Radiology

Table of Contents
Lectures ..................................................................................................................................... 2
Lecture 1: Physics in radiology part 1 ............................................................................................ 2
Lecture 2: Physics in radiology part 2 ............................................................................................ 2
Lecture 3: X-ray production ............................................................................................................ 4
Lecture 4: Clinical radiology of respiratory system part 1........................................................... 5
Lecture 5: Clinical radiology of respiratory system part 2........................................................... 6
Lecture 6: Musculoskeletal imaging (PDF) .................................................................................... 9
Lecture 7: Cardiovascular system (PDF) ..................................................................................... 10
Lecture 8: Neurology (PDF) .......................................................................................................... 11
Lecture 9: Radiology of digestive system...................................................................................... 15
Lecture 10: Radiology of urinary system ..................................................................................... 17
Practice 1: Radiological changes in respiratory system diseases ............................................... 18
Practice 2: Radiological changes in respiratory system diseases ............................................... 19
Practice 3: Digestive and abdominal radiology ........................................................................... 20
Practice 4: Clinical radiology of the urinary system ................................................................... 21
Radiological images ........................................................................................................................ 23
Radiology
Lectures

Lecture 1: Physics in radiology part 1

How do vectors of the electric and magnetic field oscillate?

• Normal plane
• In the direction of spread

What is near field?

• A description which states vectors of the electric and magnetic field become weaker
and non-existent as they move further from the electric conductor

How do we create a radiation field?

• It is created by changes in the magnetic and electric field

What can electromagnetic waves pass through?

• Vacuum and other material media

How is the speed of the electromagnetic wave different in a material media vs vacuum?
• It is slower and the wavelength is reduced

What are the different type of electromagnetic radiation?

• Radio waves (longest), microwaves, infrared radiation, UV radiation, roentgen
radiation (X-rays), gamma radiation (shortest)

What is the formula for speed of an electromagnetic wave?

• Speed = frequency x wavelength

Lecture 2: Physics in radiology part 2

What does ionising radiation mean?

• Radiation that can discharge an electron from an atom

What are the different corpuscular ionising radiation?

• Alpha, beta (electrons and positrons), protons, ions, neutrons

What are the different electromagnetic (photon) ionising radiation?

• UV, X-ray, gamma-ray

What can block alpha, beta and gamma rays?

• Paper, aluminium block and concrete wall (in this order)

What factors influence absorption of thermal radiation?

• Physical properties of the body
• Wavelength
• Temperature of the body
What is the photoelectric effect?
• When UV light causes electron emission from the cathode

How does radiation intensity effect the photoelectric effect?

• High radiation intensity results in a higher number of photoelectrons but it does not
affect the energy of the photoelectrons

What are some details regarding X-rays?

• X-rays are electromagnetic waves
• Source is X-ray tube
• Produced by stopping moving electrons

What are the 4 different types of interactions regarding particles?

• Photoelectric effect
• Coherent scattering
• Incoherent scattering
• Production of particle pairs

What can we use computed tomography for?

• Diagnosis, patient monitoring, radiotherapy planning, screening for risk factors

How is a CT image produced?

• It is produced via a photon attenuation map

What are some principles of CT?

• Transmission profiles through many angles is required
• Arched detectors are used known as detector arrays

What law describes attenuation of a photon passing through matter?

• Beer’s law

What are the two possible orientations for nuclei with an odd number of nucleons in MRI?
• Parallel orientation (low energy)
• Antiparallel orientation (high energy)

What is the principle for MR imaging?

• The radio signal from tissues is produced when a spin returns to their equilibrium
state

What does the contrast of MR image depend on?

• Proton density (concentration)
• Relaxation time T1
• Relaxation time T2

How does magnetism affect the quality of the image produced?

• Tissues with a stronger magnetism (contain more protons) give a stronger signal and
the image will be brighter
What are the basic components of MRI devices?
• A tunnel with a magnet
• Radio frequency coils
• A computer

What are the main qualitative characteristics of a magnet for MRI?

• High magnetic field intensity
• Good temporal stability of the magnet
• Good homogeneity of the magnetic field

What are the three types of magnets?

• Permanent magnets
• Electromagnetic hybrid magnets
• Superconducting magnets

What are some advantages of MRI?

