Diagnostic Radiology a Textbook of Medical imaging , 2-Volume Set Churchill Livingstone (2014) 6th ed

Long recognized as the standard general reference in the field, this completely revised edition of Grainger and Allison's Diagnostic Radiology provides all the information that a trainee needs to master to successfully take their professional certification examinations as well as providing the practicing radiologist with a refresher on topics that may have been forgotten. Organized along an organ and systems basis, this resource covers all diagnostic imaging modalities in an integrated, correlative fashion and focuses on those topics that really matter to a trainee radiologist in the initial years of training. ...the latest edition ... continues the fine tradition set by its predecessors.... help young radiologists to prepare for their examinations and continue to be a source of information to be dipped in and out of ... senior radiologists will also find the book useful ... Reviewed by: RAD Magazine March 2015 I am sure the current edition will be successful and help young radiologists to prepare for their examinations and continue to be a source of information to be dipped in and out of... Reviewed by RAD Magazine, March 2015 Master the field and prepare for certification or recertification with a succinct, comprehensive account of the entire spectrum of imaging modalities and their clinical applications. Effectively apply the latest techniques and approaches with complete updates throughout including 4 new sections (Abdominal Imaging, The Spine, Oncological Imaging, and Interventional Radiology) and 28 brand new chapters. Gain the fresh perspective of two new editors-Jonathan Gillard and Cornelia Schaefer-Prokop -- eight new section editors -- Michael Maher, Andrew Grainger, Philip O'Connor, Rolf Jager, Vicky Goh, Catherine Owens, Anna Maria Belli, Michael Lee -- and 135 new contributors. Stay current with the latest developments in imaging techniques such as CT, MR, ultrasound, and coverage of hot topics such as: Image guided biopsy and ablation techniques and Functional and molecular imaging. Solve even your toughest diagnostic challenges with guidance from nearly 4,000 outstanding illustrations. Quickly grasp the fundamentals you need to know through a more concise, streamlined format. Access the full text online at Expert Consult. GRAINGER & ALLISON’S DIAGNOSTIC RADIOLOGY A Textbook of Medical Imaging: Volume I Grainger & Allison’s Diagnostic Radiology Copyright page Table of Contents Preface List of Section Editors List of Contributors A Principles of Imaging Techniques and General Issues 1 Medical Physics: Chapter Outline Radiation Risks Deterministic and Stochastic Effects Fetal Exposure Legislation and Principles of Radiation Protection Patient Doses in Diagnostic Imaging Estimating Patient Doses Typical Patient Doses Detectors for Radiography and Fluoroscopy Optimising Patient Dose Optimising Patient Dose in Nuclear Medicine Areas of Special Attention Pregnancy and Potential Pregnancy Infants and Children Research Exposures Health Screening Programmes High-Dose Techniques Radiation Protection of Staff and Public Distance, Time and Shielding Personal Protection in Nuclear Medicine Radiation Hazards from Nuclear Medicine Patients Dose Monitoring Pregnant Staff Clinical Application of Radiation Dose Optimisation in CT Introduction Terms Describing CT Dose Standard Dose Low Dose Radiation Dose Descriptors in CT Volume Computed Tomography Dose Index (CTDIvol) How to Set Up a Dose Optimisation Process AEC System: Principles and Pitfalls Two Methods for Validating Dose Optimisation Parameter Optimisation Adequate References as Goals for Optimisation Up-to-Date Optimised CT Parameters CT of the Brain CT of the Thorax CT of the Lumbar Spine Summary and Conclusion Further Reading Online-only References 2 Intravascular Contrast Media for Radiography, CT, MRI and Ultrasound Chapter Outline Introduction Contrast Media for Radiography and CT Barium-Based Contrast Agents Iodine-Based Contrast Media High-Osmolar Ionic Contrast Media (Fig. 2-3) Low-Osmolar Ionic Contrast Media (Fig. 2-4) Quantity of Contrast Medium Required Contrast Media for MR Imaging Gadolinium-Based Contrast Media Pharmacokinetics Quantity of