radiological signs ( shënja radiologjike )-10

8/11/2019 Radiological Signs ( Shnja Radiologjike )-10

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Sllavko K. Kallfa

Radiological Signs

Shnja Radiologjike)

Prmbledhje Artikujsh nga

Radiopaedia.org

10


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insects and bugs

reptiles

mythical creatures

X-ray signs

insects and bugs

butterfly fracture.....................f.34

butterfly glioma.........................f.3

reptiles

cobra head sign.........................f.11

mythical creatures

cyclops lesion.............................f.21

medusa head..............................f.28
http://radiopaedia.org/articles/missing?article%5Btitle%5D=missinghttp://radiopaedia.org/articles/missing?article%5Btitle%5D=missinghttp://radiopaedia.org/articles/butterfly-gliomahttp://radiopaedia.org/articles/butterfly-gliomahttp://radiopaedia.org/articles/cobra-head-signhttp://radiopaedia.org/articles/cobra-head-signhttp://radiopaedia.org/articles/cyclops-lesionhttp://radiopaedia.org/articles/cyclops-lesionhttp://radiopaedia.org/articles/medusa-headhttp://radiopaedia.org/articles/medusa-headhttp://radiopaedia.org/articles/medusa-headhttp://radiopaedia.org/articles/cyclops-lesionhttp://radiopaedia.org/articles/cobra-head-signhttp://radiopaedia.org/articles/butterfly-gliomahttp://radiopaedia.org/articles/missing?article%5Btitle%5D=missing


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Butterfly glioma

Dr Frank Gaillardet al.

A butterfly gliomarefers to ahigh grade astrocytoma,usually aGBM(WHO grade IV), which

crosses the midline via thecorpus callosum.Other white matter commissures are also

occasionally involved. The term butterfly refers to the symmetric wing like extensions across themidline.

Most frequently butterfly gliomas occur in the frontal lobes, crossing via the genu of the corpus

callosum, however posterior butterflies are also encountered.

Like all high grade gliomas the prognosis is dismal, and usually no attempt at 'curative' resectionis made.

Differential diagnosis

primary CNS lymphoma -especially inAIDSpatients cerebral toxoplasmosis -especially inAIDSpatients

tumefactive demyelination

cerebral metastases(rare)

occasionally a leptomeningeal process which fills thequadrigeminal andambient cisterns

can cause confusion

References

1. Lee HJ, Williams R, Kalnin A et-al. Toxoplasmosis of the corpus callosum: anotherbutterfly. AJR Am J Roentgenol. 1996;166 (6): 1280-1.AJR Am J Roentgenol (citation)

-Pubmed citation

2. Rees JH, Smirniotopoulos JG, Jones RV et-al. Glioblastoma multiforme: radiologic-pathologic correlation. Radiographics. 1996;16 (6): 1413-38.Radiographics (abstract)-