• High sensitivity to changes in water content
• High sensitivity to detecting tumours
• Good for visualising organs
• Painless, non-invasive, not affected by air and bone

Lecture 3: X-ray production

What are the required components of an X-ray tube?

• Glass envelope
• Source of electrons
• Target material

What are the properties of X-rays?

• X-rays are invisible, have no mass, travel at the speed of light (in a vacuum), travel in
straight lines, have short wavelengths, unaffected by electric and magnetic fields, do
not refract, can cause ionisation
• Produced when a beam of high-energy electrons strike a metal target

Give some details about X-rays

• Produced in X-ray tubes
• X-rays are generated when electrons from a filament (cathode) interact with the target
(anode)
• The target is made of tungsten
• Two main components of an x-ray tube – cathode and anode

What term describes the release of electrons from the filament in the cathode?
• Thermionic emission

By what process are X-rays produced and how are they produced?
• Bremsstrahlung – “braking radiation”
• X-rays are produced when electrons are suddenly decelerated due to collision with
the target (anode)
What does the X-ray energy depend on?
• Distance between the electron and nucleus

What are the characteristic interactions of X-ray production?

• High velocity electrons collide with inner shell electrons (K-shell)
• Electron is displaced creating vacancy
• Outer shell electrons fill the vacant space
• X-ray photon is produced (called characteristic radiation it may also be called
Bremsstrahlung radiation or white radiation?)

What provides the energy for X-ray tubes?

• A generator

What does absorption of X-rays depend on?

• Atomic number, wavelength, density, thickness

Lecture 4: Clinical radiology of respiratory system part 1

What methods do we use for examination of the respiratory system?

• Standard radiography – upright, posteroanterior position
• Tomography
• Computerised tomography (CT)
• Pulmonary and bronchial artery angiography
• Percutaneous transthoracic biopsy

What diseases of the respiratory system cause increased aeration?

• Subcutaneous emphysema – traumatic, iatrogenic, infectious
• Pneumothorax – partial and complete, may also show hydropneumothorax,
pulmonary contusion
• Hyperinflation
o Emphysema
§ ↑ transparency
§ Expanded intercostal spaces
§ Horizontally placed posterior rib parts
§ Thin heart
• Can be caused other things – cysts (ring like opacity), bullae, abscesses, caverns,
bronchiectasis

What does consolidation mean?

• Air spaces are filled in with something as in pneumonia or pulmonary oedema

What does atelectasis mean?

• Air spaces are not filled in with anything but instead they are caved in

What does pneumothorax mean?

• Air in pleural space

Does a pneumothorax mean a collapsed lung?

• Not necessarily, especially if there is very little air in the pleural space
What can a bronchial cut off sign in the left lung indicate?
• Mucus plug in the left lung
• Can cause collapse of the left lung with mediastinal shift resulting in complete
opacification of the left hemithorax

What can we suspect if the trachea is shifted to the contralateral side of an opacification?
• We could have complete lung collapse with a pleural effusion not a pneumothorax

Ref:
• https://www.youtube.com/watch?v=uK9D1Tsu4X4

Lecture 5: Clinical radiology of respiratory system part 2

What aspects do we look at when we describe opacities?

• Localisation, number, borders, shape, size, intensity, homogeneity, relationship
toward other structures

What are some diseases with decreased aeration and greater opacification?
• Alveolar consolidation
• Tuberculosis
• Protozoal and metazoal (infections)
• Atelectasis
• Occupational diseases
• Diffuse lung fibrosis
• Lung cancer
• Pleural disease

Give an example of a disease that can cause alveolar consolidation and possible ddg
• Pneumonia
• Ddg – atelectasis, pleural effusion, lung cancer, oedema

What are complications of pneumonia?

• Abscess, pleuritis, fistula

What features can we see with primary TBC?

• Primary Ghon complex
• Primary affect – primary focus with perifocal lymphangitis
• Centripetal lymphangitis
• Central lymphadenitis

What features can we see with secondary TBC?

• Presents usually in higher lung parts, soft tissue opacity, irregular, not well
demarcated
• Haematogenous spread – acute miliary lung TBC, acute micronodular lung TBC…
• Bronchogenous spread – exudation (alveolar consolidation), fibrosis (linear reticular
opacities), caseous necrosis (cavern)

Give examples of protozoal and metazoal infections

• Pneumocystis carinii
• Echinococcus
State radiological signs of atelectasis
• Narrowed intercostal spaces
• Soft tissue opacities, homogenous, sharply demarcated
• Pulls adjacent structures towards the lesion (opacity)

What are differential diagnoses for atelectasis?