Contrast Medium Required Iron-Based Contrast Media Manganese-Based Contrast Media Tissue-Specific MR Contrast Agents Use of Extracellular MR Contrast Agents for Radiographic Examinations Contrast Media for Ultrasound Microbubbles Pharmacokinetics Effect on Echogenicity Safety Recommendations Potential Developments Informed Consent Summary of Product Characteristics (sPc) Off-Label Use Adverse reactions Types of Reactions Idiosyncratic Reactions Chemotoxic Reactions Acute Non-renal Adverse Reactions Incidence Risk Factors Prevention Acute Renal Adverse Reactions (Contrast-Induced Nephropathy) Late Adverse Reactions Very Late Adverse Reactions Thyrotoxicosis Pregnancy and Lactation Interaction Extravasation Measurement of Glomerular Filtration Rate Further Reading Online-only References 3 Ultrasound Chapter Outline Nature of Ultrasound Ultrasonic Transducers Propagation in Tissue Attenuation Reflection Ultrasound Methods The Pulse-Echo Method Beam Steering Resolution Artefacts Interpretative Principles Shadowing and Increased Through Transmission Echogenicity Doppler Theoretical Basis of Doppler Studies Characteristics of Blood Flow Information in the Doppler Signal Pulsatility Measurements Spectral Content Colour Doppler Power Doppler Volume Flow Measurement Doppler Artefacts, Errors and Pitfalls Sample Volume Size and Position Velocity Information Wall Filters Colour Artefacts Contrast Agents Safety Developments in Ultrasound High Frequencies, 3D, Elastography Ultrasound Therapy Acknowledgements Further Reading Physics Clinical Safety New Developments 4 Computed Tomography Chapter Outline Computed Tomography (CT): A Brief History Principles of Computed Tomography CT Numbers and Image Matrix Generations of CT Development X-Ray Tubes X-Ray Detectors Slice Wars and Beyond Image Reconstruction Filtered Back Projection Iterative Reconstruction Helical CT Reconstruction of Arbitrary Section Thickness and Orientation Image Quality and Radiation Dose Contrast Media Preparation Contrast Medium Injection Potential Complications Gastrointestinal Contrast Agents Optimising Image Acquisition CT Protocols Planning Image Analysis CT-Guided Interventions Planning and Patient Preparation Procedure Follow-Up Advanced Techniques Cardiac CT Dual-Energy CT Subtraction Imaging CT Perfusion Motion Analysis Further Reading Online-only References 5 Magnetic Resonance Imaging Chapter Outline Historical Perspective Spin Physics Excitation and Relaxation: Free Induction Decay and Echoes Signal Localisation: Techniques for Building Images 2D Encoding 3D Encoding Fast and Alternative k-space Tranversal Parallel Imaging Pulse Sequences Variations on a Spin Echo Basic Two-Dimensional Spin-Echo Sequence Multi-Spin Echo Single-Shot Fast Spin Echo (SS-FSE) or Half-Fourier Acquired Single-Shot Turbo Spin Echo (HASTE) Variations on a Gradient Echo/Field Echo Basic Two-Dimensional Gradient-Echo Sequence Three-Dimensional Gradient Echo Magnetisation Prepared Rapid Acquisition Gradient Echo (MP-RAGE) or Turbo-FLASH or Inversion Recovery-Prepared Fast Spoiled Gradient-Recalled Echo Instrumentation Magnets Gradients Radiofrequency Computers Physical Parameters That Provide Contrast Proton Density T1 (Longitudinal Relaxation Time or Spin–Lattice Relaxation Time) T2 (Transverse Relaxation Time or Spin–Spin Relaxation Time) T2* and Endogenous Susceptibility Exogenous Contrast Agents Chemical Shift Proton Spectroscopy Water/Fat Imaging Flow Time-of-Flight MRA Phase Contrast MRA Non-Contrast-Enhanced MRA (Fresh Blood Imaging) Non-Contrast-Enhanced MRA (Balanced Steady-State Free Precession) Perfusion (Microvascular Flow) Diffusion Safety Considerations Static Magnetic Field Time-Varying Magnetic Field Gradients Radiofrequency Field Conclusion Further Reading Online-only References 6 Radionuclide and Hybrid Imaging Chapter Outline Introduction and General Principles Basic Physics Structure of the Atom Radioactivity Alpha Radiation Beta Radiation Positron Emission X and Gamma Radiation Definitions Interaction of X and Gamma Radiation with Matter The Gamma Camera Detection System Collimators Temporal Resolution Techniques of Image Acquisition and Processing Gamma Camera Limitations Principles of Emission Tomography (PET and SPECT) Tomographic Reconstruction