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Differential Diagnosis in Computed Tomography
Satish K Bhargava, Sumeet Bhargava
CHAPTER 1:
Brain
INTRACRANIAL CALCIFICATION (TABLES 1.1 AND 1.2)
DIFFERENTIAL DIAGNOSIS OF BRAIN TUMORS (TABLES 1.3 AND 1.4)
Supratentorial Midline Tumors
Supratentorial Midline Cysts
PSEUDOMASSES OF BRAIN (TABLE 1.5)
INTRACRANIAL MASSES (TABLE 1.6)
NONTUMORAL BRAIN LESIONS (TABLE 1.7)
WHITE AND GRAY MATTER LESIONS (TABLES 1.8 AND 1.9)
Multifocal White Matter Lesions
Periventricular Hypodensity
Brainstem Hypodensity (Table 1.10)
Bilateral Focal/Diffuse Hypodensities Basal Ganglia
Bilateral Hyperdense (Calcification) Basal Ganglia
Hyperdense Falx
Ring Enhancing Lesions Crossing the Corpus Callosum
Innumerable Small Enhancing Brain Nodules (Table 1.11)
Gyriform Enhancement (Table 1.12)
Multifocal Brain Tumors and Tumor-like Lesions
VENTRICULAR LESIONS
Ventricular Enlargement
Small Ventricles
Abnormal Ventricular Configuration
Hydrocephalus (Fig. 1.16)
Holoprosencephaly
Alobar Type
Semilobar Type
Lobar Type
Hydranencephaly
Atrophy
Corpus Callosum Agenesis (Fig. 1.17)
Arnold-Chiari Malformation
DIFFERENTIATING FEATURES OF BRAIN LESIONS (TABLE 1.13)
MISCELLANEOUS LESIONS OF THE BRAIN
Intraparenchymal Hemorrhagic Lesions in Brain
CT Findings of Hemorrhage
Hypertensive ICH (HICH) (Fig. 1.40)
Aneurysm and Vascular Malformation (AVM, Cavernous Angioma) ICH (Fig. 1.41)
Perinatal Hemorrhage
Hemorrhagic Infarction (Reperfusion or Venous)
Neoplastic
Amyloid Angiopathy
Inflammatory Disease and Vasculitis
Drug Abuse
Blood Dyscrasias and Coagulopathies
Eclampsia
Diffuse Axonal Injury (DAI)
Cortical Contusions (Fig. 1.44)
Deep Cerebral and Brainstem Lesions
Conditions Primarily Presenting as Cerebral Atrophy (Table 1.14)
Conditions Primarily Presenting as Cerebellar Atrophy (Table 1.14)
Effaced Basal Cisterns
CT DIFFERENTIAL DIAGNOSIS OF CEREBELLOPONTINE ANGLE (CPA) MASSES (TABLE 1.15)
CT DIFFERENTIAL DIAGNOSIS OF INFRATENTORIAL LESIONS (TABLE 1.16)
CT DIFFERENTIAL DIAGNOSIS OF SUPRATENTORIAL MASS LESIONS (TABLE 1.17)
CT DIFFERENTIAL DIAGNOSIS OF WHITE MATTER DISEASES (TABLE 1.18)
CHAPTER 2:
Spinal Cord
SPINAL CORD LESIONS (TABLES 2.1 AND 2.2)
LESIONS ASSOCIATED WITH SPINAL STENOSIS (TABLES 2.3 AND 2.4)
CHAPTER 3:
Ear and Temporal Bone
DIFFERENTIAL DIAGNOSIS OF EAR LESIONS (TABLES 3.1 AND 3.2)
LESIONS OF THE MIDDLE EAR AND MASTOID (TABLE 3.3)
INFECTIVE, MISCELLANEOUS LESIONS OF MIDDLE EAR AND MASTOID (TABLE 3.4)
INTERNAL EAR LESIONS (TABLES 3.5 TO 3.13)
Endolymphatic Sac Lesions
CECT
NCCT
CHAPTER 4:
Orbital Lesions
ALTERED GLOBE SIZE
Microphthalmia
Macrophthalmia
ORBITAL LESIONS WITH BONE INVOLVEMENT
CHAPTER 5:
Nasal or Paranasal Sinus Lesions
HYPERDENSITIES ON NECT IN SINONASAL REGION
CHAPTER 6:
Neck
PHARYNGEAL AND PARAPHARYNGEAL LESIONS
Pharyngeal Mucosal Space (Table 6.1)
Thornwaldt's Cyst
Angiofibroma
Squamous Cell Carcinoma (Fig. 6.1)
Lymphoma
Parapharyngeal Space (Tables 6.2 and 6.3)
Atypical Second Branchial Cleft Cyst
Salivary Gland Adenoma
Lipoma (Fig. 6.2)
Paragangliomas (Glomus Tumors)
Ectatic Carotid Artery
NECK SPACE LESIONS
Sublingual Space (Table 6.4)
Ranula
Ludwig's Angina