• Pleural effusion, pneumonia, post-operative pneumonectomy
• Radiation-induced fibrosis

State occupational diseases

• Silicosis, asbestosis

State diseases with diffuse fibrosis

• Interstitial connective tissue

State radiological signs of diffuse fibrosis

• ↓ lucency of lung fields, reticular opacities (lines that form a net like structure)
• The heart may also appear shaggy

State benign soft tissue tumours

• Fibroma, myoma, lipoma, hamartoma

How do benign tumours present radiologically?

• Solitary round opacity, calcification (may be present)

State malignant forms of lung cancer

• Carcinoma
o Central, peripheral
o Pancoast tumour – cancer that starts at the apex of the lung
• Sarcoma
What are features of peripheral lung cancer?
• Soft tissue opacity
• No air bronchogram
• Irregular shape
• Lobulated contour – i.e. it looks like a cloud (bubbly)
o https://radiologykey.com/pulmonary-neoplasms-4/
• Corona maligna
• Pleural tail – an abnormal mass which has a “tail”

What are features of central lung carcinoma?

• Central, hilar localisation
• Soft tissue opacity
• Irregular contour
• Atelectasis maybe present

What are features of Pancoast tumour?

• Localised at the apex
• Homogenous soft tissue opacity
• Osteolysis may occur
State pleural diseases
• Pleuritis – wet, dry
• Tumours

Extra:

What is alveolar consolidation?

• Air replaced with fluid/pus
• Appears white, patchy/homogenous, no tracheal shift
• Presence of air bronchogram
• No structural distortion of the lung

How is a collapse different to a consolidation?

• Appears white but tracheal shift occurs
• No air bronchograms
• Distortion of lung architecture
Ref
• https://www.youtube.com/watch?v=RLtKLuEtp3Y

What can cause lung collapse?

• Pneumothorax
• Blocked airway – carcinoma, foreign body
• Post-surgery

How can we tell if there is a pneumothorax?

• Shift of the trachea, greater lucency on the side of pneumothorax, no bronchovascular
markings
Ref:
• https://www.youtube.com/watch?v=SpB8fd1ogqY
• https://www.youtube.com/watch?v=nG8KYloFTog

What features can we see in interstitial pulmonary oedema (a form of consolidation)?

• Vascular congestion
• Kerley A and B lines
• Peribronchial cuffing
• Vascular indistinctness – hilar haze
• Fissural thickening

What are Kerley A and B lines?

• Kerley A lines are larger and more centrally located
• Kerley B lines are lines located at the periphery of a chest X-ray
• Both indicate interlobular septal thickening
Ref
• https://www.youtube.com/watch?v=Z23qveLG6UI
• (note the entire clip is not useful)

What is the difference between pleural effusion and atelectasis?

• Pleural effusion results in tracheal deviation away from the opacification
• Atelectasis results in tracheal deviation towards the opacification
What are interstitial markings?
• This refers to the reticular patterns that we see on chest X-ray
Ref
• https://radiology.expert/x-thorax/pathology/interstitial-lungdiseases/

Lecture 6: Musculoskeletal imaging (PDF)

What is the difference between osteoporosis and osteomalacia? (simplified)

• Osteoporosis – bone thinning
• Osteomalacia – failed mineralisation

Which is the characteristic site of muscle strain?

• Myotendinous junction

What is the first line imaging modality to examine joints?