SPECT Design and Characteristics PET Design and Characteristics Hybrid Systems: SPECT-CT, PET-CT and PET-MRI Quantification and Image Processing General Processing Quantification Image Registration Image Interpretation Non-Imaging Applications Radiopharmaceuticals Further Reading Online-only References 7 Functional, Physiological and Molecular Imaging Chapter Outline Physiological Imaging with Contrast Media Why Use Kinetic Modelling? Contrast Agent Pharmacokinetics Measurement of Tracer Concentration Modelling and Mathematical Approaches Perfusion Fractional Vascular Volume Other Functional Indices Summary Principles of Molecular Imaging Molecular Imaging and Hypoxia Inducible Factor-1 Direct Molecular Imaging Indirect Molecular Imaging Comparison of Molecular Imaging Strategies Molecular Imaging and Biotechnology Applications of Molecular Imaging Combined Physiological and Molecular Imaging Summary Appendices Appendix 1 Appendix 2 Appendix 3 Appendix 4 Appendix 5 Further Reading Online-only References B The Chest and Cardiovascular System 8 Techniques in Thoracic Imaging Chapter Outline Chest Radiography Equipment Considerations Additional Radiographic Views Portable Chest Radiography Novel Radiographic Techniques Computed Tomography of the Thorax Dual-Energy CT Dose Considerations Intravenous Contrast Medium Enhancement and Timing of CT Data Acquisition Window Settings High-Resolution Computed Tomography Ultrasound Endoscopic and Endobronchial Ultrasound Magnetic Resonance Imaging Ventilation–Perfusion Scintigraphy Further Reading Online-only References 9 The Normal Chest Chapter Outline The Lungs The Central Airways The Lungs Beyond the Hila The Hila The Mediastinum Computed Tomography and Magnetic Resonance Imaging Radiographic Appearances Junction Lines Left Mediastinum above the Aortic Arch Right Middle Mediastinal Border below the Azygos Arch Retrosternal Line The Diaphragm Further Reading Online-only References 10 The Chest Wall, Pleura, Diaphragm and Intervention Chapter Outline The Chest Wall Soft Tissues Breasts Subcutaneous Emphysema Bony Structures Ribs Clavicles Spine The Pleura Pleural Effusion Imaging Pleural Effusion Some Specific Pleural Effusions Pneumothorax Primary Spontaneous Pneumothorax Secondary Spontaneous Pneumothorax Complications Pleural Thickening and Fibrothorax Pleural Calcification Pleural Tumours Localised Pleural Tumours Diffuse Pleural Tumours The Diaphragm Level Eventration Movement and Paralysis Diaphragmatic Hernias Diaphragmatic Trauma Neoplasms of the Diaphragm Further Reading Online-only References 11 The Mediastinum, Including the Pericardium Chapter Outline Mediastinal Diseases Mediastinal Masses Incidence Approach to Mediastinal Masses Parathyroid Masses Lymphofollicular Thymic Hyperplasia and Rebound Thymic Hyperplasia Mediastinal Lymphadenopathy Foregut Duplication Cysts Mediastinal Pancreatic Pseudocyst Mesenchymal Tumours and Tumour-Like Conditions Fat-Containing Hernias Other Mediastinal Lesions Acute Mediastinitis Fibrosing Mediastinitis Mediastinal Haemorrhage Pericardium Imaging Pericardial Disease Developmental Anomalies Congenital Absence of the Pericardium Acquired Pericardial Disease Pericardial Effusion Cardiac Tamponade Pericarditis Constrictive Pericarditis Acknowledgement Further Reading Online-only References 12 Pulmonary Infection in Adults Chapter Outline Types of Pneumonias Community-Acquired Pneumonia (CAP) Hospital-Acquired Pneumonia (HAP) Ventilator-Associated Pneumonia (VAP) Health Care-Associated Pneumonia (HCAP) Clinical Utility and Limitations of Chest Radiography and CT Patterns of Pulmonary Infection Complications of Pneumonia Integrating Clinical and Imaging Findings Lobar Pneumonia Most Common Organisms Immunocompromised Host Endemic in Certain Geographic Areas Bronchopneumonia Most Common Organisms Atypical Pneumonia New Emerging Viruses Changing Spectrum of HIV Infections: 30 Years Later Mycobacterium tuberculosis Primary Tuberculosis Reactivation and Reinfection Tuberculosis Pulmonary Non-Tuberculous Mycobacteria (NTMB) Fungal Infection Parasitic Infections Protozoa Amoebiasis Nematodes Dirofilariasis Cestodes Echinococcosis (Hydatid Disease) Trematodes Paragonimiasis Further Reading Online-only References 13 irway Disease and