic Resonance Urography Computed Tomography and Magnetic Resonance Urographic Appearance of Bladder Cancers Sensitivity and Specificity of Computed Tomography and Magnetic Resonance Urography in Detecting Bladder Cancers Risks of Computed Tomography and Magnetic Resonance Urography Use of Positron Emission Tomography for Detecting and Evaluating Bladder Cancers Staging Imaging for Local Staging of Bladder Cancer Imaging for Detection of Regional and Distant Metastatic Disease Upper Tract Evaluation Treatment and Follow-Up Clinical and Imaging Follow-Up of Patients After Topical Treatment of Bladder Cancer Imaging of Patients Following Neoadjuvant Chemoradiation and Before Surgery Imaging Follow-Up of Patients After Cystectomy Use of Imaging to Identify Tumour Response to Chemotherapy Uncommon Bladder Neoplasms Squamous Cell Carcinomas Adenocarcinomas Cancers in Bladder Diverticula Other Urinary Tract Malignancies Benign Bladder Lesions Further Reading Classic Book/Articles Recent Journal Articles 32 Prostate Chapter Outline Introduction Anatomy Risk Stratification Detection and Localisation Prostate Imaging—Reporting and Data System Magnetic Resonance Sequences T1 Weighted Magnetic Resonance Imaging T2 Weighted Magnetic Resonance Imaging Peripheral Zone Transition Zone Diffusion-Weighted Imaging Dynamic Contrast-Enhanced Magnetic Resonance Imaging Benign Findings Benign Prostatic Hyperplasia Prostatitis Staging Nodal Staging Non-Nodal Metastases Local Disease Stage Post-Treatment Evaluation Prostate Biopsy Further Reading 33 The Male Reproductive Structures Chapter Outline Methods of Examination Anatomy Scrotal Masses Testicular Masses Malignant Testicular Pathology Staging Testicular Malignancy Computed Tomography Non-Primary Testicular Malignancies, Lymphoma and Leukaemia Non-Malignant Focal Testicular Lesions Non-Focal Testicular Abnormalities Tubular Ectasia Testicular Microlithiasis Extratesticular Scrotal Lesions Cystic Lesions Solid Extratesticular Lesions Acute Epididymitis Testicular Atrophy Testicular Trauma Cryptorchidism Testicular Torsion Male Infertility Erectile Dysfunction Evaluation of the Soft Tissues of the Penis Further Reading 34 Gynaecological Imaging in Oncology Chapter Outline Imaging Techniques Ultrasound Computed Tomography Magnetic Resonance Imaging Positron-Emission Tomography/Computed Tomography Endometrial Carcinoma Detection, Diagnosis and Staging Ultrasound Computed Tomography Magnetic Resonance Imaging Stage I Stage II Stage III Stage IV Positron-Emission Tomography/Computed Tomography Recommended Imaging Approach Carcinoma of the Cervix Detection, Diagnosis and Staging Ultrasound Computed Tomography Magnetic Resonance Imaging Stage I Stage II Stages III and IV Positron-Emission Tomography/Computed Tomography Recommended Imaging Approach Ovarian Carcinoma Detection, Diagnosis and Staging Ultrasound Computed Tomography Magnetic Resonance Imaging Positron-Emission Tomography/Computed Tomography Recommended Imaging Approach Conclusion Acknowledgements Further Reading 35 Benign Gynaecological Disease Chapter Outline Imaging Techniques Ultrasound (US) Computed Tomography (CT) Magnetic Resonance Imaging (MRI) Hysterosalpingography (HSG) and Fallopian Tube Catheterisation Sonohysterography Congenital Anomalies of the Female Genital Tract Müllerian Duct Anomalies Class I: Uterine Agenesis or Hypoplasia Class II: Unicornuate Uterus Class III: Uterus Didelphys Class IV: Bicornuate Uterus Class V: Septate Uterus Class VI: Arcuate Uterus Class VII: Diethylstilbestrol Related Vaginal Anomalies Imaging of Ambiguous Genitalia Benign Uterine Conditions Fibroids Ultrasound Magnetic Resonance Imaging Computed Tomography Hysterosalpingography Endometrial Polyps Endometrial Hyperplasia Pelvic Pain Endometriosis Ultrasound Magnetic Resonance Imaging Adenomyosis Ultrasound Magnetic Resonance Imaging Pelvic Inflammatory Disease Ultrasound Computed Tomography Magnetic Resonance Imaging Pelvic Varices Ovarian Vein Thrombosis Benign Ovarian Conditions Functional Ovarian Cysts Polycystic Ovaries Benign Tumours of the Ovary Epithelial Tumours Germ Cell Tumours Stromal Cell Tumours Ovarian Torsion Vaginal Cysts Pelvic Floor Dysfunction Urethral Bulking Agents Mid-Urethral Slings Sacrocolpopexy Infertility and Pregnancy-Related Imaging Ovulation Hyper-Stimulation Syndrome (OHSS) Ectopic Pregnancy Abnormal Placental Morphology: Succenturiate Placenta, Circumvallate Placenta and Placenta Membranacea Abnormal Placental Positions: Placenta Previa and Low-lying Placenta Anomalous Cord Insertion and Vasa Previa Placenta Accreta, Percreta and Increta Placental Abruption and Haemorrhage Retained Products of Conception Uterine Arteriovenous Malformation (AVM) Further Reading 36 Genitourinary Tract Trauma Chapter Outline Introduction Renal Trauma Imaging Technique for Renal Injury Grading of Renal Injury and Implications for Management Computed Tomography Findings of Grade I Renal Injury Computed Tomography Findings of Grade II Renal Injury Computed Tomography Findings of Grade III Renal Injury Computed Tomography Findings of Grade IV Renal Injury Computed Tomography Findings of Grade V Renal Injury Segmental Renal Infarcts Active Bleeding Traumatic Renal Pseudoaneurysm Ureteral Injury Imaging Technique and Computed Tomography Findings of Ureteral Injury Bladder Injury Imaging Technique Computed Tomography Findings Urethral Injury Imaging Technique Imaging Findings of Urethral Injury Scrotal Injury Imaging Technique and Findings Penile Injuries Imaging Technique and Imaging Findings Further Reading 37 Adrenal Imaging Chapter Outline The Adrenal Glands Anatomy and Physiology Anatomy Physiology Incidentally Detected Adrenal Mass Computed Tomography Lesion Size and Contour Intracellular Lipid Content of the Adrenal Mass Contrast Enhancement and Contrast Washout Characteristics Histogram Analysis Method Dual-Energy Computed Tomography Magnetic Resonance Imaging Conventional Spin-Echo Imaging Gadolinium-Enhanced Magnetic Resonance Imaging Chemical-Shift Imaging Positron-Emission Tomography Percutaneous Adrenal Biopsy Adrenal Scintigraphy Incidentally Detected Non-functioning Adrenal Masses Adrenal Cysts Myelolipoma Imaging Functional Disorders of the Adrenal Gland Hyperfunctioning Adrenocortical Disorders Cushing’s Syndrome ACTH-independent Cushing’s syndrome. Adrenal adenomas. Adrenal carcinoma. Primary pigmented nodular adrenocortical disease. ACTH-independent macronodular adrenal hyperplasia. ACTH-dependent Cushing’s syndrome. Primary Hyperaldosteronism (Conn’s Syndrome) Virilisation Congenital adrenal hyperplasia. Adrenal virilising tumours. Hyperfunctioning Adrenal Medullary Disorders Phaeochromocytomas Adrenal Medullary Hyperplasia Neuroblastoma and Ganglioneuroblastoma Adrenal Hypofunction (Addison’s Disease) Primary Adrenal Hypofunction Secondary Adrenal Hypofunction Conclusion Further Reading SECTION C The Musculoskeletal System 38 Current Status of Imaging of The Musculoskeletal System Chapter Outline Introduction Conventional Radiography Tomosynthesis Ultrasound Elastography Computed Tomography Dual-Energy Computed Tomography Metal Artefact Reduction Magnetic Resonance Imaging Metal Artefact Reduction Diffusion-Weighted Imaging Whole-Body Magnetic Resonance Imaging Cartilage Mapping Elastography Nuclear Medicine Arthrography Further Reading 39 Internal Derangements of Joints Chapter Outline Introduction The Shoulder Rotator Cuff Disease Glenohumeral Joint Instability Superior Labral Tears The Acromioclavicular Joint The Sternoclavicular Joint The Elbow Tendons Bone and Cartilage Ligaments Hand and Wrist Bone Wrist Ligaments Triangular Fibrocartilage Wrist Tendons Median Nerve Ulnar Collateral Ligament of the Thumb The Hip Labrum and Cartilage Muscle and Tendon Bone Bursae The Knee Menisci Anterior Cruciate Ligament Posterior Cruciate Ligament Medial Collateral Ligament Lateral Collateral Ligament Complex and Posterolateral Corner The Extensor Mechanism and Patellofemoral Joint Bone and Cartilage Bursae The Ankle and Foot Ligaments Tendons Bone Tarsal Coalition Other Soft-Tissue Abnormalities Further Reading 40 Bone Tumours (1) Chapter Outline General Characteristics of Bone Tumours Age at Presentation Radiological Assessment of Bone Tumours Location Rate of Growth Periosteal Reaction Matrix Mineralisation Computed Tomography and Magnetic Resonance Imaging in Diagnosis and Staging Benign Bone Tumours Chondrogenic Tumours Osteochondroma Radiological Features Subungual Exostosis Radiological Features Enchondroma Radiological Features Less Common Varieties of Chondroma Periosteal chondroma. Enchondromatosis (Ollier disease). Enchondromatosis with haemangiomas (Maffucci syndrome). Chondroblastoma Radiological Features Chondromyxoid Fibroma Radiological Features Bizarre Parosteal Osteochondromatous Proliferation Radiological Features Osteogenic Tumours Osteoma Radiological Features Osteoid Osteoma Radiological Features Osteoblastoma Radiological Features Fibrogenic Tumours Desmoplastic Fibroma Radiological Features Fibrohistiocytic Tumours Fibrous Cortical Defect Non-Ossifying Fibroma Radiological Features