• Radiography

Punched out erosions with overhanging edges surrounding the 1st metatarsophalangeal
joint, along with preservation of joint space width are characteristic of
• Gout

Which of the following is most likely an insufficiency fracture? (** Ans)

• Distal femur fracture in a 16-year-old girl following motor vehicle accident
• Hip fracture in a 72-year-old woman who fell in a bathroom **
• Metatarsal fracture in a newly recruited 21-year-old soldier
• Distal radius fracture in an otherwise healthy 34-year-old woman who slipped on ice
and fell on her outstretched hand
Lipohaemarthrosis on a horizontal X-ray beam radiograph denotes that a fracture is:
• Intra-articular

An otherwise healthy 20-year-old male presents with knee pain following trauma during a
football game. Radiographs reveal soft tissue swelling about the knee and a well-defined
lytic cortical-subcortical lesion at the lateral aspect of the distal femur with a thin sclerotic
rim and mildly lobulated outline. Later, MRI reveals an anterior cruciate ligament tear and
no fluid-fluid levels within the described femur lesion. The previously asymptomatic distal
femur lesion is most likely:
• An osteosarcoma
• An osteoid osteoma
• A non-ossifying fibroma **
• An aneurysmal bone cyst

What would be your recommendation for the bone lesion in the previous question?
• Leave it alone

Which of the following suggests more aggressiveness for bone lesions on radiographs?
• Permeative pattern (it suggests malignancy) **
• Solid type periosteal reaction
 • Narrow zone of transition

A soft tissue mass with well defined (distinct) margins on imaging is benign
• True
• False **

Osteoporosis is best assessed with:

• Radiographs
• US
• MRI
• Dual energy X-ray absorptiometry **

Lecture 7: Cardiovascular system (PDF)

State causes of enlargement of right atrium

• Congenital cardiac disease
• Myocardiopathy
• Tricuspid stenosis/regurgitation
• ASD
• Pulmonary atresia

State causes of enlarged aorta

• Hypertension, aortic stenosis, aortic regurgitation, aneurysm

State causes for enlarged right ventricle

• L-R shunt, pulmonary hypertension

State causes of left atrium enlargement

• Mitral stenosis/regurgitation
• LA myxoma
• PDA

State causes of left ventricle enlargement

• HTA?
• Aortic stenosis, aortic regurgitation, congestive heart failure

State examination modalities for the cardiovascular system

• Echocardiography
• Echocardiography – CDFI
• MSCT
• MRI
• Ventriculography
• Coronarography
• Aortography

What can echocardiography – CDFI measure?

• Cardiac output and ejection fraction
State 3 congenital heart diseases
• VSD, PDA, Tetralogy of Fallot, stenosis, ASF, COA

State 3 causes of L-R shunt

• ASD, VSD, PDA

What is one special feature of dextrocardia?

• The axis of the heart is orientated to the right

What are the different types of heart diseases?

• Congenital heart disease
• Ischaemic heart disease
• Non-ischaemic heart diseases e.g. valvular diseases, cardiomyopathy, tumours,
trauma

State mitral valve diseases

• Mitral stenosis – LA enlargement, ↑PVP, pulmonary oedema…
• Mitral regurgitation – LA and LV enlargement, pulmonary oedema…

State 3 features of cardiomyopathy on CXR

• Triangular heart
• Flat contours (heart arches)
• Blunt cardiophrenic angles

What is pericarditis?
• Inflammation of the pericardium

What can we see in pericardium pericardial effusion?

• ↑ cardiac diameter
• Calcification (may be present)

Lecture 8: Neurology (PDF)

• Acute infarct is the most important part for neurology

Where are Broca’s area and Wernicke’s area?

Where is the cingulate gyrus?

Where are the nuclei, thalamus and globus pallidus?

Where are the hippocampus, brainstem and corpus callosum?

What connects the two parts of the brain?

• Corpus callosum

What are the different types of MRI?

• Diffusion weighted imaging (DWI – MRI technique
• Perfusion MRI
 • Functional MRI
• MR Spectroscopy

State 3 indications for brain MRI

• Congenital lesions (MRI)
• Trauma, ischemic dx
• Brain tumours (CT and MRI but mostly MRI)

Through which foramina do the lateral ventricles communicate with the third ventricle?
• Monro foramina

What sulcus is the red arrow pointing to and what sulcus is the blue arrow pointing to?
• Red – marginal sulcus
• Blue – central sulcus

A 55-year-old male patient with right hemiparesis. What is

the diagnosis?
• Acute left infarct in the left middle cerebral
vascular territory

A 63-year-old male with right sciatica, what is the

diagnosis?
(View image)
• L3-L4 right subarticular disc herniation

A 31-year-old female with a long history of recurrent episodes of numbness and tingling in
her arms and legs, vision loss and fatigue
• Multiple sclerosis – presents with multiple white matter lesions in the brain

A 45-year-old male with acute onset of severe headache

• Subarachnoid haemorrhage
• There is a thick white area below the skull

A 67-year-old male presents with seizures. Where is the lesion located? (View image)
• In the right central gyrus immediately anterior to the central sulcus
An 18-year-old female with sudden paraplegia reported respiratory viral process the week
before. What is the most likely diagnosis?
• Myelitis – long segment of the spinal cord depicting high signal intensity on T2 MRI
image

What is the most likely diagnosis? (View image)

• Meningioma

What anatomical structure is the red asterisk indicating?

