Grainger & Allison’s Diagnostic Radiology. A Textbook of Medical Imaging Volume 1

Cover Grainger & Allison’s Diagnostic Radiology Copyright Page Table Of Contents Preface List of Section Editors List of Contributors Dedication SECTION A The Chest and Cardiovascular System 1 Current Status of Thoracic Imaging Chapter Outline Chest Radiography Equipment Considerations Radiographic Projections Portable Chest Radiography Novel Radiographic Techniques Computed Tomography of the Thorax Principles From Single-Slice to Multidetector Computed Tomography High-Resolution Computed Tomography Intravenous Contrast Medium Enhancement and Timing of Computed Tomography Acquisition Additional Postprocessing Techniques Dual-Energy Computed Tomography Computed Tomography Dose Considerations Low-Dose Computed Tomography Ultrasound Endoscopic and Endobronchial Ultrasound Magnetic Resonance Imaging Radionuclide Imaging Ventilation–Perfusion Scintigraphy Positron Emission Tomography Further Reading 2 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 Right Mediastinum Above the Azygos Vein Left Mediastinum Above the Aortic Arch Trachea and Retrotracheal Area in the Lateral View Supra-Aortic Mediastinum on the Lateral View Right Middle Mediastinal Border Below the Azygos Arch Left Cardiac Border Below the Aortic Arch Paraspinal Lines Retrosternal Line The Diaphragm Further Reading 3 The Chest Wall, Pleura, Diaphragm and Intervention Chapter Outline The Chest Wall Soft Tissues Breasts Muscles Soft-Tissue Calcification Subcutaneous Emphysema Bony Structures Ribs Sternum Clavicles Scapula Spine Chest Wall Tumours Soft-Tissue Tumours Bone Tumours The Pleura Pleural Effusion Imaging Pleural Effusion Chest Radiograph Free pleural fluid. Loculated (encysted, encapsulated) pleural fluid. Pleural effusion in the supine patient. Ultrasound Computed Tomography Magnetic Resonance Imaging Positron-Emission Tomography/Computed Tomography Some Specific Pleural Effusions Exudates and Transudates Empyema Chylothorax Haemothorax Hepatic Hydrothorax Bronchopleural Fistula Pneumothorax Imaging Pneumothorax Chest Radiography Typical Signs. Atypical Signs Ultrasound Computed Tomography Primary Spontaneous Pneumothorax Secondary Spontaneous Pneumothorax Complications Haemopneumothorax Tension Pneumothorax Pyopneumothorax Adhesions Reexpansion Oedema Pleural Thickening and Tumours Imaging Pleural Thickening and Tumours Chest Radiography Ultrasound Computed Tomography Magnetic Resonance Imaging Positron-Emission Tomography/Computed Tomography Pleural Plaques Diffuse Pleural Disease Pleural Tumours Pleural Fibroma Pleural Lipoma Malignant Mesothelioma (Primary Pleural Malignancy) Pleural Metastases (Secondary Pleural Malignancy) Tumour-Like Conditions of the Pleura Pleural Calcification Intervention Chest Wall Intervention Pleural Intervention Pleural Aspiration Chest Drains Pleural Biopsy Complications of Image-Guided Pleural Intervention Intercostal artery injury. Iatrogenic pneumothorax. Iatrogenic infection. Diaphragm Imaging the Diaphragm Chest Radiograph Ultrasound Computed Tomography Magnetic Resonance Imaging Eventration Movement and Paralysis Diaphragmatic Hernias Diaphragmatic Trauma Neoplasms of the Diaphragm Further Reading Classic Books/Articles Recent Journal Articles 4 The Mediastinum, Including the Pericardium Chapter Outline Mediastinal Diseases Mediastinal Masses Incidence Imaging Techniques Radiography Computed Tomography Magnetic Resonance Imaging Ultrasound Radionuclide Examinations Approach to Mediastinal Masses Localise to the Mediastinum Localise Within the Mediastinum Characterise on Computed Tomography or Magnetic Resonance Imaging Thyroid Masses Parathyroid Masses Thymic Tumours Thymomas Thymic Carcinoma Thymic Neuroendocrine Tumour (Thymic Carcinoid) Thymolipomas Lymphofollicular Thymic Hyperplasia and Rebound Thymic Hyperplasia Thymic Cyst Germ-Cell Tumours of the Mediastinum Teratomas Seminoma Non-Seminomatous Germ-Cell Tumours Mediastinal Lymphadenopathy Malignant Lymphoma and Leukaemia Lymph Node Calcification Low-Attenuation Nodes Enhancing Lymph Nodes Lymph Node Enlargement Sarcoidosis. Tuberculosis and histoplasmosis. Metastatic carcinoma. Reactive hyperplasia. Thoracic lymphadenopathy in AIDS. Foregut Duplication Cysts Bronchogenic Cysts Oesophageal Duplication Cysts Neurenteric Cysts Mediastinal Pancreatic Pseudocyst Neurogenic Tumours Peripheral Nerve Sheath Tumours Sympathetic Ganglion Tumours Mediastinal Paragangliomas Lateral Thoracic Meningocele Extramedullary Haematopoiesis Mesenchymal Tumours and Tumour-Like Conditions Lymphangiomas (Cystic Hygromas) Haemangiomas Fatty Lesions in the Mediastinum Mediastinal Lipomatosis Fatty Tumours of the Mediastinum Fat-Containing Hernias Other Mediastinal Lesions Acute Mediastinitis Fibrosing Mediastinitis Mediastinal Haemorrhage Pneumomediastinum Pericardium Imaging Pericardial Disease Developmental Anomalies Congenital Absence of the Pericardium Pericardial Cysts Acquired Pericardial Disease Pericardial Effusion Cardiac Tamponade Pericarditis Constrictive Pericarditis Pericardial Neoplasms Acknowledgement Further Reading 5 Pulmonary Infection in Adults Chapter Outline Types of Pneumonias Community-Acquired Pneumonia (CAP) (Box 5.1) Hospital-Acquired Pneumonia (HAP) Ventilator-Associated Pneumonia (VAP) Health Care–Associated Pneumonia (HCAP) Aspiration Pneumonia Clinical Utility and Limitations of Chest Radiography and Computed Tomography Computed Tomography Patterns of Pulmonary Infection Complications of Pneumonia Integrating Clinical and Imaging Findings Lobar Pneumonia Most Common Organisms Streptococcus pneumoniae. Klebsiella. Legionella sp. Chlamydia. Moraxella catarrhalis. Immunocompromised Host Nocardia sp. Actinomyces sp. Endemic in Certain Geographic Areas Coxiella burnetii (Rickettsial Pneumonia). Francisella tularensis. Bronchopneumonia Most Common Organisms Staphylococcus aureus. Escherichia coli. Pseudomonas aeruginosa. Haemophilus influenzae. Atypical Pneumonia Mycoplasma pneumoniae. Viral Influenza A. Adenovirus. Respiratory syncytial virus (RSV). Epstein–Barr virus (EBV). Varicella-zoster virus. Herpes simplex virus type 1 (HSV 1). Hantaviruses. Cytomegalovirus (CMV). New Emerging Viruses Human metapneumovirus (hMPV). Severe acute respiratory syndrome coronavirus. Middle East respiratory syndrome. Avian flu (H5N1). Swine influenza (H1N1). Changing Spectrum of Human Immunodeficiency Virus Infections: 40 Years Later Mycobacterium tuberculosis Primary Tuberculosis Reactivation and Reinfection Tuberculosis Pulmonary Non-Tuberculous Mycobacteria (NTMB) Fungal Infection Aspergillus Infection Candidiasis Pneumocystis jiroveci Mucormycosis Cryptococcosis Histoplasmosis Coccidioidomycosis Paracoccidioidomycosis (South American Blastomycosis) North American Blastomycosis Parasitic Infections Protozoa Amoebiasis Malaria Nematodes Dirofilariasis Ascariasis Strongyloidiasis Trypanosomiasis Cysticercosis Toxocariasis Cestodes Echinococcosis (Hydatid Disease) Trematodes Paragonimiasis Schistosomiasis Further Reading 6 Large Airway Disease and Chronic Airflow Obstruction Chapter Outline Introduction Tracheal Disorders Post-Traumatic Strictures Infectious Tracheobronchitis Primary Malignant Neoplasms Secondary Malignant Neoplasms Benign Neoplasms Wegener Granulomatosis Relapsing Polychondritis Tracheobronchial Amyloidosis Sarcoidosis Inflammatory Bowel Disease Tracheobronchopathia Osteochondroplastica Sabre-Sheath Trachea Tracheobronchomegaly (Mounier-Kuhn Disease) Tracheobronchomalacia