Benign Fibrous Histiocytoma Radiological Features Giant Cell Tumour Radiological Features Vascular Tumours Haemangioma Radiological Features Lipogenic Tumours Intra-Osseous Lipoma Lesions of Undefined Neoplastic Nature Aneurysmal Bone Cyst Radiological Features Simple Bone Cyst Radiological Features Fibrous Dysplasia Radiological Features Osteofibrous Dysplasia Radiological Features Further Reading 41 Bone Tumours (2) Chapter Outline Introduction Bone Metastases Distribution of Bone Metastases Diagnosis of Bone Metastases Clinical Radiological Features Prostate. Breast. Lung. Kidney. Melanoma. Radiological Investigation of Bone Metastases Bone Metastases in Children Primary Malignant Neoplasms of Bone Chondroid Origin Chondrosarcoma Clinical Presentation Imaging Features Other Chondrosarcoma Variants Periosteal Chondrosarcoma Mesenchymal Chondrosarcoma Clear Cell Chondrosarcoma Osteoid Origin Osteosarcoma Central Osteosarcomas Conventional central osteosarcoma Clinical presentation. Imaging features. Other varieties of central osteosarcoma. Surface Osteosarcomas Parosteal osteosarcoma. Periosteal osteosarcoma. High-grade surface osteosarcoma. Secondary Osteosarcoma Paget sarcoma. Post-radiation sarcoma. Fibrous Origin Marrow Tumours Ewing Sarcoma and Primitive Neuroectodermal Tumour Imaging Features Notochordal Origin Chordoma Miscellaneous Tumours Malignant Vascular Tumours Adamantinoma Further Reading 42 Soft-Tissue Tumours Chapter Outline Introduction Imaging Characterisation of Soft-Tissue Masses Radiographs Computed Tomography Ultrasound Magnetic Resonance Imaging World Health Organisation Classification of Soft-Tissue Tumours Adipocytic (Lipomatous) Tumours Lipoma Radiographs Ultrasound Computed Tomography Magnetic Resonance Imaging Other Benign Adipocytic Tumours Lipoblastoma Hibernoma Malignant Adipocytic Tumours Atypical Lipomatous Tumour/ Well-Differentiated Liposarcoma Other Adipocytic Malignancies Dedifferentiated Liposarcoma Myxoid Liposarcoma Fibroblastic/Myofibroblastic Tumours Nodular Fasciitis Elastofibroma Fibromatoses Superficial Fibromatosis Palmar fibromatosis (Dupuytren’s disease). Plantar fibromatosis (Ledderhose disease). Other forms. Desmoid-Type Fibromatosis Fibroma of the Tendon Sheath So-Called Fibrohistiocytic Tumours Tenosynovial Giant Cell Tumour Tenosynovial Giant Cell Tumour, Diffuse-Type (Pigmented Villonodular Synovitis) Vascular Tumours Haemangioma Radiographs Ultrasound Magnetic Resonance Imaging Chondro-Osseous Tumours Soft-Tissue Chondromas Tumours of Nerves Benign Nerve Sheath Tumours Malignant Nerve Tumours Malignant Peripheral Nerve Sheath Tumours Tumour-Like Lesions Arising From Nerves (Pseudotumours) Nerve Sheath Ganglion (Intra-Neural Ganglion) Traumatic Neuroma Morton’s Neuroma Lipomatosis of Nerve Tumours of Uncertain Differentiation Myxoma Soft-Tissue Sarcomas Synovial Sarcoma Non-Neoplastic Tumour Mimics Accessory Muscles Traumatic Lesions Infection/Inflammation Synovial Disorders Acknowledgement Further Reading 43 Metabolic and Endocrine Skeletal Disease Chapter Outline Bone Physiology and Pathophysiology Bone Cells Bone Formation and Turnover Bone Growth and Development Osteoporosis Definition and Epidemiology Radiological Features Spine in Osteoporosis Vertebroplasty and Kyphoplasty Osteoporotic Fractures Aetiology Regional Osteoporosis Generalised Osteoporosis Postmenopausal osteoporosis. Age-related osteoporosis. Osteoporosis of young adults. Idiopathic juvenile osteoporosis. Secondary osteoporosis. Osteogenesis Imperfecta Type I Type II (Lethal Perinatal) Type III (Progressive Deforming Type) Type IV (Moderately Severe) Types V to XI Quantitative Assessment of the Skeleton Dual Energy X-Ray Absorptiometry Quantitative Computed Tomography Quantitative Ultrasound Radiogrammetry Vertebral Morphometry Other Research Methods Parathyroid Disorders Hyperparathyroidism Primary Hyperparathyroidism Secondary Hyperparathyroidism Clinical Presentation Treatment Radiological Findings Subperiosteal erosions. Intracortical bone resorption. Chondrocalcinosis. Brown tumours (osteitis fibrosa cystica). Osteosclerosis. Osteoporosis. Metastatic calcification. Hypoparathyroidism Aetiology Radiological Abnormalities Pseudohypoparathyroidism Radiographic Abnormalities Pseudo-Pseudohypoparathyroidism Rickets and Osteomalacia Vitamin D Deficiency Genetic Disorders of Vitamin D Metabolism Oncogenic Osteomalacia Radiological Appearances Rickets. Osteomalacia. Renal Osteodystrophy Renal Tubular Defects X-linked hypophosphataemia. Other Causes of Rickets and Osteomalacia (Not Related to Vitamin D Deficiency or Hypophosphatemia) Hypophosphatasia Sclerosing Bone Diseases and Other Bone Disorders Osteopetrosis Autosomal Recessive Lethal Type of Osteopetrosis Benign, Autosomal Dominant Type of Osteopetrosis (Albers-Schönberg Disease) Hyperphosphatasia Miscellaneous Vitamin D Intoxication Hypervitaminosis A Fluorosis Other Endocrine Diseases Cushing Disease Thyroid Disease Acromegaly Further Reading 44 Arthritis Chapter Outline Imaging of Joint Disease Plain Radiographic Interpretation: General Principles Soft-Tissue Swelling Alteration in Joint Space Bone Changes Osteopenia. Erosion. Entheseal disease. Bone Alignment Distribution of Joint Involvement Osteoarthritis Primary Osteoarthritis Secondary Osteoarthritis Radiographic Findings Radiographic Changes at Specific Joints Knee Hip Hands and Wrists Spine Advanced Imaging Erosive (Inflammatory) Osteoarthritis The Inflammatory Arthritides Rheumatoid Arthritis Synovitis Radiographic Features Radiographs in Treated Inflammatory Disease Sero-Negative Arthritis Ankylosing Spondylitis Sacroiliitis. Spinal disease. Peripheral joint involvement. Psoriatic Arthritis Joints of the hands and feet. Spinal and large joint disease. Reactive Arthritis Enteropathy-Associated Arthritis The Crystal Arthritides Gout Acute intermittent gout. Chronic tophaceous gout. Calcium Pyrophosphate Dihydrate Crystal Deposition Disease Imaging findings. Pyrophosphate arthropathy. Calcium Hydroxyapatite Crystal Deposition Disease Periarticular hydroxyapatite deposition disease. Intra-articular hydroxyapatite deposition disease. Connective Tissue Disease Scleroderma Dermatomyositis and Polymyositis Systemic Lupus Erythematosus Rheumatic Fever (Jaccoud Arthropathy) Mixed Connective Tissue Disease Miscellaneous Joint Disease Diffuse Idiopathic Skeletal Hyperostosis Haemophilic Arthropathy Other musculoskeletal manifestations of haemophilia. Neuropathic Arthropathy Synovial (Osteo)-Chondromatosis Pigmented Villonodular Synovitis Lipoma Arborescens Amyloid Sarcoid Hypertrophic Pulmonary Osteoarthropathy Multicentric Reticulohistiocytosis Haemochromatosis Further Reading 45 Appendicular and Pelvic Trauma Chapter Outline Introduction Fracture Types Adult Fracture Patterns and Ancillary Findings Complete Fractures Orientation. Location. Distraction, impaction and angulation. Articular involvement. Soft tissue features. Comminuted Fractures Occult Fractures Types of Occult Fracture Occult-Complete Fractures Occult-Incomplete Fractures Bone Bruising Insufficiency, Pathological and Stress Fractures Avulsion Fractures Paediatric Fractures Morphological Types Plastic bowing fracture. Buckle (torus) fracture. Green stick fracture. Growth Plate Injuries Type I Type II Type III Type IV Type V Dislocation and Subluxation The Shoulder Anterior Dislocation Posterior Dislocation Luxatio Erecta Acromio-Clavicular Joint The Elbow Children Supracondylar Fractures Lateral epicondyle fractures. Medial epicondyle fractures. Adults The Wrist Radius and Ulna Children Adults Colles Fracture Smith Fracture Barton Fracture Chauffeur Fracture (Hutchinson Fracture) Carpal Injuries Scaphoid Triquetrum Carpal Dislocation and Subluxation Lunate Dislocation Perilunate Dislocation Mid-Carpal Dislocation Scapholunate Disassociation Injuries of the Metacarpals and Phalanges Condylar Fractures Articular Fractures Avulsion Fractures Pelvic and Acetabular Fractures Pelvic Ring Fractures Anatomy Classification Anterior Compression Injuries Lateral Compression Injury Vertical Shear Complex Injuries Acetabular Fractures Anatomy Classification Elementary Patterns Anterior Wall Fractures Posterior Wall Fractures Anterior and Posterior Column Fractures Transverse Fractures Complex Fractures Pelvic Avulsion Injuries Pelvic Insufficiency and Stress Fractures Pathological Fractures The Hip and Proximal Femur Femoral Neck Fracture Intertrochanteric and Subtrochanteric Fracture Lesser Trochanter Fracture Atypical Femoral Fractures The Knee Tibial Plateau Fractures Anterior Cruciate Ligament Avulsion Fracture Segond Fracture Fibula Avulsion Fracture Patella Fractures Patellar Dislocation The Ankle Supination-Abduction (Fig. 45.94) Supination-Lateral Rotation (Fig. 45.97) Pronation-Abduction (Fig. 45.100) Pronation-Lateral Rotation (Fig. 45.103) Pilon Fracture Paediatric Ankle Fractures Tillaux Fracture Triplane Fracture Talar Dome Fractures Calcaneal Fractures Talar Fractures Foot Injuries Lisfranc Injury Stress Fracture Further Reading 46 Bone, Joint and Spinal Infections Chapter Outline Introduction Epidemiology