Chronic Airway Obstruction Chapter Outline Introduction Tracheal Disorders Post-Traumatic Strictures Infectious Tracheobronchitis Primary Malignant Neoplasms Secondary Malignant Neoplasms Benign Neoplasms ANCA-Associated Granulomatous Vasculitis Relapsing Polychondritis Tracheobronchial Amyloidosis Sarcoidosis Inflammatory Bowel Disease Tracheobronchopathia Osteochondroplastica Sabre-Sheath Trachea Tracheobronchomegaly (Mounier–Kuhn Syndrome) Tracheobronchomalacia Tracheobronchial Fistula and Dehiscence Bronchiectasis Radiographic Findings CT Findings Accuracy of CT Cystic Fibrosis Allergic Bronchopulmonary Aspergillosis (ABPA) Dyskinetic Cilia Syndrome Broncholithiasis Bronchiolitis Infective Bronchiolitis Inflammatory (Non-Infective) Bronchiolitis Obliterative (Constrictive) Bronchiolitis Pathological Features Radiological Findings CT Assessment of Air Trapping Chronic Obstructive Pulmonary Disease (COPD) Pathological Findings Inflammatory Changes in the Airways in COPD Radiographic Findings CT Findings Small Airway Disease Emphysema Large Airway Disease CT Quantitative Analysis of Extent of Disease Asthma Radiographic Findings CT Findings Further Reading Online-only References 14 Pulmonary Lobar Collapse: Chapter Outline Mechanisms and Causes of Lobar Collapse Radiographic Considerations Direct Signs of Volume Loss Indirect Signs of Volume Loss Ancillary Features of Lobar Collapse Computed Tomography of Lobar Collapse Technique Utility Potential Pitfalls Other Imaging Techniques in Lobar Collapse Patterns of Lobar Collapse Right Upper Lobe Collapse Left Upper Lobe Collapse Right Middle Lobe Collapse Right and Left Lower Lobe Collapse Whole Lung Collapse Combinations of Lobar Collapse Further Reading Online-only References 15 Pulmonary Neoplasms Chapter Outline Bronchogenic Carcinoma Histopathology Genetic Factors Epidermal Growth Factor Receptor (EGFR) Lung Cancer and Other Environmental Factors Smoking Lung Cancer Screening Chest Radiographic Screening CT Screening Radiation Dose Considerations Pulmonary Nodules Management of Small Pulmonary Nodules Nodule Density Other Forms of Nodule Assessment Nodule Follow-Up PET/CT Lung Cancer Staging—the 7Th Edition of the TNM Staging System for Lung Cancer Additional Pulmonary Nodules in the Presence of Lung Cancer M Descriptors Summary Imaging Protocols for Lung Cancer Staging The Current Standards of CT Technology Imaging Features of Bronchogenic Carcinoma Peripheral Tumours Central Tumours Staging Intrathoracic Spread of Bronchial Carcinoma Extrathoracic Staging of Lung Cancer Pulmonary Sarcoma and Other Primary Malignant Neoplasms Benign Pulmonary Tumours Hamartoma Other Benign Pulmonary Neoplasms Leiomyoma Benign Lymphoproliferative Disorders Lymphocytic Interstitial Pneumonia Follicular Bronchiolitis Malignant Lymphoproliferative Disorders Lymphoma Other Findings in Pulmonary Lymphoma Leukaemia Metastases Lymphangitic Carcinomatosis Unusual Patterns of Metastatic Cancer Endobronchial Metastases Further Reading Online-only References 16 High-Resolution Computed Tomography of Interstitial and Occupational Lung Disease Chapter Outline High-Resolution Computed Tomography Patterns of Diffuse Lung Disease Reticular Pattern Nodular Pattern Ground-Glass Pattern Mosaic Attenuation Pattern Idiopathic Interstitial Pneumonias Usual Interstitial Pneumonia/Idiopathic Pulmonary Fibrosis Classic HRCT Findings Non-Specific Interstitial Pneumonia Classic HRCT Findings Cryptogenic Organising Pneumonia Respiratory Bronchiolitis–Interstitial Lung Disease and Desquamative Interstitial Pneumonia Classic HRCT Findings Acute Interstitial Pneumonia/Diffuse Alveolar Damage Classic HRCT Findings Lymphoid Interstitial Pneumonia Classic HRCT Findings Idiopathic Pleuroparenchymal Fibroelastosis Classic HRCT Findings Sarcoidosis Lymphadenopathy Parenchymal Changes High-Resolution Computed Tomography Features Classic HRCT Findings Hypersensitivity Pneumonitis Classic HRCT Findings Langerhans Cell Histiocytosis Classic HRCT Findings Lymphangioleiomyomatosis Classic HRCT Findings Connective Tissue Diseases Rheumatoid Disease Classic HRCT Findings Sjögren’s Syndrome Classic HRCT Findings Progressive Systemic Sclerosis (Scleroderma) Classic HRCT Findings Polymyositis/Dermatomyositis Classic HRCT