Basic Knowledge Radiology

Description:
Clear and compact, this textbook provides you with a complete overview of all radiology content relevant to the exam. It guides you in an easy-to-understand and GK-oriented manner through the entire basic knowledge from the fundamentals to the most important clinical pictures, including nuclear medicine and radiation therapy. Benefit from the many years of experience of the lecturers, who have carefully selected and prepared the essentials for you.

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Preface

Modern medicine without imaging diagnostics and therapy is no longer imaginable in this day and age. Although every medical specialty deals “a little bit” with the imaging procedures of its own spectrum, the radiologists’ and nuclear medicine specialists’ claim is to have an overview of the diagnostics necessary for the problem and to keep an eye on the secondary findings, which may become the main findings for the patient.

At the same time, the fields of radiology, nuclear medicine, and radiotherapy remain in constant flux due to technical developments. Due to the diversity and the increasingly strong interventional field (especially in radiology), the areas are far from a “work in the dark closet.”

In particular, the radiologist treats patients of any age and with almost any disease. So one is something like a specialized all-rounder. But there is also a need for specialization: pediatric radiology, neuroradiology, or interventional radiology require special knowledge and skills. Nuclear medicine specialists and radiologists work closely together to offer patients the best possible diagnostics in PETCT examinations. And the constant technical development also demands continuous training for colleagues who have been working in the profession for many years.

In the course of your studies, you have certainly had some contact with X-rays, nuclear medicine, or radiation therapy. But how does it all actually work? And why does the nuclear medicine doctor get upset about your blood pressure medication before the kidney scintigraphy? Why does the MTRA stop her when she walks into the MRI? And why doesn’t the radiotherapist want to give radiation to the demented patient for whom surgery seems far too costly? We want to answer these and other questions and share our enthusiasm for our specialties with you.

With the basic knowledge of radiology and imaging procedures, we want to give you an overview of diagnostic and therapeutic options for the most common diseases. In doing so, a book alone cannot claim to be complete; it is not for nothing that the libraries of the radiology departments tend to be the most extensive ones in a hospital. But we want to lay a starting point for a very interesting field of medicine, from which you can at least go the first part of the way. This includes the correct use of the methods with knowledge of the advantages and disadvantages and the correct description of the findings. The evaluation of the same is also in the professional everyday life often a rereading in thick special tomes and the discussion of the possible diagnoses with colleagues of their own and the treating specialty.

Special thanks go to our author colleagues, without whom this book would not be equipped with so much expertise: Dr. Blum, Dr. Kremers, Dr. Wenker, Dr. Heilsberg, and Dr. Münstermann. We would also like to thank our colleagues Heinrich Rühe, Madlen Hagemann, and Dominika Kotas, as well as Dr. Matthias Göb, who actively supported us in compiling the images.

Further thanks go to the staff at Springer-Verlag, above all to Mrs. Rose-Marie Doyon in project management, for the opportunity to make this book a reality and for the corresponding support.

We welcome suggestions and comments from you to further develop the book and adapt it to the needs of our readers.

We hope that this book will be a valuable companion for you as a student in clinical traineeship or PJ and also as a resident in radiology, nuclear medicine, or radiotherapy in your everyday student and professional life.