• Insula – located in depth to the Sylvian fissure
Lecture 9: Radiology of digestive system

What do we use to visualise the GIT when using X-ray examination?

• Contrast agent

State 3 indications for abdominal X-ray

• Bowel obstruction (ileus)
• Peroration of a hollow organ (stomach, intestine)
• Renal or biliary colic

State a physiological lucency

• Lucency at the fornix of the stomach

What causes lucency in the stomach?

• Hydrogen gas

What does pneumoperitoneum indicate?

• Perforation of a hollow organ

What do we call small and large amounts of gas in the abdomen?

• Small amount of gas – sickle lucency
• Large amount of gas – cresent lucency

How can we differentiate between SBO and LBO? (EXTRA)

• SBO – centrally located, lines that traverse the circumference of the bowels
• LBO – peripherally located, lines that do not traverse the entire circumference of the
bowels
Ref:
• https://www.youtube.com/watch?v=33QsQbngCuk
• https://www.youtube.com/watch?v=LhvRXoq3aFo

State 1 rule for examination using a contrast

• Liquid or solid food must not be take 12hrs before examination

State a contrast agent

• Barium sulfate
• Iodine contrast agents e.g. gastrografin

What is achalasia?
• Muscles of the oesophagus fail to contract correctly and the ring muscle fail to open
properly

What tumours of the oesophagus which cause a filling defect?

• Epithelial – polyps, adenomas, papilloma
• Mesenchymal – leiomyoma, haemangioma, lymphangioma
State reasons for vein dilation in the lower oesophagus
• Portal hypertension, portal venous shunt, hepatic cirrhosis

State 3 features suggesting benign gastric ulcer

• Outpouching of ulcer crater
• Presence of ulcer crater
• Hampton’s line → H for harmless = benign

State features suggesting malignant gastric ulcer

• Does not protrude beyond the gastric contour
• Irregular and shallow ulcer crater
• Carman meniscus sign → C for carcinoma = malignant

State 3 features of benign polyps

• Oval, round, well demarcated

How can malignant tumours of the stomach present?

• Exophytic (medular or vegetative) – resembles “dog bite” – protrudes into the lumen
• Infiltrative – “apple core” – develops circularly
• Ulcerative – creates the effect of irregular walls

What are the 3 different types of hiatus hernias?

• Hiatus hernia in short oesophagus
• Paraesophageal hiatus hernia
• Sliding hiatus hernia

State 3 steps in radiology of the small intestine

• Cleaning the intestinal contents
• Drink barium milk
• X-ray examination

State 3 details about terminal ileitis

• Inflammation of the small intestine
• May trigger hypermotility, spasms, irregular mucosal structures
• Presence of SKIP lesions

State 2 methods used for radiology of the colon

• Double contrast method – using a device the pneumocolon
• Monocontrast method or irrigography – using barium

Which part of the intestine is the widest?

• Cecum

How long is the large intestine?

• 1.5m
What is ulcerative colitis?
• Exudative necrotising inflammation of the colon

What features do we see for ulcerative colitis?

• Spasticity, jagged contours

What features do we see in chronic ulcerative colitis?

• Disappearing haustra
• Fibrosis, narrowing
• Serious complications – peroration, fistulas, cancer

What is the difference between Crohn’s disease and ulcerative colitis?

• Crohn’s – mix of healthy and inflamed intestine, affects all layer’s, commonly
affected site is terminal ileum
• Ulcerative colitis – continuous inflammation of the colon, affects inner most layer

What is diverticulosis?
• Small pouches, usually present on sigmoid colon

How can we visualise diverticula?

• Irrigography

How do diverticula appear radiologically?