Pubmed citation
http://radiopaedia.org/users/frankhttp://radiopaedia.org/users/frankhttp://radiopaedia.org/articles/diffuse-astrocytoma-gradinghttp://radiopaedia.org/articles/diffuse-astrocytoma-gradinghttp://radiopaedia.org/articles/diffuse-astrocytoma-gradinghttp://radiopaedia.org/articles/glioblastomahttp://radiopaedia.org/articles/glioblastomahttp://radiopaedia.org/articles/glioblastomahttp://radiopaedia.org/articles/cns-tumours-classification-whohttp://radiopaedia.org/articles/cns-tumours-classification-whohttp://radiopaedia.org/articles/cns-tumours-classification-whohttp://radiopaedia.org/articles/corpus-callosumhttp://radiopaedia.org/articles/corpus-callosumhttp://radiopaedia.org/articles/corpus-callosumhttp://radiopaedia.org/articles/primary-cns-lymphomahttp://radiopaedia.org/articles/primary-cns-lymphomahttp://radiopaedia.org/articles/hiv-aids-1http://radiopaedia.org/articles/hiv-aids-1http://radiopaedia.org/articles/cerebral-toxoplasmosis-2http://radiopaedia.org/articles/cerebral-toxoplasmosis-2http://radiopaedia.org/articles/hiv-aids-1http://radiopaedia.org/articles/hiv-aids-1http://radiopaedia.org/articles/hiv-aids-1http://radiopaedia.org/articles/tumefactive_demyelinating_lesionhttp://radiopaedia.org/articles/tumefactive_demyelinating_lesionhttp://radiopaedia.org/articles/cerebral-metastaseshttp://radiopaedia.org/articles/cerebral-metastaseshttp://radiopaedia.org/articles/quadrigeminal-cistern-1http://radiopaedia.org/articles/quadrigeminal-cistern-1http://radiopaedia.org/articles/ambient-cisternhttp://radiopaedia.org/articles/ambient-cisternhttp://radiopaedia.org/articles/ambient-cisternhttp://www.ajronline.org/cgi/content/citation/166/6/1280http://www.ajronline.org/cgi/content/citation/166/6/1280http://www.ajronline.org/cgi/content/citation/166/6/1280http://www.ncbi.nlm.nih.gov/pubmed/8633432http://www.ncbi.nlm.nih.gov/pubmed/8633432http://www.ncbi.nlm.nih.gov/pubmed/8633432http://radiographics.rsna.org/content/16/6/1413.abstracthttp://radiographics.rsna.org/content/16/6/1413.abstracthttp://radiographics.rsna.org/content/16/6/1413.abstracthttp://www.ncbi.nlm.nih.gov/pubmed/8946545http://www.ncbi.nlm.nih.gov/pubmed/8946545http://www.ncbi.nlm.nih.gov/pubmed/8946545http://radiographics.rsna.org/content/16/6/1413.abstracthttp://www.ncbi.nlm.nih.gov/pubmed/8633432http://www.ajronline.org/cgi/content/citation/166/6/1280http://radiopaedia.org/articles/ambient-cisternhttp://radiopaedia.org/articles/quadrigeminal-cistern-1http://radiopaedia.org/articles/cerebral-metastaseshttp://radiopaedia.org/articles/tumefactive_demyelinating_lesionhttp://radiopaedia.org/articles/hiv-aids-1http://radiopaedia.org/articles/cerebral-toxoplasmosis-2http://radiopaedia.org/articles/hiv-aids-1http://radiopaedia.org/articles/primary-cns-lymphomahttp://radiopaedia.org/articles/corpus-callosumhttp://radiopaedia.org/articles/cns-tumours-classification-whohttp://radiopaedia.org/articles/glioblastomahttp://radiopaedia.org/articles/diffuse-astrocytoma-gradinghttp://radiopaedia.org/users/frank


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Synonyms & Alternative Spellings

Synonyms or Alternative SpellingInclude in

Listings?

Butterfly gliomas

GBM butterfly

glioma Yep, this is what a butterfly looks like. Wikipedia source image here Photograph by

Dirk van der Made - for more photos see here.


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From the case:

Butterfly glioma

Modality: MRI
http://radiopaedia.org/cases/butterfly1802http://radiopaedia.org/cases/butterfly1802http://radiopaedia.org/cases/butterfly1802


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From the case:

Butterfly glioma

Modality: MRI
http://radiopaedia.org/cases/butterfly1802http://radiopaedia.org/cases/butterfly1802http://radiopaedia.org/cases/butterfly1802


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From the case:Butterfly glioblastoma (gross pathology)

Modality: Gross pathology
http://radiopaedia.org/cases/butterfly-glioblastoma-gross-pathologyhttp://radiopaedia.org/cases/butterfly-glioblastoma-gross-pathologyhttp://radiopaedia.org/cases/butterfly-glioblastoma-gross-pathologyhttp://radiopaedia.org/cases/butterfly-glioblastoma-gross-pathology


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Butterfly glioma


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From the

case:Butterfly glioma

Modality: MRI
http://radiopaedia.org/cases/butterfly-glioma-1http://radiopaedia.org/cases/butterfly-glioma-1http://radiopaedia.org/cases/butterfly-glioma-1http://radiopaedia.org/cases/butterfly-glioma-1


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From the case:

Butterfly glioma

Modality: MRI
http://radiopaedia.org/cases/butterfly-glioma-2http://radiopaedia.org/cases/butterfly-glioma-2http://radiopaedia.org/cases/butterfly-glioma-2


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Cobra head sign

Dr Ian BickleandRadswikiet al.

