Parto Teb Azma

History (HX):
Clinical history of ulcerative colitis for 6 years 27 year – M
Abdominal liver function tests and jaundice
Findings:
Mild dilatation of intrahepatic bile ducts and strictures at
RHD and LHD as well as intrahepatic bile duct beading
Diagnosis (DX):
Primary sclerosing cholangitis
Discussion :
The most common findings in PSC on MRI:
-Intrahepatic bile duct dilatation (77%)
-Intrahepatic bi le ducts stricture (67%)
-Extrahepatic bile duct wall thickening and enhancement (64%)
- Extrahepatic bile duct stenosis (50%)
-Intrahepatic bile duct beading (36%) key finding MIP

History (HX): Incidental finding on ultrasound exam
Findings:
Low attenuated subcapsular liver mass with peripheral nodular enhancement and filling in on delayed study.
Diagnose (DX): Liver hemangioma
Discussion:
Hemangioma is the most common benign tumor of the liver.
The classic diagnostic findings for hemangioma are as follows:
On unenhanced CT: Hypoattenuation similar to that of vessels
On dynamic contrast CT or MR imaging: Peripheral globular enhancement and a centripetal fill-in pattern with attenuation of enhancing areas identical to that aorta and blood pool.

History (HX): Dyspnea
Findings:
Complete collapse of right lung with heterogeneous attenuation value and obliteration of right bronchus related to tumoral involvement right sided pleural effusion
Diagnose (DX): Bronchogenic carcinoma (S.C.C)
Discussion:
In most cases of S.C.C tumor areas centrally within lobar or segmental bronchus. The central location of the tumor account for the presenting symptoms of cough and hemoptysis and common radiographic finding of a hilar mass with or without obstructive pneumonitis or atelectasis.

History (HX): Hirsutism
Findings:
Small 12×10 mm lesion in left adrenal gland
Normal right sided
Diagnose (DX): Adrenal adenoma
Discussion:
Unenhanced CT attenuation value can characterize an adrenal mass as a benign adenoma (adenoma attenuation value is lower than nonadenomas lesion 25H compared with 32H). Adenoma mean diameter is usually lower than nonadenomas. (<1 cm compared with 2/4 cm)

History (HX): Left flank pain, hematuria
Findings:
filling defect in renal pelvis
Diagnose (DX): Non opaque stone
Discussion:
Unenhanced helical CT has been shown to have a sensitivity of 97% , aspecifity 96% and an accuracy of 97% for the diagnosis of urolithiasis. This examination has become the primary technique in many centers for the evaluation of renal calculi in the acute setting and it has been recived in the clinical community particularly in emergency deportments.
Main disadvantage: relatively high radiation dose

History (HX): Left flank pain – hematuria
Findings:
Large opaque stone in left side of pelvis on KUB compatible with filling defect in distal ureter, left hydrouretronephrosis
Diagnose (DX): Left distal ureter stone

History (HX): Reported left hydronephrosis on ultrasound exam
Findings:
Pressure effect upon pelvicalyceal system, no hydronephrosis
Diagnose (DX): Parapelvic cyst
Discussion:
Sonography with show multiple echo free areas in the region of the renal sinus. Differentiation from hydronephrosis may be difficult and renal sinus cysts are one of the most common causes of a false positive diagnosis of hydronephrosis on ultrasound . On contrast enhanced scans and on IVP nondilated pelvis with be stretched and compressed by and curve between renal sinus cysts.
DD: Renal sinus lipomatosis , lymphoma, hemorrhage and urinoma