Submandibular Space (Table 6.5)
Second Branchial Cleft Cyst
Thyroglossal Cyst
Dermoid and Epidermoid
Buccal Space
Masticator Space (Table 6.6)
Accessory Parotid Gland
Hemangioma
Malignant Schwannoma
Retropharyngeal Space (Table 6.7)
Lymphadenopathy
Abscesses (Fig. 6.9)
Posterior Cervical Space (Table 6.8)
Atypical Second Branchial Cleft Cyst
Prevertebral/Perivertebral Space
PAROTID LESIONS
Parotid Space (Table 6.9)
Lymphoepithelial Cysts
First Branchial Cleft Cyst
Hemangioma
Lymphangioma
Warthin's Tumor (Papillary Cystadenoma Lymphomatosum) (Fig. 6.11)
LESIONS OF THE ORAL CAVITY (TABLE 6.10)
Lingual Thyroid
LARYNGEAL OR VISCERAL SPACE (TABLE 6.11)
Other Lesions
Cervical Thymic Cyst
Zenker's Diverticulum
THYROID AND PARATHYROID GLAND LESIONS (TABLES 6.12 AND 6.13)
Parathyroid Lesions
Parathyroid Cyst
Parathyroid Mass
LYMPH NODES IN THE NECK
Superficial
Deep
Size Criteria for Lymphadenopathy
Shape Criteria
Central Hypodensity in Nodes
Calcification in Nodes
CT DIFFERENTIAL DIAGNOSIS OF THYROID DISEASES (TABLE 6.14)
DIFFERENTIAL DIAGNOSIS OF PAROTID LESIONS (TABLE 6.15)
CHAPTER 7:
Chest
PULMONARY NODULAR AND CAVITATING LESIONS
Solitary Pulmonary Nodule
Malignant Lesions (Table 7.1)
Benign Lesions (Table 7.1)
Age
Lesions
MASS WITHIN A CAVITY
INTERSTITIAL LUNG DISEASES
CYSTIC PULMONARY DISEASES* (TABLES 7.6 AND 7.7)
CT Angiogram Sign
Differential Diagnosis of Opacity with an Air Bronchogram
MEDIASTINAL MASSES
ANTERIOR MEDIASTINAL MASSES (TABLES 7.8 AND 7.9)
MIDDLE MEDIASTINAL MASSES (TABLE 7.10)
POSTERIOR MEDIASTINAL MASSES (TABLE 7.11)
Mediastinal Masses Containing Fat
Mediastinal Cysts
CLASSIFICATION OF REGIONAL INTRATHORACIC LYMPH NODES (TABLE 7.12)
MEDIASTINAL LYMPHADENOPATHY (TABLE 7.13)
LESIONS OF TRACHEOBRONCHIAL TREE
Congenital Lesions (Table 7.14)
Acquired Lesions (Table 7.15)
PLEURAL LESIONS
PLEURAL CALCIFICATION (TABLE 7.16)
LOCAL PLEURAL MASSES (TABLE 7.17)
Pleural Thickening (Fig. 7.34)
Causes
CHAPTER 8:
Abdomen
ABDOMINAL WALL LESIONS (TABLES 8.1 AND 8.2)
HERNIAS THROUGH ABDOMINAL WALL (TABLE 8.3)
HEPATOBILIARY LESIONS
Hepatic Lesions
Focal Hepatic Lesions (Table 8.4)
Hepatic Lesions: CT Differential Diagnosis (Tables 8.5 and 8.6)
Diffuse Liver Disease (Table 8.8 and Fig. 8.20)
Hemochromatosis
Diffuse Fatty Infiltration (Fig. 8.21)
Acute Portal Vein Thrombosis (Fig. 8.22)
Amyloidosis, Sarcoidosis
Diffuse HCC
Diffuse Metastatic Disease (Fig. 8.23)
Diffuse Lymphoma
Diffuse Hepatic Lesions: CT Differential Diagnosis (Table 8.9)
Contour Abnormalities (Table 8.10)
GALLBLADDER AND BILIARY TRACT LESIONS
Biliary Lesions (Table 8.11)
Hyperdense Bile
Biliary Lesions Associated with Wall Thickening (Table 8.12)
SPLENIC AND PANCREATIC LESIONS
Splenic Lesions (Table 8.13)
Diffusely Hyperdense Spleen
Pancreatic Lesions (Table 8.14)
Fatty and Atrophic Pancreas (Fig. 8.38)
GASTROINTESTINAL LESIONS
Gastric Lesions (Table 8.15)
Gastric Lesions Associated with Wall Thickening
Small Bowel Lesions (Table 8.16)
Small Bowel Lesions Associated with Wall Thickening
Colonic Lesions (Table 8.17)
Lesions Associated with Colonic Wall Thickening
PERITONEAL AND MESENTERIC/OMENTAL LESIONS (TABLE 8.18)
Lipoma
Liposarcoma
Enteric Cyst