The cobra head sign(or spring onion sign) refers to dilatation of the distal ureter, surroundedby a thin lucent line, which is seen in patients with an adult-typeureterocoele.The presence ofthis cobra head appearance is an indicator of uncomplicated ureterocele.

The lucent hood represents the combined thickness of the ureteral wall and prolapsed bladder

mucosa, outlined by contrast material within the bladder lumen.

This lucent line should be thin and well defined. Any thickening, irregularity, or loss of

definition of the cobras hood should raise concern for the presence of a pseudoureterocoele.

References

1. Dyer RB, Chen MY, Zagoria RJ. Classic signs in uroradiology. Radiographics.

2004;24 Suppl 1 : S247-80.doi:10.1148/rg.24si045509-Pubmed citation

2. Chavhan GB. The cobra head sign. Radiology. 2002;225 (3): 781-2.Radiology (full

text)-doi:10.1148/radiol.2253011206-Pubmed citation


Synonyms or Alternative Spelling Include in Listings?Adder head sign

Cobra-head sign

Adder's head sign

Spring onion sign

Cobra's head sign
http://radiopaedia.org/users/clonvarahttp://radiopaedia.org/users/clonvarahttp://radiopaedia.org/users/radswikihttp://radiopaedia.org/users/radswikihttp://radiopaedia.org/users/radswikihttp://radiopaedia.org/articles/ureterocoelehttp://radiopaedia.org/articles/ureterocoelehttp://radiopaedia.org/articles/ureterocoelehttp://radiopaedia.org/articles/pseudoureterocoelehttp://radiopaedia.org/articles/pseudoureterocoelehttp://radiopaedia.org/articles/pseudoureterocoelehttp://dx.doi.org/10.1148/rg.24si045509http://dx.doi.org/10.1148/rg.24si045509http://dx.doi.org/10.1148/rg.24si045509http://www.ncbi.nlm.nih.gov/pubmed/15486245http://www.ncbi.nlm.nih.gov/pubmed/15486245http://www.ncbi.nlm.nih.gov/pubmed/15486245http://radiology.rsna.org/content/225/3/781.fullhttp://radiology.rsna.org/content/225/3/781.fullhttp://radiology.rsna.org/content/225/3/781.fullhttp://radiology.rsna.org/content/225/3/781.fullhttp://dx.doi.org/10.1148/radiol.2253011206http://dx.doi.org/10.1148/radiol.2253011206http://dx.doi.org/10.1148/radiol.2253011206http://www.ncbi.nlm.nih.gov/pubmed/12461261http://www.ncbi.nlm.nih.gov/pubmed/12461261http://www.ncbi.nlm.nih.gov/pubmed/12461261http://www.ncbi.nlm.nih.gov/pubmed/12461261http://dx.doi.org/10.1148/radiol.2253011206http://radiology.rsna.org/content/225/3/781.fullhttp://radiology.rsna.org/content/225/3/781.fullhttp://www.ncbi.nlm.nih.gov/pubmed/15486245http://dx.doi.org/10.1148/rg.24si045509http://radiopaedia.org/articles/pseudoureterocoelehttp://radiopaedia.org/articles/ureterocoelehttp://radiopaedia.org/users/radswikihttp://radiopaedia.org/users/clonvara


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From the case:Ureterocoele

Modality: X-ray
http://radiopaedia.org/cases/ureterocoelehttp://radiopaedia.org/cases/ureterocoelehttp://radiopaedia.org/cases/ureterocoelehttp://radiopaedia.org/cases/ureterocoele


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From the case:Ureterocoele

Modality: X-ray
http://radiopaedia.org/cases/ureterocoelehttp://radiopaedia.org/cases/ureterocoelehttp://radiopaedia.org/cases/ureterocoelehttp://radiopaedia.org/cases/ureterocoele


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Ureterocele

From the case:Ureterocele

Modality: Fluoroscopy
http://radiopaedia.org/cases/ureterocele-4http://radiopaedia.org/cases/ureterocele-4http://radiopaedia.org/cases/ureterocele-4http://radiopaedia.org/cases/ureterocele-4


