Saturday, 12 October 2013

Adult Head: Routine (Helical Mode) (Protocol # 1.1)

Billing:
1. CT Head without, or with, or without and with
2. Contrast if used
Setup: 
1. Supine, AP and lateral scouts, no gantry angle 
2. Helical mode should be used routinely for adult head CT scans. Only use axial mode 
when you cannot move the patient’s head into proper position (trauma, cervical 
collar, rigid neck).
3. Patient Positioning: Tilt the patients head so that a line connecting the lateral 
canthus of the eye and the EAC is perpendicular to the CT tabletop (see below). Use 
axial mode and angle the gantry if you cannot place the patient’s head within 15 
degrees of the proper setup angle. 
4. Start scans at the bottom of C1 and scan through the top of the head
DFOV: Preferred 20 cm (Range 18-22)
Contrast: 
1. 150 ml of 240 mg/dl non-ionic contrast @ 0.6 ml/sec (4.2 minutes)
2. Begin scanning as soon as contrast injection is finished


Thursday, 10 October 2013

Temporal Ch Mastoiditis.



Date: October 10, 2013
Name:   





CT TEMPORAL BONES (AXIAL & CORONAL CUTS) REVEALED:

The internal auditory canals showing normal CT measurements.

Normal CT appearance of middle and inner ear structures, no bony lesions.

No soft tissue mass lesions.

Normal CT appearance of the masoid air cells.

IMPRESSION:

Normal CT study of the temporal bones.


Best regards
                 

PNS Chr Sinusitis




Date: Thursday, 10 October, 2013
Name:  





CT PARANASAL SINUSES (CORONAL CUTS) REVEALED:




Lt. maxillary, Rt. sphenoid sinuses show normal CT features.

Hypoplastic Lt. frontal sinus is seen.

Mild hypertrophy of inferior nasal turbinates is seen.

Slightly deviated nasal septum to Lt. side is noted.




Best regards
                                       


orbit




Date:  
Name:  

CT ORBITS (AXIAL & CORONAL) REVEALED:

There is a relatively hyperdense enhancing mass measuring:    X     at Lt. supraorbital and prefrontal region.

Normal underlying bone structures with no intracranial extension.

No intra- or extra-conal mass lesions.

Normal CT appearances of both eye globes.


Best regards

multiple disc bulges + degenerative changes

Date:  
Name:  






CT LUMBOSACRAL SPINE (L3-S1) REVEALED:


L3-L4, L4-L5 & L5-S1 disc levels: evidence of multiple diffuse disc bulges indenting the ventral aspect of the thecal sac.


Diffuse disc degenerative changes are seen at the scanned levels seen as decrease disc heights and vaccum phenomena.

Lt. facet joint arthropathy is seen at L3-L4 noted as sclerosis of the joint with vaccum phenomena.


No spinal canal stenosis.

 No para-vertebral soft-tissue masses or collections.


Impression

Multiple diffuse disc bulges with spondylotic changes.

Best regards

LS - L2-S1 - disc bulges + degenerative changes




Date: Thursday, October 10, 2013
Name:  





CT LUMBOSACRAL SPINE (L3-S1) REVEALED:


At L4-L5 level: evidence of postero-lateral disc bulge indenting the ventral aspect of the thecal sac with encroachment upon the exit nerve root foraminae.

At L5-S1 level: evidence of SMALL Rt. postero-lateral disc bulge toutching the anterior aspect of the thecal sac with preservation of exit foraminae.

At L3-L4 level: shows normal CT appearance with no evidences of significant disc bulge.

Mild spondylolisthesis is seen.

Normal bony spinal canal.

No para-vertebral soft-tissue masses or collections.



Best regards
               .

LS - L2-S1 - Combined spinal canal stenosis.




Date: October 10, 2013
Name:   




CT LUMBOSACRAL SPINE (L3-S1) REVEALED:

Multiple axial cuts were obtained through the lmbar spine from L3-S1 and revealed:


At L4-L5: Lt. postero-lateral disc herniation impinging on the dural sac.

At L3-L4 and L5-S1: diffuse disc bulge is noted.

At L2-L3: no disc bulge or herniation.


Normal bony spinal canal.
Normal apophyseal joints.
No para-spinal abnormalities.