Table of contents :
Preface
Contents
About the Editors
Contributors
Editors and Contributors
I: Basics
1: Physical Basics
1.1 Radioactivity and Its Interactions
1.1.1 Radioactive Decay Modes
1.1.2 The Physical Half-Life
1.1.3 Physical Interaction Processes of Electromagnetic Radiation with Matter
Interaction of Photon Radiation with Matter
1.1.4 Interaction of Particle Radiation with Matter
1.2 X-Rays
1.3 Dose Terms
1.3.1 Kerma = Kinetic Energy Released in Matter
1.3.2 Ion Dose
1.3.3 Absorbed Dose
1.3.4 Equivalent Dose
1.3.5 Incident Dose
1.3.6 Surface Dose
1.3.7 Deep Dose
1.3.8 Dose Area Product
1.3.9 Dose Length Product
1.3.10 Organ Dose
1.3.11 Effective Dose
1.3.12 Personal Dose, Local Dose and Body Dose
1.4 Effect of Ionizing Radiation on the Organism
1.4.1 Radiation Effects
Stochastic Radiation Effect
Deterministic Radiation Effect
1.4.2 Phases of the Radiation Effect
Physical Phase
Physical and Chemical Phase
Biochemical Phase
Biological Phase
2: Conventional X-ray Diagnostics
2.1 Design and Operation of an X-ray System
2.1.1 The X-ray Source
Structure of the X-ray Tube
The Depth Stop with Light Sighting
2.1.2 The X-ray Generator
Tube Voltage
Tube Current
Dose
Exposure Point System
Automatic Exposure Control
2.1.3 Mapping Laws
Ray Theorem
Projection/Parallax
Distortion
Law of Distance Squared
2.1.4 Quality of the X-ray Image and Quality Improvement Measures
The Good X-ray Image
Motion Blur
Scattered Beam Reduction
Image Noise in Digital X-ray Images
2.1.5 Setting Up a Bucky Workstation
Bucky Table
Grid Wall Stand
Tripod
2.1.6 Mobile X-ray Equipment
2.1.7 Special Radiation Protection Measures
Direct Radiation Protection
Indirect Radiation Protection
2.2 Digital Image Processing
2.2.1 Matrix
2.2.2 Color Depth
2.2.3 Error Correction
3: Mammography
3.1 Design and Function of a Mammography Device
3.1.1 The Heel Effect
3.1.2 Compression, Scattered Radiation Reduction
3.1.3 Magnification Mammography
3.1.4 Automatic Exposure Control
3.1.5 Image Receiver, Image Viewing
4: Transillumination
4.1 Image Intensifier (BV)
4.1.1 Structure of A Fluoroscopy Unit
5: Angiography, Rotational Angiography/Angio-CT
5.1 DSA Technique
5.2 Angiography-CT Rotational/Angio-CT
5.3 Seldinger Technique
6: Computed Tomography (CT)
6.1 History
6.2 Design and Operation of A Computer Tomograph
6.3 Investigation Techniques
6.3.1 CT Sequence
6.3.2 CT Dynamic
6.3.3 CT Spiral/CT Singleslice (SS-CT)
6.3.4 CT Multislice (MS-CT)
Detector Design
6.3.5 CT Dual-Source (DS-CT)
6.4 Important Parameters in Spiral CT
6.4.1 Pitch Factor
6.4.2 Collimation
6.4.3 Tube Voltage (kV)
6.4.4 Tube Current-Time Product (mAs)
6.4.5 Scan Time (S)
6.4.6 z-sharp Technology
6.5 Parameters for Image Reconstruction
6.5.1 Layer Thickness
6.5.2 Increment
6.5.3 Convolution Kernel, Reconstruction Filter or Algorithm
6.5.4 Windowing
6.5.5 z-Interpolation
6.6 Image Formation
6.6.1 Filtered Back Projection
6.6.2 Iterative Reconstruction
6.6.3 Hounsfield Scale
6.6.4 Window Technology
6.7 Post-Processing
6.7.1 2D Representation
6.7.2 3D Representation
6.8 Artifacts
6.8.1 Movement Artefact
6.8.2 Pulsation Artefact
6.8.3 Metal Artifact
6.8.4 Partial Volume Effect/Partial Volume Effect
6.8.5 Hardening Artefact
6.8.6 Measuring Field Overrun
6.8.7 Photon Starvation Artefact
6.8.8 Ring Artefact
6.8.9 Line Artifact
6.9 Radiation Protection Measures and Dose Reduction
6.9.1 Dosage Modulation
6.9.2 Adaptive ECG Pulsing
6.9.3 Avoidance of Overranging
6.9.4 Iterative Reconstruction
7: Magnetic Resonance Imaging (MRI)
