Facebook Radiology

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اشترك في: الخميس إبريل 04, 2013 10:28 pm

Re: Learning Radiology

مشاركةبواسطة دكتور كمال سيد » الاثنين مايو 19, 2014 6:21 pm

(Young heavy smoker with no leg pulse. Why? (hint: not atherosclerosis
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اشترك في: الخميس إبريل 04, 2013 10:28 pm

Re: Learning Radiology

مشاركةبواسطة دكتور كمال سيد » الاثنين مايو 19, 2014 6:25 pm

ANSWER: http://goo.gl/W61lA5

Buerger disease

Case contributed by: Dr G Balachandran

Presentation:
40 years old male was referred for evaluation of intermittent claudication in left lower limb.He was a chronic,heavy smoker.

Patient Data:
Age: 40
Gender: Male
Modality: CT

CTA shows total obstruction at left external iliac artery ,femoral.popliteal arteries.

Normal right side lower limb arteries.


Case Discussion:

Buerger disease is an obliterative arteritis found predominantly in heavy smokers. It most commonly affects medium and small vessels of the lower extremities.

VRs allow visualization of complex, overlapping arterial channels without the need for preliminary bone removal, providing an excellent overview of the complex anatomy.

Peripheral CTA provides complete delineation of both the femoropopliteal segment and inflow and outflow arteries, including lesion number, length, stenosis diameter and morphology, adjacent normal arterial caliber, degree of calcification, and status of distal runoff vessels.
These findings help in planning the procedure with respect to route of access, balloon selection, and expected long-term patency after femoropopliteal intervention.
Compared with catheter angiography, peripheral CTA provides better estimates of the effects of eccentric stenoses on luminal diameter reduction .
In addition, collateral vessels can be evaluated with MIP and VR images, and arterial segments distal to long-segment occlusions are well visualized peripheral CTA is more cost effective than digital subtraction angiog-raphy (DSA) for preprocedure evaluation of patients with claudication

http://radiopaedia.org/cases/buerger-disease
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اشترك في: الخميس إبريل 04, 2013 10:28 pm

Re: Learning Radiology

مشاركةبواسطة دكتور كمال سيد » الأحد مايو 25, 2014 3:16 pm

? 70yo woman with sepsis. Diagnosis

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The left kidney is somewhat swollen, enhances less than the right, and demonstrates extensive surrounding stranding. Although the collecting system is a little prominent, with enhancing mucosa, no ureterolithiasis can be identified (a few pelvic phleboliths can be seen to be separate from the ureter on the MPR of the thin slices - not shown).
No abscess is identified, although both kidneys demonstrate cortical scars, presumably related to prior (paediatric) reflux

: Case Discussion
Pyelonephritis usually presents with loin pain, however in the elderly, localising signs are often absent. It is crucial to ensure the collecting system is not obstructed as an infected obstructed kidney needs urgent drainage.
http://radiopaedia.org/cases/pyelonephritis-2
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