Classification Paediatric Musculoskeletal Infections Pathophysiology Clinical Features Investigations and Management Plain Radiographs Ultrasound Computed Tomography Magnetic Resonance Imaging Nuclear Medicine Chronic Recurrent Multifocal Osteomyelitis Synovitis, Acne, Pustulosis, Hyperostosis and Osteitis Syndrome Sclerosing Osteomyelitis of Garré Necrotising Fasciitis Adult Musculoskeletal Infections Pathogenesis Clinical Features Investigations and Management Plain Radiographs Ultrasound Computed Tomography Magnetic Resonance Imaging Nuclear Medicine Osteomyelitis Secondary to Prosthetic Devices Diabetic Foot Plain Radiography Magnetic Resonance Imaging Septic Arthritis Musculoskeletal Tuberculosis Pathogenesis Investigations (Table 46.2) Plain Radiography Computed Tomography Magnetic Resonance Imaging Unusual Musculoskeletal Infections Atypical Mycobacterial Musculoskeletal Infections Hydatid Disease Bone Infections in Sickle Cell Disease Musculoskeletal Fungal Infections Musculoskeletal Infections in Human Immunodeficiency Virus Patients Differential Diagnosis Management Spinal Infection Vertebral Osteomyelitis Pyogenic Vertebral Osteomyelitis Symptoms Investigations Plain radiographs. Computed tomography. Magnetic resonance imaging. Nuclear medicine. Treatment Tuberculous Vertebral Osteomyelitis Plain Radiographs Computed Tomography Magnetic Resonance Imaging Unusual Spine Infections Further Reading SECTION D The Spine 47 Current Status of Imaging of the Spine and Anatomical Features Chapter Outline Anatomy Osseous Elements Vertebral Body Neural Arch Spinous and Transverse Processes Joints Facet Joints Uncovertebral Joints Intervertebral Disc—Symphysis Ligaments Longitudinal Ligaments Ligamentum Flavum Interconnecting Ligaments Neural Structures—Spinal Cord, Spinal Nerves, Dura Mater Vascular Structures Craniocervical Junction Imaging Techniques Plain Radiography Myelography Spinal Angiography Computed Tomography Magnetic Resonance Imaging Spin-Echo T1 Weighted Imaging Contrast-Enhanced T1 Weighted Imaging Spin-Echo and Fast Spin-Echo T2 Weighted Imaging Gradient-Echo Imaging Fat-Suppression Magnetic Resonance Pulse Sequences Frequency-Selective Saturation Short Tau Inversion Recovery Frequency-Selective Inversion Pulse (Spectral Presaturation with Inversion Recovery [SPIR], Spectral Presaturation Attenuated Inversion Recovery [SPAIR]) Diffusion-Weighted Imaging Fluid-Attenuated Inversion Recovery Three-Dimensional Imaging Artefacts Susceptibility Artefacts Motion Artefacts Truncation Artefacts Cerebrospinal Fluid Pulsation Artefacts Single-Photon Emission Computed Tomography Further Reading 48 Degenerative Disease of the Spine Chapter Outline Introduction Degenerative Disc Disease Nomenclature and Classification Age-Related Changes in the Intervertebral Disc Degenerative Disc Disease Annular Tears Disc Herniation Spontaneous Regression of Disc Herniation Vertebral End Plates and Bone Marrow Changes Uncovertebral Degeneration Pathology of the Posterior Elements Osteoarthritis of the Facet Joints Associated Soft-Tissue Changes Degenerative Cysts Arising From the Facet Joints Cysts of the Ligamentum Flavum Ligamentum Flavum Hypertrophy Degenerative Changes of the Neural Arch Neural Arch Intervertebral Neoarthrosis Spinous Process Abnormalities and Associated Ligamentous Changes Degenerative Spondylolisthesis Degenerative Spinal Stenosis Degenerative Spinal Canal Stenosis Degenerative Foraminal Stenosis Degenerative Scoliosis Further Reading 49 Spinal Tumours Chapter Outline Radiological Investigations in Spinal Tumours Plain Radiography Computed Tomography Magnetic Resonance Imaging Diffusion-Weighted Imaging Bone Scintigraphy Positron Emission Tomography Classification of Spinal Tumours Intramedullary Tumours Ependymoma Myxopapillary Ependymoma Astrocytoma Haemangioblastoma Ganglioglioma Less-Frequent Intramedullary Tumours Metastasis. Spinal Cord Tumour Mimics Cavernous malformation (cavernoma). Intradural Extramedullary Tumours Nerve Sheath Tumours: Schwannoma and Neurofibroma Meningioma Metastases Less-Frequent Extramedullary Tumours Intradural Extramedullary Tumour Mimics Extradural Tumours Metastatic Spine Disease Primary Vertebral Tumours Benign Primary Vertebral Tumours Vertebral Haemangioma Osteoid Osteoma/Osteoblastoma Osteoblastoma Aneurysmal Bone Cyst Eosinophilic Granuloma (Unifocal Langerhans Cell Histiocytosis) Benign Notochordal Cell Tumours Locally Aggressive Primary Vertebral Tumours Chordoma. Giant cell tumours. Primary Malignant Vertebral Tumours Multiple Myeloma and Plasmacytoma Chondrosarcoma Ewing Sarcoma Osteosarcoma Further Reading 50 Non-Tumoural Spinal Cord Lesions Chapter Outline Inflammatory Disease Multiple Sclerosis Acute Disseminated Encephalomyelitis Acute Transverse Myelitis Neuromyelitis Optica Systemic Lupus Erythematosus Sarcoidosis Demyelinating Polyneuropathies Guillain–Barré Syndrome Chronic Inflammatory Demyelinating Polyneuropathy Vascular Diseases Spinal Dural Arteriovenous Fistula Spinal Arteriovenous Malformations Spinal Cord Cavernous Malformation Spinal Cord Infarction Spinal Cord Vasculitis Infections Spinal Cord Infection Can Be Bacterial, Viral, Fungal or Parasitic in Origin Developmental and Cyst-Like Lesions Intramedullary Lipoma Lipomyelomeningodysplasias Diastematomyelia Neuroenteric and Other Developmental Cysts Chiari Malformations Chiari Type I Lesion (Cerebellar Ectopia) Chiari Type II Malformations Meningoceles Anterior Sacral Meningocele Lateral Thoracic Meningocele Anterior Thoracic Meningocele With Ventral Herniation of the Spinal Cord Intraspinal Arachnoid Cyst Syringomyelia Neurodegenerative and Metabolic Diseases Motor Neurone Disease Spinal Muscular Atrophy Spinocerebellar Ataxia Friedreich Ataxia Subacute Combined Degeneration of the Spinal Cord Further Reading 51 Postoperative Spine Chapter Outline Introduction Principles of Spinal Surgery Imaging Techniques in Postoperative Spine Intraoperative and Perioperative Complications Early Complications Late Complications Failed Back Surgery Syndrome Further Reading 52 Spinal Trauma Chapter Outline Clinical Aspects Imaging Techniques and Evaluation Cervical Spine Conventional Radiography Computed Tomography Magnetic Resonance Imaging Thoracolumbar Spine Conventional Radiography Computed Tomography Specific Injury Patterns Cervical Spine Atlanto-Occipital Dissociation Occipital Condyle Fractures C1 Injuries Rotatory Subluxation Jefferson Fracture C2 Injuries Odontoid Fractures Hangman Fracture Hyperflexion Injuries Hyperflexion-Rotation Injury Hyperextension Injuries Lateral Flexion Injury Thoracic and Lumbar Spine Classification Systems Flexion-Compression and Flexion-Distraction Injuries Burst Fractures Fracture-Dislocation The Rigid Spine Neurological Injury Spinal Cord Brachial Plexus Injury Further Reading SECTION E Neuroimaging 53 Current Status of Imaging of the Brain and Anatomical Features Chapter Outline Introduction Anatomy of the Brain and Vascular System Embryology Brain Anatomy Cerebral Cortex, Lobar Anatomy and Deep Grey Matter Structures White Matter Limbic System, Hypothalamus and Pituitary Gland Ventricular System and Subarachnoid Space Cerebellum Brainstem Cerebral Vasculature Cerebral Arteries Anterior Circulation Posterior Circulation External Carotid Artery Anastomotic Pathways Intracranial Veins Techniques for Imaging the Brain and Cerebral Vasculature Plain Radiographs Transcranial or Orbital Ultrasound Computed Tomography Introduction Background Basic Principles and Scanning Parameters Image Reconstruction and Display Image Appearance Indications, Risks and Benefits Artefacts and Limitations Magnetic Resonance Imaging Introduction Background Basic Principles Magnetic resonance imaging machine. Signal generation. Image appearance and basic applications. Functional Magnetic Resonance Imaging Interventional Magnetic Resonance Imaging Indications, risks and benefits. MRI artefacts. Nuclear Medicine Single-Photon Emission Computed Tomography Positron Emission Tomography Vascular Imaging Techniques Digital Subtraction Angiography Computed Tomography Angiography Computed tomography perfusion. Magnetic Resonance Angiography Further Reading 54 Imaging of Head Trauma Chapter Outline Introduction Modality and Technique Mechanism of Injury Primary Injury Calvarial/Skull Fractures Skull Base Fracture Vascular Injury Traumatic Intra-Cranial Haemorrhage Epidural Haemorrhage Subdural Haemorrhage Traumatic Subarachnoid Haemorrhage Traumatic Injury to the Brain Contusional Brain Injury Diffuse Axonal Injury Chronic Imaging Findings of Traumatic Parenchymal Injury Secondary Brain Injury Further Reading 55 Benign and Malignant Intracranial Tumours in Adults Chapter Outline Radiological Investigations in Intracranial Tumours Computed Tomography Magnetic Resonance Imaging Structural Magnetic Resonance Imaging Advanced Physiological and Molecular Imaging Methods Magnetic Resonance Perfusion-Weighted Imaging Magnetic Resonance Spectroscopy Magnetic Resonance Diffusion Imaging Functional Magnetic Resonance Imaging Positron-Emission Tomography World Health Organization Classification of Central