7.1 Which Core Is Actually Spinning Here and What Does It Have to Do with Magnets?
7.2 Longitudinal Magnetization
7.3 MR Signal
7.3.1 T1 Relaxation Time
7.3.2 T2 Relaxation Time
7.4 Location Coding
7.4.1 Layer Selection
7.4.2 Phase Coding
7.4.3 Frequency Coding
7.4.4 K-space and Fourier Transformation
7.5 Proton Thrusting and Gradient Ballet: the Interplay of High-Frequency Pulses and Spatial Coding
7.5.1 Refocusing
7.5.2 Echo and Repetition Time or T1 and T2 Contrast
T1 Weighting
T2 Weighting
Characteristics of Different Weightings
7.6 Sequence Theory
7.6.1 Gradient Echo Sequences
7.6.2 Fat Saturation
Inversion Recovery
Frequency Selective Saturation or Spectral Saturation
Chemical Shift or Dixon Method
7.6.3 Vessel Mapping
Angiography Time-of-Flight
Phase Constrastangiography
Angiography Contrast-Enhanced
7.6.4 Diffusion Imaging
7.7 Contrast Agent
7.8 Security
7.8.1 Attraction of the Magnet
7.8.2 Implants
7.8.3 Volume
7.8.4 Tissue Stimulation
7.8.5 Emergency Bell
8: Sonography
8.1 Physical Basics of Sonography
8.1.1 Ultrasonic Waves
8.1.2 Procedure
A-Mode
M-Mode
B-Mode
Sonography Doppler
Sonography Color Doppler and Power Doppler
8.2 Design and Operation of a Sonography Device
8.2.1 Transducers
8.2.2 Where to Press…
8.3 Possibilities and Limits of Ultrasound Diagnostics
9: Contrast Agent
9.1 X-ray Contrast Medium
9.1.1 Classification of X-ray CMs
Contrast Media Negative
Contrast Media Positive
Water-Soluble Contrast Media Containing Iodine (. Fig. 9.4)
Water-Insoluble Contrast Media
Contrast Media Containing Oil
9.2 MR Contrast Medium
9.2.1 Gadolinum
9.3 Sonographic Contrast Agent
9.4 Contraindications
9.5 Side Effects
9.6 Pregnancy and Breastfeeding
10: Radiotherapy
10.1 Possibilities and Principles of Radiooncology
10.1.1 Brachytherapy
10.1.2 Particle Therapy
10.1.3 Therapy Concepts in Radiooncology
10.1.4 Fractionation
10.2 Irradiation Planning
10.2.1 Further Processing
10.3 Design and Function of Radiooncological Irradiation Equipment
10.3.1 Linear Accelerator
Respiratory Gated Radiotherapy
10.3.2 Dose Distribution in Tissue
Deep Dose Profile
10.3.3 Irradiation Techniques
10.3.4 Irradiation Variants
10.3.5 X-ray Therapy Equipment
11: Nuclear Medicine
11.1 Imaging and Therapeutic Options
11.1.1 Scintillation Counter: Scanner, Gamma Camera, Gamma Probe
11.1.2 Semiconductor Cameras
11.1.3 PET
11.1.4 Hybrid Systems
11.1.5 Therapy Options
Radioiodine Therapy
Radiosynoviorthesis (RSO)
Palliative Pain Therapy for Bone Metastases
Radioimmunotherapy
131I-MIBG (Meta-Iodo-Benzyl-Guanidine) Therapy
Peptide Therapy
Selective Internal Radiotherapy (SIRT)
11.2 Radiation Protection
11.2.1 Hot Laboratory
Generator
Lead Castle (Screening Wall)
Spacers
Syringe Shields
Transport Equipment
Waste Containers
Decay Space
11.2.2 Investigation Area
11.2.3 Leaving the Department
11.3 Detection of Radioactivity
11.3.1 Scintillation Detectors
Probe Measuring Station
Gamma Probe