Mesenteric/Omental/Mesothelial Cyst (Fig. 8.56)
Lymphangioma
Pseudomyxoma Peritonei (Fig. 8.57)
Retractile Mesenteritis/Chronic Fibrosing Mesenteritis/Weber Christian Disease/Mesenteric Panniculitis (Figs 8.58 and 8.59)
Mesothelioma
Peritoneal Carcinomatosis (Figs 8.60 and 8.61)
Splenosis
RETROPERITONEAL LESIONS (TABLE 8.19)
Lymphadenopathy
Seroma
Retroperitoneal Mesenchymal Tumors (Figs 8.66 and 8.67)
Neurogenic Tumors
Undescended Testis
Retroperitoneal Fibrosis/Ormond's Disease (Fig. 8.69)
Atherosclerosis of Aorta
Aortic Aneurysm
Aortic Dissection
Thrombosis of the Inferior Vena Cava
ADRENAL LESIONS (TABLE 8.20)
Causes of Bilateral Adrenal Enlargement
Adrenal Cyst
Adrenal Hemorrhage
Adrenal Adenoma (Fig. 8.71)
Adrenal Carcinoma
Adrenal Hyperplasia
Myelolipoma
Neuroblastoma (Fig. 8.72)
Pheochromocytoma/Adrenal Paraganglioma
GENITOURINARY LESIONS
Renal Lesions (Table 8.21)
Hyperdense Renal Lesion on Noncontrast CT
Bilateral Renal Lesions
Renal Lesions Presenting in Neonatal Period
Renal Lesions Presenting in Childhood Period
Renal Sinus Lipomatosis/Fibrolipomatosis
Focal Caliectasis
Pelvicaliceal Cyst/Diverticulum
Simple Cyst
Parapelvic/Peripelvic Cyst/Renal Sinus Cyst/Parapelvic Lymphangiectasia
Autosomal Dominant or Adult Polycystic Kidney Disease
Autosomal Recessive/Neonatal or Infantile Polycystic Kidney Disease (ARPKD)
Multicystic Dysplastic Kidney
Multilocular Cystic Nephroma (Fig. 8.74)
Medullary Cystic Disease/Nephronophthisis
Acquired Cystic Disease of Dialysis
Von Hippel Lindau Disease
Renal Pseudotumor
Nephroblastomatosis
Oncocytoma/Proximal Tubular Adenoma
Angiomyolipoma/Renal Hamartoma (Fig. 8.75)
Renal Cell Carcinoma (Figs 8.76 and 8.77)
Transitional Cell Carcinoma (Fig. 8.78)
Wilms' Tumor/Nephroblastoma
Mesoblastic Nephroma
Leukemia/Lymphoma
Renal Leiomyoma/Capsuloma
Lobar Nephronia/Acute Focal Bacterial Nephritis
Renal Abscess (Fig. 8.79)
Xanthogranulomatous Pyelonephritis
Arteriovenous Malformation
Perinephric Lesions (Table 8.22)
Urinoma/Perirenal Pseudocyst (Fig. 8.80)
Lymphocele
Lymphangiomatosis/Lymphangiectasia (Fig. 8.81)
Bladder and Pelvic Lesions
Urinary Bladder Lesions
Pelvic Lesions
Male Reproductive System
Seminal Vesicle Lesions
Testes
Female Reproductive System Lesions
Vagina and Vulva
Cervix and Uterus
Adnexa
Cervix and Uterus
Adnexa (Table 8.24)
Common Hemorrhagic Lesions of the Ovary
CHAPTER 9:
Musculoskeletal System
BONY LESIONS
Well-defined Lytic Lesions (Table 9.1)
Ill-defined Lytic Lesions (Table 9.2)
Lytic Lesions with Surrounding Sclerosis
Expansile and Hypodense Bony Lesion (Table 9.3)
Moth-eaten Lesions in Bone (Table 9.4)
Lucent Bone Lesions Containing Calcium or Bone (Table 9.5)
Sclerotic Bone Disease (Table 9.6)
Bone Sclerosis with a Periosteal Reaction
Solitary Sclerotic Bone Lesion with a Lucent Center
Mixed Sclerotic and Lytic Lesions (Table 9.7)
Fluid Levels in Bone Tumors (Table 9.8)
Salient Features of Bone Tumors and Tumor-like Lesions
Actinomycosis
Adamantinoma of the Long Bones/Angioblastoma
Aneurysmal Bone Cyst (ABC) (Fig. 9.3)
Angiosarcoma of Bone
Avascular Necrosis of Bone (AVN)
Bone Island/Enostosis
Brodie's Abscess (Fig. 9.4)
Brown Tumors of Hyperparathyroidism
