Diagnostic Imaging

Diagnostic Imaging

Coloured Atlas

Angiograms

[Courtesy of Dr. N. Jaffer]

Angiograms

Angiogram – CT

CT angiograms permit for a non-invasive method of investigating the vasculature. In the image above, one readily recognizes the celiac artery and its branches, the superior mesenteric artery, and the left kidney. However the most prominent feature of this CTA is the infra-renal aortic aneurysm. [Courtesy of Dr. N. Jaffer]

Angiogram - CT

Abdominal Aortic Aneurysm – AAA

Left Image: Abdominal axial CT with contrast demonstrating a large AAA with extensive intraluminal thrombosis. Patent central lumen containing contrast surrounded by thrombus peripherally. Aortic wall evident due to circumferential calcification (atherosclerosis).

Right Image: Abdominal axial CT with contrast showing abdominal aorta of normal diameter.
[Courtesy of Dr. N. Jaffer]

Abdominal Aortic Aneurysm - AAA

Microcalcifications

The left mammogram depicts microcalcifications, as can be seen with DCIS.
The right mammogram depicts microcalcifications after surgical excision with needle localization.

Microcalcifications

Mammography

Normal Mammography
The left image is of a normal craniocaudal view of a breast mammogram.
The right image is that of a normal mediolateral oblique view of a breast mammogram.

Mammography

Ductogram

An essentially normal ductogram (galactogram).

Ductogram

Side Markers

Side Markers (Left vs Right)

No image available

Rotation

To assess rotation of the film, compare the distance between a spinous process to each of the clavicles. If the supinous process is closer to one clavicle, that side is rotated posteriorly.

Rotation

Penetration

To ensure adequate penetration, the thoracic spine should be visible.

Penetration

Patient ID

No image available

Degree of Inspiration

To ensure proper inflation, the 6th rib should be visible anteriorly and the 10th rib posteriorly.

Degree of Inspiration

Ureteric Obstruction

Observe the obstructive lesion near the lower end of the right ureter. On simultaneous retrograde examination, the lower margin of the obstructing lesion is clearly demarcated.

Ureteric Obstruction

Intravenous pyelogram

Intravenous pyelogram (IVP) (1 hour post-dye injection) showing right hydronephrosis, hydroureter, dilated renal pelvis and calvx.

Intravenous pyelogram

UPJ Obstruction

Congenital UPJ Obstruction & Hydronephrosis
Congenital utero-pelvic junction (UPJ) obstruction & hydronephrosis. This image demonstrates severe hydronephrosis of the right kidney. Retrograde pyelography demonstrates an obstruction at the UPJ. The obstruction in this patient was congenital.

UPJ Obstruction

Stone CT

Non-contrast CT for renal colic.
Left Image: shows right-sided pelvicaliectasis relative to the left-sided renal collecting system.
Right Image: shows calculus in the distal right ureter as the cause.
[Courtesy of Dr. N. Jaffer]

Stone CT

Hydronephrosis

Hydronephrosis of left kidney on ultrasound caused by a left upper ureteric stone seen on abdominal X-ray (red arrow).

Hydronephrosis

Uterus

Uterine Fibroid
Axial CT image of the female pelvis showing large uterine fibroid with the body of the uterus. (Courtesy of Dr. N. Jaffer)

Uterus

Female Pelvis – US

Normal Female Pelvis (US)
Transabdominal ultrasound showing normal bladder, uterus and ovaries. (Courtesy of Dr. N. Jaffer)

Female Pelvis - US

Female Pelvis – MRI

Normal Female Pelvis (MRI)
Sagittal MRI of the female pelvis. (Courtesy of Dr. N. Jaffer)

Female Pelvis - MRI

Bony Pelvis

Pelvic AP radiographs showing the male (left) and female (right) bony pelvis. Note that the male pelvis is narrower, with a “heart-shaped” pelvic inlet, while the female is wider, with a circular or oval-shaped pelvic inlet. (Courtesy of Dr. N. Jaffer)

Bony Pelvis

Ovaries

Ultrasound Image of Polycystic Ovaries
Note the cystic appearance resembling a “string of black pearls.”