Nervous System Tumours 2016 Intra-Axial Tumours Gliomas Isocitrate Dehydrogenase Wild-Type Astrocytoma (WHO II–III) Glioblastoma (WHO IV) Isocitrate Dehydrogenase-Mutant Lower Grade Gliomas Oligodendroglioma (IDHmut With 1p19q Codeletion) Isocitrate Dehydrogenase-Mutant Astrocytoma (IDHmut 1p19q Intact) Midline Glioma, Histone H3 K27M-Mutant Post-Treatment Monitoring of Gliomas The Role of Advanced Physiological Magnetic Resonance Imaging in Glial Tumours Tumours of Predominantly Neuronal Cell Origin Gangliogliomas and Gangliocytomas Dysembryoplastic Neuroepithelial Tumour Other Glioneuronal Tumour Types Non-Glial Brain Malignancy Lymphoma Metastases Intraventricular Tumours Ependymoma Central Neurocytoma Choroid Plexus Tumours Colloid Cyst Meningioma Extra-Axial Tumours Meningiomas Cranial Nerve Sheath Tumours Epidermoid and Dermoid Tumours Meningeal Metastases Skull Base Tumours Chordomas Glomus Jugulare Tumours Pineal Region Tumours Pituitary Region Tumours Pituitary Adenomas Craniopharyngiomas Rathke Cleft Cysts Other Sellar Region Tumours Further Reading 56 Neurovascular Diseases Chapter Outline Stroke Pathophysiology The Penumbra Model Stroke Classification Causes Large Vessel Thromboembolic Stroke (40%) Cardioembolic Stroke (15% to 30%) Small Vessel or Lacunar Stroke (15% to 30%) Borderzone Infarction Global Hypoxic–Ischaemic Injury Imaging Strategies and Goals in Acute Stroke Objectives of Non-Enhanced Cranial Computed Tomography in Acute Stroke Hyperacute Infarct Imaging Signs on Computed Tomography ASPECTS Infarct Size Scoring System Advanced Imaging Objectives of Penumbral Imaging Perfusion imaging. Magnetic Resonance Imaging in Acute Stroke Angiographic imaging. Assessment of collateral flow. Additional advanced imaging techniques. Computed tomography or magnetic resonance imaging? Subacute and Chronic Infarct Imaging Signs Atheromatous Extracranial Vascular Disease Imaging Options for Carotid Stenosis Vessel plaque imaging. Imaging Signs Non-Atheromatous Extracranial Vascular Narrowing Arterial Dissection Fibromuscular Dysplasia Intracranial Vascular Disease Ischaemic Microangiopathy Moyamoya Vasculitis Cerebral Venous Thrombosis Non-Traumatic Intracranial Haemorrhage Subarachnoid Haemorrhage Initial Investigation of Acute Subarachnoid Haemorrhage Aneurysmal Subarachnoid Haemorrhage Angiography in Acute Subarachnoid Haemorrhage Imaging of Incidental Intracranial Aneurysms Intracerebral Haemorrhage Appearance on Computed Tomography and Magnetic Resonance Imaging Angiography in Intracerebral Haemorrhage Arteriovenous Malformations Subdural and Extradural Haemorrhage Further Reading 57 Intracranial Infections Chapter Outline Bacterial Infections Bacterial Meningitis Cerebritis and Brain Abscess Epidural Abscess and Subdural Empyema Ventriculitis Tuberculosis Neurosyphilis Fungal Infections Viral Infections Herpes Simplex Encephalitis Other Viral Encephalitides Human Immunodeficiency Virus and Acquired Immunodeficiency Syndrome Human Immunodeficiency Virus Encephalopathy Human Immunodeficiency Virus and Vascular Disease Progressive Multifocal Leukoencephalopathy Immune Reconstitution Inflammatory Syndrome Parasitic Infections Toxoplasmosis Cysticercosis Echinococcus (Hydatid Disease) Malaria Further Reading 59 Neurodegenerative Diseases and Epilepsy Chapter Outline Ageing and Dementia—Introduction and Clinical Overview Normal Ageing Phenomena in the Brain Dementia—Imaging Approach Indications for Imaging Protocol for Computed Tomography and Magnetic Resonance Imaging Alzheimer Disease and Other Primary Neurodegenerative Dementias Alheimer Disease Frontotemporal Lobar Degeneration Vascular Dementia Large-Vessel Vascular Dementia Small-Vessel Vascular Dementia Cerebral Autosomal Dominant Arteriopathy With Subcortical Infarcts and Leukoencephalopathy, Fabry Disease and Cerebral Amyloid Angiopathy Systemic Causes of Vascular Dementia Differential Diagnosis of WM Disorders in Dementia Rapidly Progressive and Other Atypical Dementias Infectious and Inflammatory Disease Human Immunodeficiency Viruses and Progressive Multifocal Leukoencephalopathy Prion Disease Autoimmune Limbic Encephalitis Toxic/Metabolic and Leukodystrophic Disorders Parkinson Disease and Related Disorders Idiopathic Parkinson Disease and Differential Diagnosis Dementia With Parkinsonism Neurodegeneration and Other Movement Disorders Epilepsy Introduction and Clinical Overview The New Basic Classification of Seizures Focal Seizures Generalised Seizures Epilepsy—Imaging Approach Indications for Imaging Imaging Protocol Epilepsy—Structural Alterations Malformation of Cortical Development Vascular Malformations Hippocampal Sclerosis Hypoxic-ischaemic haemorrhagic disorders Traumatic Brain Injury Tumours Epilepsy—Metabolic Aetiology Epilepsy—Immune Aetiology Epilepsy—Infectious Aetiology Epilepsy—Structural Brain Alterations— Congenital Disorders Malformation of Cortical Development: Migration and Gyration Disorders Epilepsy—Structural Brain Alterations— Genetic Syndromes Epilepsy—Structural Brain Alterations— Predominately Acquired Diseases Hippocampal Sclerosis Neoplasms Post-Traumatic Epilepsy Cerebrovascular Disorders Epilepsy—Infectious Aetiology Further Reading 58 Inflammatory and Metabolic Disease Chapter Outline Inflammatory-Demyelinating Disorders of the Central Nervous System Multiple Sclerosis Magnetic Resonance Imaging Multiple Sclerosis Variants Marburg Disease Schilder Disease Baló Concentric Sclerosis Pseudotumoural Lesions Neuromyelitis Optica Spectrum Disorders Acute Disseminated Encephalomyelitis Acute Disseminated Encephalomyelitis Variants Bickerstaff encephalitis. Acute haemorrhagic leukoencephalitis. Primary and Secondary Vasculitis Introduction Primary Angiitis of the Central Nervous System Secondary Central Nervous System Vasculitis Primary Systemic Vasculitis With Central Nervous System Involvement Giant-cell arteritis. Takayasu arteritis. Kawasaki disease. Polyarthritis nodosa. Neurosarcoidosis Behçet Disease Systemic Lupus Erythematosus Metabolic and Toxic Disorders in the Adult Radiotherapy Postradiotherapy Leukoencephalopathy Radionecrosis Radiation-Induced Vascular Malformations Stroke-Like Migraine Attacks After Radiation Therapy Syndrome Methotrexate Posterior Reversible Encephalopathy Syndrome Mild Encephalopathy With a Reversible Isolated Splenium of the Corpus Callosum Lesion Brain Gadolinium Deposition Alcohol-Related Diseases Brain Atrophy Marchiafava–Bignami Disease Drug-Induced Encephalopathies Cocaine Opioids and Derivatives Cannabis Ecstasy Other Intoxications Methanol Poisoning Diethylene Glycol Carbon Monoxide Heavy Metal Poisoning Organic Solvent Poisoning Metabolic Encephalopathy Inherited Metabolic Encephalopathy in Adults X-Linked Adrenoleukodystrophy Krabbe Disease Fabry Disease Metachromatic Leukodystrophy MELAS Non-Inherited Metabolic Encephalopathy Wernicke Encephalopathy Osmotic Demyelination Hepatic Encephalopathy Acute Glycaemia Disorders Hypoglycaemia Hyperglycaemia Without Ketosis Acknowledgements Further Reading 60 The Orbit Chapter Outline Introduction Orbital Anatomy Osseous Anatomy Muscular Anatomy The Globe Vascular and Nervous Supply of the Orbit Imaging of the Orbit Orbital Pathology Congenital Disease Coats’ Disease Persistent Hypertrophic Primary Vitreous Retinopathy of Prematurity Coloboma Dermoid Disorders of Globe Size or Shape Degenerative Disease Drusen Orbital Inflammatory Disease Thyroid Orbitopathy Idiopathic Orbital Inflammation Systemic Inflammatory Diseases With Orbital Involvement IgG4-Related Orbital Disease Sarcoidosis Granulomatosis With Polyangiitis Orbital Apex Disorders Orbital Infection Lacrimal Gland Pathology Benign Lacrimal Fossa Masses Malignant Lacrimal Fossa Masses Benign Neoplasms and Mass-Like Lesions Nerve Sheath Tumour Optic Nerve Glioma Optic Nerve Sheath Meningioma Vascular Lesions of the Orbit Cavernous Haemangioma Capillary Haemangioma Varix Venous Lymphatic Malformation Arteriovenous Malformations Carotid-Cavernous Fistula Malignant Neoplasms Uveal Melanoma Metastatic Disease Lymphoproliferative Malignancy Paediatric Neoplasms Retinoblastoma Rhabdomyosarcoma Medulloepithelioma Ischaemia Orbital Trauma The Retro-Orbital Visual Pathway Introduction Anatomy Pathologies of the Anterior Visual Pathway (Optic Nerves, Chiasm and Optic Tracts) Congenital Intrinsic Tumours Inflammatory/Demyelinating Lesions Extrinsic Compression Pathologies of the Posterior Visual Pathway (Lateral Geniculate Nucleus, Optic Radiation and Visual Cortex) Central Gaze Palsies Other Neuro-Ophthalmological Conditions Idiopathic Intracranial Hypertension Recurrent Ophthalmoplegic Cranial Neuropathy Further Reading 61 Head and Neck Radiology Chapter Outline Introduction The Ear The Auricle and External Auditory Canal Anatomy Pathology Chronic Stenosing Otitis Externa. Exostoses and Osteoma of the External Auditory Canal. Keratosis Obturans. External Auditory Canal Cholesteatoma. Necrotising Otitis Externa. Neoplasia of the Auricle and External Auditory Canal. Congenital Atresia/Stenosis of the External Auditory Canal. The Middle Ear Anatomy and Physiology Pathology