Apple core lesion

Various Appearance of Portal Hypertension ~ To be continued

Spenoadrenorenal shunt

Pseudomyxoma peritonei

Ruptured mucocele with foreign body peritonitis
Male: cystadenocarcinoma of appendix
Female: cystadenocarcinoma of ovary

*Thickening of peritoneal + omental sufaces
*Omental cake
*Posterior fixation of bowel loops and mesentery
*Voluminous septated/loculated pseudoascites
*Several thin-walled cystic masses of different size throughout abdominal cavity
*Scalloped contour of liver and splenic margins
Annular / semicircular calcifications

Sign of Intraperitoneal Free Air

Rigler's sign
Triangle sign
Falciform ligament sign
Inverted V sign
Urachus sign
Hyperlucent liver sign
Hepatic age som
Doge cape sign
Anterior superior oal sign
Foot ball sign
Dolphin sign

The pathway of ascites flow over lower abdomen

a. The pelvic cavity, especially the pouch of Douglas
Pouch of Douglas - The most caudal and posterior part of the peritoneal cavity
Upper 4th sarcal segment
Fixation of the peritoneum to Denonvillier's fascia
b. The right lower quadrant at the termination of the small bowel mesentery
c. The superior aspect of the sigmoid mesocolon
d. The right paracolic gutter

Gastric Volvulus

Gastric volvulus
- Mesenteroaxial type: from lesser to greater curve
- Organoaxial type: from cardia to pylorus
Cause
- Diaphragmatic defect
- Intestinal malrotation
- Wandering spleen
-Absence of gastrophrenic ligament and gastrosplenic ligament
Resolve spontaneously sometimes.

*Organoaxial vovulus*

Juxtapapillary diverticula

Major Upper Abdominal Peritoneal Reflection

Falciform ligament - Right coronary ligament - Left triangular ligament
Lesser omentum
Gastrohepatic ligament
- Glisson's capsule
- Left gastric artery
- Coronary vein
- Left gastric nodal chain
Hepatoduodenal ligament
- Free edge of gastrohepatic ligament
- Portal triad
- Portacaval region

Gastrocolic ligament
- Gastroepiploic vessels
- superior mesenteric vein ate the level of uncinate process of pancreas
- Transverse mesocolon
- Taenia mesocolica
Duodenocolic ligament
- descending duodenum
- posterior hepatic flexure
Gastrosplenic ligament
- Gastrocolic ligament and extended from the greater curvature of the stomach to the spleen.
Phrenicocolic ligament
- From the anatomic splenic flexure of the colon to the diaphragm at the level of 11th rib and serves to support the spleen in the left upper quadrant
Small bowel mesentery
- Extended from the left side of the second lumbar vertebra downward to the right. across the aorta and inferior vena cava, to the right sarcoiliac joint, about 15cm.

Typical aging change of pancreas

Bone Island

A bone island, also known as an enostosis, is a focus of compact bone located in cancellous bone. This is a benign entity that is usually found incidentally on imaging studies; however, the bone island may mimic a more sinister process, such as an osteoblastic metastasis.
In CT: a round nodule without extension outside the cancellous bone and does not cause bony destruction

Intestinal intussusception

Acute segmental infarction of kidney

Groove pancreatitis

a form of segmental pancreatitis affecting the head of the pancreas, is localized within the "groove" between pancreas head, duodenum, and common bile duct. Differentiation between groove pancreatitis and pancreatic head carcinoma is often difficult.

Impact of protein plug over Santorini's duct may be the cause of groove pancreatitis

Image: a mass was detected in the head of the pancreas that involved the duodenum. Dynamic CT demonstrated a poorly enhancing lesion extending between the pancreatic head and the duodenum.

Bowler Hat Sign

For differienation of polyp and diverticulm of colon.
Bowler hat pointing toward center of cup showed a polyp and pointing away from center of cup showed a diverticulum
When the bowler hat is nearly parallel to long axis of bowel, it is impossible to determine whether it is a polyp or a diverticulum

Metastasis with hepatoduodenal ligament extension

Gastric cancer with hepatic hilum invasion and common hepatic artery encased.

The spreading from hepatoduodenal ligament can be domostrated from this image

Squamous cell carcinoma

30% of lung cancer
Related to smoking
65% found in main, lobar, or segmental bronchi
Endobronchial mass
Bronchial obstruction
Infiltration of bronchial wall
Local invasion
Hilar mass
Atelectasis and consolidation common
30% solitary nodule or mass
Central necrosis and cavitation relatively common
Metastasis late
Relatively good prognosis

Atelectasis

cause: tumor (most SCC), TB, sarcoidosis, Post operative atelectasis. Large left atrium.
Types:
Resorption - Obstruction
Relaxation - Passive, Pleural effusion, pneumothroax
Adhesive - ARDS (decrease in surfatant production)
Cicatricial - Lung fibrosis
ex. right middle lobe syndrome
Discoid atelectasis: Emoblus, Penumonia, Inadequate inspiration Carcinoma
Segmental atelectasis
Sign
Double lesion sign - RUL and RML collapse
Shifting granuloma sign
Golden's S sign - RUL
Juxtaphrenic peak - UL
Luftsichel sign - LUL - Apical cap
Falt waist sign - LLL
Comet-tail sign - Rounded
Rounded atelectasis - Posterior lower lobe. often free pleural effusion with inflammation

Overture

It's said the author of "Radiology Review Manual" wrote this book when he was a resident according his note for examination. Therefore, in the era of Web 2.0, maybe I can record my study and my idea in this blog. It is a start and it is a record of my work.