• Oval masses with a short neck along the lumen of the colon

State a feature we can see in tumours of the colon on irrigography

• Round, sharp lacunar defects at the end of the lumen

Where do most malignant tumours of the colon appear?

• Rectum

Lecture 10: Radiology of urinary system

What is lucency vs opacity?

• Lucency = black, opacity = white

What do opacities indicate?

• Soft tissues, calcifications, foreign bodies

What does lucency indicate?

• Gas

What is voiding cystourethrography?

• A technique for visualising the urethra and urinary bladder during urination

Why do we do voiding cystourethrography (VCUG)?

• To check bladder and urethral function
What are indications for VCUG?
• Frequent infections, functional disorder, obstruction, vesicoureteral reflux (VUR)

State a contraindication for examination of the urinary system

• Sensitivity to iodine contrast media

What are 3 advantages of ultrasound imaging?

• Simple, quick, no contraindications for children and pregnant women (no contrast
media used)

How do bladder stones appear on US?

• High intensity echoes within the bladder
• Presents with an acoustic shadow

How does hydronephrosis appear on US?

• Lucent (dark)

Give two indications for CT

• Cysts, tumours

Does MRI involve contrast media?

• No

What does angiography involve?

• Seldinger technique (a method to access to blood vessels)
• Local anaesthesia
• Femoral artery puncture
• Introducing guide wire and a catheter

What are indications for angiography?

• Tumours
• Arteriovenous malformation
• Haematuria
• Renovascular hypertension
• Preparation for treatment

State a non-vascular interventional procedure

• Percutaneous drainage

Practice 1: Radiological changes in respiratory system diseases

Important for exams

• Hydropneumothorax – presence of air and fluid in pleural space, appears as a
straight line with opacity below it
• Lung oedema – fluid in lungs, appears hazy, increased cardiothoracic ratio/cardiac
silhouette size, upper lobe pulmonary venous diversion (stag’s antler sign)
 • Emphysema – damage to inner walls of alveoli, hyperinflation, flattened
hemidiaphragms, increased lucency
• Pneumothorax – no vascular opacities, lucency, tracheal shift (maybe seen), white
line (pleural edge is visible), pneumothorax line, collapsed lung, mediastinal shift
• Malignant cavern – cave like structure, opaque below and lucent above
• Bronchopneumonia (lobar pneumonia) – appears as scattered nodular opacities
• Pleural effusion – opacity + tracheal shift away from opacification + curve at the
costophrenic angle
• Fibrosis in apices
• Atelectasis - trachea is pulled towards opacity
• Massive pleural effusion
• Pneumonia – area of opacification
• Lucency – area of gas (dark)
• Generalised –
• Subcutaenous –
• Consolidations –
• Tumours
• Fibrosis – don’t need to be concerned about this
• Occupational – don’t need to be concerned about this
• Other things to know
• What produces a shadow, transparency?
• Inflammation vs consolidation, pneumonia, oedema
• Lung tumours (primary hemarthoma), speculation, irregular shape for malignant
tumour with pleural effusion

What is the algorithm for chest X-ray?

• DRSABCDE – details, ripe image, soft tissue and bones, airways and mediastinum,
breathing, circulation diaphragm and extras

State one way you could tell if an X-ray is PA or AP?

• PA presents with clavicles over the lung field

What diseases can cause increased lucency?

• Emphysema, COPD, pneumothorax

State 3 radiological features of increased aeration (lucency)

• Diffuse lucency, flat diaphragm domes, horizontal ribs

Practice 2: Radiological changes in respiratory system diseases

What is the algorithm for describing a lesion?

• LSSIHR – localisation, shape, size, intensity, homogeneity, relationship

What can cause alveolar consolidation?

• Oedema, exudate, blood
What are some features of alveolar consolidation?
• Soft tissue opacity, different localisation, irregular shape
• Not sharply demarcated
• Inhomogenous
• Position of adjacent structures is not affected

State 3 radiological features of lung oedema

• Presence of Kerly A and B lines
• Presence of soft tissue opacities (not well demarcated)
• “butterfly” appearance

How does pneumonia appear radiologically?

• Specific segment is affected
• Triangular, well delineated

How does bronchopneumonia appear radiologically?

• Poorly demarcated opacity
• Opacity is inhomogenous

State 2 stages of silicosis

• Multiple nodules (opacities) with hilar enlargement
• Growth of opacities due to connective tissues

What is diffuse lung fibrosis?

