Brain Imaging: Case Review Series Lalendra Upreti, Ankur Arora, Sunil Kumar Puri
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1BRAIN IMAGING: Case Review Series2
3BRAIN IMAGING: Case Review Series
Ankur Arora MD DNB FRCR (UK) Assistant Professor Department of Radiodiagnosis Institute of Liver and Biliary Sciences (ILBS) An Autonomous Institute under Government of NCT of Delhi New Delhi, India Sunil Kumar Puri MD Director-Professor and Head Department of Radiodiagnosis GB Pant Hospital and associated Maulana Azad Medical College New Delhi, India Lalendra Upreti MD DNB Professor Department of Radiodiagnosis GB Pant Hospital and associated Maulana Azad Medical College New Delhi, India
4Published by
Jaypee Brothers Medical Publishers (P) Ltd
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Brain Imaging: Case Review Series
© 2011, Jaypee Brothers Medical Publishers
All rights reserved. No part of this publication should be reproduced, stored in a retrieval system, or transmitted in any form or by any means: electronic, mechanical, photocopying, recording, or otherwise, without the prior written permission of the authors and the publisher.
First Edition: 2011
9789350253892
Typeset at JPBMP typesetting unit
Printed in India
5Preface
The intent of this book is to provide 200 need-to-know neuroradiological diagnoses in Brain Imaging for the radiology residents, neuroradiology fellows and practicing radiologists. The book is ideal for those who are preparing for their MD, DMRD, DNB and FRCR examinations. The format simulates the way radiology residents are generally taught. The teaching of radiology residents is typically performed using the ‘case discussion technique’ wherein the resident is usually unaware of the diagnosis and is presented with specific images and allied clinical details. The discussant is required to determine pertinent imaging findings and generate a reasonable differential diagnoses based on the imaging findings and relevant clinical history, and, by the process of elimination, decide on the most likely diagnosis. A similar ‘case discussion format’ has been adopted in this book, providing the readers with images from the latest available imaging modalities and covering all major diseases that are encountered in everyday clinical practice. In reading each case, the reader should direct attention to the clinical history and provided radiological images. After arriving at a diagnosis, the reader should then flip the page for the correct diagnosis as well as the supplementary commentary on each case. An attempt has been made to answer almost all frequently asked questions in the radiological examinations. The commentary although not all-encompassing serves as a fundamental framework on which one can add information from more comprehensive texts. Each case is followed by distinct learning points and the best-diagnostic-clue, so as to provide novice as well as experienced readers a brief but succinct summary of the particular disease entity. A concise list of particularly relevant references has also been provided. Purposely, the cases are randomly assorted and not organized by disease-type into congenital, infective or neoplastic entities so as to provide the readers with a realistic examination scenario. The cases (in the textbook) based upon the varying difficulty levels have been categorized into Basic, Intermediate and Advanced (50 cases in each). In addition, 50 online cases are also provided. This richly illustrated series contains cases that are a compilation of illustrative teaching material collected over past several years and the authors sincerely hope that the readers will find this book enormously useful. The readers' comments and questions are heartily welcomed.
Ankur Arora
Sunil Kumar Puri
Lalendra Upreti6
7Acknowledgments
We are indebted to Dr SK Sarin, Director, Institute of Liver and Biliary Sciences (ILBS), New Delhi, India. He has been a constant source of inspiration, encouragement and a guiding force.
We are grateful to Dr Veena Choudhary, Director, GB Pant Hospital, New Delhi, India for her valuable guidance and support in completing this book.
We wish to express our gratitude to Dr Satbir Singh, Professor, GB Pant Hospital, New Delhi, India whose constant motivation and encouragement were of tremendous help. We also acknowledge Dr Ashok Sharma and Dr Poonam Narang for their valuable inputs.
Many of the cases in this book are obtained from Mahajan Imaging Center, and we are much indebted to Dr Harsh Mahajan (Padma Shree, Honorary Radiologist to the President of India) for heartily sharing these cases.
We are thankful to Prof Hans L Bloem, Editor-in-Chief, EURORAD (the largest peer-reviewed teaching database of the European Society of Radiology on the Internet), for permitting us to duplicate several cases published by us at the EURORAD.
We are grateful to Dr VRK Rao, Professor and Head, Department of Radiodiagnosis, Kasturba Medical College (KMC), Manipal, Karnataka, India and one and all of the Radiology departments of Kasturba Medical College (KMC), Manipal and Mangalore, Karnataka, India for their unswerving support.
We acknowledge the impetus and constructive feedbacks received from Dr Raghu HR, Pediatric Radiologist, Arkansas Children's Hospital, Little Rock, United States; Dr Aravinda KM, Montefiore Medical Center, New York, United States; Dr Avinash KR and Dr Naveen M Kulkarni, Massachusetts General Hospital, Boston, United States and Dr Rajiv Gupta, Senior Consultant Radiologist, Medanta-The Medicity, Gurgaon, Haryana, India.
Our sincere thanks to Dr Ruchi Bhutani, Consultant Radiologist, Fortis La Femme Hospital, New Delhi, India who has spent many a sleepless nights painstakingly editing the manuscript.
We are also thankful to Dr Abhay Kapoor and Dr Vandana, Senior Residents, GB Pant Hospital, New Delhi, India and Dr Chandan Kakkar and Dr Ashwin M Polnaya, Assistant Professors, Kasturba Medical College (KMC), Manipal, Karnataka, India for their assistance in the preparation of the manuscript.
Warm gratitude is due to the non-teaching staff including the technical staff and radiographers of Department of Radiodiagnosis, GB Pant Hospital, New Delhi, India for their incessant support.
Our earnest thanks to the faculty members and colleagues of various clinical specialties whose patients formed the framework of this case review series.
Last but not least, we are grateful and appreciative of the support, patience and encouragement extended by our family members, friends and colleagues.8