Case of the Week: Duplicated Collecting System (VCUG & Ultrasound)

In this radiology lecture, we discuss the imaging appearance of duplicated collecting system and ureterocele, with attention to US and VCUG.

Key points include:

  • Weigert-Meyer rule: Remember the mnemonic “DUMI.”
  • With duplex kidneys and complete ureteral Duplication, ureter draining Upper pole inserts ectopically into bladder Medially and Inferiorly to ureter draining lower pole.
  • Lower pole moiety inserts orthotopically.
  • Upper pole moiety often ends as an ectopic ureterocele.
  • Upper pole moiety tends to obstruct, and lower pole moiety is prone to reflux.
  • Obstructed upper pole moiety causes mass effect with resultant inferior displacement of the lower pole moiety and the “drooping lily” sign.

Click the YouTube Community tab or follow on social media for bonus teaching material posted throughout the week!

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Case of the Week: Colonic Lymphoma (CT & PET)

In this radiology lecture, we discuss the imaging appearance of large bowel lymphoma.

Key points include:

  • Often isodense to skeletal muscle.
  • May have aneurysmal dilatation of involved bowel.
  • Less likely obstructive and longer segment involvement compared to colonic adenocarcinoma.
  • Located near ileocecal valve.
  • GI lymphoma: Most common in stomach, followed by small bowel (ileum, jejunum, duodenum), least common site colorectal.
  • Splenomegaly and severe lymphadenopathy favor lymphoma but may not be present.

Click the YouTube Community tab or follow on social media for bonus teaching material posted throughout the week!

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Twitter: https://twitter.com/radiologistHQ

Case of the Week: Ovarian Torsion (Ultrasound)

In this radiology lecture, we discuss the ultrasound appearance of ovarian torsion.

Key points include:

  • Rotation of ovarian vascular pedicle with obstruction to venous outflow and arterial inflow.
  • Enlarged, heterogenous ovary due to hemorrhage and edema.
  • Small peripheral cysts with “follicular ring” sign: Thick, hyperechoic rim surrounding follicles of torsed ovary.
  • Classically, absent vascular flow.
  • However, up to 60% of patients with torsion have normal color Doppler findings, and arterial flow may even be preserved!
  • Most common finding is decreased or absent venous flow.
  • Twisted vascular pedicle: Most definitive sign of torsion, present in up to 88% of patients.
  • “Whirlpool” sign: Flow within the twisted vascular pedicle.

Click the YouTube Community tab or follow on social media for bonus teaching material posted throughout the week!

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Twitter: https://twitter.com/radiologistHQ

Case of the Week: Cecal Volvulus (X-ray & CT)

In this inaugural case of the week radiology lecture, we discuss the imaging appearance of cecal volvulus!

Key points include:

  • Cecal volvulus occurs when there is twisting of cecum around the mesentery with proximal large bowel obstruction.
  • Cecum normally <9 cm, rest of large bowel <6 cm.
  • Topogram (scout view) extremely helpful.
  • Vector typically points towards LUQ, but instead of worrying about vector direction, look for proximal dilated small bowel (as opposed to large bowel) to differentiate from sigmoid volvulus.
  • Complications include pneumoperitoneum = bowel perforation (Rigler’s sign, falciform ligament sign) and pneumatosis = cecal ischemia.

Click the YouTube Community tab or follow on social media for bonus teaching material posted throughout the week!

Instagram: https://www.instagram.com/radiologistHQ/
Facebook: https://www.facebook.com/radiologistHeadQuarters/
Twitter: https://twitter.com/radiologistHQ

Webinar: Ultrasound of Ovarian Cystic Disease

Check out my FREE webinar titled “Ultrasound of Ovarian Cystic Disease” on Wednesday, September 29, 2021 at 7-8 PM ET, hosted by the American Institute of Ultrasound in Medicine (AIUM). A Q&A session follows the presentation.

In case you missed the lecture or would like to watch it again, click here: https://learn.aium.org/products/ultrasound-of-cystic-ovarian-disease-neoplastic-non-neoplastic

Enjoy!

Webinar: Ultrasound of Genitourinary Infectious Disease

Check out my FREE webinar titled “Ultrasound of Genitourinary Infectious Disease” on Thursday, March 25, 2021 at 1-2 PM ET, hosted by the American Institute of Ultrasound in Medicine (AIUM). A Q&A session follows the presentation.

In case you missed the lecture or would like to watch it again, you can find it here: https://learn.aium.org/products/ultrasound-of-genitourinary-infectious-disease

Enjoy!

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