Cholesteatoma. Tympanosclerosis. Otosclerosis. Fenestral. Retrofenestral or pericochlear. Ossicular disruption. Venous sinus thrombosis. Intracranial complications. The Inner Ear Anatomy and Physiology Pathology Vestibular schwannoma. Trauma. Congenital malformations. Facial palsy. Glomus tumours (paragangliomas). Cochlear electrode implantation. The Sinonasal Region Anatomy and Physiology Radiology and Pathology Rhinosinusitis Nasal Polyposis Antrochoanal Polyp Mucocoeles Epistaxis Nasal and Paranasal Sinus Tumours Osteoma Inverted Papilloma Juvenile Angiofibroma Sinonasal Malignancy The Oral Cavity Anatomy Radiology and Pathology Mucosal Lesions The Salivary Glands Anatomy Radiology and Pathology Tumours—Benign, Malignant Sialadenitis Sialolithiasis Fractures of the Facial Skeleton Fractures of the Zygomatic Complex Orbital Blow-Out Fractures Radiological Investigation of Maxillary Fractures Fractures of the Mandible The Temporomandibular Joint Anatomy Pathology and Radiology Developmental Abnormalities Temporomandibular Joint Dysfunction Arthritides Injury The Suprahyoid Neck Anatomy The Parapharyngeal Space The Parotid Space Anatomy and radiology. The Retropharyngeal Space and Danger Space Anatomy. Pathology. The Masticator Space Mandible Anatomy. Pathology and radiology Inflammation. Tumours. The Carotid Space Anatomy. Pathology Carotid artery dissection. Carotid and vagal paragangliomas. Schwannoma. The Pharyngeal Mucosal Space (PMS) Anatomy. Nasopharynx Anatomy. Radiology and pathology Nasopharyngeal malignancy. Oropharynx Anatomy. Radiology and pathology. Perivertebral Space The Infrahyoid Neck Anatomy Hypopharynx Radiology and Pathology Larynx Anatomy and Physiology Radiology and Pathology Laryngeal malignancy. Laryngeal squamous cell carcinoma. Chondrosarcoma Adenoid cystic carcinoma. Laryngocoele. Recurrent laryngeal nerve. Thyroid and Parathyroid Anatomy Radiology Ultrasound. Nuclear medicine. Magnetic resonance imaging and computed tomography. Thyroid Pathology Thyroiditis. Thyroid malignancy. Parathyroid Pathology Cervical lymph nodes Radiology and pathology Acknowledgements Further Reading SECTION F Oncological Imaging 62 Introduction to Oncological Imaging Chapter Outline Imaging Techniques for Cancer Imaging Computed Tomography Magnetic Resonance Imaging Positron-Emission Tomography Diagnosis and Imaging Primary Diagnosis Confirmation of Diagnosis Staging Staging Systems Diagnosis and Staging in Clinical Practice Non–Small Cell Lung Cancer Breast Cancer Prostate Cancer Rectal Cancer Distant Metastatic Disease Assessment of Treatment Response Objective Response Assessment Imaging Post-Treatment Residual Masses Treatment Toxicity Lung Bone and Bone Marrow Neurotoxicity Hepatic Toxicity Cardiotoxicity Surveillance and Restaging Surveillance of Asymptomatic Patients Restaging of Symptomatic Patients Conclusion Further Reading 63 The Breast Chapter Outline Mammographic Techniques Standard Projections Additional Projections Breast Compression Radiation Dose Digital Breast Tomosynthesis Digital Breast Tomosynthesis in Breast Cancer Screening Contrast Enhanced Spectral Mammography Ultrasound Ultrasound Technique Normal Breast Anatomy Breast Pathology Benign Lesions With Mass Effect Cysts Fibroadenomas and Related Conditions Papilloma Lipoma Hamartoma Invasive Carcinoma Classification of Invasive Breast Cancer Imaging Appearance of Invasive Breast Cancer Mammography. Ultrasound. The Differential Diagnosis of Malignancy Microcalcifications Benign Microcalcifications Malignant Microcalcifications Breast Magnetic Resonance Imaging Technique Lesion Characterisation Indications for Breast Magnetic Resonance Imaging Local Staging Monitoring Response to Neoadjuvant Chemotherapy High-Risk Screening Managing Magnetic Resonance Imaging-Detected Lesions Controversies Surrounding the Use of Breast Magnetic Resonance Imaging Magnetic Resonance Imaging for Imaging Breast Implants Nuclear Medicine Techniques Interventional Breast Radiology Core Needle Biopsy Vacuum-Assisted Biopsy (VAB) Guidance Methods for Breast Needle Biopsy Number of Samples Magnetic Resonance Imaging-Guided Biopsy Managing the Result of Needle Biopsy Preoperative Localisation of Impalpable Lesions Breast Cancer Screening Programmes Introduction The Evidence for Population Screening Which Age Groups Should Be Screened? The Screening Process and Assessment Interval Cancers The Benefits and Harms of Breast Cancer Screening Conclusion Further Reading 64 Reticuloendothelial Disorders Chapter Outline Epidemiology Age Infectious Agents Immunosuppression Genetic Factors Gender and Race Histopathological Classification Hodgkin Lymphoma Non-Hodgkin Lymphoma Staging, Investigation and Management Hodgkin Lymphoma Clinical Features and Staging Prognosis and Treatment Early-Stage Disease (Stages IA and IIA). Advanced-Stage Disease (Stages IIB, IIIA/B and IVA/B). Non-Hodgkin Lymphoma Clinical Features and Staging Prognosis and Treatment Lymph Node Disease in Lymphoma Imaging Nodal Disease Choice of Imaging Technique Neck Thorax Abdomen and Pelvis Extranodal Disease in Lymphoma Thorax Pulmonary Parenchymal Involvement Primary Pulmonary Lymphoma Pleural Disease Pericardium and Heart Thymus Chest Wall Breast Hepatobiliary System and Spleen Liver Spleen Gastrointestinal Tract Stomach Small Bowel Colon and Rectum Oesophagus Pancreas Genitourinary Tract Kidneys Bladder Prostate Testis Female Genital Tract Adrenal Glands Musculoskeletal System Bone Marrow Bone Central Nervous System Primary Secondary Orbit Head and Neck Lymphoma Waldeyer’s Ring Salivary Glands Thyroid Mucosa-Associated Lymphoid Tissue Lymphomas Burkitt Lymphoma Lymphoma in the Immunocompromised Lymphomas Associated With HIV (AIDS-Related Lymphomas) Post-transplant Lymphoproliferative Disorders Monitoring Response to Therapy Prognostication Residual Masses Computed Tomography Magnetic Resonance Imaging Functional Imaging Response Criteria Computed Tomography Response Criteria FDG PET/CT Response Criteria FDG-PET/CT in Response Assessment Treatment Planning With FDG PET/CT Surveillance and Detection of Relapse Conclusion Further Reading 65 Bone Marrow Disorders Chapter Outline Myeloproliferative Neoplasms Polycythaemia Vera Clinical Features Imaging Findings Primary Myelofibrosis Clinical Features Imaging Features Haematologic Malignancies Leukaemia Clinical Features Imaging Features Lymphoma Clinical Features Imaging Features Primary Bone Lymphoma Clinical Features Imaging Features Plasma Cell Dyscrasias Solitary Plasmacytoma of Bone Clinical Features Imaging Features Multiple Myeloma Clinical Features Imaging Features Miscellaneous Conditions Systemic Mastocytosis Clinical Features Imaging Features The Histiocytoses Langerhans Cell Histiocytosis Imaging Features Erdheim–Chester Disease Imaging Findings Further Reading 66 Bone Marrow Disorders: Chapter Outline Disorders of Red Cells Physiological Marrow Reconversion The Anaemias The Myelodysplastic Syndromes The Haemoglobinopathies Thalassaemia Clinical Features Radiological Features Hypertransfusion. Iron chelation therapy. Bisphosphonate therapy. Sickle Cell Disease Clinical Features Radiological Features Marrow hyperplasia. Bone infarction. Osteomyelitis. Disorders of Blood Coagulation Haemophilia (Haemophilia A) Christmas Disease (Haemophilia B) Von Willebrand Disease Radiological Features Further Reading 67 Imaging for Radiotherapy Planning Chapter Outline Types of Radiotherapy External Beam Radiotherapy Conventional External Beam Radiotherapy Three-Dimensional Conformal Radiotherapy Intensity-Modulated Radiotherapy Stereotactic Body Radiotherapy Brachytherapy Particle Therapy The Radiotherapy Pathway Target Volume Definition Clinical Volume Definition (Non-Imaging Based) Computed Tomography Simulation Image Fusion Dosimetry Delivery and Verification Image-Guided Radiotherapy Planar (Two-Dimensional) Imaging Volumetric (Three-Dimensional) Imaging Four-Dimensional Imaging Adaptive Radiotherapy Magnetic Resonance Imaging-Guided Radiotherapy Functional Imaging in the Radiotherapy Process Inclusion of Biological Information to the Treatment Process Radiomics Conclusion Further Reading 68 Functional and Molecular Imaging for Personalized Medicine in Oncology Chapter Outline Personalised Medicine in Oncology Dynamic Contrast Enhanced- Computed Tomography Contrast Agent Kinetics Magnetic Resonance Imaging Dynamic Contrast-Enhanced Magnetic Resonance Imaging Diffusion-Weighted Imaging Magnetic Resonance Spectroscopy Positron Emission Tomography Fluorodeoxyglucose Positron Emission Tomography Non-Fluorodeoxyglucose Positron Emission Tomography Tracers Emerging Molecular Imaging Techniques and Theranostics Ultrasound Optical Imaging Conclusion: Role of Functional and Molecular Imaging in Oncology Further Reading SECTION G Paediatric Imaging 69 Current Status of Paediatric Imaging Chapter Outline Projection Radiography Fluoroscopy Ultrasound Computed Tomography 320-Row Multidetector Computed Tomography Dual-Source Computed Tomography Dual-Energy Computed Tomography Radiation Dose Considerations Patient Care Dental Cone Beam Computed Tomography