Caceres’ Corner Case 100 (Update: Solution)

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Dear Friends,

Muppet and I are very happy to have reached one hundred cases. We hope you enjoyed them as much as we did. Radiographs of this case belong to a 52-year-old man with vague chest complaints. He was operated on for testicular tumour fifteen years earlier.

Check the images below, leave your thoughts and diagnosis in the comments section, and come back on Friday to find out the answer.

Diagnosis:

1. Duplication cyst
2. Lymphangioma
3. Metastasis from testicular tumour
4. None of the above

Read more…

13
Oct 2014
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ECR on Demand Preview: The hand and wrist #RC 1910 #A-585

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RC 1910 – The hand and wrist, A-585 C- Tumours and tumour-like lesions

A short preview of lecture A-585 ‘C. Tumours and tumour-like lesions’, from the session RC 1910 ‘The hand and wrist’ at ECR 2014, given by E. Llopis from Valencia, Spain.

Watch the whole lecture and many more at http://ipp.myESR.org

Direct link: http://bit.ly/The_hand_and_wrist

Monday, March 10, 16:00 – 17:30 / Room E1

Abstract:

Radiological study of the wrist and hand is challenging due to its complex anatomy with many small structures and the number of normal bone and soft tissue variants that might mimic injuries. Moreover, many findings can be asymptomatic. Their knowledge is important to avoid misdiagnosis. During this lecture we will also review the role of the different imaging modalities, such as plain films for wrist alignment and bone structures as well as the important role of US and MR in differentiating tumour from tumour-like conditions. We will become familiar with some specific radiological findings that allow us to make accurate diagnoses of soft tissue and bone lesions.

11
Oct 2014
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Interview: Dr. Catherine Owens, chair of the ESR Subspecialties and Allied Sciences Committee

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Organisations that represent professionals working in radiological subspeciaties and allied sciences are vital parts of the ESR community. The ESR has its own body – the Subspecialties and Allied Sciences Committee – that is dedicated to discussing and highlighting issues that affect these groups. We spoke to chairperson Dr. Catherine Owens to find out about her role, the committee’s functions and some of the items on its current agenda.

ESR Office: What is the main purpose of the Subspecialties and Allied Sciences Committee (SASC) and how does it operate?

Catherine Owens: The SASC was formed to unite all of the important subspecialties within clinical radiology, and the important allied healthcare professionals. The committee is made up of the presidents of each of the ESR’s Subspecialties and Allied Sciences Member Societies. This provides a forum to highlight the common issues within radiology and to try to empower the individual groups to understand and help find joint solutions. As a united group we are more able to increase our powers to lobby national and EU groups to solve some of the current challenges facing radiologists.

Dr. Catherine Owens, chair of the ESR's Subspecialties and Allied Sciences Committee

Dr. Catherine Owens, chair of the ESR’s Subspecialties and Allied Sciences Committee

Practically speaking, the committee coordinates initiatives related to pertinent issues within all subspecialties in radiology and allied disciplines, in cooperation with the Education Committee for specific educational issues and with the Quality, Safety and Standards Committee for specific professional issues. In addition, the committee assists the European Congress of Radiology Programme Planning Committee in the preparation of the educational and scientific programme for the annual ECR meetings.

Specific tasks and responsibilities of the group include revising detailed curricula for subspecialty training in liaison with the Education Committee; devising Strategies to support the provision of subspecialist radiology; providing liaison between European subspecialty societies, allied sciences societies and the ESR; and contributing to the overall strategies of the ESR related to professional issues, training harmonisation and research collaboration.

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ECR On Demand Preview: – Chest emergencies #MC622 #A-136

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MC 622 – Chest emergencies, A-136 A. Thoracic injuries (S.E. Mirvis)

A short preview of lecture A-136 ‘A. Thoracic injuries’, from the session MC 622 ‘Chest emergencies’ at ECR 2014, given by S.E. Mirvis from Baltimore, United States.

Watch the whole lecture and many more at http://ipp.myESR.org
Direct link: http://bit.ly/Chest_emergencies

 

Friday, March 7, 14:00 – 14:30 / Room F1

Abstract:

Chest trauma is directly responsible for 25 % of all trauma deaths and is a major contributor in another 50 % of all trauma mortality. Blunt trauma, accounting for 90 % of chest injuries, is the third most common site of injury in polytrauma patients. Plain radiographs still have a role in recognition of some acute thoracic pathology that requires immediate further management, either diagnostically and/or therapeutically, such as tension pneumothorax, major transdiaphragmatic herniation, large hemothorax or obvious mediastinal hematoma. MDCT of the chest is now typically included in a whole body scan with IV contrast to facilitate rapid diagnosis on polytrauma cases using less radiation than selected segmental scans. MDCT is the well-proven diagnostic gold standard for chest injury evaluation. The major advantages of MDCT over other modalities include identification of active bleeding, direct signs of trachea or esophageal injury, direct evidence of major arterial vascular injury, such as pseudoanurysms, pneumo and hemopericardium, location and extent of lung contusion and laceration, and assessment for thoracic spine, shoulder girdle and rib fractures. Diaphragm injuries are well depicted by MDCT, especially on the left by identifying both the torn diaphragm edges, herniation and constriction of abdominal contents at the level of the torn diaphragm (collar sign), and direct contact of herniated structures with the posterior chest wall (dependent viscera). Tracheal injuries are suggested by diffuse and progressive pneumomediastinum, dilated tracheostomy cuff, ectopic endotracheal tube, and direct connection of mediastinal air with the trachea lumen. CT-angiography eliminates the majority of indications for diagnostic catheter angiography.