Borehole Logging Station
Liquid Scintillators
Gas Ionization Detectors
Activimeter
Personal Dosimeter
Ring Dosimeter
Electronic Dosimeters
Whole Body Counter
Contamination Measuring Equipment
11.4 Image Formation Systems
11.4.1 Gamma Camera
Collimators
Sodium Iodide Crystal
Photomultiplier
Gamma Spectrum
Measuring Head Electronics
SPECT
11.5 Radionucleotides in Medical Application
11.5.1 Diagnostic Imaging
11.6 Radiopharmacology
11.7 Quality Assurance Measures of Radiopharmaceuticals
11.7.1 Radioisotope Purity
11.7.2 Chemical Purity
11.7.3 Radiochemical Purity
11.7.4 Specific Activity
11.7.5 Stability
11.7.6 Microbiological Purity
11.8 Contamination and Decontamination Measures
11.8.1 Contamination
11.8.2 Decontamination
12: Emergencies and Extreme Situations
12.1 Extreme Situations
12.1.1 Polytrauma
12.1.2 Anaphylactoid Reaction
12.1.3 CT-Guided Puncture
12.1.4 Seizure During Stent Angioplasty
12.2 Contrast Agent Incident and Emergency Medication
12.2.1 Side Effects
Contrast Induced Nephropathy (CIN)
Hyperthyroidism and Thyrotoxic Crisis
Nephrogenic Systemic Fibrosis (NSF)
Circulatory Arrest
Seizures
13: Legislation
13.1 Basic Law (GG)
13.2 Patients’ Rights Act
13.2.1 Reconnaissance
Duties/Rights During the Practical Year
What Must Be Disclosed?
Information Requirements
13.3 Data Protection
13.4 Atomic Energy Act (AtG)
13.5 X-ray Ordinance (RöV)
13.6 Radiation Protection Ordinance (StrSchV)
13.7 Radiation Protection Areas
13.8 Occupationally Exposed Persons
13.9 Technical Knowledge
13.10 Justifying Indication
13.11 Medical Devices Act (MPG)
13.12 Maternity Protection Act (MuSchG)
13.13 Working Time Act
II: Disease Patterns
14: Neurology
14.1 Anatomical Structures
14.2 Disease Patterns
14.2.1 Intracranial and Spinal Hemorrhages
14.2.2 Ischemic Diseases
14.2.3 Intracerebral Tumors
14.2.4 Cerebrospinal Fluid Circulation Disorder
14.2.5 Intracranial Extraaxial Tumors
14.2.6 Cystic Intracranial Lesions
14.2.7 Chronic Inflammatory CNS Processes: Multiple Sclerosis
14.2.8 Acute Inflammatory CNS Processes
14.2.9 Epilepsy
14.2.10 Phacomatoses
14.2.11 Neurodegenerative Diseases
14.3 Diagnostics
14.3.1 Diagnostic Radiology
Sonography
Conventional X-ray Diagnostics
Fluoroscopy/Angiography
Computed Tomography (CT)
Magnetic Resonance Imaging (MRI)
14.3.2 Nuclear Medicine
Brain
Blood Flow, Regional Cerebral Blood Flow (RCBF)
Neurodegenerative Diseases
Brain Tumors
CSF Space
14.3.3 Valence
14.4 Therapy
14.4.1 Interventional Radiology
Angiographic Interventions
14.4.2 Radiotherapy
Gliomas
Glioblastoma
Astrocytoma
Oligodendroglioma
Skull Base Meningiomas
Acoustic Neuromas (Vestibular Schwannomas)
Pituitary Adenoma
Chordomas, Chondrosarcomas of the Skull Base
Craniopharyngeomas
Childhood
Cerebrospinal Fluid Space
Whole Brain
Brain Metastases
Therapy for Multiple Brain Metastases
Therapy for 1–3 Brain Metastases
Glioblastoma
Brain Metastases
15: Head/Neck
15.1 Anatomical Structures