Ovaries

Triquetral Fracture

It is either a dorsal avulsion or body fracture. Look for tenderness dorsally, distal to ulnar styloid.

Triquetral Fracture

Shoulder Dislocation

PA view and transcapular view.

Shoulder Dislocation

Scapular Fracture

Scapular Y of the shoulder.

Scapular Fracture

Scaphoid Fracture

Scaphoid fracture of the wrist. The most common carpal fracture. Look for tenderness at the anatomic snuff box. Wrist x-ray is often negative.

Scaphoid Fracture

Vestibular Schwannoma

Tumour in cerebellopontine angle. [Courtesy of Dr. W. Montanera]

Vestibular Schwannoma

Thalamic Glioma

Axial CT with contrast showing a ring enhancing lesion over the left thalamic region with central necrosis. [Courtesy of Dr. J. Spears]

Thalamic Glioma

Posterior Fossa Meningioma

T1-weighted coronal MRI with contrast. A large tumour is highlighted in the right posterior fossa and bilateral dilatation of the lateral ventricles is evident (likely secondary to compression of the 4th ventricle or Sylvian aqueduct). [Courtesy of Dr. J. Spears]

Posterior Fossa Meningioma

Pituitary Macroadenoma

[Courtesy of Dr. W. Montanera]

Pituitary Macroadenoma

Pituitary Adenoma

Multiple views of post-contrast CT image of a pituitary adenoma. The saggital view demonstrates the transphenoidal approach for surgery. [Courtesy of Dr. J. Spears]

Pituitary Adenoma

Ventriculomegaly

(Courtesy of Dr. Seaward and Dr. Ryan, Mt Sinai Hospital)

Ventriculomegaly

Monochorionic Twins

Monochorionic, diamniotic twins T sign
(Courtesy of Dr. Seaward and Dr. Ryan, Mt Sinai Hospital)

Monochorionic Twins

Dichorionic Twins

Dichorionic, diamniotic twins lamdba sign
(Courtesy of Dr. Seaward and Dr. Ryan, Mt Sinai Hospital)

Dichorionic Twins

Placenta Previa

Placenta (P) covers the os. Crosses (+) approximate the cervical length and the bladder (B) is seen on the right.
(Courtesy of Dr. Seaward and Dr. Ryan, Mt Sinai Hospital)

Placenta Previa

Nuchal Translucency

(Courtesy of Dr. Seaward and Dr. Ryan, Mt Sinai Hospital)

Nuchal Translucency

Thyroid Goiter

Right thyroid goiter with calcifications.

Thyroid Goiter

Maxillary Sinusitis

Axial CT scan of maxillary sinusitis. Note air-fluid level in left maxillary sinus. (Courtesy of Dr. A. Waltzman)

Maxillary Sinusitis

Choanal Atresia

Axial CT scan of choanal atresia (arrow indicated bony obstructive plate). (Courtesy of Dr. Papsin, HSC)

Choanal Atresia

Carcinoma

Nasopharyngeal Carcinoma

Axial CT scan of expansive tumour arising in the nasopharynx and causing bilateral nasal obstruction. (Courtesy of Dr. Irish, UHN)

Carcinoma

Adenotonsillar Hypertrophy

Lateral plain film. Note significant tonsillar (large arrow) and adenoid (small arrow) hypertrophy leading to significant narrowing of the nasal and oral airways. (Courtesy of Dr. Papsin, HSC)

Adenotonsillar Hypertrophy

Tetralogy of Fallot

Note the characteristic chest x-ray finding of a boot-shaped heart. (Courtesy Dr. E. Ng)

Tetralogy of Fallot

Respiratory Distress Syndrome

Note the ground glass appearance of the lungs. (Courtesy Dr. E. Ng)

Respiratory Distress Syndrome

Polycistic Kidney

Polycistic Kidney in Newborn

Polycistic Kidney

Pneumothorax

(Courtesy Dr. E. Ng)

Pneumothorax

Necrotizing Enterocolitis

Note the dilated loops of bowel and pneumatosis intestinalis. (Courtesy Dr. E. Ng)

Necrotizing Enterocolitis