? DANDY WALKER VARIANT

CT scan brain showing dilatation of fourth ventricle ..
??dandy walker variant


Dandy-Walker malformation is a rare congenital malformation that involves the cerebellum and fourth ventricle.
Dandy-Walker malformation is characterized by

1. agenesis or hypoplasia of the cerebellar vermis
2. cystic dilatation of the fourth ventricle
3. enlargement of the posterior fossa

A large number of concomitant problems may be present, but Dandy-Walker malformation is recognized whenever these 3 features are found

Dandy-Walker complex is characterized by

1. an enlarged posterior fossa
2. a high position of the tentorium, with upward displacement of the lateral sinuses
3. torcular herophili associated with varying degrees of vermian aplasia or hypoplasia
4. a cystic dilatation of the fourth ventricle that nearly fills the entire posterior fossa.

Dandy-Walker variant consists of vermian hypoplasia and cystic dilatation of the fourth ventricle, without enlargement of the posterior fossa.

?GLIOBASTOMA MULTIFORME

CT scan brain....(with contrast)

a heterogenous density mass iss seen in the right frontal and peri ventricular region .

there is significant mass effect on the ibsilateral lateral ventricle and midline shift.

there is perilesional edema ..seen as hypodense area surrounding the mass....

Bone window reveals erosion of both inner and outer table of overlying bone

there is marginal enhancement of the mass.

ASO...

?glioblastoma multiforme

?? metastasis

SPALDING'S SIGN

In intrauterine maceration, the skull vault bones may partly overlap each other.

This is called as Spalding’s sign . It is also detectable by X Ray examination before the birth of the dead fetus .

thickened mucosal folds...?? COLITIS

Barium enema ...
there id thickening of mucosa seen in the region of sigmoid and descending colon...the thickened mucosal folds show overlapping...the appearance also suggests possibility of pseudopolyps...

HORSE SHOE KIDNEY

There is fusion of lower poles of both kidneys in the midline with 1.8 cm thick renal tissue anterior to the aorta..

Also there is grossly distended fluid filled colon with enhancing walls

AORTOGRAM

AORTOGRAM

a normal aortogram is seen showing the normal anatomical pattern of coronary vessels arising from the aorta

complication of coronary angiography

one of the serious cpmlications of coronary angiography......is the damage to the wall of coraonary vessel...!!!!!!
this is an angiogram taken from a patient whose left main stem got damaged from the catheter and resulted in extravasation of the contrast into the pericardium......

GRADING OF SEVERITY OF MITRAL STENOSIS

MILD

MODERATE

SEVERE

PARASTERNAL SHORT AXIS VIEW

PARASTERNAL LONG AXIS VIEW ON ECHO

MITRAL STENOSIS

CALCIFIED MITRAL VALVE ,MITRAL STENOSIS WITH MILD MITRAL REGURGITATION

echocardiography ..four chamber view of heart reveals calcification of mitral valve with mitral stenosis and mild mitral regurgitation.

MITRAL STENOSIS ,TRICUSPID REGURGE, CLOT IN LA

ECHO of heart four chamber view reveals a huge clot in the left atrium.There is severe mitral stenosis with the leaflets of mitral valve failing to open.

colour doppler reveals reversal of flow through the tricuspid valve in systole upto the middle of right ventricle indicating moderate tricuspid regurgitation

ATRIAL SEPTAL DEFECT on echocardiography

ASD secundum is seen

GB STONE on ultrasonography.

TUMOUR OF RIGHT URETER ON MR UROGRAPHY

MR UROGRAPHY:

there is moderate dilatation of pelvicalyceal system of right kidney with dilated ureter upto the sacro iliac joint.

There is abrupt narrowing of distal end of ureter.

axial T2WI reveal soft tissue intensity mass involving the ureter and extending 2cm in length.

No involvement of periureteric fat is seen.

Note is made of follicular cyst in right ovary appearing as a hyperintense cystic lesion in the right pelvis on T2WI.

uterus and left ovary are unremarkable.

no lymphadenopathy seen.

diagnosis:

TUMOUR OF RIGHT URETER (?TRANSITIONAL CELL CA)

T2N0M0

CALLOSAL TUMOUR

CT scan brain with contrast reveals a heterogenously enhancing mass in the area of genu of corpus callosum.

the lesion is splaying the anterior horns of lateral ventricle outwards and shows mass effect and midline shift.

thw lesion is compressing upon the left sided lateral ventricle resulting in dilatation of right sided lateral ventricle.

opacity left lung field..needs a diagnosis anyone?

CHEST X RAY of an infant shows a homogenous opacity involving the left lung field.

there is massive right sided mediastinal shift.

CT scan of the same patient reveals a soft tissue density mass in the left lung area

Post fatty meal contraction of gall bladder

T-TUBE CHOLANGIOGRAM.

reveals normal study..

there is normal outline of CBD and intrahepatics.

the CBD shows normal opening into the duodenum.

post fatty meal film reveals contraction of the GB

??PLEURAL opacity

X ray right shoulder joint including the right upper chest.

shoulder joint appears normal.

an extra pulmonary opacity is seen along the upper right chest wall.

a patch of acinar shadowing is seen in the upper zone.

possibilities are:

old infection in upper zone with one of the following :

1. pleural based lesion

2.loculated pleural effusion

3.pleural reaction

4.bony lesion

? CHRONIC OSTEOMYELITIS

X RAY KNEE JOINT AP ( oblique ) including lower end of femur..

multiple cavitating lesions are senn invoving the lower end of femur.the lesions mostly involve the medullary cavity and are extending into the cortex causing cortical thinning. multiple bony spicules are seen arising from the periosteum and extending into the soft tissues medially.

note is made of an opacity in the proximal end of tibia.

normal joint space..

possibility of chronic osteomyelitis cannot be excluded

Normal DMSA renal study

SCARRED LEFT KIDNEY on DMSA scan

Normal right kidney with possible scar in upper pole

Scarred left kidney at upper pole, middle and lower pole.

multiple METASTATIC deposits on bone scan

SCARRED RIGHT KIDNEY on DMSA scan

HORSE SHOE KIDNEY on DMSA scan.

dilated intrahepatics...? CAROLI'S

CT ABDOMEN axial cuts.

the intrahepatic biliary channels are dilated without presence of air or stones.

Both lobes of the liver are involved.

possibilities are:

1.caroli's disease

2.Choledochal cysts

3.Focal dilatation of the intrahepatic bile ducts

4.Hereditary ductal dilatation

CEREBELLAR TUMOUR...?GLIOMA

MRI BRAIN ...

isointense masses are seen involving the both cerebellar hemispheres evident on both T1WI AND T2WI.

the masses are sendwitching the fourth ventricle and are compressing it resulting in mild hydrocephalic changes because of narrowing of outflow tract.

there are fluid intensity components of the lesions,evident as hyperintense on T2WI and hypointense on T1WI.

post contrast sequences reveal subtle marginal enhancement of the lesions.

possibilities are:

1.?Glioma with solid and cystic component

2.??PNET