Tracheobronchial Fistula and Dehiscence Bronchiectasis Radiographic Findings Computed Tomographic Findings Accuracy of Computed Tomography Cystic Fibrosis Allergic Bronchopulmonary Aspergillosis Diskinetic Cilia Syndrome Broncholithiasis Obliterative (Constrictive) Bronchiolitis Pathological Features Radiological Findings Computed Tomography Assessment of Air Trapping Chronic Obstructive Pulmonary Disease Pathological Findings Radiographic Findings Computed Tomographic Findings Visually Defined Computed Tomography Pattern of Emphysema Visually Defined Computed Tomography Patterns of Airway Diseases Associated Features Quantitative Computed Tomography Image Analysis Quantitative Analysis of Emphysema Extent Quantitative Computed Tomography Analysis of Gas Trapping Quantitative Analysis of Airway Dimensions Asthma Radiographic Findings Computed Tomography Findings Quantitative Computed Tomography Imaging of Airways in Asthma Further Reading 7 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 8 Pulmonary Neoplasms Chapter Outline Histopathology Treatment-Predictive Biomarkers Epidermal Growth Factor Receptor KRAS Anaplastic Lymphoma Kinase ROS1 BRAF Programmed Cell Death Ligand 1 Re-biopsy Lung Cancer and Other Environmental Factors Smoking Passive Smoking General Environmental Pollutants Asbestos Radon Lung Cancer Screening Chest Radiographic Screening Computed Tomography Screening Radiation Dose Considerations The Future of Screening Pulmonary Nodules Management of Small Pulmonary Nodules Nodule Size and Growth Rate Location, Shape and Morphology Nodule Contour Nodule Density Subsolid Nodules Pericystic Tumours Other Forms of Nodule Assessment Nodule Enhancement Positron Emission Tomography/Computed Tomography Tissue Sampling Lung Cancer Staging—the 8Th Edition of the TNM Staging System Additional Pulmonary Nodules in the Presence of Lung Cancer N Descriptors M Descriptors Small Cell Lung Cancer Bronchopulmonary Carcinoid Tumour Summary Imaging Protocols for Lung Cancer Staging The Current Standards of Computer Tomography Technology Imaging Features of Bronchogenic Carcinoma Peripheral Tumours Tumour Shape and Margins Cavitation Calcification Other Findings Central Tumours Collapse/Consolidation in Association With Central Tumours Staging Intrathoracic Spread of Bronchial Carcinoma Hilar Enlargement Mediastinal Invasion Chest Wall Invasion Pleural Involvement Summary Extrathoracic Staging of Lung Cancer Pulmonary Sarcoma and Other Primary Malignant Neoplasms Benign Pulmonary Tumours Hamartoma Other Benign Pulmonary Neoplasms Leiomyoma Inflammatory Myofibroblastic Tumour Sclerosing Haemangioma Squamous Papillomas 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 Miliary Metastases Tumour Emboli Further Reading 9 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 Mosaic Attenuation Pattern Cystic Pattern Idiopathic Interstitial Pneumonias Usual Interstitial Pneumonia/Idiopathic Pulmonary Fibrosis Classical HRCT Findings Non-Specific Interstitial Pneumonia Classical HRCT Findings Cryptogenic Organising Pneumonia Respiratory Bronchiolitis–Interstitial Lung Disease and Desquamative Interstitial Pneumonia Classical HRCT Findings Acute Interstitial Pneumonia/Diffuse Alveolar Damage Classical HRCT Findings Lymphoid Interstitial Pneumonia Classical HRCT Findings Idiopathic Pleuroparenchymal Fibroelastosis Classical HRCT Findings Sarcoidosis Lymphadenopathy Parenchymal Changes High-Resolution Computed Tomography Features Classical HRCT Findings Hypersensitivity Pneumonitis Classical HRCT Findings Langerhans Cell Histiocytosis Classical HRCT Findings Lymphangioleiomyomatosis Classical HRCT Findings Connective Tissue Diseases Rheumatoid Disease Classical HRCT Findings Sjögren Syndrome Classical HRCT Findings Progressive