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Ureterocele Post

intravenous diureteric 30 mins film shows complete wash out of contrastFrom the case:Ureterocele

http://radiopaedia.org/cases/ureterocele-4http://radiopaedia.org/cases/ureterocele-4http://radiopaedia.org/cases/ureterocele-4http://radiopaedia.org/cases/ureterocele-4


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From the

case:Ureterocoele

http://radiopaedia.org/cases/ureterocoele-4http://radiopaedia.org/cases/ureterocoele-4http://radiopaedia.org/cases/ureterocoele-4http://radiopaedia.org/cases/ureterocoele-4


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From the case:

Ureterocoele

http://radiopaedia.org/cases/ureterocoele-4http://radiopaedia.org/cases/ureterocoele-4http://radiopaedia.org/cases/ureterocoele-4


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Cyclops lesion

Dr Frank Gaillardet al.

A cyclops lesion, (also known as localised anterior arthrofibrosis) , is usually found as acomplication ofACL repairs.

Epidemiology

Cyclops lesions occur with an estimated frequency of 1 - 9.8% of patients following anterior

cruciate ligament reconstruction. They are rarely encountered in patients who have not had ACL

reconstruction, but have nonetheless sustained ACL injuries3.

Clinical presentation

When symptomatic the knee has difficulty fulling extending and is painful when attempts aremade, with an eventual audible and palpable clunk. It typically presents8 to 32 weeks (16

weeks on average) after ACL repair3.

Pathophysiology

The exact aetiology is uncertain, and may be related to gradual fraying and bunching up of ACL

or graft fibres, excessive fibrosis, or alternatively due to uplifting of fibrocartilaginous tissueduring drilling of the tibia for anterior cruciate ligament reconstruction serves as a nidus for

fibrous tissue deposition.

The end result, regardless of cause, is a rounded fibrous ball sitting in the intercondylarnotch. Pathologically, the lesion consists of central granulation tissue surrounded by dense

fibrous tissue.

Radiographic features

MRI

As with other internal derangements of the knee, MRI is the modality of choice for assessing the

post operative knee.

At MR imaging, a soft-tissue mass is seen anteriorly or anterolaterally in the intercondylar notch

near the tibial insertion of the reconstructed anterior cruciate ligament.

Because of its fibrous content, a cyclops lesion typically has intermediate to low signal intensity

with all pulse sequences.

Treatment and prognosis
http://radiopaedia.org/users/frankhttp://radiopaedia.org/users/frankhttp://radiopaedia.org/articles/missing?article%5Btitle%5D=acl-repairshttp://radiopaedia.org/articles/missing?article%5Btitle%5D=acl-repairshttp://radiopaedia.org/articles/missing?article%5Btitle%5D=acl-repairshttp://radiopaedia.org/articles/missing?article%5Btitle%5D=acl-repairshttp://radiopaedia.org/users/frank


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Treatment is arthroscopic excision.

Etymology

The lesion was so named because of its bulbous appearance and characteristic focal areas of

reddish-blue discoloration (from venous channels) that resemble an eye at arthroscopy.

References

1. Mccauley TR. MR imaging evaluation of the postoperative knee. Radiology. 2005;234(1): 53-61.doi:10.1148/radiol.2341031302-Pubmed citation

2. Sheldon PJ, Forrester DM, Learch TJ. Imaging of intraarticular masses. Radiographics.

25 (1): 105-19.doi:10.1148/rg.251045050-Pubmed citation

3. Runyan BR, Bancroft LW, Peterson JJ et-al. Cyclops lesions that occur in the absence

of prior anterior ligament reconstruction. Radiographics. 27 (6): e26.doi:10.1148/rg.e26-Pubmed citation


Synonyms or Alternative Spelling Include in Listings?