      Best regards

                 

L3-S1 Normal





Date: Thursday, 10 October, 2013
Name:  



CT LUMBOSACRAL SPINE (L3-S1) REVEALED:


-At L4-5 & L5-S1 levels: central disc herniation & diffuse disc bulge with impingement on the dural sac & obliteration of the epidural fat.

-At L3-4 level: no disc bulge or herniation.

-Normal dimensions of bony spinal canal.

-Normal CT appearance of the apophyseal joints.

-No evidence of bone destruction is seen. 

-No para-spinal soft tissue masses or collection are seen.


      Best regards

Doppler



Date: October 10, 2013
Name:   


CT LUMBOSACRAL SPINE (L2-S1 LEVELS) AND RT TIBIA  REVEALED:

Multiple axial cuts were obtained through the lmbar spine from L2-S1 and revealed:


At L4-L5: central and Lt. para-central disc herniation endenting dural sac and obliterating Lt. lateral recess.

At L3-L4: midl diffuse annular disc bulge.


The remaining scanned level is normal.

Normal facetal joints.
Normal bony spinal canal.
No para-spinal abnormalities.



       Best regards
           

CT-CHESTnormal



Date: October 10, 2013
Name:   




CT Chest revealed:

MULTIPLE AXIAL CUTS WERE OBTAINED AFTER IV CONTRAST:

Both lungs are hyperinflated with increased AP diameter of chest.

Evidence of air trapping are noted as increased translucency of lung parenchyma.
The anterior junctional line is elongated due to hyperinflation and is slightly deviated to Lt. side. No pulmonary focal lesions, the appearances are suggestive of small air way disease ?? bronchiolitis.

Normal CT apperance of the heart and great vessels.

No medistinal lymphadenopathy.

No pleural effusions.

Normal bony thorax.


Thanks,
 

CT-CHEST malignant mass



Date:  
Name:  




CT Chest revealed:

Multiple helical cuts were obtained through the chest without IV injection of contrast and revealed: 


There is relative decreased size of the Lt. lung in comparison to the Rt. one due to previous partially lobectomy.

-NO pleural effusion is seen.

-No pulmonary focal lesion is seen.

-The mediastinum is wide due to dilated aorta.

-Small flakes of coronary calcifications are seen.

-Intact bony thorax.



        Best regards


 

CT -pelvis & hips



Date: Thursday, 10 October, 2013

Name:   






CT PELVIS & BOTH HIPS REVEALED:


Mild diastasis of symphysis pubis.

No bony injury is seen.

Both hip and sacroiliac joints are normal.

Both iliac bones and sacrum appear normal.



Best regards
 

CT -Neck




Date: Thursday, 10 October, 2013
Name:  






CT NECK  REVEALED:
Multiple axial cuts were taken through the neck after adminstration of IV contrast revealed : 


Normal CT features of the thyroid gland.

No cervical lymphadenopathy.

Normal CT features of pharyngeal and nasopharyngeral structures.

Intact vascular structures of the neck.

CONCLUSION:

Normal study.





Best regards

CT -knee



Date: Thursday, 10 October, 2013
Name:  






CT RT. KNEE REVEALED:


A tiny bone fragment measuring about 6 x 4 mm is seen in the posterior part of the intercondylar notch.

No evidence of focal lesion in the visualized bones.

No evidence of abnormal soft tissue.





Best regards

CT dysplasia sacral agenesis





Date: Thursday, October 10, 2013
Name:  






CT LUMBOSACRAL SPINE (L3-S1) REVEALED:


Revision of the available plain X-Ray of the lumbosacral spine as well and revealed evidences of spinal dysplasia noted as disfigurement and shortening of lumbar vertebrae of L4 to S1.

Evidence of cetral canal stenosis noted as small mid sagittal diameter of bony spinal canal with markedly decreased interpedicular distance of lumbar spine from L4 to S1.

Evidence of hypogenesis of coccyx noted from plain X-Ray.

Evidence of marked disc degeneration of L5 –S1 level noted as decreased disc hight and vacuum phenomenon.

Evidence ofRt neural foraminal stenosis at the same level( L5-S1) with enchroachement on the lateral exit nerve root.

Evidence of of scoliosis on the Lt side .

No para-vertebral soft-tissue masses or collections.

No radiological evidences of Pott,s disease.

Best regards

CT -Cervical


Date: October 10, 2013
Name:  Khalil Mohammed Said



CT CERVICAL SPINE REVEALED:

Multiple axial cuts were taken through the cervical spine and revealing:

Mild posterior diffuse dic bulge of C6-C7 disc.

