Radiology 101: The Basics & Fundamentals of Imaging

421 Pages·2013·124.42 MB·English

by  Wilbur L. Smith MD

RADIOLOGY 101
The Basics and Fundamentals of Imaging
F o u r t h E d i t i o n
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RADIOLOGY 101
The Basics and Fundamentals of Imaging
F o u r t h E d i t i o n
E D I t O R s
Wilbur L. Smith, Md
Professor and Chair
Diagnostic Radiology
Wayne State University School of Medicine
Academic Radiology (3L8)
Detroit Receiving Hospital
Detroit, Michigan
thomas A. Farrell, MB, FrCr, MBA
Section Head, Interventional Radiology
NorthShore University HealthSystem
Clinical Assistant Professor of Radiology
Department of Radiology
The University of Chicago Pritzker School of Medicine
Evanston, Illinois
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© 2014 by LIPPINCOtt WILLIAMs & WILKINs, a WOLtERs KLUWER business
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Third edition © 2010 by LIPPINCOTT WILLIAMS & WILKINS, a WOLTERS KLUWER business
Second edition @ 2005 by LIPPINCOTT WILLIAMS & WILKINS, a WOLTERS KLUWER business
First edition @ 1999 by LIPPINCOTT WILLIAMS & WILKINS, a WOLTERS KLUWER business
All rights reserved. This book is protected by copyright. No part of this book may be reproduced in any form by
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Materials appearing in this book prepared by individuals as part of their official duties as U.S. government
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Printed in China
Library of Congress Cataloging-in-Publication Data
Radiology 101 : basics and fundamentals of imaging / editors, Wilbur L.
Smith, Thomas A. Farrell. – Fourth edition.
p. ; cm.
Radiology one o one
Radiology one hundred one
Radiology one hundred and one
Basics and fundamentals of imaging
Includes bibliographical references and index.
ISBN 978-1-4511-4457-4 (alk. paper)
I. Smith, Wilbur L., editor of compilation. II. Farrell, Thomas A. (Clinical assistant professor of radiology), editor
of compilation. III. Title: Radiology one o one. IV. Title: Radiology one hundred one. V. Title: Radiology one
hundred and one. VI. Title: Basics and fundamentals of imaging.
[DNLM: 1. Diagnostic Imaging. 2. Radiology. WN 180]
RC78
616.07’54–dc23
2013025390
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A teacher affects eternity; he can never tell where his
influence stops.
Henry Adams (American Philosopher)
Almost 25 years ago a jovial roguish man with a dry
wit decided to devote the rest of his professional career
to teaching students the art of radiology. Coming from
a practice in the Midwest he decided to join the faculty
at the University of Iowa to “have some fun.” His “fun”
resulted in innumerable publications, grants, and
teaching awards both national and university wide. His
recognition of the need to spread his lighthearted and
practical philosophy of learning led to the first three
editions of this book. At the outset, Bill Erkonen was a
practical man and insisted the book be written to let
the reader have fun. The book has always been pub-
lished in soft cover intentionally aiming to keep the
costs low, within the budget of students. Bill is now
fully retired and age is taking its toll but his spirit lives
on in those he teaches and inspires today. This book is
dedicated to his ongoing joy in teaching.
—Wilbur Smith
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Contributing Authors
Carol A. Boles, Md t. Shawn Sato, Md
Associate Professor of Radiology Senior Radiology Resident
Department of Diagnostic Radiology The University of Iowa
Wake Forest Baptist Medical Center Iowa City, Iowa
Winston-Salem, North Carolina
Yutaka Sato, Md, FACr
William E. Erkonen, Md Professor
Associate Professor Emeritus of radiology Department of Radiology
Department of Radiology The University of Iowa
The University of Iowa Iowa City, Iowa
Iowa City, Iowa
Ethan A. Smith, Md
Laurie L. Fajardo, Md, MBA, FACr Clinical Assistant Professor
Clinical Assistant Professor of Radiology Section of Pediatric Radiology
Department of Radiology Department of Radiology
The University of Chicago C.S. Mott Children’s Hospital
NorthShore University HealthSystem University of Michigan Health System
Evanston, Illinois Ann Arbor, Michigan
thomas A. Farrell, MB, FrCr, MBA Wilbur L. Smith, Md
Section Head, Interventional Radiology Professor and Chair
NorthShore University HealthSystem Diagnostic Radiology
Clinical Assistant Professor of Radiology Wayne State University School of Medicine
Department of Radiology Academic Radiology (3L8)