• Formation of connective tissue in alveolar wall

What features do we see for diffuse lung fibrosis on X-ray and CT?
• X-ray – generally reduced lucency of lower lung zones
• CT – honeycomb pattern

State X-ray features for pleuritis

• Soft tissue opacity located in CF angle, extends up, meniscus sign

State features of massive pleural effusion

• Homogenous soft tissue opacity, whole lung, not sharply demarcated, pushes
adjacent structures away from lesion

Practice 3: Digestive and abdominal radiology

What is pneumoperitoneum?
• Presence of gas in the abdominal cavity

What can we assess in the digestive tract using contrast media?

• Length, diameter, anatomy, filling, peristalsis, mucous folds

What is achalasia?
• Disorder of the oesophagus – makes it difficult to swallow
What is a corrosive stricture?
• Fibrotic narrowing of the oesophagus

Practice 4: Clinical radiology of the urinary system

What are differential diagnoses for calculosis?

• Nephrocalcinosis, cysts, tumour, chronic inflammation, AIDs?

What does dilation of the pelvicalyceal system indicate?

• Obstruction

How does a renal cyst appear on CT?

• Hypodense, oval, well demarcated

How can we assess bladder tumour?

• Cystography

What congenital abnormalities can we find in the urinary system?

• Ectopic kidney, double ureter

How can a neurogenic bladder appear on X-ray?

• “Christmas tree like”

What is percutaneous nephrostomy?

• Placement of a small, flexible rubber tube (catheter) through the skin into the kidney
to drain urine

What is excretory urography?

• A type of contrast study used to verify and localise upper urinary tract disease

QFRE
• Stroke imaging, location of Ewing sarcoma, interventional radiology
o Ewing’s sarcoma – tumour formed from bone cells or soft tissue around bone
o Often occurs in the bones of the legs and pelvis but can occur in any bone
• Perthes bone disease
o A condition where femoral head loses temporarily loses blood supply – it can
cause bone necrosis
• How do bone cysts look like?
o Fluid filled spots in bone
• What is Meckel’s diverticulum?
o Small pouch in the wall of intestine
o Formed near the junction of small and large intestine
o Remnant tissue (i.e. it is not needed)
• Hypoechoic – dark
• Hyperechoic – black
• Anechoic – without echos e.g. cysts
• T1 – clear fluid is represented by a low signal, water is black/dark
• T2 – clear signal is presented by a high signal, water is bright
• Bud chiari syndrome = hepatic vein occlusion
 Radiological images

Figure 1 Pneumothorax
Figure 2 Lung oedema

Figure 3 Pneumonia Figure 4 Pneumocystis carinii

Figure 5 Echinococcosis
Figure 7 Atelectasis Figure 8 Asbestosis

Figure 9 Silicosis Figure 10 Fibrosis (seen on periphery)

with shaggy borders of heart

Figure 11 Lung cancer

Figure 12 Pancoast tumour
 Figure 13 Pleuritis

Figure 15 Pleural effusion

Figure 16 Subcutaneous emphysema Figure 17 Emphysema

Figure 19 Giant bulla

Figure 18 Bronchogenic cyst

Figure 20 Abscess Figure 21 TB cavern

Figure 22 Bronchiectasis Figure 23 Alveolar consolidation

Figure 24 TB Figure 25 Fistula

Figure 26 Pleural fibroma

Figure 27 Uterine leiomyoma

 Figure 29 Pulmonary oedema
Figure 28 Hamartoma

Figure 30 Pericardial effusion Figure 31 Bowel obstruction (ileus)

Figure 32 Intestinal perforation Figure 33 Gastric ulcer

Figure 34 Hiatus hernia

Figure 35 Crohn's ileitis
Figure 37 Ulcerative colitis

Figure 38 Diverticulosis
Figure 39 Voiding
cystourethrography (VCUG)

Figure 40 Hydronephrosis on US
Figure 41 Corrosive
strictures
Figure 42 Oesophageal varices Figure 43 Sliding hernia

Figure 44 Hiatus hernia (2)

Figure 45 Renal cyst

Figure 46 Bladder tumour

Figure 47 Massive pleural effusion and atelectasis

Figure 49 CXR anatomy