Findings Systemic Lupus Erythematosus Classic HRCT Findings Systemic Vasculitides Churg–Strauss Syndrome Classic HRCT Findings Drug-Induced Lung Disease Diffuse Alveolar Damage Interstitial Pneumonia Organising Pneumonia Eosinophilic Pneumonia Classic HRCT Findings Occupational Lung Disease The International Labour Office Classification Silicosis/Coal Worker’s Pneumoconiosis Classic HRCT Findings Asbestos-related Disease Benign Pleural Effusions Pleural Plaques Diffuse Pleural Thickening Round Atelectasis Asbestosis Classic HRCT Findings Further Reading Books/Book Chapters Reviews/Papers Online-only References 17 Thoracic Trauma and Related Topics Chapter Outline Thoracic Trauma Introduction Types of Injury Diagnostic Approach Specific Thoracic Injuries Following Trauma Heart Mediastinum Lung Parenchyma Diaphragm Thoracic Imaging in the Intensive Care Patient Introduction Cardiopulmonary Disease Atelectasis Pulmonary Oedema Haemorrhage Extra-Pulmonary Air Support and Monitoring Apparatus Airway Post-Surgical Imaging in the Chest Introduction Post-Pneumonectomy Lung Transplantation Preoperative Imaging Postoperative Imaging Surgical Treatment of Emphysema Bullectomy Further Reading Online-only References 18 Airspace Diseases Chapter Outline Introduction An Approach to the Radiological Diagnosis of Airspace Diseases Anatomical Considerations Radiological Signs of Airspace Disease Pulmonary Oedema Chest Radiography in Pulmonary Oedema Vascular Changes Alveolar Oedema Radiographic Differentiation of Cardiogenic and Non-Cardiogenic Pulmonary Oedema CT in Pulmonary Oedema Diffuse Pulmonary Haemorrhage Idiopathic Pulmonary Haemosiderosis Antibasement Membrane Antibody Disease (Goodpasture’s Syndrome) Wegener’s Granulomatosis (ANCA-Associated Granulomatous Vasculitis) Organising Pneumonia Eosinophilic Lung Disease Simple Pulmonary Eosinophilia (Löffler’s Syndrome) Acute Eosinophilic Pneumonia Chronic Eosinophilic Pneumonia Pulmonary Alveolar Proteinosis Alveolar Microlithiasis Further Reading Books/Book Chapters Reviews/Papers Online-only References 19 Cardiac Anatomy and Imaging Techniques Chapter Outline Normal Chest Radiography Cardiac Magnetic Resonance Cardiac Axis Imaging Planes Body Axes Imaging Planes Normal Anatomy on CMR Images Computed Tomography Imaging Techniques CT Imaging of Ventricles and Myocardial Tissue Coronary Arteries by CT Valves Pulmonary Veins Other Structures Echocardiography Valves Acknowledgement Further Reading MRI CT Echo Online-only References 20 Congenital Heart Disease: Chapter Outline Introduction Clinical Presentation Later Clinical Presentation Morphological Description and Sequential Segmental Analysis Sequential Segmental Analysis Step 1—Atrial Situs Step 2—Ventricular Morphology Physiological and Functional Assessment Non-Invasive Imaging Techniques Ultrasound Magnetic Resonance Imaging Computed Tomography Conventional Radiology Diagnostic Features The Pulmonary Vasculature Heart Size, Shape and Position Specific Lesions Acyanotic Lesions Septal Defects Abnormalities of the Great Vessels Valvular Heart Disease Coronary Artery Abnormalities Cyanotic Congenital Heart Disease Tetralogy of Fallot Transposition of the Great Arteries Pulmonary Atresia Double Outlet Right Ventricle Common Arterial Trunk Single Ventricles Systemic-to-Pulmonary Artery Shunt Bidirectional Glenn Circulation Conclusion Further reading Online-only References 21 Non-ischaemic Acquired Heart Disease Chapter Outline Role of Imaging Chest Radiography Echocardiography Magnetic Resonance Imaging Computed Tomography Cardiomyopathies Hypertrophic Pattern Dilated Phenotype Restrictive Phenotype Arrhythmogenic Right Ventricular Cardiomyopathy Unclassified Cardiomyopathy Myocarditis Valvular Heart Disease Mitral Valve Disease Mitral Valve Prolapse Mitral Stenosis Rheumatic Mitral Valve Disease Tricuspid Valve Disease Aortic Valve Disease Aortic Stenosis Aortic Regurgitation Prosthetic Cardiac Valves Complications of Prosthetic Valves Structure Fracture Valve Regurgitation Thromboembolism Tumours of the Heart Metastasis Primary Cardiac Tumours Cardiac Myxoma Lipomas Rhabdomyomas Papillary Fibroelastoma Hydatid Disease Primary Malignant Tumours of the Heart Sarcomas Lymphoma Pericardial Diseases Anatomy Pericardial Cysts