CLINICAL ULTRASOUND A Case-based Approach
CLINICAL ULTRASOUND A Case-based Approach
Editors
Corinne Deurdulian MD
Associate Professor Department of Radiology Keck School of Medicine University of Southern California Department of Veterans Affairs Los Angeles, CA, USA
Mark E Lockhart MD MPH
Professor Chief, Abdominal Imaging Chief, Genitourinary Radiology Department of Radiology University of Alabama at Birmingham School of Medicine
Birmingham, AL, USA
Foreword
Edward G Grant
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Clinical Ultrasound: A Case-based Approach
First Edition: 2020
9789386056924
Printed at
My parents, Nora and Toros, for making me everything that I am
My husband, Donald, for his unconditional love and tireless support
My children, Vaughn and Remy, for their love, understanding, and self-sufficiency to allow me the time to work on this endeavor
And to Carol Mittelstaedt, teacher, mentor, friend, and pioneer –
you will always be missed
CD
My loving family
ML
Contributors
- Sarah Abdulla MD MS
- University of Pittsburgh School of Medicine and Medical Center
- Presbyterian University Hospital
- Pittsburgh, PA, USA
- Dana Amiraian MD
- Department of Radiology
- Mayo Clinic
- Jacksonville, FL, USA
- Mariet Asadoorian MD
- Department of Radiology
- Keck School of Medicine
- University of Southern California
- Los Angeles, CA, USA
- David Becker-Weidman MD
- Resident
- Department of Radiology
- Thomas Jefferson University Hospital
- Philadelphia, PA, USA
- Alok Bhatt MD
- Department of Radiology
- Keck School of Medicine
- University of Southern California
- Los Angeles, CA, USA
- Shweta Bhatt MBBS MD
- Professor
- Department of Radiology
- Mayo Clinic
- Jacksonville, FL, USA
- Jason Birnbaum MD MS
- Department of Imaging Sciences
- University of Rochester School of Medicine
- Rochester, NY, USA
- Noah Brauner MD
- Department of Radiology
- Keck School of Medicine
- University of Southern California
- Los Angeles, CA, USA
- Lauren A Brown MD
- Resident
- Department of Radiology
- Thomas Jefferson University Hospital
- Philadelphia, PA, USA
- Kaleigh L Burke MD
- Fellow
- Department of Radiology
- Duke University Medical Center
- Durham, NC, USA
- Melanie P Caserta MD
- Assistant Professor
- Department of Radiology
- Division Chair of Ultrasound
- Mayo Clinic
- Jacksonville, Florida, USA
- Sarah Russell Ceglar MD MS
- Resident
- Department of Radiology
- Keck School of Medicine
- University of Southern California
- Los Angeles, CA, USA
- Argha Chatterjee MD PDCC
- Department of Radiology
- University of Alabama at Birmingham
- School of Medicine
- Birmingham, AL, USA
- Frank Chen MD
- Assistant Professor
- Department of Radiology
- Mayo Clinic
- Jacksonville, FL, USA
- Wui K Chong MD
- Associate Professor
- Department of Radiology
- Chief, Ultrasound Section
- Division of Diagnostic Imaging
- The University of Texas MD Anderson Cancer Center
- Houston, Texas, USA
- Nicholas G Clayton MD
- Department of Radiology
- University of Alabama at Birmingham
- School of Medicine
- Birmingham, AL, USA
- Clayton W Commander MD PhD
- Resident
- Department of Radiology
- University of North Carolina
- Chapel Hill, NC, USA
- Mougnyan Cox MD
- Resident
- Department of Radiology
- Thomas Jefferson University Hospital
- Philadelphia, PA, USA
- Elizabeth Deans MD
- Resident
- Department of Radiology
- University of North Carolina
- Chapel Hill, NC, USA
- Amit B Desai MD
- Senior Associate Consultant
- Department of Radiology
- Mayo Clinic
- Jacksonville, FL, USA
- Sandeep Deshmukh MD
- Clinical Associate Professor
