Semiotics in Radiology

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Ethelbert Powell
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1 Adelino Santos Health Technology College Coimbra, Portugal

2 Collaboration of António Agudo Student of Radiology College of Health Technology Coimbra, Portugal

3 What are the most important points to evaluate in a radiographic image? Study technique Anatomy, Positioning and Focus Protection and Collimation Radiologic findings Pathology and Etiology

5 We re facing un MRI image of the skull in which we see no identifying data. Coronal long TR * (STIR or T2) with fat suppression in frontal lobe. The sinuses are clean and cornets free. No mass displayed occupying space or midline shift. In retro-orbital spaces the muscles are seen correctly and can notice a deck asymmetry in the optic nerves.

7 We are looking at an image of chest CT in which we see no identifying data, but only laterality. It is an axial image with parenchymal lung window at the level of the right atrium and left ventricle. The parenchyma is displayed not correctly because is a breathed study. At the anterior chest we can see an asymmetry with sternum ditching, which displaces the heart to the left, caused by pectus excavatum.

9 We have a picture of coronal CT pelvis, which was submitted to postprocessing, in which the identification data was masked. We observe a later coloredmetallic artefact that corresponds to a cemented hip prosthesis, which is luxatedin its theoretical place. The window collimation is not adequate because the major trochanter of the luxatedhip is outfield. We can also see inferiorly an artifact corresponding to a connector and its monitoring cable.

11 We re dealing with an image of conventional radiology abdomen with intravenous contrast, without any identification data. The field of view is not adequate because the pubic symphysis and the joints are cut, and also we do not see the hemidiaphragms. No collimation window, but the image has diagnostic translation. Increase kv for betterqualityimage. We can see a caudal displacement of the right theoretical kidney and metal artifacts, corresponding to surgical intervention staples, probably a former transplant. The kidney has a pelvic and calycealdilatation compatible with hydronephrosisdue to possible obstruction of the ureter (this late and also the bladder are not shown). We can also see two metal artifactscorresponding to hip cemented prosthesis. Along both acetabula anomalous signs are compatible with cement extravasation of the previous intervention.

13 We are analysing an image diagnostic of conventional radiology of lateral left thorax without any identifying data, with good exposure parameters. There is no collimation window and the field of view is inappropriate because the costophrenicwright angle is cut. We can see a left pleural effusion (sign of bowl) and anterior diaphragm is blurred above the gastric chamber. We can see appropriately cardiac silhouette and aortic arch.

15 We are studying a conventional x-ray image of a simple abdomen in which the ID window is hidden.the exposure parameters are correct and the image is diagnostic. However, there is no collimation window and the field of view is inappropriate because the pubic symphysis and both diaphragms are cut. The abdomen presents no levels and gas is well distributed by all area. We can see a diffuse dilation of intestinal loops with much aerial contents in the small intestine and in the colon, and a dilated gastric tube, which can be compatible with intestinal paresis.

17 We have a MRI image of skullwithno identifying data. It is an axial image, supratentorialt1 weighed with intravenous contrast. We can see a large-sized lesion in white matter of the left hemisphere, septate, hypointense, which does not capture contrast or produce oedema with, however, a mass effect notoriously displacing the midline obliterating both stems of left lateral ventricle. This may be compatible with septate cysts.

19 We analyse two images of a sagittal T2 weighed MRI of the lumbar spine and without any identifying data. We can observe a disc protrusion at the L4-L5 level and a signal intensity decrease in most of discs which could be compatible with dehydration. There are irregularities in the vertebrae lower plates from D-11 to L-2. Two hyperintense images are evident at levels D- 6 and D-12 with poorly defined edges, which could be liquid, oedema or fat infiltration inside the bodies. To make the differential diagnosis will require a STIR sequence (or repeat the same with fat suppression).

21 We are observing a coronal MRI T2 image of pelvis without any identifying data. At the level of the ovaries we can see an heterogeneousround mass of well defined edges, hyperintense, with approximately 3 inches at its longitudinal axis and about 2 inches at its transverse axis. The uterus is in anteversion. This lesion can be compatible with a right ovarian complex cyst, which shifts to the left the uterus (in anteversion) and produces a notorious mass effect over the bladder.

23 We have a conventional x-ray image of the pelvis with contrast called hysterosalpingographywithout any kind of identification data. The field of view and collimation window are correct as well as the exposure factors, ensuring a diagnostic image. Good exposure parameters. There stomuchpelvic gas suggestive of patient s poor preparation. At the bottom centerwe can see a metalic artifactcorresponding to the speculum. We can see abicorneseptateuterus. In its left branch there is a small, rounded, hypodense, sharply defined borders image which should probably correspond to an air bubble in the contrast medium. The fallopian tubes are permeable and can be well visualized throughout all the way. However, there is bilateral extravasation.

24 Semiotics in Radiology Adelino Santos College of Health Technology Coimbra, Portugal

10/17/2016. Nuts and Bolts of Thoracic Radiology. Objectives. Techniques

10/17/2016. Nuts and Bolts of Thoracic Radiology. Objectives. Techniques Nuts and Bolts of Thoracic Radiology October 20, 2016 Carleen Risaliti Objectives Understand the basics of chest radiograph Develop a system for interpreting chest radiographs Correctly identify thoracic