Magnetic Resonance Imaging Patient Preparation Radiofrequency Coils Motion Artefact Reduction Tissue Contrast Image Resolution Imaging Planes Practical Consequences Nuclear Medicine Further Reading 70 The Neonatal and Paediatric Chest Chapter Outline The Neonatal Chest Normal Anatomy and Artefacts Normal Lung Development Idiopathic Respiratory Distress Syndrome Transient Tachypnoea of the Newborn Meconium Aspiration Syndrome Neonatal Pneumonia Air Leaks Pleural Effusions Surfactant Dysfunction Disorders Lines and Tubes The Chest in Older Children The Chest Radiograph Normal Variants Cardiac or Respiratory? The Lungs Pulmonary Infection Bacterial Versus Viral Features of Infection Round Pneumonia Necrotising/Cavitary Pneumonia Specific Infections Tuberculosis Mycoplasma pneumoniae Late Complications of Infection Pleural Effusion The Acutely Wheezing Child Asthma Inhaled Foreign Bodies Stridor Congenital Chest Abnormalities Bronchopulmonary Foregut Malformations Congenital Thoracic Cysts Congenital Pulmonary Airway Malformations Congenital Diaphragmatic Hernia Pulmonary Sequestration Congenital Lobar Overinflation Bronchial Atresia Lung Agenesis–Hypoplasia Complex Congenital Venolobar Syndrome—Scimitar Syndrome Malignancy Mediastinal Masses Anterior mediastinum. Middle mediastinum. Posterior mediastinum. Pulmonary and Endobronchial Tumours Chest Wall Tumours Cystic Fibrosis Immunodeficiency Human immunodeficiency virus. Infectious pulmonary complications of immunodeficiency Pneumocystis jiroveci (carinii) pneumonia. Invasive pulmonary aspergillosis. Non-infectious pulmonary complications Lymphoproliferative disease and lymphocytic interstitial pneumonia. Diffuse alveolar haemorrhage. Idiopathic pneumonia syndrome. New techniques in paediatric respiratory imaging Lung ultrasound Lung MRI Summary Further Reading 71 Paediatric Abdominal Imaging Chapter Outline Introduction Visible Abnormalities of the Anterior Abdominal Wall Gastroschisis Omphalocele Bladder Exstrophy—Epispadias—Cloacal Exstrophy Complex The Choking Neonate Oesophageal Atresia and Tracheo-Oesophageal Fistula Post-surgery imaging. The Vomiting Neonate Non-Bilious Vomiting Obstruction of the Stomach Enteric Duplication Cysts Gastric Perforation Bilious Vomiting Small Bowel Malrotation and Volvulus Management Duodenal Atresia and Stenosis Small Bowel Atresia and Stenosis Neonatal Abdominal Distension Necrotising Enterocolitis Intra-abdominal Lymphatic Malformation Megacystis–Microcolon–Intestinal Hypoperistalsis (Berdon) Syndrome Delayed Passage of Meconium Hirschsprung Disease Functional Immaturity of the Colon and Meconium Plug Syndrome Meconium Ileus Colon Atresia Distal Ileal Atresia Anorectal and Cloacal Malformations The Infant and Older Child Abdominal Pain Acute Appendicitis Mesenteric Lymphadenitis Inflammatory Bowel Disease Ultrasonography. Conventional barium studies. Magnetic resonance imaging. Computed tomography. Intussusception Small bowel intussusception. Constipation Intestinal Motility Disorders Henoch–Schönlein Purpura Abdominal Distension Enteric Duplication Cysts Mesenteric Cysts Non-Bilious Vomiting Gastro-Oesophageal Reflux Disease Organoaxial Torsion and Gastric Volvulus Malrotation With Chronic Intestinal Obstruction or Intermittent Volvulus Hypertrophic Pyloric Stenosis Omphalomesenteric (Vitelline) Duct Remnants Meckel Diverticulum Gastrointestinal Malignancies The Immunocompromised Child Abdominal Manifestations of Cystic Fibrosis Abdominal Trauma The Liver Imaging Techniques Ultrasonography Magnetic Resonance Imaging Computed Tomography Angiography Imaging Anatomy Liver Involvement in Congenital Malformation and Infections, Syndromes and Systemic Conditions Non-Obstructive Jaundice Infection Chronic Liver Disease Cirrhosis Fibrosis Non-Alcoholic Fatty Liver Disease Fibropolycystic Liver Disease Suprahepatic Chronic Liver Disease Portal Vein Portosystemic Shunts Extrahepatic Portal Vein Occlusion Portal Hypertension Portal Venous Gas Preduodenal Portal Vein Mass Lesions Imaging Features Hepatoblastoma (Fig. 71.47) Vascular Neoplasms Mesenchymal Hamartoma (Fig. 71.48) Liver Metastases Trauma Transplant Biliary System Imaging Techniques Imaging Anatomy Jaundice Biliary Atresia (Fig. 71.50) Choledochal Malformation (Choledochal Cyst; Fig. 71.51) Inspissated Bile Persistent Intrahepatic Cholestasis Sludge and Gallstones Spontaneous Perforation of the Bile Ducts Cholangitis Sclerosing Cholangitis Neoplasia Pancreas Imaging Techniques Imaging Anatomy Congenital Abnormalities and Associations Pancreas Divisum (Fig. 71.52) Annular Pancreas (Fig. 71.53) Other Systemic Disorders Cystic Fibrosis (Fig. 71.54) Other Pancreatitis Trauma Congenital Hyperinsulinism Neoplasms Spleen Imaging Techniques Imaging Anatomy Imaging Findings Splenomegaly Wandering Spleen Focal Lesions Calcifications Lateralisation Disorders (Fig. 71.59) Infarction Trauma Neoplasia Further Reading 72 Imaging of the Kidneys, Urinary Tract and Pelvis in Children Chapter Outline Overview Imaging Techniques Plain Radiography Ultrasound Standard Technique Normal Gonadal Imaging in Girls Normal Gonadal Imaging in Boys Cystography Micturating (Voiding) Cystogram (MCUG/VCUG) Indications. Micturating cystourethrography technique. Contrast-Enhanced Ultrasonography Technique. Nuclear Medicine Direct Radio-Isotope Cystogram Technique. Indirect Radio-Isotope Cystogram Static Renal Scintigraphy Using 99mTc-Dimercaptosuccinic Acid Dynamic Renography Technique. Urography (Plain Radiograph and Intravenous Urogram) Computed Tomography Method Magnetic Resonance Imaging Method Interventional Procedures Angiography Antegrade Pyelogram Nephrostomy Retrograde Pyelogram Renal Biopsy Congenital Anomalies Renal Anomalies Renal Agenesis Abnormal Migration and Fusion of the Kidneys Renal Ectopia Abnormalities With Renal Fusion Cross Fused Renal Ectopia Duplex Kidneys Imaging Anomalies of the Renal Pelvis and Ureter Pelviureteric Junction Obstruction Imaging Megaureter and Hydroureter Imaging Bladder Anomalies Prune-Belly Syndrome Functional Bladder Disturbance and Neurogenic Bladder Urethral Anomalies Posterior Urethral Valves Imaging Anterior Urethral Abnormalities Urethral Stricture Rectourethral Fistula Duplication of the Urethra Uterus and Vagina Undescended Testis Antenatal Diagnosis of Pelvicalyceal and/or Ureteral Distention Prenatal Diagnosis of Congenital Abnormalities of the Renal/Urological Tract (CAKUT) and Differential Diagnosis Bilateral Renal Pelvic Dilatation Unilateral Renal Pelvic Dilatation Megaureter Renal Failure Renal Vein Thrombosis Urinary Tract Infection and Vesicoureteric Reflux Clinical Setting Imaging Renal Abscess Xanthogranulomatous Pyelonephritis Renal Cystic Disease Cystic Dysplasia Multicystic Dysplastic Kidney Simple Cysts Localised Cystic Disease of the Kidney Acquired Cystic Renal Disease Genetic Cystic Disease Autosomal Dominant Polycystic Kidney Disease Imaging Tuberous Sclerosis Autosomal Recessive Polycystic Kidney Disease Juvenile Nephronophthisis/Medullary Cystic Disease Imaging Nephrocalcinosis Renal Calculi Tumours Benign Tumours Nephroblastomatosis Mesoblastic Nephroma Multilocular Cystic Nephroma Angiomyolipoma Malignant Tumours Wilms Tumour Clear Cell Sarcoma of the Kidney Rhabdoid Tumour of the Kidney Renal Cell Carcinoma Lymphoma and Leukaemia Rhabdomyosarcoma Inflammatory Diseases of the Scrotum Testicular Torsion Scrotal Masses Ovarian Masses Ovarian Cysts Torsion of the Ovaries and Adnexa Ovarian Tumours Presacral Masses Hypertension Trauma Renal Transplantation Pre-Transplantation Post-Transplantation Further Reading 73 Skeletal Radiology in Children Chapter Outline Constitutional Disorders of Bone Nomenclature Prevalence Diagnosis Imaging Prenatal Screening and Investigation Imaging for Diagnosis Imaging for Complications Management Genetic Counselling Osteochondrodysplasias Chromosomal Disorders Trisomy 21 (Down Syndrome) 45XO (Turner Syndrome) Localised Disorders of the Skeleton Developmental Dysplasia of the Hip Idiopathic Avascular Necrosis of the Femoral Head (Perthes Disease) Slipped Capital Femoral Epiphysis Femoral Dysplasia (Idiopathic Coxa Vara/Proximal Focal Femoral Deficiency Spectrum) Idiopathic Coxa Vara Proximal Focal Femoral Deficiency Tibia Vara and Tibial Bowing Talipes Madelung Deformity Radial Dysplasia Sprengel Deformity (Congenital Elevation of the Scapula) Scoliosis Neurocutaneous Syndromes Neurofibromatosis Tuberous Sclerosis Inflammatory Disorders Juvenile Idiopathic Arthritis Juvenile Dermatomyositis Chronic Recurrent Multifocal Osteomyelitis Non-Inflammatory Disorders Haemophilia Pigmented Villonodular Synovitis Synovial Osteochondromatosis Metabolic and Endocrine Disorders Rickets Vitamin D Deficiency Rickets Vitamin D-Dependent Rickets Vitamin D-Resistant (Hypophosphataemic) Rickets Renal Osteodystrophy Tumour Rickets Other Dietary Deficiencies and Toxicity Scurvy Fluorosis Lead Poisoning Endocrine Disorders Hyperparathyroidism Hypoparathyroidism Pseudohypoparathyroidism and Pseudo-Pseudohypoparathyroidism Hypothyroidism Haemoglobinopathies Sickle Cell Disease Thalassaemia Storage Disorders Gaucher Disease