15.2 Disease Patterns
15.2.1 Head
Sinusitis
Mucocele
Tumors
Nasopharyngeal Area
Orbit
Salivary Glands
Fractures
Skull Base
Zygomatic Bone
Middle Face
Orbital Floor
15.2.2 Neck
Laryngocele
Trachelastenosis
Cervical Cyst
Thyroid Gland
Parathyroid Gland
Tumors
Laryngeal Carcinoma
Thyroid Carcinoma
Salivary Gland Carcinoma
15.3 Diagnostics
15.3.1 Diagnostic Radiology
Sonography
Conventional X-ray Diagnostics
Fluoroscopy/Angiography
Computer Tomography (CT)
Magnetic Resonance Imaging (MRI)
15.3.2 Nuclear Medicine
15.3.3 Valence
15.4 Therapy
15.4.1 Radiotherapy
Head/Neck Tumors
Nasopharyngeal Carcinoma (Carcinoma of the Nasopharynx)
Oropharyngeal Carcinoma (Carcinoma of the Oral Cavity)
Oral Cavity Carcinoma (Carcinoma of the Floor of the Mouth, Carcinoma of the Tongue)
Hypopharyngeal Carcinoma (Carcinoma of the Lower Pharynx)
Laryngeal Carcinoma (Carcinoma of the Larynx)
16: Gynecology
16.1 Anatomical Structures
16.2 Disease Patterns
16.2.1 Chest
Breast Carcinoma
Fibroadenoma
Cysts
Fibrocystic Mastopathy
Mastitis (Plasma Cell Mastitis)
16.2.2 Small Basin
Tumors of the Ovary
16.2.3 Tumors of the Uterus
Fibroids
Polyps
Carcinoma of the Corpus
Cervical Carcinoma
Endometriosis
Cysts
Inflammatory Changes
Endometritis
Adnexitis
Torsions
16.2.4 External Female Genitalia
16.3 Diagnostics
16.3.1 Diagnostic Radiology
Sonography
Conventional X-ray Diagnostics
Computed Tomography
Magnetic Resonance Imaging
16.3.2 Nuclear Medicine
Breast Carcinoma
Vulvar Carcinoma
SLN Diagnostics in Other Gynecological Tumors
Ovarian Carcinomas
16.3.3 Valence
16.4 Therapy
16.4.1 Interventional Radiology
Stereotactic Vacuum Suction Biopsy of the Breast
16.4.2 Radiotherapy
Cervical Carcinoma
Breast Carcinoma
Vaginal Carcinoma
Vulvar Carcinoma
17: Respiratory System
17.1 Anatomical Structures
17.1.1 Trachea and Lungs (Pulmo)
17.2 Disease Patterns
17.2.1 Pleura
Pleural Effusion
Pleural Callosity
Pneumothorax
Mesothelioma
17.2.2 Emphysema
17.2.3 Bronchiectasis
17.2.4 Pulmonary Oedema
17.2.5 Pulmonary Fibrosis
17.2.6 Infectious Diseases
Pneumonia
Tuberculosis
Ascaridosis
Echinococcal Infection
17.2.7 Interstitial Lung Disease
Silicosis
Asbestosis
Organic Dusts
17.2.8 Pneumonitis Radiation
17.2.9 Lymphangiosis Carcinomatosa
17.2.10 ARDS
17.2.11 Sarcoidosis
17.2.12 Tumors
Bronchial Carcinoma
Malignant Lymphoma
Metastases
17.2.13 Pulmonary Embolism
17.2.14 Childhood
Surfactant Deficiency Syndrome
Hemorrhage
Pulmonary Emphysema
Lung Cyst
Transient Neonatal Tachypnea
Meconium Aspiration
17.3 Diagnostics
17.3.1 Diagnostic Radiology
Sonography
Conventional X-ray Diagnostics
Fluoroscopy/Angiography
Computed Tomography
Magnetic Resonance Imaging
17.3.2 Nuclear Medicine
Pulmonary Ventilation Scintigraphy
Lung Perfusion Scintigraphy
Evaluation
Determination of Postoperative Pulmonary Function
Right-Left-Shunt
Pulmonary Hypertension
Lung PET
17.3.3 Valence
17.4 Therapy
17.4.1 Interventional Radiology