Chondroblastoma/Codman's Tumor
Chondromyxoid Fibroma
Chondrosarcoma (Figs 9.5 and 9.6)
Chordoma
Cortical Dermoid
Desmoplastic Fibroma
Enchondroma
Epidermoid/Inclusion Cyst
Ewing's Sarcoma (Fig. 9.7)
Fibrosarcoma
Fibrous Cortical Defect
Fibrous Dysplasia
Garre's Osteomyelitis
Geode/Subchondral Cyst
Giant Cell Tumor (GCT)/Osteoclastoma (Fig. 9.8)
Glomus Tumor
Hemangioma (Fig. 9.9)
Hemophilic Pseudotumor
Histiocytosis
Hydatid Disease of Bone
Intraosseous Ganglion
Leukemia
Lipoma
Maduramycosis (Madura Foot)
Malignant Fibrous Histiocytoma
Metastases (Fig. 9.10)
Multiple Myeloma
Nonossifying Fibroma
Osteoblastoma/Giant Osteoid Osteoma
Osteochondroma (Figs 9.11 to 9.13)
Osteoid Osteoma (Fig. 9.14)
Osteoma
Osteomyelitis
Osteosarcoma (Fig. 9.23)
Periosteal/Juxtacortical Chondroma
Paget's Disease
Plasmacytoma
Primary Lymphoma of Bone/Reticulum Cell Sarcoma
Unicameral/Simple Bone Cyst (Fig. 9.24)
RIB LESIONS
Lytic Lesions (Table 9.9)
Sclerotic Lesions
Lesions Involving Multiple Ribs
SKULL AND JAW LESIONS
Sclerotic Lesions of the Skull Vault (Table 9.10)
Hyperdense Skull Base (Table 9.11)
Lytic Lesion in the Vault of the Skull (Table 9.12)
Lytic Lesions Involving Base of Skull
Button Sequestrum
Destructive Lesions Affecting the Petrous Pyramid, Middle Ear and Antrum (Table 9.13)
Lesions of the Orbit (Table 9.14)
Lytic Lesions in the Jaw (Table 9.15)
Sclerotic Lesions of the Jaw
Salient Features of the Jaw Lesions
Periodontal Abscess
Periapical Abscess
Periapical Granuloma
Periodontal Cyst: Dental, Radicular or Apical Cyst
Dentigerous Cyst (Follicular Cyst)
Primordial Cyst
Fissural/Developmental Cyst
Ameloblastoma of the Jaw
Burkitt's Lymphoma
Hyperparathyroidism
Radionecrosis
Stafne's Mandibular Defect/Salivary Inclusion Defect
Hypercementosis
Cementoma
Postinflammatory Sclerosing Osteitis
Benign Osteosclerosis
Odontome
BONY SPINAL LESIONS
Expansile Lesions of the Vertebra (Table 9.16)
Lesions Involving Multiple Vertebrae (Table 9.17)
Differential Involvement of the Part of Vertebra (Table 9.18)
Differential Diagnosis of Selected Craniovertebral Anomalies
Anomalies of the Occipital Bone
Anomalies of the Atlas and the Axis
Atlantoaxial Subluxation
Discal Calcification
Enlarged Intervertebral Foramina
Vertebral Pedicle Erosion or Destruction
Solitary Dense Pedicle
Pott's Disease (Figs 9.28 to 9.30)
Pyogenic Spondylitis
ARTHRITIS
Osteopenia
Joint Effusion (Fig. 9.31)
Joint Space Narrowing
Erosions, Cysts, Geodes and Bone Resorption
Changes in the Ossification Center and the Small Bones
Subchondral Sclerosis and Osteophytes
Periosteal New Bone Formation
Malalignment, Subluxation and Dislocation
Disorganization
Ankylosis
Distribution and Sequence of Changes
Soft Tissue Swelling, Atrophy and Calcification
SPINE
Differential Diagnosis of Intra-articular Loose Bodies
Differentiating Features of Pyogenic and Tubercular Arthritis (Table 9.19)
SOFT TISSUE LESIONS
Soft Tissue Calcification (Table 9.20)
Bony and Soft Tissue Lesions (Table 9.21)
CT Differential Diagnosis of Joint Diseases (Table 9.22)
Soft Tissue Lesions (Table 9.23)
Spinal Fractures (Table 9.24)
INDEX
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