Infection of the Bones and Joints Osteomyelitis Infective Arthritis Infection of the Spine (Discitis and Osteomyelitis) Acknowledgements Further Reading 74 Paediatric Musculoskeletal Trauma and the Radiology of Nonaccidental Injury and Paediatric Factures Chapter Outline Physeal Injuries The Upper Limb Shoulder/Humerus Elbow Forearm/Wrist/Hand The Lower Limb Pelvis Acetabular, Hip and Femur Knee Tibia/Ankle/Foot Tibia Ankle Foot Cervical Spinal Injuries Nonaccidental Injury Clinical Presentation and the Role of the Radiologist Injury Patterns Shaken Baby Syndrome General Imaging Strategies Skeletal Injury The Skeletal Survey Bone Scintigraphy Magnetic Resonance Imaging Ultrasound Fracture Patterns in Accidental Versus Nonaccidental Injury Rib Fractures Metaphyseal Injury Long Bone Fractures Unusual Fractures Fracture Healing Differential Diagnosis Birth Trauma Accidental Injury Generalised Bone Disease Brain Injuries Pathophysiology of Skull, Brain and Spinal Canal Lesions Imaging in Abusive Head Trauma Skull Fractures Extra-Axial Haemorrhages Diffuse Hypoxic-Ischaemic Lesions Spine Injuries Strategy and Prognosis Further Reading 75 Bone Tumours and Neuroblastoma in Children Chapter Outline Bone Tumours Malignant Bone Tumours Osteosarcoma The Ewing Sarcoma Family of Tumours Bone Metastases Rare Malignant Bone Tumours in Children Benign Bone Tumours Bone-Forming Tumours Osteoid Osteoma Osteoblastoma Tumours of Fibrous Tissue Origin Non-ossifying Fibroma and Metaphyseal Fibrous Cortical Defects (Synonyms: Fibroxanthoma, Benign Fibrous Histiocytoma) Fibrous Bone Dysplasia Osteofibrous Bone Dysplasia Cartilage-Forming Tumours Osteochondroma (Exostosis) Chondroblastoma Vascular and Other Connective Tissue Tumours Myofibromatosis Gorham Disease Locally Aggressive Tumours Chondromyxoid Fibroma Tumour-like Lesions Simple Bone Cyst (Synonyms: Juvenile, Solitary or Unicameral Bone Cyst) Aneurysmal Bone Cyst Langerhans Cell Histiocytosis Neuroblastoma Imaging Radiographs Ultrasound Computed Tomography and Magnetic Resonance Imaging Radionuclide Radiology Other Imaging Techniques Neuroblastoma Staging Differential Diagnosis Further Reading 76 Paediatric Neuroradiology Chapter Outline Normal Brain Maturation Normal Myelination Normal Gyral Development Other Postnatal Maturational Changes Brain Malformations and Developmental Abnormalities Posterior Fossa Abnormalities Cerebellar Hypoplasia Dandy–Walker Malformation and Its Variants Joubert Syndrome and Related Disorders Other Posterior Fossa Malformations or Developmental Disorders Rhombencephalosynapsis. Pontine tegmental cap dysplasia. Lhermitte–Duclos or dysplastic cerebellar gangliocytoma. Chiari II Malformation Chiari I Malformation Supratentorial Abnormalities Disorders of Dorsal Induction Anencephaly. Cephalocele. Chiari II malformation (Arnold–Chiari). Disorders of Ventral Induction Holoprosencephaly. Malformations of Commissural and Related Structures Agenesis of the septum pellucidum. Commissural agenesis or dysgenesis. Agenesis of the corpus callosum. Agenesis of the corpus callosum with interhemispheric cyst. Malformations of Cortical Development—Histogenesis, Neuronal Migration and Cortical Organisation Polymicrogyria Schizencephaly Lissencephaly–Agyria–Pachygyria Grey Matter Heterotopia Hemimegalencephaly Focal Cortical Dysplasia Neurocutaneous Syndromes Neurofibromatosis Type 1 Tuberous Sclerosis Sturge–Weber Syndrome Neurofibromatosis Type 2 Other Neurocutaneous Syndromes Spinal Malformations Normal Development Definitions Open Spinal Dysraphism Closed Spinal Dysraphism Dorsal Dermal Sinus Diastematomyelia Neurenteric Cysts Disorders of the Caudal Cell Mass/Caudal Regression Syndrome Segmental Spinal Dysgenesis Inborn Metabolic Brain Disorders Craniosynostosis Neonatal Nasal Obstruction: Nasal Cavity Stenosis/Atresia Choanal Atresia and Pyriform Stenosis Skeletal Dysplasias Brain Tumours The Children’s Cancer and Leukaemia Group Guidelines Posterior Fossa Tumours Suprasellar Tumours Craniopharyngioma Hypothalamic–Optic Pathway Glioma Infundibular Tumours Pituitary Tumours Pineal Region Tumours Central Nervous System Germ Cell Tumours Primary Pineal Tumours: Pineoblastoma and Pineocytoma Supratentorial Hemispheric Tumours Astrocytomas Ependymomas Supratentorial Embryonal Tumour With Multilayered Rosettes Desmoplastic Infantile Astrocytoma/Desmoplastic Infantile Gangliogliomas Choroid Plexus Tumours Dysembryoplastic Neuroepithelial Tumours Cerebrovascular Disease and Stroke Hypoxic Ischaemic Injury in the Developing Brain Introduction Patterns of Brain Injury in the Preterm Neonate Periventricular White Matter Injury or ‘Leukomalacia’ Brain Haemorrhagic Disease Encephalopathy of Term Neonate—Patterns of Injury Miscellaneous Acquired Toxic or Metabolic Disease Intracranial and Intraspinal Infections Congenital Infections Toxoplasmosis, Rubella, Cytomegalovirus, Herpes Simplex (TORCH) Meningitis Pathophysiology Uncomplicated Meningitis Imaging of Complications (Table 76.5) Tuberculous Infection Bacterial Infection: Cerebritis and Abscess Formation Neurocysticercosis Viral Encephalitis Infection in Immunocompromised Children Spinal Infections Brain and Cord Inflammation Trauma Birth Trauma Growing Skull Fractures Spinal Trauma Atlantoaxial Rotatory Fixation Abusive Head Trauma Hydrocephalus Summary Further Reading SECTION H Interventional Radiology 77 Current Status of Imaging for Interventional Procedures Chapter Outline Introduction Computed Tomography Angiography in Clinical Practice Dual-Energy Computed Tomography Angiography Magnetic Resonance Angiography in Clinical Practice Computed Tomography Angiography or Magnetic Resonance Angiography: Safety, Preference and Ease of Use Imaging in Specific Conditions Abdominal Aortic Aneurysm Assessment for Suitability for Endovascular Repair and Postintervention Follow-Up Assessing the Aorta for Other Pathological Conditions Renovascular Hypertension Assessment of the Mesenteric Vasculature: Acute and Chronic Mesenteric Ischaemia and Acute Gastrointestinal Bleeding Acute and Chronic Mesenteric Ischaemia Acute Mesenteric Ischaemia Chronic Mesenteric Ischaemia Computed Tomography Angiography for Acute Gastrointestinal Bleeding Diagnosis of Pulmonary Embolism: D Dimer, the Wells Criteria and Computed Tomography Pulmonary Angiography and Magnetic Resonance Angiography Computed Tomography Angiography and Magnetic Resonance Angiography for Pulmonary Embolism Other Pulmonary Conditions Diagnosis of Stroke: Computed Tomography and Magnetic Resonance Diagnosis of Acute Arterial Wall Dissection Elucidating the Source of Embolic Stroke Subclavian Steal Syndrome Peripheral Vascular Disease Preintervention Imaging With Computed Tomography Angiography and Magnetic Resonance Angiography Computed Tomography Angiography Magnetic Resonance Angiography Arteriovenous Malformations Computed Tomography and Magnetic Resonance for Planning of Percutaneous Biopsy, Abscess Drainage and Tumour Ablation Further Reading 78 Angiography Chapter Outline Introduction Angiographic Technique Preparation Arterial Puncture Antegrade Versus Retrograde Puncture Equipment Sheaths Guidewires Catheters Closure Devices Contrast Medium Iodinated Contrast Media Alternative Contrast Agents Gadolinium CO2 Angiography Complications of Angiography Bleeding False Aneurysm Other Complications Further Reading 79 Aortic Intervention Chapter Outline Introduction Perioperative Management Including Infrastructure and Staffing Stent-Grafts and Basic Principles of Stent-Grafting Thoracic Aortic Intervention Anatomical Considerations Thoracic Aortic Aneurysm Outcomes of Endovascular Repair and Comparison With Surgery Acute Aortic Syndrome Thoracic Aortic Dissection Complicated Type B Dissection Chronic Dissection and Aneurysmal Development Outcomes of Endovascular Repair and Comparison With Surgery Acute Intramural Haematoma and Penetrating Ulcer Traumatic Lesions of the Thoracic Aorta Blunt Traumatic Injury to the Thoracic Aorta Penetrating Injury to the Thoracic Aorta Aortic Coarctation Abdominal Aortic Intervention Abdominal Aortic Aneurysm Anatomical Considerations in Abdominal Aortic Aneurysm Repair Risks and Timing of Repair Outcomes of Endovascular Repair and Comparison With Surgery for Elective Abdominal Aortic Aneurysm Repair Endovascular Repair of Ruptured Abdominal Aortic Aneurysm Aortic Stenoses and Occlusions Traumatic Abdominal Aortic Injuries Thoraco-Abdominal Aneurysms Surveillance Imaging and Complications Endoleak Type 1 Endoleak (See Fig. 79.28) Type 2 Endoleak (See Fig. 79.30) Type 3 Endoleak (See Fig. 79.32) Types 4 and 5 Endoleaks Device Migration, Dislocation, Kinking and Occlusion Graft Infection (See Fig. 79.33) Summary and Conclusion Further Reading 80 Peripheral Vascular Disease Intervention Chapter Outline Interventional Radiology Techniques Angioplasty Stenting Embolisation Thrombolysis Arterial System Pelvic and Lower Extremity Arteries Angiographic Anatomy Arterial Disease Affecting the Lower Extremity Diagnosis Treatment of Chronic Limb Ischaemia Iliac Artery Disease Stenosis. Occlusions. Common Femoral Artery and Profunda Femoris