Angiography
Computed Tomography
17.4.2 Radiotherapy
Bronchial Carcinoma
18: Gastrointestinal Tract
18.1 Anatomical Structures
18.2 Disease Patterns
18.2.1 Pharynx, Oesophagus
Oesophagitis
Diverticula of the Oesophagus
Swallowing Disorders
Achalasia
Oesophageal Carcinoma
Postoperative/Posttherapeutic Changes
18.2.2 Stomach and Duodenum
Gastritis, Ulcers and Complications
18.2.3 Duodenal Diverticulum
Benign Tumors
Gastric Carcinoma, Duodenal Carcinoma
Gastrointestinal Stromal Tumors (GIST)
Postoperative Changes
18.2.4 Jejunum and Ileum
Inflammatory Diseases
Coeliac Disease
Meckel’s Diverticulum
Small Intestinal Tumors
Postoperative Imaging/Complications
18.2.5 Colon and Rectum
Acute Inflammatory Diseases
Chronic Inflammatory Bowel Disease (IBD)
Voiding Disorders/Dysfunction of the Pelvic Floor
Polyps of the Colon
Colorectal Carcinoma
Postoperative/Posttherapeutic Changes and Complications
18.2.6 Mesentery, Peritoneum and Abdominal Wall
Hernias
Positional Changes of Organs of the Abdominal Cavity
Benign Changes of the Mesentery and Abdomen
Malignant Changes of the Peritoneum and Abdomen
18.2.7 Liver and Biliary System
Fatty Liver (Steatosis Hepatis)
Storage Disorders
Liver Cirrhosis
Benign Tumors of the Liver and Biliary Tract
Cystic Lesions of the Hepatic Cavity
Pseudotumours
Budd-Chiari-Syndrome
Malignant Tumors of the Liver and Biliary Tract
18.2.8 Gall Bladder and Bile Ducts
Cholecystolithiasis
Gall Bladder Polyp
Primary Sclerosing Cholangitis (PSC)
Gallbladder Carcinoma
Cholangiocellular Carcinoma (CCA), Klatskin-Tumor
18.2.9 Pancreas
Pancreas Divisum and Pancreas Anulare
Acute and Chronic Pancreatitis
Pancreatic Laceration
Pancreatic Carcinoma
Cystic Pancreatic Neoplasms
Pancreatic Endocrine Tumors
18.3 Diagnostics
18.3.1 Diagnostic Radiology
Sonography
Conventional Diagnostics
Swallowing Study
Esophageal Swallow
CT Abdomen
Colonic Contrast Enema, Conventional and MR Defecography
MRI Liver
MR-Sellink and MR-Rectum
18.3.2 Nuclear Medicine
Oesophagus
Stomach
Gastric Function Examination
Gastric Carcinoma, Gastrointestinal Stromal Tumors (GIST)
Liver
Liver Perfusion with MAA, Calculation of A Liver-Lung Shunt (. Table 18.5)
Liver Tumors and PET/CT
Intestine
Bleeding Source Search
Intestinal Carcinomas
Pancreas
18.3.3 Valence
18.4 Therapy
18.4.1 Interventional Radiology
Puncture and Drainage
Thermal Ablation of Liver Metastasis
Transjugular Intrahepatic Portosystemic Shunt (TIPSS)
Acute GI Bleeding
Vascular Occlusions and Stenoses
Portal Vein Embolization
18.4.2 Radiotherapy
Oesophageal Carcinoma
Rectal Cancer
19: Urogenital
19.1 Anatomical Structures
19.2 Disease Patterns
19.2.1 Urinary Tract
Urinary Retention
19.2.2 Urolithiasis
19.2.3 Urothelial Carcinoma
Bladder Fistulas and Leaks
Bladder Emptying and Micturition Disorders
19.2.4 Kidney Diseases
Inflammatory Renal Changes
Cystic Masses
Uncomplicated Blanched Cysts
Complicated Cysts
Cystic Kidney Disease