Mild lower cervical spondylotic chnages with anterior osteophytes at C6-C7 end plates.

Normal intervertebral joints.

Normal intervertebral foramina.

Normal bone texture.

No intra or para-spinal masses.

Best regards
 



CT - TEMPORAL BONES-normal




Date: Thursday, October 10, 2013
Name:   


CT TEMPORAL BONES (AXIAL   CUTS) REVEALED:

Normal CT appearance and aereation of both mastoid air cells.

Normal CT apperance of the ossicular chain.

Normal CT appearance of the external, middle, and internal ear structures.

Normal and equal diameter of internal auditory canal.

Normal CT appearance of the cerebello-pontine angles.




IMPRESSION:
Normal CT study.

                  Best regards
 

CT - TEMPORAL BONES - Ch. Mastoiditis




Date: Thursday, 10 October, 2013
Name:   






CT TEMPORAL BONES (AXIAL & CORONAL CUTS) REVEALED:

There is obliteraiton of the mastoid air cells on the Rt. side.

A soft tissue density is seen occupying the entire limen of the Rt. middle ear cavity, but the ossicles are still intact (not eroded).

The roof of the Rt. middle ear cavity (tegmen tympani) is seen eroded, picture of Rt. cholesteatoma with chronic masoiditis.

There is partial obliteration of the Lt. mastoid air cells, picture of chronic masoiditis (mild form).

The Lt. middle ear cavity is seen well aerated and the ossicles within are seen intact.


Best regards
                        

CT - PELVIS & BOTH HIPS



Date:  October 10, 2013
Name:  


CT PELVIS AND BOTH HIPS:

There is fracture of the posterior lip of the Rt. acetabulum.

A small intraarticular bony fragment is seen in acetabular floor.

Lt. hip joint is normal.

Both femoral heads are normal.

No pelvic masses are seen.

Best regards
.

CT - BRAIN Hydro


Date: Thursday, October 10, 2013
Name:  






CT Brain Revealed: 
Multiple axial cuts were taken through the brain without contrast, and revealed:


A case of severe obstructive hydrocephalus more on Lt. side most probably at the level of aqueduct noted as markedly dilated both lateral ventricles, more on Lt. side and ballooning of 3rd ventricle.

Presence of the cortex excludes the possibility of being hydraencephaly.



-Normal CT appearance of the brain parenchyma with no focal leisons.

-No intraaxial hematomas or extra-axial collections.

-Normal CT appearance of the ventricular system and posterior fossa structures.

-No midline shift.

-Normal bony skull.



CONCLUSION:
Normal CT study.


                                Best Regards,

CT - BRAIN + PNS - Normal

Date: 17/07/03
Name:   



CT PNS (Axial & Cronal) reveals:

Normal CT features of the frontal, maxillary, eithmoidal and sphenoid sinuses.

Hypertrophied inferior and middle nasal trubinates.

Central nasal septum.

Patent osteomeatal complex.

Nornal orbital cuts.

No bony destruction or mass lesions are seen.





Best regards

CT - BRAIN - Normal without C


Date: Thursday, 10 October, 2013
Name:  

CT Brain
Multiple axial cuts were taken through the brain without contrast, and revealed

Normal CT appearance of the brain parenchyma with no focal lesions.

No intracerebral or extra-axial hematomas are seen.

Normal CT appearance of the ventricular system.
                                                                                                                                      
Normal posterior fossa.

Intact bony cranium.                                                                                                                                                  
       
                                                                                               
CONCLUSION      
Normal CT study                                                                                                                                                                                                                                                                                             
                               

                                                               Best Regards,

CT - BRAIN - macro-sellar adenoma




Date: Thursday, December 19, 2002
Name:   


CT BRAIN  REVEALED:

Multiple axial cuts were taken through the brain WITH & WITHOUT administration of i.v. contrast, and revealed:


A well defined rounded, markedly enhanced, sellar mass lesion measures 3 x 3.5 x 2 cm, that representing macro-sellar adenoma.

No intra-cerebral or extra-axial collections noted.

Normal CT features of the ventricular system.

Normal posterior fossa contents.

No bony abnormalities are noted.



IMPRESSION:
Macro-sellar adenoma.