Localised anterior arthrofibrosis
http://dx.doi.org/10.1148/radiol.2341031302http://dx.doi.org/10.1148/radiol.2341031302http://dx.doi.org/10.1148/radiol.2341031302http://www.ncbi.nlm.nih.gov/pubmed/15564389http://www.ncbi.nlm.nih.gov/pubmed/15564389http://www.ncbi.nlm.nih.gov/pubmed/15564389http://dx.doi.org/10.1148/rg.251045050http://dx.doi.org/10.1148/rg.251045050http://dx.doi.org/10.1148/rg.251045050http://www.ncbi.nlm.nih.gov/pubmed/15653590http://www.ncbi.nlm.nih.gov/pubmed/15653590http://www.ncbi.nlm.nih.gov/pubmed/15653590http://dx.doi.org/10.1148/rg.e26http://dx.doi.org/10.1148/rg.e26http://dx.doi.org/10.1148/rg.e26http://www.ncbi.nlm.nih.gov/pubmed/17712103http://www.ncbi.nlm.nih.gov/pubmed/17712103http://www.ncbi.nlm.nih.gov/pubmed/17712103http://dx.doi.org/10.1148/rg.e26http://www.ncbi.nlm.nih.gov/pubmed/15653590http://dx.doi.org/10.1148/rg.251045050http://www.ncbi.nlm.nih.gov/pubmed/15564389http://dx.doi.org/10.1148/radiol.2341031302


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cyclops lesion Original wikipedia file here


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From the case:Cyclops

lesion
http://radiopaedia.org/cases/cyclops-lesionhttp://radiopaedia.org/cases/cyclops-lesionhttp://radiopaedia.org/cases/cyclops-lesionhttp://radiopaedia.org/cases/cyclops-lesionhttp://radiopaedia.org/cases/cyclops-lesionhttp://radiopaedia.org/cases/cyclops-lesion


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cyclops lesion
http://radiopaedia.org/articles/cyclops_lesionhttp://radiopaedia.org/articles/cyclops_lesionhttp://radiopaedia.org/articles/cyclops_lesion


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From the case:Cyclops lesion

Modality: MRI
http://radiopaedia.org/cases/cyclops-lesion-1http://radiopaedia.org/cases/cyclops-lesion-1http://radiopaedia.org/cases/cyclops-lesion-1http://radiopaedia.org/cases/cyclops-lesion-1


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From the case:Cyclops lesion

Modality: MRI
http://radiopaedia.org/cases/cyclops-lesion-2http://radiopaedia.org/cases/cyclops-lesion-2http://radiopaedia.org/cases/cyclops-lesion-2http://radiopaedia.org/cases/cyclops-lesion-2


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Medusa By Carvaggio Author:

Michelangelo Merisi da Caravaggio or Caravaggio (1573(1573)1610(1610))Original file:

http://commons.wikimedia.org/wiki/File:Medusa_by_Carvaggio.jpgModifications: background and

dropshadowLicense: This image (or other media file) is in the public domain because its copyright has

expired.This applies to the United States, Australia, the European Union and those countries with a

copyright term of life of the author plus 70 years.


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From the case:Developmental venous anomaly

Modality: MRI
http://radiopaedia.org/cases/developmental-venous-anomaly-4http://radiopaedia.org/cases/developmental-venous-anomaly-4http://radiopaedia.org/cases/developmental-venous-anomaly-4http://radiopaedia.org/cases/developmental-venous-anomaly-4


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From the

case:Venous angioma

Modality: CT
http://radiopaedia.org/cases/venous-angiomahttp://radiopaedia.org/cases/venous-angiomahttp://radiopaedia.org/cases/venous-angiomahttp://radiopaedia.org/cases/venous-angioma


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From the case:

Venous angioma

Modality: CT
http://radiopaedia.org/cases/venous-angiomahttp://radiopaedia.org/cases/venous-angiomahttp://radiopaedia.org/cases/venous-angioma


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Butterfly Fracture

Butterfly FractureA fracture in which the centre fragment is triangular shaped.

Butterfly Fracture

No particular mechanism is associated with butterfly fractures


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In In this


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example, there is a comminuted fracture of the mid and distal diaphysis of the tibia with a butterfly

fragment (A).this example, there is a comminuted fracture of the mid and distal diaphysis of the tibia

with a butterfly fragment (A).

A comminuted fracture has multiple fracture lines that communicate to a single point or plane. The

large fragments are generally referred to as "butterfly" fragments. In this example, there is acomminuted fracture of the mid and distal diaphysis of the tibia with a butterfly fragment (A).

radiological signs ( shënja radiologjike )-10

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