Solid Masses of the Kidney
Angiolipoma
Oncocytoma
Lymphoma
Metastasis
Renal Cell Carcinoma (NCC)
Nephroblastoma
Vascular Stenoses and Occlusions
Renal Infarction
Renal Artery Stenosis
Investment Variants
Renal Agenesis
Malrotation
Horseshoe Kidney
Accessory Vascular Supply
19.2.5 Injuries to the Kidneys and Urinary Tract
19.2.6 Adrenal Gland
Pheochromocytoma
Adrenal Metastases
19.2.7 Prostate
Prostatic Hypertrophy
Prostate Carcinoma
Prostatitis
19.2.8 Testis and Epididymis
Hydrocele
Testicular Torsion
Inflammatory Changes of the Testis
Varicocele
Testicular Retention
Testicular Tumors
Seminal Vesicles
19.3 Diagnostics
19.3.1 Diagnostic Radiology
Sonography
Conventional X-ray Diagnostics
Fluoroscopy/Angiography
Computed Tomography
Magnetic Resonance Imaging
19.3.2 Nuclear Medicine
Renal Scintigraphy
19.3.3 Valence
19.4 Therapy
19.4.1 Interventional Radiology
Ultrasound/Nuclear Magnetic Resonance Imaging
Angiography
19.4.2 Radiotherapy
Urinary Bladder Carcinoma
Prostate Carcinoma (Carcinoma of the Glandular Tissue of the Prostate Gland)
Testicular Tumors (Seminoma, Non-Seminoma)
20: Musculoskeletal Diseases
20.1 General
20.2 Anatomical Structures
20.2.1 Bone Structure
20.3 Clinical Pictures
20.3.1 Fractures
Long Bong Bones, Short Bones
Vertebral Body
Cranial Bones
Child Fractures
Greenwood Fracture
Bead Breakage
Injuries to the Epiphyseal Fossa
20.3.2 Luxation
20.3.3 Inflammatory Diseases
Spondylodiscitis/Spondylitis
Osteomyelitis/Osteitis
Rheumatoid Arthritis (RA)
20.3.4 Degenerative Diseases
Herniated Discs
Arthrosis
20.3.5 Tumors and Tumor-like Lesions
Examples of Benign Tumors and Tumor-like Lesions
Juvenile Bone Cyst/Single Bone Cyst
Osteoid Osteoma
Examples of Malignant Bone Tumors
Classic Osteosarcoma
Chondrosarcoma
Osseous Metastases
20.3.6 Congenital Disorders of the Skeletal System
Congenital Hip Dysplasia
Congenital Foot Deformities
20.3.7 Diseases of the Infantile Skeleton
Perthes’ Disease/Legg-Calvé-Perthes’ Disease
Epiphysiolysis Capitis Femoris
Coxitis Fugax
20.4 Diagnostics
20.4.1 Diagnostic Radiology Services
Sonography
Conventional X-ray Diagnostics
Fluoroscopy/Angiography
Computed Tomography
Magnetic Resonance Imaging
20.4.2 Nuclear Medicine Diagnostics
Skeletal Scintigraphy
Inflammatory Scintigraphy of the Skeleton
20.4.3 Valence
20.5 Therapy
20.5.1 Interventional Radiology
Tumor Embolization
Computed Tomography-Guided Bone Tumor Treatment
Pain Management
20.5.2 Nuclear Medicine
Radiosynoviorthesis (RSO)
Palliative Therapy of Bone Metastases
20.5.3 Radiotherapy
Soft Tissue Sarcomas
Bone Sarcomas
21: Cardiovascular Diseases
21.1 Anatomical Structures
21.2 Disease Patterns
21.2.1 Heart
Acute Myocardial Infarction
Cardiomyopathies
Dilated Cardiomyopathy (DCM)
Hypertrophic Cardiomyopathy (HCM)
HCM with Hypertrophied Left Ventricular Myocardium
Restrictive Cardiomyopathy (RCM)
Unclassified Cardiomyopathies
Myocarditis
Cardiac Tumor