Pericardial Defects Pericardial Diverticulum Pericardial Effusion Pericardial Inflammation Constrictive Pericarditis Pericardial Masses Further Reading Online-only References 22 Ischaemic Heart Disease Chapter Outline Introduction Pathophysiology of Ischaemic Heart Disease Coronary Artery Imaging Functional Imaging Stress Imaging Myocardial Infarct Imaging Myocardial Viability Imaging Imaging of Complications Related to Ischaemic Heart Disease Prognosis Assessment in Ischaemic Heart Disease Role of Conventional Chest Radiography in Ischaemic Heart Disease Differential Diagnosis in Ischaemic Heart Disease Further Reading Online-only References 23 Pulmonary Circulation and Pulmonary Thromboembolism Chapter Outline Pulmonary Circulation Pulmonary Circulation Anatomy Pulmonary Arteries Pulmonary Veins Pulmonary Circulation Physiology Pulmonary Vascular Patterns Pulmonary Venous Hypertension Interstitial Oedema (Grade 2) Pulmonary Arterial Hypertension Pulmonary Arteriovenous Malformations Pulmonary Thomboembolic Disease Acute Pulmonary Thromboembolism Diagnosing Acute Pulmonary Embolism Imaging Findings Chronic Pulmonary Thromboembolism Conclusion Acknowledgements Further Reading Online-only References 24 The Thoracic Aorta: Chapter Outline The Normal Aorta Diagnostic Aspects Acquired Aortic Abnormalities Acute Aortic Syndrome Aortic Dissection Classification Intramural Haematoma Penetrating Atherosclerotic Ulcer (PAU) Traumatic Aortic Injury (TAI) Imaging Aortic Aneurysms Atherosclerotic Aortic Aneurysms Abdominal Aneurysms Mycotic Aneurysms Preoperative Evaluation of Acute Aortic Syndromes Impending Aortic Rupture Visceral Malperfusion Preoperative or Pre-Interventional Evaluation Postoperative Evaluation Management of Aortic Diseases Traumatic Aortic Injury (TAI) Aortic Dissection Inflammatory Diseases of the Aorta and Mid-Aortic Syndrome Mid-Aortic Syndrome Aortic Occlusive Disease Chronic Aortic Occlusive Disease Congenital Aortic Abnormalities Vascular Rings Double Aortic Arch Vascular Rings Associated with Left Aortic Arch Coarctation of the Aorta Management Pseudocoarctation Aortic Atresia Further Reading Online-only References C Abdominal Imaging 25 Current Status of Imaging of the Gastrointestinal Tract: Chapter Outline The Plain Abdominal Radiograph Abnormal Gas Distribution Pneumoperitoneum Gas in Bowel Wall Gas in Retroperitoneum Gas in Other Organs Dilatation of Bowel Gastric Dilatation Distinction between Small- and Large-Bowel Dilatation Small-Bowel Dilatation Large-Bowel Dilatation Pseudo-Obstruction Abnormal Bowel Wall Pattern Small-Bowel Ischaemia Large-Bowel Ischaemia Inflammatory Bowel Disease Pseudomembranous Colitis Acute Abdominal Inflammatory Conditions Ultrasound in Appendicitis Computed Tomography in Appendicitis Other Inflammatory Conditions Imaging the Abdomen with CT: Radiation Issues Automatic Tube Current Modulation Iterative Reconstruction Algorithms CT Dose Reduction in Clinical Practice Further Reading Online-only References 26 The Oesophagus Chapter Outline Anatomy and Function Anatomy (Table 26-1) Embryology Function Examination Plain Radiography Ultrasound Fluoroscopy Endoscopy CT MRI Endoscopic Ultrasound Radionuclide Radiology Including PET-CT Pathological Features Oesophageal Cancer CT for Oesophageal Cancer EUS for Oesophageal Cancer PET-CT for Oesophageal Cancer Other Oesophageal Neoplasms Benign Lesions Malignant Lesions Hiatus Hernia Gastro-Oesophageal Reflux Disease Complications of GORD Other Varieties of Oesophagitis Oesophageal Diverticula Motility Disorders Achalasia Diffuse Oesophageal Spasm Neuromuscular Disorders Miscellaneous Conditions Oesophageal Varices Trauma Further reading Online-only References 27 The Stomach Chapter Outline Anatomy Radiological Techniques Fluoroscopy Cross-Sectional Imaging Multidetector Computed Tomography (MDCT) Magnetic Resonance Imaging (MRI) Gastric Pathology Inflammatory Disease and Infiltrative Diseases Helicobacter pylori and Diseases of the Stomach Neoplastic Diseases Mucosal Polyps Mesenchymal Tumours Early Gastric Cancer Advanced Gastric Cancer Gastric Lymphoma Metastatic Disease Miscellaneous Conditions Positional Abnormalities Gastric Volvulus Prepyloric Web (Antral Mucosal Diaphragm) Hypertrophic Pyloric Stenosis Ectopic