Superficial Femoral Artery Stenosis. Occlusions. Popliteal Artery Calf Vessels Treatment of Acute Lower Limb Ischaemia Upper Extremity Arteries Anatomy Pathology Endovascular Treatment Gastrointestinal System Angiography Mesenteric Haemorrhage Visceral Artery Aneurysms Occlusive Mesenteric Vascular Disease Bronchial Artery Embolisation The Carotid Arteries Imaging Angiography Endovascular Treatment of Carotid Artery Stenosis Venous System Lower Extremity Venous System Imaging Assessment Endovascular Treatment of Iliofemoral Deep Venous Thrombosis Upper Extremity Venous Obstruction Superior Vena Cava Disease Inferior Vena Cava Filters Complications of Endovascular Procedures Further Reading 81 Image-Guided Biopsy and Ablation Techniques Chapter Outline Image-Guided Biopsy Introduction Principles of Image-Guided Biopsy Case Selection Preprocedural Assessment Core Biopsy Versus Fine-Needle Aspiration Biopsy Needles Fine-Needle Aspiration Cytology Needles Core Biopsy Needles Core Biopsy Needles Semiautomatic, For Example Temno, SuperCore (Fig. 81.1) Fully Automatic, For Example Achieve, BioPince, Bard Max-Core (Fig. 81.3) Menghini Technique Biopsy Needles, For Example Surecut Coaxial Technique Imaging Modalities for Biopsy Ultrasound Computed Tomography Magnetic Resonance Imaging Positron Emission Tomography/Computed Tomography Fluoroscopy Stereotactic Tips and Tricks ‘Look Before you Leap’—Procedural Set-Up Avoiding Inadequate Samples Improving Needle Tip Visualisation in Ultrasound-Guided Biopsy Postprocedural Care Specimen Handling Complications and Safety Issues Track Seeding Summary Image-Guided Tumour Ablation The Case for Tumour Ablation The Principles of Tumour Ablation Ablative Energies Radiofrequency Ablation Microwave Ablation Cryoablation Focused Ultrasound Irreversible Electroporation Interstitial Laser Photocoagulation Chemical Ablation Image Guidance Preprocedural Planning Procedural Targetting Periprocedural Monitoring Postprocedural Imaging Understanding and Modifying Tumour Pathophysiology Specifics and Current Outcomes Renal Cancer Hepatocellular Carcinoma Colorectal Liver Metastases Lung Tumour Ablation Bone Tumour Ablation Continuity of Care Summary Further Reading 82 Image-Guided Drainage Techniques Chapter Outline Indications and Contraindications Management of Anticoagulant Medication Prior to Percutaneous Drainage Imaging Guidance Patient Preparation and Care Catheter Insertion Catheter Management Specific Drainage Techniques Chest Hepatic Parenchyma Pancreas and Peripancreatic Region Gallbladder Spleen Subphrenic Collections Peritoneum Deep Pelvic Collections Organ Traversal Paediatric Patients Complications Conclusion Further Reading 83 Hepatobiliary Intervention Chapter Outline Management of Biliary Obstruction Introduction Background Percutaneous Transhepatic Cholangiography Biliary Drainage: External, Internal–External Biliary Stenting: Metal, Plastic Benign Disease Benign Strictures Calculous Disease Percutaneous Biliary Intervention Complications Vascular Interventional Techniques in the Liver Chemoembolisation Background Indications Transarterial Chemoembolisation Contraindications Preprocedure Medication/Sedation/Analgesia Performing the Procedure Postprocedure Complications Imaging Post Chemoembolisation Transarterial Chemoembolisation Literature Radioembolisation Background Patient Selection Performing the Procedure: Planning 90Y Administration 90Y Complications Imaging Post Radioembolisation Radioembolisation Results Hepatic Arterial Embolisation for Haemorrhage Transjugular Intrahepatic Portosystemic Shunt Background Imaging Preprocedure Evaluation Performing the Procedure Post Procedure Complications Portal Vein Embolisation Background Performing the Procedure Hepatic Venous Interventions: Budd–Chiari Syndrome Background Diagnosis Treatment Further Reading 84 Vascular Genitourinary Tract Intervention Chapter Outline Kidney Renal Artery Stenosis Background Aetiology and Pathology Diagnosis of Renal Artery Stenosis Atheromatous Renovascular Disease Clinical presentation of atheromatous renovascular disease. Treatment of atheromatous renovascular disease. Renal revascularisation trials. Technique for Renal Artery Angioplasty and Stenting Renal artery angioplasty. Renal artery stenting. Fibromuscular disease. Takayasu arteritis. Neurofibromatosis. Williams syndrome. Renal Denervation Background Pathophysiology Technique Results Renal Tumours Benign Malignant Renal Arteriovenous Malformation Renal Artery Aneurysms Technique Trauma Embolisation (Table 84.4) Kidney Ureter Bladder Prostatic Artery Embolisation Technique Fibroid Embolisation Uterine Artery Embolisation Treatment Options Imaging Technique Safety and Efficacy Obstetric Haemorrhage Postpartum Haemorrhage Causes of Postpartum Haemorrhage Management of Postpartum Haemorrhage Technique Abnormal Placentation Management of abnormal placentation. Complications of Embolisation and Balloon Occlusion Results of Haemorrhage Control for Postpartum Haemorrhage Ectopic Pregnancy and Spontaneous Abortion Pelvic Congestion Syndrome Treatment Varicocele Treatment Further Reading 85 Non-Vascular Genitourinary Tract Intervention Chapter Outline Introduction Percutaneous Renal Access— Important Anatomical Factors Renal Position Relations of the Kidney Pelvicalyceal Anatomy of the Kidney Renal Vascular Anatomy Other Anatomical Factors Important for Renal Access Renal Anatomy and Percutaneous Entry General Equipment for Renal Access Access Needle Guidewires Catheters Percutaneous Nephrostomy (PCN) Techniques Patient Preparation and Procedure Single Puncture Ultrasound-Guided Percutaneous Nephrostomy (PCN) Single Puncture Fluoroscopically Guided Percutaneous Nephrostomy (PCN) Double Puncture Combined Ultrasound and Fluoroscopy-Guided Percutaneous Nephrostomy (PCN) Computed Tomography–Guided Nephrostomy Catheter Fixation and Removal Difficult or Complicated Nephrostomy Non-Dilated Kidneys Horseshoe Kidney Transplant Kidney Paediatric Nephrostomy Pregnancy Complications of Percutaneous Nephrostomy (PCN) and Management Percutaneous Nephrolithotomy (PCNL) Technique of Percutaneous Nephrolithotomy (PCNL) Tract Planning Tract Dilatation Complications of Percutaneous Nephrolithotomy and Management Antegrade Ureteric Stents Indications for Ureteric Stents Ureteric Stents Versus Percutaneous Nephrostomy Types of Ureteric Stents Plastic Stents Metal Stents Pathological and Functional Changes After Stenting Clinical Efficacy of Current Stents Practical Aspects of Antegrade Stenting Technique of Antegrade Stenting Stent Lumen Size Stent Length Type of Stent Insertion of a Plastic Stent Insertion of a Metal Ureteric Stent Further Issues About Ureteric Stents Retroperitoneal Looping of Stent/Wire False Passage Created During Stricture Cannulation Stenting of Ureteroileal or Ureterocolic Anastomosis Tortuous Ureter Tight or Rigid Stricture A Stent Cannot Be Advanced Across the Stricture, Even After Dilatation Improvement in Stent Position The Thread Loops Will Not Disengage Extra-Anatomical Stenting Monitoring Ureteric Stents Exchanging or Removing Stents Balloon Dilatation of Ureteric Strictures Treatment of Urinary Leaks and Fistulas Suprapubic Bladder Catherisation Managing a Non-Deflatable Urinary Catheter Balloon Percutaneous Cystolithotripsy (PCCL) Interventional Procedures in the Prostate Gland and Seminal Vesicles Drainage of Prostate and Perirectal Abscess Seminal Vesiculography and Cyst Sampling Insertion of Prostate Fiducials and Absorbable Hydrogel Spacer Prostate Brachytherapy, Cryotherapy and Prostate Ablation Ablation of Renal Cysts or Lymphoceles Further Reading 86 Venous Access and Interventions Chapter Outline Introduction Prior General Assessment General Patient and Interventional Suite Preparation Central Venous Catheters Tunnelled Central Venous Catheter: Hickman Line Tunnelled Central Venous Catheter: Groshong Catheter Tunnelled Central Venous Catheter: Totally Implantable Vascular Access Device Tunnelled Central Venous Catheter: the Haemodialysis Catheter Translumbar Dialysis Catheter Insertion Transhepatic Dialysis Catheter Insertion Peripherally Inserted Central Catheters Complications and Their Management Short-Term Complications Haemorrhage Inadvertent Arterial Puncture Air Embolism Pleural Puncture Arrhythmias Laceration of Central Veins Long-Term Complications Infection Fibrin Sheath Thrombosis Tip Malposition Catheter Kinks/Fractures Diagnostic Evaluation Further Reading 87 Skeletal Interventions Chapter Outline Introduction Image-Guided Bone Biopsy Patient Preparation Bone Biopsy Techniques Performing the Procedure Results Spinal Infiltration Procedures Lumbar Disc Herniation Indications Technique Complications Radiofrequency for Pain Management Pulsed Radiofrequency Ablation Facet Joint Syndrome Technique Cervical Spine Procedures Percutaneous Discectomy Technique Percutaneous Vertebral Augmentation Osteoplasty and Osteosynthesis Ablation of Bone Tumours Complications Osteoid Osteomas Embolisation of Bone Tumours Neuromodulation and Neurostimulation Further Reading
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