Systemic Sclerosis (Scleroderma) Classical HRCT Findings Polymyositis/Dermatomyositis Classical HRCT Findings Systemic Lupus Erythematosus Classical HRCT Findings Systemic Vasculitides Eosinophilic Granulomatosis With Polyangiitis (Formerly Churg–Strauss Syndrome) Classical HRCT Findings Microscopic Polyangiitis Classical HRCT Findings Drug-Induced Lung Disease Diffuse Alveolar Damage Interstitial Pneumonia Organising Pneumonia Eosinophilic Pneumonia Classical HRCT Findings Occupational Lung Disease The International Labour Office Classification Silicosis/Coal Worker’s Pneumoconiosis Classical HRCT Findings Asbestos-Related Disease Benign Pleural Effusions Pleural Plaques Diffuse Pleural Thickening Round Atelectasis Asbestosis Classical HRCT Findings Further Reading 11 Airspace Diseases Chapter Outline Introduction Suggested Approach to the Radiological Diagnosis of Airspace Diseases Anatomical Considerations Radiological Signs of Airspace Disease Pulmonary Oedema Chest Radiography in Pulmonary Oedema Vascular Alterations Interstitial Oedema Alveolar Oedema Radiographic Differentiation of Cardiogenic and Non-Cardiogenic Oedema Computed Tomography in Pulmonary Oedema Diffuse Pulmonary Haemorrhage Idiopathic Pulmonary Haemosiderosis Antibasement Membrane Antibody Disease (Goodpasture’s Syndrome) Granulomatosis With Polyangiitis (GPA; Formerly Wegener’s Granulomatosis) Organising Pneumonia Eosinophilic Lung Disease Simple Pulmonary Eosinophilia (Löffler’s Syndrome) Acute Eosinophilic Pneumonia (AEP) Chronic Eosinophilic Pneumonia Pulmonary Alveolar Proteinosis Alveolar Microlithiasis Further Reading 12 Cardiac Anatomy and Imaging Techniques Chapter Outline Normal Chest Radiography Cardiac Magnetic Resonance Cardiac Axis Imaging Planes Body Axes Imaging Planes Normal Anatomy on Cardiac Magnetic Resonance Images Computed Tomography Imaging Techniques Computed Tomography Imaging of Ventricles and Myocardial Tissue Coronary Arteries by Computed Tomography Valves Pulmonary Veins Other Structures Echocardiography Valves Acknowledgement Further Reading 13 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 Step 3—Ventriculo-Arterial Connection Step 4—Identification of Other Abnormalities Physiological and Functional Assessment Non-Invasive Imaging Techniques Echocardiography Magnetic Resonance Imaging Computed Tomography Conventional Radiology Diagnostic Features The Pulmonary Vasculature Heart Size, Shape and Position Specific Lesions Acyanotic Lesions Septal Defects Atrial Septal Defects Key imaging goals Atrioventricular Septal Defects Key imaging goals Ventricular Septal Defects Key imaging goals Abnormalities of the Great Vessels Patent Ductus Arteriosus Key imaging goals Coarctation of the Aorta Key imaging goals Interrupted Aortic Arch Key imaging goals Abnormalities of the Aortic Arch and Vascular Rings Key imaging goals Valvular Heart Disease Aortic Valve Disease Key imaging goals Pulmonary Valve Disease Key imaging goals Ebstein Anomaly of the Tricuspid Valve Key imaging goals Coronary Artery Abnormalities Anomalous Coronary Arteries Key imaging goals Cyanotic Congenital Heart Disease Tetralogy of Fallot Key imaging goals Transposition of the Great Arteries Key imaging goals Congenitally Correct Transposition of the Great Arteries Key imaging goals Pulmonary Atresia Pulmonary atresia with a ventricular septal defect. Key imaging goals Pulmonary atresia with an intact ventricular septum. Double Outlet Right Ventricle Key imaging goals Common Arterial Trunk Key imaging goals Anomalous Pulmonary Venous Connection/Drainage Key imaging goals Single Ventricles Systemic to Pulmonary Artery Shunt Key imaging goals following stage 1: pre-bidirectional cavopulmonary connection (pre-BCPC) Bidirectional Glenn Circulation Key imaging goals following stage 2: pre-total cavopulmonary connection (pre-TCPC) Fontan Circulation Key imaging goals following stage 3: post-total cavopulmonary connection (post-TCPC) Recent Developments in Cardiac Magnetic Resonance Imaging Hybrid Catheter/Cardiac Magnetic Resonance Imaging Laboratory Fetal Cardiac Magnetic Resonance Imaging Post-Mortem Cardiac Magnetic Resonance Imaging Three-Dimensional Printing Conclusion Further Reading 14 Nonischaemic Acquired Heart Disease Chapter Outline Role of Imaging Chest Radiography (CXR) 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 Chordal Rupture Functional Mitral Regurgitation Mitral Stenosis Rheumatic Mitral Valve Disease Tricuspid Valve Disease Aortic Valve Disease Aortic Stenosis Aortic Regurgitation New Magnetic Resonance Imaging Techniques Prosthetic Cardiac Valves Complications of Prosthetic Valves Structure Fracture Porcine Bioprosthesis Infective Endocarditis Valve Regurgitation Thromboembolism Tumours of the Heart Metastasis Primary Cardiac Tumours Benign Cardiac Tumours Cardiac Myxoma Lipomas Rhabdomyomas Fibroma Papillary Fibroelastoma Haemangioma Hydatid Disease Malignant Cardiac Tumours Primary Malignant Tumours of the Heart Sarcomas Sarcomas with myofibroblastic differentiation. Rhabdomyosarcoma. Lymphoma Pericardial Diseases Anatomy Pericardial Cysts Pericardial Defects Pericardial Diverticulum Pericardial Effusion Pericardial Inflammation Constrictive Pericarditis Pericardial Masses Further Reading 16 Pulmonary Circulation and Pulmonary Thromboembolism Chapter Outline Pulmonary Circulation Pulmonary Circulation Anatomy Pulmonary Arteries Pulmonary Veins Bronchial Arteries Pulmonary Circulation Physiology Pulmonary Vascular Patterns Pulmonary Venous Hypertension Vascular Redistribution (Grade 1) Interstitial Oedema (Grade 2) Alveolar Oedema (Grade 3) Pulmonary Arterial Hypertension Vascular Signs Cardiac Signs Parenchymal Signs Pulmonary Arteriovenous Malformations Pulmonary Thomboembolic Disease Acute Pulmonary Thromboembolism Background Diagnosis Clinical (Pre-Test) Probability Estimate and D-Dimer Testing Imaging Findings Plain Chest Radiography Transthoracic or Transoesophageal Ultrasound (Echocardiography) Conventional Pulmonary Angiography Compression Ultrasound of the Legs Ventilation–Perfusion Scintigraphy Computed Tomography Pulmonary Angiography Computed tomography pulmonary angiography protocol. Combined protocols: one-stop-shop procedure. Computed tomography pulmonary angiography during pregnancy. Computed tomography pulmonary angiography assessment. Computed tomography perfusion. Magnetic Resonance Imaging Diagnostic Strategies Chronic Pulmonary Thromboembolism Conclusion Acknowledgements Further Reading 15 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 17 The Thoracic Aorta Chapter Outline The Normal Aorta Diagnostic Aspects Chest X-Ray and Echocardiography Angiography Computed Tomography and Magnetic Resonance Imaging Acute Diseases Chronic Diseases Acquired Aortic Abnormalities Acute Aortic Syndrome Aortic Dissection Classification Imaging Magnetic resonance imaging. Computed tomography. Intramural Haematoma Magnetic Resonance Imaging Computed Tomography Penetrating Atherosclerotic Ulcer Traumatic Aortic Injury Imaging Magnetic resonance imaging. Computed tomography. Aortic Aneurysms Atherosclerotic Aortic Aneurysms Thoracic Aneurysms Magnetic resonance imaging. Computed tomography. Abdominal Aneurysms Inflammatory Aneurysms Computed tomography. Magnetic resonance imaging. Mycotic Aneurysms Aortic Sinus Aneurysms Preoperative Evaluation of Acute Aortic Syndromes Impending Aortic Rupture Visceral Malperfusion Preoperative or Preinterventional Evaluation Postoperative Evaluation Management of Aortic Diseases Traumatic Aortic