Core Radiology
A Visual Approach to Diagnostic Imaging
Core Radiology
A Visual Approach to Diagnostic Imaging
Jacob Mandell
Radiology Residency, Class of 2013,
Brigham and Women’s Hospital, Boston, MA, USA
University Printing House, Cambridge cb2 8bs, United Kingdom
Published in the United States of America by Cambridge University Press, New York
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It furthers the University’s mission by disseminating knowledge in he pursuit of education, learning and research at the highest international levels of excellence.
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Information on this title: www.cambridge.org/9781107679689
© Jacob Mandell 2013
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First published 2013
Printed in Spain by Grafos SA, Arte sobre papel
A catalogue record for this publication is available from the British Library
ISBN 978-1-107-67968-9 Paperback
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Cambridge University Press has no responsibility for the persistence or accuracy of URLs for external or third-party internet websites referred to in this publication, and does not guarantee that any content on such websites is, or will remain, accurate or appropriate.
Every effort has been made in preparing this book to provide accurate and up-to-date information which is in accord with accepted standards and practice at the time of publication. Although case histories are drawn from actual cases, every effort has been made to disguise the identities of the individuals involved. Nevertheless, the authors, editors and publishers can make no warranties that the information contained herein is totally free from error, not least because clinical standards are constantly changing through research and regulation. The authors, editors and publishers therefore disclaim all liability for direct or consequential damages resulting from the use of material contained in this book. Readers are strongly advised to pay careful attention to information provided by the manufacturer of any drugs or equipment that they plan to use.
For my wife Julie and our sons Baylor and Cameron.
You are the most amazing family I can ask for.
CONTENTS
Acknowledgements viii
List of contributors ix
1Thoracic Imaging 1
2Gastrointestinal imaging 87
3Genitourinary imaging 157
4Neuroimaging 201
5Musculoskeletal imaging 346
6Ultrasound 464
7Nuclear imaging 553
8Breast imaging 592
9Cardiovascular imaging 658
10Interventional radiology 694
11Pediatric imaging 741
12Physics of imaging 838 Index 865
acknowledgements
A thousand thanks to my parents Karen and Fred, Julie’s parents May and Henry, and my sisters Hinda and Becky. Your support and love is essential for everything we do.
This book would not have been possible without the unwavering support of Dr. Barbara
Weissman, the Brigham and Women’s Radiology Residency program director and my unofficial mentor. Thank you for actually saying “that’s a great idea!” when I told you about the book a couple months after you met me, and for not acting too surprised when I actually finished it three years later.
This book would be a pale shadow of its current form without the invaluable contributions from each faculty and resident contributor, listed individually on the following pages. Thank you so much for investing so many hours in this project.
Thanks to Dr. Amir Zamani for kindly allowing me to use images from your teaching files and to Dr. Peter Doubilet and Dr. Steven Seltzer for your early and very helpful advice.
contributors
Juan Carlos Baez, MD
Resident in Radiology,
Brigham and Women’s Hospital
Beryl R. Benacerraf, MD
Clinical Professor of Radiology and
Obstetrics and Gynecology,
Harvard Medical School
Scott Britz-Cunningham, MD, PhD
Staff Radiologist, Department of Nuclear Medicine,
Brigham and Women’s Hospital
Assistant Professor of Radiology,
Harvard Medical School
Paul M. Bunch, MD
Resident in Radiology,
Brigham and Women’s Hospital
Michael J. Callahan, MD
Director, Computed Tomography
Division Chief, Abdominal Imaging
Department of Radiology,
Boston Children’s Hospital
Assistant Professor of Radiology,
Harvard Medical School
Jeffrey Forris Beecham Chick, MD
Resident in Radiology,
Brigham and Women’s Hospital
Sona A. Chikarmane, MD
Resident in Radiology,
Brigham and Women’s Hospital
Mary Elizabeth Cunnane, MD
Staff Radiologist,
Massachusetts Eye and Ear Infirmary
Instructor of Radiology,
Harvard Medical School
Pamela Deaver Ketwaroo, MD
Resident in Radiology,
Brigham and Women’s Hospital
Christine M. Denison, MD
Staff Radiologist, Division of Breast Imaging,
Brigham and Women’s Hospital
Assistant Professor of Radiology,
Harvard Medical School
Naman S. Desai, MD
Resident in Radiology,
Brigham and Women’s Hospital
Alexandra Fairchild, MD
Resident in Radiology,
Brigham and Women’s Hospital
Ritu R. Gill, MD, MPH
Staff Radiologist, Division of Thoracic Imaging,
Brigham and Women’s Hospital
Assistant Professor of Radiology,
Harvard Medical School
Alisa Suzuki Han, MD
Staff Radiologist, Division of Angiography and
Interventional Radiology,
Brigham and Women’s Hospital
Instructor of Radiology,
Harvard Medical School
Michael Hanley, MD
Staff Radiologist,
Division of Thoraco-Abdominal Imaging,
University of Virginia Health System
Assistant Professor of Radiology,
University of Virginia School of Medicine
Timothy P. Killoran, MD
Staff Radiologist, Division of Angiography and
Interventional Radiology,
Brigham and Women’s Hospital
Instructor of Radiology,
Harvard Medical School
Meaghan M. Mackesy, MD
Resident in Radiology, Brigham and Women’s Hospital
Jonathan Opraseuth, MD
Resident in Radiology, Brigham and Women’s Hospital
Sanjay Prabhu, MBBS, DCH, MRCPCH, FRCR
Director, Radiology Advanced Image Analysis Lab, Staff Radiologist, Boston Children’s Hospital Instructor in Radiology,
Harvard Medical School
Sughra Raza, MD
Associate Director of Breast Imaging,
Brigham and Women’s Hospital
Associate Professor of Radiology, Harvard Medical School
Julie A. Ritner, MD
Staff Radiologist, Divisions of Ultrasound and Breast
Imaging, Brigham and Women’s Hospital
Instructor in Radiology,
Harvard Medical School
Justin R. Routhier, MD
Resident in Radiology, Brigham and Women’s Hospital
Ari Sacks, MD
Resident in Radiology, Brigham and Women’s Hospital
Cheryl A. Sadow, MD
Staff Radiologist, Division of Abdominal Imaging and Intervention, Brigham and Women’s Hospital
Assistant Professor of Radiology, Harvard Medical School
Asha Sarma, MD
Resident in Radiology, Brigham and Women’s Hospital
Nehal Shah, MD
Staff Radiologist, Division of Musculoskeletal Imaging and Intervention,
Brigham and Women’s Hospital
Instructor in Radiology,
Harvard Medical School
Jeffrey Y. Shyu, MD
Resident in Radiology, Brigham and Women’s Hospital
Kirstin M. Small, MD
Staff Radiologist, Division of Musculoskeletal Imaging and Intervention,
Brigham and Women’s Hospital
Instructor in Radiology,
Harvard Medical School
Stacy E. Smith, MD
Section Head and Barbara N. Weissman Distinguished Chair of Musculoskeletal Imaging and Intervention
AssociateDirector,RadiologyResidencyProgram,
Brigham and Women’s Hospital
Assistant Professor of Radiology, Harvard Medical School
Darryl B. Sneag, MD
Resident in Radiology, Brigham and Women’s Hospital
Shreya Sood, MD
Resident in Radiology, Brigham and Women’s Hospital
Michael Steigner, MD
Staff Radiologist, Division of Non-invasive Cardiovascular Imaging,
Brigham and Women’s Hospital
Instructor in Radiology,
Harvard Medical School
Barbara N. Weissman, MD
Vice Chair, Department of Radiology,
Section Head Emeritus,Musculoskeletal Imaging Director, Radiology Residency Program
Brigham and Women’s Hospital Professor of Radiology, Harvard Medical School
Ged Wieschhoff, MD
Resident in Radiology, Brigham and Women’s Hospital
Jeremy R. Wortman, MD
Resident in Radiology, Brigham and Women’s Hospital
Gregory L. Wrubel, MD
Clinical Fellow in Diagnostic Neuroradiology,
Brigham and Women’s Hospital
List of contributors