Pancreas The Postoperative Stomach Bariatric Surgery for Obesity Other Surgeries Advances in Gastric Imaging Further Reading Online-only References 28 The Duodenum and Small Intestine Chapter Outline The Duodenum Anatomy and Normal Appearances Radiological Investigation Barium Studies Peptic Ulceration Postbulbar Ulceration Gastric Heterotopia Diverticula Neoplasms Benign Neoplasms Other Conditions Pancreatitis Progressive Systemic Sclerosis The Small Intestine Anatomy and Normal Appearances Radiological Investigation Plain Radiographs Ultrasound Angiography The Abnormal Small Intestine Crohn’s Disease Radiological Appearances Coeliac Disease Neoplasms Malignant Neoplasms Benign Neoplasms Infections and Infestations Mesenteric Adenitis Tuberculosis Yersiniosis Chronic Radiation Enteritis Mechanical Small Intestinal Obstruction Acute Mesenteric Ischaemia Vasculitis Occult Gastrointestinal Bleeding Diverticula and Blind Loops Jejunal Diverticula Ileal Diverticula Neuromuscular Disorders Nodular Lymphoid Hyperplasia and Immunoglobulin Deficiency Whipple’s Disease Intestinal Lymphangiectasia Eosinophilic Gastroenteritis Mastocytosis Angio-Oedema Amyloidosis Acquired Immune Deficiency Syndrome Behçet’s Disease Graft-Versus-Host Disease Non-steroidal Anti-Inflammatory Drug Enteritis Further Reading Online-only References 29 The Large Bowel Chapter Outline Anatomy Radiological Investigation Tumours Polyps Polyposis Syndromes Radiographic Features of Polyps Colorectal Cancer Colon Cancer Rectal Cancer Anal Cancer Appendix Tumours Lymphoma Secondary Cancers Diverticulitis Epiploic Appendagitis Colitis Imaging Features of Colitis Inflammatory Bowel Disease Differential Features Carcinoma in Colitis Other Common Causes of Colitis Ischaemic Colitis Radiation Colitis Behçet’s Syndrome Infectious Colitis Pseudomembranous Colitis Neutropenic Colitis Parasitic Colitis Tuberculosis Amoebiasis Acquired Immunodeficiency Syndrome Defunctioned Colon Acute Fulminant Colitis Perforation Miscellaneous Conditions Large-Bowel Strictures Pseudodiverticula Appendicitis Lipomatous Disorders of the Large Bowel Pneumatosis Coli Volvulus Intussusception Endometriosis Retrorectal Lesions Functional Disorders of the Anorectum Anal Fistula Further Reading Online-only References 30 Imaging of the Peritoneum, Mesentery and Omentum Chapter Outline Anatomical Considerations Introduction Peritoneal Spaces Supramesocolic Space Inframesocolic Space Peritoneal Reflections The Mesenteries The Omentum Pathological Considerations Ascites Intraperitoneal Air Developmental/Congenital Anomalies Rotational Anomaly Developmental Defects Mesenteric Cysts Infections–Inflammations Tuberculosis Hydatid Disease Crohn’s Disease Mesenteric Lymphadenitis Acute Pancreatitis Whipple’s Disease Mesenteric Panniculitis–Sclerosing Mesenteritis Sclerosing Peritonitis Non-inflammatory Oedema Epiploic Appendagitis Omental Infarction Neoplastic Diseases Neoplastic Diseases of Peritoneum Direct Spread Along Mesenteric and Ligamentous Attachments Primary Neoplasms Neoplastic Diseases of Mesentery Primary Neoplasms Neoplastic Diseases of the Omentum Further reading Online-only References 31 The Liver and Spleen Chapter Outline Liver Anatomy Subdivisions (Fig. 31-2) Lobar Agenesis/Atrophy (Figs. 31-3 and 31-4) Liver Imaging Techniques Plain Radiography Ultrasound Technique Computed Tomography Technique (Fig. 31-9) Normal Magnetic Resonance Imaging Techniques (Fig. 31-11) Intravenous Contrast Agents (Fig. 31-12) Scintigraphy Technique Angiography Diffuse Disease Benign Diffuse Disease Hepatic Steatosis Viral Hepatitis Wilson’s Disease Malignant Diffuse Disease Focal Disease Calcification Parenchymal Gas Benign Cystic Lesions Cysts Hydatid Disease Malignant Cystic Lesions Metastases Benign Solid Lesions Haemangioma Atypical Haemangiomas Hepatic Adenoma Focal Fat Biliary Hamartomas (Fig. 31-44) Malignant Solid Lesions Hepatocellular Carcinoma Fibrolamellar Carcinoma (FLC) (Fig. 31-53) Hepatoblastoma Metastases Vascular Lesions Budd–Chiari Syndrome Veno-Occlusive Disease Arterioportal Shunts Intrahepatic Portosystemic Shunts Hepatic Trauma Liver Transplantation Background and Indications Perioperative Imaging Liver Biopsy Liver Biopsy, Aspiration and Drainage Spleen Anatomy Congenital