- Vice Chair
- Community Radiology Specialists
- Medical Director
- Jefferson Outpatient Imaging
- Department of Radiology
- Thomas Jefferson University Hospital
- Philadelphia, PA, USA
- Corinne Deurdulian MD
- Associate Professor
- Department of Radiology
- Keck School of Medicine
- University of Southern California
- Department of Veterans Affairs
- Los Angeles, CA, USA
- Joseph R England MD
- Department of Radiology
- Keck School of Medicine
- University of Southern California
- Los Angeles, CA, USA
- David T Fetzer MD
- Assistant Professor
- Medical Director of Ultrasound
- Department of Radiology Division of Abdominal Imaging
- UT Southwestern Medical Center
- Dallas, Texas, USA
- Mason B Frazier MD
- Associate Professor
- Musculoskeletal Section
- Vice Chair of Clinical Affairs
- Executive Medical Director
- Department of Radiology
- University of Alabama at Birmingham School of Medicine
- Birmingham, AL, USA
- Adam Gleason MD
- Resident
- Department of Radiology
- UT Southwestern Medical Center
- Dallas, Texas, USA
- Gowthaman Gunabushanam MD
- Associate Professor
- Department of Radiology and Biomedical Imaging
- Yale University School of Medicine
- New Haven, CT, USA
- Akshya Gupta MD
- Assistant Professor
- Department of Radiology
- University of Pennsylvania
- Philadelphia, PA, USA
- David Hansberry MD PhD
- Resident
- Department of Radiology
- Thomas Jefferson University Hospital
- Philadelphia, PA, USA
- Tarek Hegazi MD
- Fellow
- Department of Radiology
- Thomas Jefferson University Hospital
- Philadelphia, PA, USA
- Matthew T Heller MD FSAR
- Associate Professor
- Department of Radiology
- Director,
- Radiology Residency Program
- University of Pittsburgh School of Medicine and Medical Center
- Pittsburgh, PA, USA
- Kimberly N Hoang MD
- Department of Radiology
- Keck School of Medicine
- University of Southern California
- Los Angeles, CA, USA
- Jane Hur MD
- Fellow
- Massachusetts General Hospital
- Resident
- Department of Radiology
- Thomas Jefferson University Hospital
- Philadelphia, PA, USA
- Alexander Kessler MD
- Assistant Professor
- Department of Imaging Sciences
- University of Rochester Medical Center
- Rochester, NY, USA
- Kevin G King MD
- Assistant Professor
- Department of Clinical Radiology
- Keck School of Medicine
- University of Southern California
- Los Angeles, CA, USA
- Ellie R Lee MD
- Clinical Associate Professor
- Abdominal Imaging Division
- Department of Radiology
- University of North Carolina at Chapel Hill
- Chapel Hill, NC, USA
- Youn Kyung Lee MD
- Department of Radiology
- Keck School of Medicine
- University of Southern California
- Los Angeles, CA, USA
- Mark D Little MD
- Assistant Professor
- Department of Radiology
- University of Alabama at Birmingham
- School of Medicine
- Birmingham, AL, USA
- Mark E Lockhart MD MPH
- Professor
- Chief, Abdominal Imaging
- Chief, Genitourinary Radiology
- Department of Radiology
- University of Alabama at Birmingham
- School of Medicine
- Birmingham, AL, USA
- Shelby Lundahl MD
- Fellow
- Department of Radiology
- Keck School of Medicine
- University of Southern California
- Los Angeles, CA, USA
- Robert Lynch MD
- Assistant Professor
- Department of Radiology
- Baylor College of Medicine
- Houston, Texas, USA
- Andrej Lyshchik MD PhD
- Associate Professor
- Department of Radiology
- Thomas Jefferson University Hospital
- Philadelphia, PA, USA
- Neil Malhotra MD
- Resident
- Department of Radiology
- Thomas Jefferson University Hospital
- Philadelphia, PA, USA
- Michelle McNamara MD
- Associate Professor
