Classic Imaging Signs. A Guide to the Whole Body PDF
Preview Classic Imaging Signs. A Guide to the Whole Body
Classic Imaging Signs A Guide to the Whole Body Bo Gao Alexander M. McKinney Editors 123 Classic Imaging Signs Bo Gao • Alexander M. McKinney Editors Shi Zhou • Shi Zuo Associate Editors Classic Imaging Signs A Guide to the Whole Body Editors Bo Gao Alexander M. McKinney Department of Radiology Department of Radiology Affiliated Hospital University of Miami Miller of Guizhou Medical University School of Medicine Guiyang Miami, FL China USA ISBN 978-3-030-56347-9 ISBN 978-3-030-56348-6 (eBook) https://doi.org/10.1007/978-3-030-56348-6 © Springer Nature Switzerland AG 2021 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. The publisher, the authors and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, expressed or implied, with respect to the material contained herein or for any errors or omissions that may have been made. The publisher remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. This Springer imprint is published by the registered company Springer Nature Switzerland AG The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland Foreword: Imaging Signs Radiologic and radiographic “imaging signs” are critical to our quick recog- nition of disease states and instituting therapy. They are also perhaps even more vital to the teaching element for trainees, since such prompt recognition of an abnormal imaging pattern cements the appearance in the memory of the learner for future recognition. The goal of proposing such “signs” is that eventually a particular disease state’s radiologic appearance ultimately becomes accepted as a classic “imaging sign,” and thus gains recognition among radiologists and other subspecialists for general use. While it is acknowledged that a disease state does not absolutely have to exhibit the clas- sic imaging sign (e.g., the “Rigler sign” of pneumoperitoneum), it is quite important to note such a sign, when present, as early as possible, in order to alert the ordering provider to a preventable complications of the disease state. The editors, Drs. Gao and McKinney et al., organized this text in a very practical fashion that can serve as a quick reference to enhance the reader’s understanding of each imaging sign, regardless of their level of training or experience. While there are many other texts and websites that address imag- ing signs by subspecialty (e.g., cardiothoracic or neuroradiology), body part (e.g., lung or renal), or particular disease state (e.g., pneumoperitoneum or meningioma), this text distinguishes itself as a compendium of each subspe- cialty/organ system. The text is organized by each body part/organ system (e.g., brain, spine, chest, etc.), with Individual topics for each sign. Another distinguishing factor is that this text also provides the proven or presumed pathophysiologic reasoning for that imaging appearance, as well as variants or alternative names for each sign. Finally, I note that the editors incorporated newer signs (e.g., the “swallowtail sign” on susceptibility-weighted MRI) along with the classic imaging signs and attempted to provide the reliability or sensitivity/specificity of these signs when such data were available. Hence, this text on “Imaging Signs” will likely serve to augment both the educational and clinical aspects for trainees and staff physicians, and enable prompt recognition of particular disease states. This is becoming increasingly v vi Foreword: Imaging Signs vital in this era of remote education, diagnosis, and therapy. Further editions and versions will presumably expand upon this novel work and continue to enlighten our trainees and provide a useful resource to practicing physicians. Jafar Golzarian, MD Professor of Radiology and Surgery Vice Chair, Faculty Affairs Medical School Director, Division of Interventional Radiology University of Minnesota Medical Center Minneapolis, MN, USA Foreword: Classic Imaging Signs: A Guide to the Whole Body Medical imaging/radiology has developed tremendously in the last decades with the emergence of novel imaging techniques, especially the flourishing of advanced CT and MRI. In recent years, even with the rapid evolution of modern imaging modalities, radiology still has an irreplaceable role in diagnosis within standard clinical practice. The field of medical image analysis has grown exponentially, with an increased number of pattern recognition tools and an increase in data set sizes. Competent imaging acquisition often entails referring to other realms of knowledge to acquire insights with the aid of metaphors. Problems with timing, efficiency, and missed diagnoses may occur at all stages of the imaging chain. This book Classic Imaging Signs: A Guide to the Whole Body is written by leading experts with irrespective imaging specialty backgrounds. The editors, Drs. Gao and McKinney et al., organized this text in a very practical fashion that can serve as a quick reference to enhance the reader’s understanding of each imaging sign. This book is intended to help radiologists and students accomplish this task. It provides practicing radiologists and radiology resi- dents or fellows with the level of knowledge necessary to avoid misinterpreta- tion and help make precise diagnoses in the presence of certain classic pathognomonic features. Judgment of image sign, as one of the core principles of radiology, relies on the integration of multilayered data with distinctive decision-making. If we are to use terms with full understanding, we should be capable to visualize the object depicted by that term, imagine its radiologic appearance, and transfer that picture to the radiologic image before us. This book serves to augment both the educational and clinical aspects for trainees and staff