Variations Accessory Spleen or Splenunculus (Fig. 31-74) Acquired Diseases Trauma (Fig. 31-76) Infarction (Figs. 31-78 and 31-79) Benign Lesions Cysts (Fig. 31-80) Malignant Lesions Angiosarcoma (Fig. 31-83) Lymphoma (Fig. 31-84) Metastases (Fig. 31-85) Other Problems Portal Hypertension/Splenic Vein Thrombosis Sarcoidosis Haemosiderosis Further Reading Online-only References 32 The Biliary System Chapter Outline Biliary Anatomy Gallbladder Anatomical Variants Methods of Investigation Ultrasound Computed Tomographic Cholangiography Magnetic Resonance Cholangiopancreatography Endoscopic Retrograde Cholangiopancreatography Percutaneous Transhepatic Cholangiography Intraoperative Cholangiography T-Tube Cholangiography Hepatobiliary Scintigraphy Endoscopic Ultrasound Disorders of the Gallbladder Gallbladder Stones Sludge Milk of Calcium Bile Cholecystitis Acute Calculous Cholecystitis Emphysematous Cholecystitis Acalculous Cholecystitis Gallbladder Mucocele Gallbladder Fistulae Porcelain Gallbladder Adenomyomatous Hyperplasia Gallbladder Polyps Gallbladder Carcinoma Gallbladder Metastases and Lymphoma Role of Radiology in Investigation of Jaundice Benign Bile Duct Pathology Choledocholithiasis Ultrasound Hepatolithiasis Benign Biliary Strictures Postoperative Strictures Primary Sclerosing Cholangitis Pancreatitis Acute Bacterial Cholangitis Parasitic Infections Ascaris lumbricoides Biliary Leaks and Bile Duct Injuries Biliary Cystic Disease Neoplastic Bile Duct Pathology Cholangiocarcinoma Metastases and Lymphoma Pancreatic and Ampullary Tumours Miscellaneous Biliary Tumours Liver Atrophy Lobar or Segmental Duct Obstruction Haemobilia Interventional Techniques Percutaneous Cholecystostomy Percutaneous Transhepatic Biliary Catheterisation Malignant Disease Hilar Strictures—Special Considerations Benign Disease Percutaneous Transjejunal Biliary Intervention Biopsy Techniques Further Reading Online-only References 33 The Pancreas Chapter Outline Embryology The Normal Pancreas Congenital Anomalies Pancreas Divisum Annular Pancreas Pancreatic Agenesis, Hypoplasia and Ectopic Pancreas Acute Pancreatitis Imaging in Acute Pancreatitis Interstitial Oedematous Pancreatitis Necrotising Pancreatitis Pancreatic and Peripancreatic Collections Pseudocyst Acute Necrotic C VOLUME 1 -- SECTION ONE Imaging techniques and general issues -- 1. RADIOGRAPHIC TECHNIQUES -- 2. CONTRAST MEDIA -- 3. ANGIOGRAPHY: PRINCIPLES, TECHNIQUES AND COMPLICATIONS -- 4. ULTRASOUND -- 5. COMPUTED TOMOGRAPHY -- 6. MAGNETIC RESONANCE IMAGING -- 7. RADIONUCLIDE IMAGING: NUCLEAR MEDICINE (NM) INCLUDING POSITRON EMISSION IMAGING (PET) -- 8. FUNCTIONAL, PHYSIOLOGICAL AND MOLECULAR IMAGING -- 9. RADIATION ISSUES RADIATION PROTECTION AND PATIENT DOSES IN DIAGNOSTIC IMAGING -- 10. PICTURE ARCHIVING AND COMMUNICATION SYSTEMS (PACS) -- 11. CLINICAL GOVERNANCE - INCLUDING AUDIT, MEDICO-LEGAL ASPECTS, ETC. -- SECTION TWO The chest and cardiovascular system -- 11. TECHNIQUES AND ANATOMY -- 12. THE NORMAL CHEST -- 13. THE CHEST WALL, PLEURA AND DIAPHRAGM -- 14. THE MEDIASTINUM INCLUDING THE PERICARDIUM -- 15. PULMONARY INFECTION IN ADULTS -- 16. LARGE AIRWAY DISEASE AND CHRONIC AIRFLOW OBSTRUCTION -- 17. PULMONARY LOBAR COLLAPSE: ESSENTIAL CONSIDERATIONS -- 18. PULMONARY NEOPLASMS -- 19. INTERSTITIAL AND OCCUPATIONAL LUNG DISEASE -- 20. TRAUMA AND INTENSIVE CARE RADIOLOGY -- 21. AIR-SPACE DISEASES -- 22. CARDIAC TECHNIQUES AND ANATOMY -- 23. CONGENITAL HEART DISEASE -- 24. ACQUIRED VALVULAR HEART DISEASE AND POSTOPERATIVE FEATURES -- 25. ISCHAEMIC HEART DISEASE -- 26. THE PULMONARY CIRCULATION AND PULMONARY THROMBOEMBOLISM -- 27. THE AORTA -- 28. THE PERIPHERAL VASCULAR SYSTEM -- SECTION THREE Gastrointestinal imaging -- 29. ANATOMY AND TECHNIQUES INCLUDING THE PLAIN ABDOMINAL RADIOGRAPH -- 30. THE OESOPHAGUS -- 31. THE STOMACH -- 32. THE SMALL INTESTINE INCLUDING THE DUODENUM -- 33. THE LARGE BOWEL -- 34. IMAGING OF THE PERITONEUM, MESENTERY AND OMENTUM -- 35. THE LIVER, INCLUDING TRANSPLANTATION ISSUES -- 36. THE BILIARY SYSTEM -- 37. THE PANCREAS -- VOLUME 2 -- SECTION FOUR The genitourinary tract -- 38. TECHNIQUES AND ANATOMY -- 39. RENAL PARENCHYMAL DISEASE INCLUDING RENAL FAILURE, RENOVASCULAR DISEASE AND TRANSPLANTATION -- 40. RENAL MASSES -- 41. UPPER URI