09
Oct 2014
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Dr. Pepe’s Diploma Casebook: Case 62 – SOLVED!

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Dear Friends,

Today I am showing PA chest and sagittal CT of a 66-year-old woman with a persistent RLL infiltrate and negative bronchoscopy. Check the images below, leave me your thoughts in the comments section, and come back on Friday for the answer.

Diagnosis:
1. Tuberculosis
2. Chronic aspiration pneumonia
3. Carcinoma
4. None of the above

Read more…

ECR on Demand Preview: The treated spine and joints #E³ 920a #A-246

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E³ 920a – The treated spine and joints, A-246 A. Imaging of the postoperative spine (P.N.M. Tyrrell)

A short preview of lecture E³ 920a’ The treated spine and joints’, from the session A-246 ‘A. Imaging of the postoperative spine’ at ECR 2014, given by P.N.M. Tyrrell from Oswestry, United Kingdom.

Watch the whole lecture and many more at http://ipp.myESR.org
Direct link: http://bit.ly/The_treated_spine_and_joints

 

Saturday, March 8, 10:30 – 12:00 / Room A

Abstract:

Spinal surgery is most frequently performed to decompress (disc herniation, stenosis, malignant infiltration), fuse and stabilise (particularly following trauma or infiltrative destructive processes) and correct deformity. Often, there may be a combination of these procedures at one operation. Surgical instrumentation or bone graft is sometimes employed. Patients may present themselves with symptoms early or late following the procedure. This interactive session seeks to address the variety of surgical procedures undertaken and subsequently imaged post-operatively because of symptoms. The session aims to help one to understand and become familiar with the expected post-operative imaging appearances related to the surgical procedure, learn about abnormal pathological features as a cause of symptoms in the acute and more chronic situation and explore the diagnosis and differential diagnosis. This may include post-operative fibrosis versus recurrent disc herniation versus post-operative infection. Failure of fusion due to failure of instrumentation or inadequate take of bone graft can give rise to pseudoarthrosis. Recurrent stenotic symptoms may relate to an inadequate decompression, recurrent disc herniation, post-operative haematoma, extension of a malignant process or ischaemic damage.

Pink Ribbon Day – October 1, 2014

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In the world of health awareness, the pink ribbon is probably one of the best known symbols there is. Supporters of charities and organisations promoting breast cancer awareness have been wearing the pink ribbon since 1992, when it was adopted as the official symbol of National Breast Cancer Awareness Month in the US. Since then, the pink ribbon has gone global, and is recognised as a symbol of support for breast cancer awareness in countries all around the world.

As the most common cause of cancer death among females worldwide, breast cancer is naturally always a part of the programme at the European Congress of Radiology. So to mark Pink Ribbon Day, we decided to pick out a few key sessions from our ECR On Demand archive, to highlight the vital role that medical imaging plays in the detection, diagnosis, treatment and follow-up of breast cancer.

Watch the preview below and follow the links underneath to gain access to full lectures on our ECR On Demand platform.

Watch an extra long ECR on Demand preview clip about breast imaging:

Imaging after treatment of breast cancer – E³ 220, A 003 (M.H. Fuchsjäger)

Or check out the selected related lecture recordings below:

CC 1618 – Follow-up of local treatments of breast cancer:
Watch the whole ECR on Demand lectures here.
E3 420b – Mammography:
Watch the whole ECR on Demand lectures here.
E3 530b – Breast US:
Watch the whole ECR on Demand lectures here.
E3 620 – MRI of the breast:
Watch the whole ECR on Demand lectures here.
E3 720b – Image-guided breast biopsy:
Watch the whole ECR on Demand lectures here.
E3 820c – Multidisciplinary team meeting from Milan, IT:
Watch the whole ECR on Demand lectures here.
E2 920b – How to report:
Watch the whole ECR on Demand lectures here.

 

 

01
Oct 2014
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ECR on Demand Preview: RECIST criteria #CC718 #A-187

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CC 718 – Imaging after systemic therapies: the standards, A-187 A. RECIST criteria (Y. Menu)

A short preview of lecture CC 718 ‘Imaging after systemic therapies: the standards’, from the session A-187 ‘A. RECIST criteria’ at ECR 2014, given by Y. Menu from Paris, France.

Watch the whole lecture and many more at http://ipp.myESR.org
Direct link: http://bit.ly/Imaging_after_systemic_…

 

Friday, March 7, 16:00 – 17:30 / Room Conf. Room M3

Abstract:

The routine practice of oncologic imaging requires standardisation, which means that we need to harmonise technical protocols and agree on the meaning of selected words for the radiological report. The words “Response, “Progression” and “Stable disease” are precisely defined according to internationally accepted thresholds and criteria. Although the rules are quite simple and rather easy to apply, they are very efficient in the classification of the response to treatment, and therefore for the medical decisions. However, the role of the radiologist is not limited to measurements and calculation. The detection of new lesions may be challenging and requires experience. The differential between cancer progression and complications of the treatment might be very difficult and requires an adequate communication with the referring clinician. Overall, most of the decisions taken by the clinician will be related to imaging results, stressing the importance of adequate protocols and reports.

30
Sep 2014
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Caceres’ Corner Case 99 (Update: Solution)

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Dear Friends,

Muppet is very excited because case 100 is only two weeks away. In the meantime, he wants to present a simple case that we saw one month ago. The radiographs below belong to a 53-year-old man with cough and fever. What do you see?

Leave your thoughts in the comments and come back on Friday for the answer.

Read more…

29
Sep 2014
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Dr. Pepe’s Diploma Casebook: Case 61 – SOLVED!

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Dear Friends,

Today I am presenting pre-op chest films of a 48-year-old man with renal carcinoma. How will you define the lesion at the right cardiophrenic angle?

1. Benign nodule
2. Primary malignancy
3. Metastatic nodule
4. Can’t tell

Check the images below, leave your answer in the comments and come back on Friday for the answer.

Read more…