- Director,
- Medical Student Education
- Chief, GI Radiology
- Department of Radiology
- University of Alabama at Birmingham
- School of Medicine
- Birmingham, AL, USA
- Benjamin J Mullenbach MD
- Department of Radiology
- University of Alabama at Birmingham
- School of Medicine
- Birmingham, AL, USA
- Brandon H Murti MD
- Department of Radiology
- Keck School of Medicine
- University of Southern California
- Los Angeles, CA, USA
- Laurence Needleman MD
- Associate Professor
- Department of Radiology
- Co-Director,
- Jefferson Vascular Center
- Medical Director,
- Noninvasive Vascular Laboratory
- Thomas Jefferson University Hospital
- Philadelphia, PA, USA
- Jeffrey W Nix MD
- Assistant Professor
- Department of Urology
- Director of Robotic Surgery
- University of Alabama at Birmingham
- School of Medicine
- Birmingham, AL, USA
- David M Obert MD
- Fellow
- Department of Radiology
- University of Alabama at Birmingham
- School of Medicine
- Birmingham, AL, USA
- Daniel Oppenheimer MD
- Assistant Professor
- Department of Imaging Sciences
- University of Rochester School of Medicine
- Rochester, NY, USA
- Keith D Pettibon MD
- Department of Radiology
- University of Alabama at Birmingham
- School of Medicine
- Birmingham, AL, USA
- Jason A Pietryga MD
- Assistant Professor
- Department of Radiology
- University of Alabama at Birmingham
- School of Medicine
- Birmingham, AL, USA
- Ashley E Prosper MD
- Assistant Clinical Professor
- UCLA Department of Radiological Sciences
- Divisions of Thoracic Imaging and Diagnostic Cardiovascular Imaging
- Los Angeles, CA, USA
- Ramanujam Prativadi MD
- Assistant Professor
- Department of Radiology
- Northwestern University
- Chicago, IL, USA
- Mollie Rashid MD
- Department of Radiology
- Keck School of Medicine
- University of Southern California
- Los Angeles, CA, USA
- Mitchell A Rees MD
- Resident
- University of Pittsburgh School of Medicine and Medical Center
- Presbyterian University Hospital
- Pittsburgh, PA, USA
- Margarita V Revzin MD MS FSRU
- Assistant Professor
- Department of Radiology and Biomedical Imaging
- Yale University School of Medicine
- New Haven, CT, USA
- Andrew M Reynolds MD
- Department of Radiology
- University of Alabama at Birmingham
- School of Medicine
- Birmingham, AL, USA
- Lana Rivers MD
- Clinical Instructor
- Department of Radiology
- University of North Carolina at Chapel Hill
- Chapel Hill, NC, USA
- Allison M Roberts MD
- Department of Radiology
- Keck School of Medicine
- University of Southern California
- Los Angeles, CA, USA
- Michael G Rodriguez MD
- Assistant Professor
- Musculoskeletal Section
- Department of Radiology
- University of Alabama at Birmingham
- School of Medicine
- Birmingham, AL, USA
- Aleksandr Rozenberg MD
- Resident
- Department of Imaging Sciences
- Thomas Jefferson University Hospital
- Philadelphia, PA, USA
- Ravinder Sidhu MD
- Associate Professor
- Department of Imaging Sciences
- University of Rochester School of Medicine
- Rochester, NY, USA
- Jesse Sinanan MD
- Fellow
- Department of Radiology
- Thomas Jefferson University Hospital
- Philadelphia, PA, USA
- Andrew B Sneed MD
- Fellow
- Department of Radiology
- University of Alabama at Birmingham
- School of Medicine
- Birmingham, AL, USA
- Jeffrey W Streb MD
- Department of Radiology
- Keck School of Medicine
- University of Southern California
- Los Angeles, CA, USA
- Amir Talebi-Liasi MD
- Fellow
- Department of Radiology
- Keck School of Medicine
- University of Southern California
- Los Angeles, CA, USA
- Allison L Tan MD
- Assistant Professor
- