49 episodes

High-yield, educational radiology lectures utilizing a multimodality imaging approach including MRI, CT, ultrasound, radiography, and nuclear medicine. Lectures are presented in both didactic and quiz formats. These video podcasts are designed for radiology residents, fellows, and radiologists, as well as any student or practitioner interested in optimizing patient care through radiology. Visit www.radiologistHQ.com for more info and reference material.

Radiology Lectures | Radiologist Headquarters Daniel J. Kowal, MD

    • Health & Fitness

High-yield, educational radiology lectures utilizing a multimodality imaging approach including MRI, CT, ultrasound, radiography, and nuclear medicine. Lectures are presented in both didactic and quiz formats. These video podcasts are designed for radiology residents, fellows, and radiologists, as well as any student or practitioner interested in optimizing patient care through radiology. Visit www.radiologistHQ.com for more info and reference material.

    • video
    Case Review: Ultrasound & CT of Retroperitoneal Fibrosis

    Case Review: Ultrasound & CT of Retroperitoneal Fibrosis

    In this radiology lecture, we discuss the ultrasound and CT appearance of retroperitoneal fibrosis.

    Key points include:



    * Most cases (70%) are idiopathic = Ormond disease.

    * Nonspecific symptoms depending on involved structures: Malaise, weight loss, low-grade fever.

    * Ureteral entrapment: Obstructive uropathy or renal failure, may see medial deviation of middle third of ureters with hydronephrosis.

    * Venous entrapment: Lower extremity edema, deep venous thrombosis.

    * CT: Soft tissue mass anterolateral to aorta with posterior sparing.

    * DDx: Retroperitoneal Lymphoma will Lift the aorta.

    * MRI: Low T1/T2 signal when inactive, T2 bright with early enhancement when active inflammation.

    * PET/CT: Avid when metabolically active, may aid in identifying appropriate biopsy sites.



    Click the YouTube Community tab or follow on social media for bonus teaching material posted throughout the week!

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    Twitter: https://twitter.com/radiologistHQ

    • 4 min
    • video
    Case Review: CT & MRI of Perihilar Cholangiocarcinoma (Klatskin Tumor)

    Case Review: CT & MRI of Perihilar Cholangiocarcinoma (Klatskin Tumor)

    In this radiology lecture, we discuss the CT and MRI appearance of perihilar cholangiocarcinoma.

    Key points include:



    * Perihilar cholangiocarcinoma (AKA Klatskin tumor) occurs at bifurcation of the hepatic duct.

    * Cholangiocarcinoma (CC) is a primary malignant tumor of bile duct epithelium, usually adenocarcinoma.

    * CC is the most common primary hepatic malignancy after hepatocellular carcinoma (HCC), and most are extrahepatic (as opposed to intrahepatic).

    * Appearance of CC is based on growth pattern: Mass-forming, periductal infiltrating, and intraductal growing.

    * Risk factors: Parasite infection, choledochal cyst, primary sclerosing cholangitis, recurrent pyogenic cholangitis, and inflammatory bowel disease (ulcerative colitis).

    * Patients are usually 65 or older.

    * On CT and MRI, perihilar CC appears as a biliary stricture with shouldering/abrupt tapering.

    * If a mass is visible, will typically have rimlike enhancement with gradual centripetal enhancement on delayed images, be T2 bright (but not as homogeneous or as bright as hemangioma), and may have a targetlike appearance on DWI (favors CC over HCC).



    Click the YouTube Community tab or follow on social media for bonus teaching material posted throughout the week!

    Instagram: https://www.instagram.com/radiologistHQ/

    Facebook: https://www.facebook.com/radiologistHeadQuarters/

    Twitter: https://twitter.com/radiologistHQ

     

    • 9 min
    • video
    Case Review: Ultrasound & CT of Medullary Sponge Kidney

    Case Review: Ultrasound & CT of Medullary Sponge Kidney

    Join me in this radiology lecture revealing the ultrasound and CT appearance of medullary sponge kidney (MSK).

    Key points include:



    * MSK is a developmental ectasia with cystic dilatation of the collecting tubules in the pyramids leading to medullary nephrocalcinosis.

    * DDx medullary nephrocalcinosis: Hyperparathyroidism (most common cause in adults), renal tubular acidosis (type 1), MSK, hypervitaminosis D, other causes of hypercalcemia, sarcoidosis.

    * MSK associations: Beckwith-Wiedemann syndrome, congenital hemihypertrophy, Caroli disease, Ehlers-Danlos syndrome.

    * US: Echogenic medullary pyramids.

    * CT: Renal calculi, striated nephrogram, excretory phase “paintbrush” appearance or “growing calculus” sign.