Injury Aortic Dissection Type A dissection. Type B dissection. Endovascular treatment of type B dissection. Inflammatory Diseases of the Aorta and Midaortic Syndrome Midaortic Syndrome Granulomatous vasculitis (Takayasu disease). Imaging. Prognosis and treatment. Von Recklinghausen disease (type 1 neurofibromatosis). Aortic Occlusive Disease Chronic Aortic Occlusive Disease Investigation and management. Acute Aortic Occlusive Disease Imaging and management. Congenital Aortic Abnormalities Vascular Rings Double Aortic Arch Other Vascular Rings Associated With Aortic Arch Abnormalities Right aortic arch with aberrant left subclavian artery and left ligamentum arteriosum. Right aortic arch with mirror-image branching and retro-oesophageal ligamentum arteriosum. Vascular Rings Associated With Left Aortic Arch Aortic Arch Abnormalities Without an Anatomical Ring Anomalous innominate artery. Retro-oesophageal right subclavian artery with an otherwise normal left arch. Imaging Coarctation of the Aorta Chest X-Ray Magnetic Resonance Imaging Computed Tomography Management Pseudocoarctation Aortic Atresia Further Reading SECTION B Abdominal Imaging 18 Current Status of Imaging of the Gastrointestinal Tract Chapter Outline Plain Abdominal Radiograph and Interpretation 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 Large-Bowel 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 Computed Tomography: Radiation Issues Automatic Tube Current Modulation Iterative Reconstruction Algorithms Role of MRI in the Acute Abdomen Radiation Dose Reduction in Clinical Practice Further Reading 19 The Oesophagus Chapter Outline Anatomy and Function Anatomy (Table 19.1) Embryology Function Examination Plain Radiography Ultrasound Fluoroscopy Endoscopy Computed Tomography Magnetic Resonance Imaging Endoscopic Ultrasound Radionuclide Radiology Including Positron-Emission Tomography–Computed Tomography Pathological Features Oesophageal Cancer Computed Tomography for Oesophageal Cancer Endoscopic Ultrasound for Oesophageal Cancer Positron-Emission Tomography–Computed Tomography for Oesophageal Cancer Treatment of Oesophageal Cancer Other Oesophageal Neoplasms Benign Lesions Malignant Lesions Hiatus Hernia Gastro-Oesophageal Reflux Disease Complications of Gastro-Oesophageal Reflux Disease Reflux oesophagitis. Columnar-lined oesophagus. Other Varieties of Oesophagitis Oesophageal Diverticula Motility Disorders Achalasia Jackhammer Oesophagus Systemic Disorders Neuromuscular Disorders Miscellaneous Conditions Oesophageal Diverticula Oesophageal Varices Schatzki Ring Dysphagia Lusoria Dysphagia Aortica Trauma Congenital Conditions Further Reading 20 The Stomach Chapter Outline Anatomy Radiological Techniques Fluoroscopy Cross-Sectional Imaging Multidetector Computed Tomography Magnetic Resonance Imaging FDG-PET and FDG-PET-CT Gastric Pathology Inflammatory Disease and Infiltrative Diseases Helicobacter pylori and Diseases of the Stomach Gastric Ulcer Gastric Erosions Gastritis Atrophic Gastritis Infectious Gastritis Crohn and Other Granulomatous Diseases Hypertrophic Gastritis Ménétrier Disease Zollinger-Ellison Syndrome Eosinophilic Gastroenteritis Corrosive Ingestion Amyloidosis Neoplastic Diseases Mucosal Polyps Mesenchymal Tumours Gastric Carcinoma Early Gastric Cancer Advanced Gastric Cancer Staging of Gastric Cancer Gastric Lymphoma Carcinoid Metastatic Disease Miscellaneous Conditions Positional Abnormalities Hiatus Hernia Gastric Volvulus Gastric Pneumatosis Prepyloric Web (Antral Mucosal Diaphragm) Diverticula Hypertrophic Pyloric Stenosis Varices Gastric Distention Gastroparesis Ectopic Pancreas Bariatric Surgery The Postoperative Stomach Complications of Bariatric Surgery Non-Bariatric Gastric Surgeries Complications of Non-Bariatric