physicians, and enable prompt recognition of particular dis- ease states. This is becoming increasingly vital in this era of remote educa- tion, diagnosis, and therapy. The editors of this book have provided thorough and illustrative reviews of these emerging and controversial topics. I con- gratulate the editors on their accomplishment of this work, and I look forward to future editions since we seemingly encounter new diseases and signs every year. I am pretty glad to introduce this book to those who are addicted to the clinical practice and research of clinical radiology. Hai-yang Li, MD Professor of Surgery Chair, Clinical Medical School, Guizhou Medical University President, The Affiliated Hospital of Guizhou Medical University Guiyang, China vii Preface Image signs refer to the normal structures of the human body or imaging information or radiologic findings produced by pathology under any type of imaging modalities. An “iconographic” glossary of terms used for imaging is reproduced-placing side by side between radiological features and those may be associated with signs, symbols, or naturalistic images. Specifically, image signs refer to the metaphor of certain tissue, structure, or lesion. One way is by linking anatomic structures and pathologic conditions with objects, places, and concepts, and codifying these relationships as metaphoric signs. To describe an unnoticed finding specific to a particular entity has always been a challenge for the radiologists. Time will be needed on investigations before we can add the specific finding to the legions of “signs” in radiology. The “signs” may become part of our language of specialty after validating by dif- ferent observers over time. The “classic signs” endorse us confidence in determining the diagnosis. Some imaging signs have been acknowledged, which are referred to as “Aunt Minnie.” When the sign is invoked, or an Aunt Minnie is recognized, it often brings an impression of the image to mind, and it may have specific diagnostic and pathologic significance. The advance of radiology, evolving with such signs, renders an otherwise difficult diagnosis easier, may help the radiologists appreciate the anatomy and pathology of an underlying abnormality, and may quickly direct the physicians to the proper diagnosis and timely intervention. This book systematically summarizes the imaging characteristics and theory of modern imaging, primarily summarizes the imaging signs characteristics and theory in the whole body, serving as a clinical guidance and having a practical significance for the understanding, prevention, and diagnosis of miscellaneous entities. This book consists of 10 chapters and covers over 300 classic radiologic signs with detailed discussion alongside illustrative photos for memory aids and clarification. The book is featured as follows: (1) covers hot topics includ- ing potential pitfalls of imaging and classic signs, (2) detailed discussions and case show highlighting clues and misinterpretation, (3) succinct content and bulleted text for quick and easy reference, and (4) detailed illustrations and annotated images. The materials included in the book were collected from various university hospitals and are well-organized, and all cases have been reviewed by subspecialty experts. Photos illustrate the etymology of each sign and enhance the learning experience. Accompanying text explains the history and meaning of the descriptive or metaphoric sign. Uniquely writ- ten from a practical point of view, each case leads you through a radiology ix x Preface expert’s thought process in analyzing imaging pitfalls and classic signs of different organs or systems. The cases highlight clinical presentation, rele- vant pathology, anatomy, physiology, and pertinent imaging features of com- mon disease processes. Key information is distilled into succinct, bulleted with detailed illustrations and wonderful images. It is designed to enhance recognition of specific imaging patterns, enabling the image interpreter to confidently reach an accurate diagnosis. This book ought to be a valuable review for trainees preparing for boards licensing examinations and can become a trusted daily reference for practicing radiologists. We wish this book to become an irreplaceable reference for readers confronted with the challenges of imaging interpretation. We sincerely appreciate all the experts and contributors who engaged in this book. Guiyang, China Bo Gao Miami, FL, USA Alexander M. McKinney Contents 1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Bo Gao, Cong-jie Long, Li Zhang, and Chi Shing Zee 2 Brain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 Alexander M. McKinney, Yang Wang, and Ze Zhang 3 Head and Neck . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85 Zhongxiang Ding, Guoyu Chen, and Alexander M. McKinney 4 Chest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 103 Tao Jiang, Yanling Zhang, Shanshan Wu, and Jujiang Mao 5 Solid Organs of Upper Abdomen . . . . . . . . . . . . . . . . . . . . . . . . . . 177 Xin Li, Chengkai Zhou, and Jie Zhou 6 Gastrointestinal Tract . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 239 Jiani Chen, Hengtian Xu, and Gui Quan Shen 7 Peritoneum and Pelvis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 273 Pinggui Lei, Bin Huang, and Hui Yu 8 Signs in Musculoskeletal Radiology . . . . . . . . . . . . . . . . . . . . . . . 291 Haitao Yang, Lingling Song, and Zhaoshu Huang 9 Spine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 327 Lingling Song, Wen Wang, Muxi Wu, and Alexander M. McKinney 10 Vascular Imaging and Interventional Strategy . . . . . . . . . . . . . . 349 Lei Xu, Xin Chen, and Shi Zhou Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 369 xi
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