MILD
MODERATE
SEVERE
Thursday, October 8, 2009
Wednesday, October 7, 2009
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
Monday, October 5, 2009
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
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.
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
MULTIPLE ENHANCING NODULES IN BRAIN..
CT BRAIN with contrast...
there are multiple enhancing nodular hyperdense lesions in the brain. There is marked perinodular edema shown as a hypodense area surrounding the hyperdensities.
There is exaggeraqted meningeal enhancement.
There is intraparenchymal edema with narrowing of the ventricular system and cisterns.
possibilities are:
1. metastasis
2. tuberculomas with meningitis.
? CARCINOMA WITH METASTASIS
CT ABDOMEN axial sections..
-There is thickening of the pylorus.
-multiple enlarged matted lymph nodes are seen along the celiac axis.
-a well defined, contour bulging, hypodense lesion is seen in the right lobe of liver.
the most probable diagnosis is...malignant disease process with metastasis to local lymph nodes and liver
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