    * Often asymptomatic but may present due to renal stones.



    Click the YouTube Community tab or follow on social media for bonus teaching material posted throughout the week!

    Instagram: https://www.instagram.com/radiologistHQ/

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    Twitter: https://twitter.com/radiologistHQ

    • 6 min
    • video
    Case Review: Ultrasound & CT of Amebic Liver Abscess

    Case Review: Ultrasound & CT of Amebic Liver Abscess

    In this radiology lecture, we discuss the ultrasound and CT appearance of amebic liver abscess.

    Key points include:



    * Entamoeba histolytica infection.

    * Endemic in Africa, Southeast Asia, and Central & South America.

    * More common in males.

    * Presents as right upper quadrant pain, fever and hepatomegaly.

    * Both amebic and pyogenic (bacterial) abscesses can have a layered wall with the “double target” or “double rim” sign.

    * Amebic more likely to be unilocular (septations present in 30%) without “cluster” sign typical of multiloculated pyogenic abscess.

    * Amebic more likely solitary, pyogenic more likely multiple.

    * Can be treated medically (metronidazole), but if diagnosis uncertain, if there is failed response to medical therapy, or if large abscess at risk for rupture = aspiration.



    Bächler P, Baladron MJ, Menias C, et al. Multimodality Imaging of Liver Infections: Differential Diagnosis and Potential Pitfalls. RadioGraphics 2016 36:4, 1001-1023.

    Click the YouTube Community tab or follow on social media for bonus teaching material posted throughout the week!

    Instagram: https://www.instagram.com/radiologistHQ/

    Facebook: https://www.facebook.com/radiologistHeadQuarters/

    Twitter: https://twitter.com/radiologistHQ

    • 5 min
    • video
    Case Review: X-ray & CT of Pulmonary Infarction

    Case Review: X-ray & CT of Pulmonary Infarction

    In this radiology lecture, we discuss the chest x-ray and CT appearance of pulmonary infarction in the setting of acute pulmonary embolism.

    Key points include:



    * Uncommon complication of pulmonary embolism.

    * Most common in right lung.

    * Risk of infarction increases with large clot burden.

    * Typically wedge-shaped, peripheral consolidation with no air bronchograms (Hampton hump).

    * However, may not be wedge-shaped, and not all wedge-shaped opacities will be infarcts in the setting of pulmonary embolism.

    * “Bubbly” consolidation containing rounded, central lucencies: Most specific finding of infarct* and represents a combination of infarcted, necrotic lung and adjacent viable, aerated lung.

    * “Vessel” sign: Enlarged vessel leading to apex of a wedge-shaped opacity. Vessel is dilated due to the presence of intraluminal thrombus or distal obstruction.



    *Revel MP, Triki R, Chatellier G, et al. Is it possible to recognize pulmonary infarction on multisection CT images? Radiology. 2007;244(3):875-882.

    Click the YouTube Community tab or follow on social media for bonus teaching material posted throughout the week!

    Instagram: https://www.instagram.com/radiologistHQ/

    Facebook: https://www.facebook.com/radiologistHeadQuarters/

    Twitter: https://twitter.com/radiologistHQ

    • 5 min
    • video
    Case Review: Ultrasound of Ruptured Ectopic Pregnancy

    Case Review: Ultrasound of Ruptured Ectopic Pregnancy

    In this radiology lecture, we discuss the ultrasound appearance of ruptured ectopic pregnancy.

    Key points include:



    * Most ectopic pregnancies occur in the fallopian tube: Ampulla most common, followed by isthmus and fimbria.

    * Risk factors: Prior ectopic pregnancy, prior surgery (fallopian tube), pelvic inflammatory disease, endometriosis, IVF.

    * “A single measurement of hCG, regardless of its level, does not reliably distinguish between ectopic and intrauterine pregnancy (viable or nonviable).”*

    * Levels of hCG in ectopic pregnancies are highly variable.

    * Tubal rupture main complication, occurs in up to 20%.

    * Free fluid in pelvis alone nonspecific, but echogenic fluid in Morison pouch (subhepatic space) and cul-de-sac raises concern for rupture.

    * Rupture is a relative contraindication to methotrexate (medical) therapy.



    *Doubilet PM, Benson CB, Bourne T, et al. Diagnostic criteria for nonviable pregnancy early in the first trimester. N Engl J Med 2013;369:1443-51.

    Click the YouTube Community tab or follow on social media for bonus teaching material posted throughout the week!

    Instagram: https://www.instagram.com/radiologistHQ/

    Facebook: https://www.facebook.com/radiologistHeadQuarters/

    Twitter: https://twitter.com/radiologistHQ

    • 5 min

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