Best Regards,

CT - BRAIN - infarction without C







Name
الخميس, أكتوبر 10, 2013


CT BRAIN  REVEALED:
Multiple axial cuts were taken through the brain without i.v. contrast, and revealed:


A hypodens area is seem the left parietal region suggestive of left cerebral infarction .
No intra-cerebral or extra-axial collections noted.

Normal CT features of the ventricular system.

Normal posterior fossa contents.

CT - ABDOMEN -




Date: Thursday, October 10, 2013
Name: 




CT ABDOMEN (with oral  and IV contrast) REVEALED:
Helical cuts were obtained through the abdomen after IV and oral contrast and revealed:

-The liver is enlarged size, displaying diffuse hypodensity suggesting diffuse fatty infiltration. No definate focal lesions are seen. No evidence of intrahepatic biliary radicals are seen.

-Normal CT appearance of GB and spleen

-Normal CT features of the pancreas, both kidneys aorta and IVC .

-Normal opacification of the stomach and bowel loops.

-No abdominal or pelvic lymphadenopathy.

-No ascites.


Impression:
Evidence of fatty infiltration of the liver.


                                             Best regards
         

CT - ABDOMEN (cirr,asci)




Date: Thursday, 10 October, 2013
Name: 


CT ABDOMEN (with oral and IV contrast) REVEALED:


The liver shows shrunken cirrhotic pattern, yet no obvious focal hepatic lesions or dilated bile ducts are seen.

The spleen was surgically removal.

Normal CT features of the pancreas, aorta and IVC.

Both kidneys show normal CT features, with good excretory function.

No abdominal or pelvic lymphadenopathy.

Massive ascites is noted.



IMPRESSION:
Shurrenked cirrhotic liver.
Massive ascites.

Best regards
 

CT - ABDOMEN & PELVIS - male - Normal

Date: October 10, 2013
Name: 

SPIRAL CT ABDOMEN AND PELVIS  REVEALED:

Helical axial cuts were obtained through the abdomen  and pelvis after oral and IV contrast and revealed:


-An exophytic mass lesion originating from the anterior border of the Rt. kidney of uniform texture and few tiny calcific foci …picture highly suggestive of renal neoplasm for excisional biopsy. 

-A single stone is seen in the Lt. renal pelvis.

-Normal excretory function of both kidneys.

-Liver showed normal CT features. No focal lesions or dilated bile ducts are seen.

-Pancreas and spleen show normal CT features.

-No evidences of lymphadenopathy.

-Normal bowel loops, No collections are seen.

-Normal lower chest cuts.

-Normal CT features of the bladder, seminal vesicles, and prostate.

CONCLUSION:

RIGHT RENAL MASS CONFINED ONLY TO THE KIDNEY.
LEFT RENAL STONE.
Regards,
          

cervical normal





Name: 
date : 

CT CERVICAL SPINE (C3-C7) REVEALED:


Evidence of posterior bulging of the C4-C5 & C5-C6 disc levels, yet the ventral epidural fat is still preserved.

Other scanned discs show normal CT appearance.

No evidence of neural foramina stenosis are seen

Normal CT appearance of facet joints.

No para-vertebral soft-tissue masses or collections.

No bony cervical rib .


Best regards
                

Angio


Angio

Date: 
Name:.


Rt. lower limb angiography was done throughout cathterization of the aorta by Rt. trans-femoral cathetrization and reveals:


The lower abdominal aorta, iliac, Rt. common femoral and popliteal arteries are seen patent and display average arterial flow pattern with normal arterial contrast opacification.

No obvious occluded or stenotic lesions along these segments.

The Rt. superficial femoral artery is seen occluded from its origin downwards till the distal one third of the arterial length with multiple arterial collateral mainly from the depp femoral one.

Multiple occluded segments along the infra-popliteal arteries with poor distal runoff.




     Best regards

ABDOMEN & PELVIS - female -


Date: Thursday, 10 October, 2013
Name:

CT ABDOMEN (IV & oral contrast) REVEALED:

The gall bladder is distended containing a solitary stone measuring about 15mm & shows diffuse edematous wall thickening … picture suggestive of acute calcular cholecystitis.

The liver shows evidences of CLD noted as subtle surface irregularity with prominent caudate lobe & attenuated hepatic veins.

The spleen is moderately enlarged displaying normal density with no focal lesions.

Both kidneys show normal CT features, with good excretory function.

Normal opacification of the stomach and bowel loops.

No abdominal or pelvic lymphadenopathy.

No ascites.

                                             Best regards