The University of Chicago Pritzker School of Medicine Detroit Receiving Hospital
Evanston, Illinois Detroit, Michigan
david M. Kuehn, Md Brad h. thompson, Md
Associate Professor Associate Professor
Department of Radiology Department of Radiology
The University of Iowa Division of Thoracic Imaging
Iowa City, Iowa Carver College of Medicine
University of Iowa Hospitals and Clinics
Vincent A. Magnotta, Phd Iowa City, Iowa
Associate Professor
Department of Radiology Limin Yang, Md, Phd
The University of Iowa Clinical Assistant Professor
Iowa City, Iowa Department of Radiology
The University of Iowa
Iowa City, Iowa
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Preface
The astute reader will notice that the following four para- essential to understand the various manifestations of dis-
graphs of this preface are identical to those penned by eases on radiologic images. Thus, this book places heavy
Dr. Erkonen in the last edition. The reason is, we could not emphasis on images, stressing normal anatomy and com-
think how to say it any better. Bill established a philosophy monly encountered radiologic pathology. We present
and legacy that we have attempted to carry through to the clearly labeled images of normal anatomy from a variety of
new edition. There is a truism in Radiology, “Human dis- angles not only on radiographs but also on other com-
eases don’t change much, just the way we image them.” monly used imaging modalities such as computed tomog-
The specialty of radiology has been around for over raphy, magnetic resonance imaging, and ultrasonography.
100 years and has played a critical role in patient diagnosis The fourth edition contains several updates and one
and care. During the last 30 years the role of radiology in new feature. The text and illustrations are updated to
patient diagnosis and care has soared on the wings of reflect the increasing applications of molecular imaging,
extraordinary technologic advances. As you read this work, digital imaging, and magnetic resonance imaging. New
remember that diseases have not changed a lot, but the chapter authors have been added, each an expert in their
way we look at them has due to these new and improved field yet writing in a style that is concise and readable. In
technologies. doing this we have attempted to maintain emphasis on the
All too often, educators incorrectly assume that the core role of basic imaging techniques such as bone radio-
students know something about the subject that they are graphs, chest radiographs and basic ultrasound which
about to study. Therefore, the third edition of Radiology form the basis suggesting advanced diagnostic imaging
101 assumes that the reader’s knowledge of radiology is at may be needed.
the most basic level. A short new chapter has been added on the appropri-
The primary purpose of this book is to give the reader ate use of imaging. Included in that chapter is a brief sec-
a “feel” for radiologic anatomy and the radiologic manifes- tion on radiation exposure, a factor of increasing concern
tations of some common disease processes. After reading when requesting imaging examinations. Indications for
this book, you will be better prepared for consultation examinations are a dynamic concept therefore the chapter
with the radiologist, and this usually leads to an appropri- emphasizes more where to find updated information, then
ate diagnostic workup. As one develops an understanding specific prescriptions for imaging usage.
of what radiology has to offer, improved patient diagnosis Adult learning theory suggests that testing on material
and care are likely to follow. In addition, the reader will be engages learners beyond the more passive role of a reader.
able to approach an image without feeling intimidated. We have therefore added questions at the end of each chapter
You might say, “it will prepare you for the wards and which the reader can use to self-assess their learning.
boards.” The book is not intended to transform the reader Above all we hope that this text continues to serve as
into a radiologist look-alike. Rather, it is designed to be a an introduction to the wonderful field of imaging. We
primer or general field guide to the basics of radiology. aspired to write a text that is easy to read and comprehend
Anatomy is the language of radiology. A solid founda- rather than one that is encyclopedic. Please reader, have
tion in good old-fashioned normal radiologic anatomy is fun and enjoy while you learn.
ix
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