Atrial Myxoma
21.2.2 Vessels
Aortic Dissection
Aortic Aneurysm
Traumatic Aortic Rupture
Acute Mesenteric Ischemia
Peripheral Arterial Occlusive Disease (PAVD)
Leriche Syndrome
Deep Vein Thrombosis of the Leg
21.3 Diagnostics
21.3.1 Radiological Diagnosis
Sonography
Conventional X-ray Diagnostics
Fluoroscopy/Angiography
Computed Tomography
Magnetic Resonance Imaging
21.3.2 Nuclear Medicine
SPECT Cardiac and PET Cardiac
Ergometric Load
Pharmacological Exposure
Polar Tomograms
21.3.3 Valence
21.4 Therapy
21.4.1 Interventional Radiology
Angiography
22: Endocrinological System
22.1 Anatomical Structures
22.2 Disease Patterns
22.2.1 Thyroid Goiter
22.2.2 Thyroid Carcinoma
22.2.3 Adrenal Adenoma
22.2.4 Adrenocortical Carcinoma
22.2.5 Pituitary Adenoma
22.3 Diagnostics
22.3.1 Diagnostic Radiology
Sonography
Conventional X-ray Diagnostics
Fluoroscopy/Angiography
Computer Tomography
Magnetic Resonance Imaging
22.3.2 Nuclear Medicine
Thyroid Scintigraphy
Parathyroid Glands (Glandulae Parathyroideae)
22.3.3 Valence
22.4 Therapy
22.4.1 Radiotherapy
Thyroid Carcinoma
22.4.2 Nuclear Medicine
Radioiodine Therapy
23: Lymphatic System
23.1 Anatomical Structures
23.2 Disease Patterns
23.2.1 Systemic Diseases
23.2.2 Hodgkin’s Disease
23.2.3 Non-Hodgkin’s Lymphoma
23.2.4 Lymph Node Metastases
23.2.5 Splenic Cysts
23.2.6 Spleen Abscess
23.2.7 Splenic Infarction
23.2.8 Splenic Rupture
23.2.9 Thymoma
23.3 Diagnostics
23.3.1 Radiological Diagnosis
Sonography
Conventional X-ray Diagnostics
Fluoroscopy/Angiography
Computer Tomography
Magnetic Resonance Imaging
23.3.2 Nuclear Medicine
Introduction to Sentinel Lymph Node Scintigraphy
Sentinel Lymph Node Scintigraphy Using the Example of Breast Carcinoma
PET in Lymphoma Diagnostics
Indication for PET
Special Features in Pediatrics
Possible Sources of Error
23.3.3 Valence
23.4 Therapy
23.4.1 Interventional Radiology
CT-Guided Biopsy
23.4.2 Radiotherapy
Hodgkin’s Disease
Non-Hodgkin’s Lymphoma (NHL)
24: Pediatrics
24.1 Thorax
24.1.1 Respiratory Distress Syndrome (ANS)
24.1.2 Meconium Aspiration
24.1.3 Oesophageal Atresia
24.1.4 Catheter in the Thoracic Region
Wash-in Catheter
Umbilical Vein Catheter (NVK)
Umbilical Artery Catheter
24.2 Gastrointestinal Tract
24.2.1 Necrotising Enterocolitis (NEC)
24.2.2 Duodenal Atresia
24.2.3 Invagination
24.3 Urogenital Tract
24.3.1 Vesicourethral Reflux (VUR)
24.4 Musculoskeletal
24.4.1 Child Abuse (Battered Child)
24.4.2 Osteomyelitis
24.4.3 Hip Dysplasia
24.5 Oncology
24.5.1 Neuroblastoma
24.5.2 Nephroblastoma (Wilms’ Tumor)
24.5.3 Medulloblastoma
III: Testing
25: MC Questions and Answers
25.1 MC Questions
25.2 MC Responses
26: Clinical Cases
26.1 Pulmonary Embolism or …
26.2 Swollen Hands
26.3 Pain in the Lower Leg
26.4 Chest Pain and Circulatory Problems
26.5 A Swollen Leg
26.6 Hematuria
26.7 Frequent Urination
26.8 Riding Accident
26.9 Laceration to the Forehead
26.10 Persistent Headache
27: Solutions