Gastric Surgery Advances in Gastric Imaging Further Reading 21 The Small Intestine, Mesentery and Peritoneal Cavity Chapter Outline The Duodenum Anatomy and Normal Appearances Radiological Investigation Disorders of the Duodenum Peptic Ulceration Postbulbar Ulceration Complications of Peptic Ulceration Diverticula Neoplasms Benign Neoplasms Malignant Neoplasms Primary Carcinoma Secondary Involvement Other Conditions Pancreatitis Crohn Disease Progressive Systemic Sclerosis Intramural Haematoma Vascular Conditions The Small Intestine Anatomy and Normal Appearances Radiological Investigation Plain Radiographs Barium Studies Computed Tomography Ultrasound Magnetic Resonance Imaging Angiography Nuclear Medicine Studies Disorders of the Small Intestine Crohn Disease Radiological Appearances Coeliac Disease Neoplasms Malignant Neoplasms Carcinoid Tumour Adenocarcinoma Lymphoma Gastrointestinal Stromal Tumours Secondary Neoplasms Benign Neoplasms Infections and Infestations Tuberculosis Yersiniosis Actinomycosis Acquired Immune Deficiency Syndrome Whipple Disease Mechanical Small-Bowel Obstruction Vascular Disease Acute Mesenteric Ischaemia Vasculitis Occult Gastrointestinal Bleeding Chronic Radiation Enteritis Miscellanous Conditions Diverticula and Blind Loops Jejunal Diverticula Meckel Diverticulum Blind Loops Ileal Diverticula Neuromuscular Disorders Eosinophilic Gastroenteritis Mastocytosis Angio-oedema Amyloidosis Behçet Disease Graft-Versus-Host Disease Non-Steroidal Anti-Inflammatory Drug Enteritis The Peritoneal Cavity, Mesentry and Omentum Anatomical Considerations Introduction Peritoneal Spaces Supramesocolic Space Inframesocolic Space Peritoneal Reflections The Mesenteries The Omentum Developmental/Congenital Anomalies Rotational Anomaly Developmental Defects Mesenteric Cysts Manifestations of Inflammation and Infection Peritonitis Tuberculosis Peritonitis Sclerosing Peritonitis Hydatid Disease of the Peritoneum Mesenteric Lymphadenitis Mesenteric Panniculitis–Sclerosing Mesenteritis Non-Inflammatory Mesenteric Oedema Epiploic Appendagitis Omental Infarction Neoplastic Diseases Secondary Carcinoma Mechanisms and Pathways of Tumour Spread Direct Invasion and Along Mesenteric– Ligamentous Attachments Intraperitoneal Seeding and Peritoneal Carcinomatosis Embolic Metastases Lymphatic Dissemination Cytoreductive Surgery Mesenteric Carcinoid Primary Neoplasms: Benign and Malignant Peritoneum Mesentery Omentum Further Reading 22 The Large Bowel Chapter Outline Anatomy Radiological Investigation Tumours Polyps Polyposis Syndromes Familial adenomatous polyposis. Hereditary non-polyposis colorectal cancer (Lynch syndrome). Peutz–Jeghers syndrome. Rare polyposes. Radiographic Features of Polyps Computed tomography colonography. Magnetic resonance colonography. Double-contrast barium enema. 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 Disease Activity in Inflammatory Bowel Disease 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 24 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 Low Phospholipid-Associated Cholelithiasis Sludge Milk of Calcium Bile Cholecystitis Acute Calculous Cholecystitis Gangrenous Cholecystitis Emphysematous Cholecystitis Acalculous Cholecystitis Xanthogranulomatous 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 Unenhanced CT Cholangiography Hepatolithiasis Benign Biliary Strictures Postoperative Strictures Primary Sclerosing Cholangitis IgG4-Related Disease Mirizzi Syndrome Pancreatitis HIV Cholangiopathy Acute Bacterial Cholangitis Recurrent Pyogenic Cholangitis Parasitic Infections Ascaris lumbricoides Hydatid Fascioliasis Biliary Leaks and Bile Duct Injuries Biliary Cystic Disease Neoplastic Bile Duct Pathology Cholangiocarcinoma Intraductal Papillary Mucinous Neoplasm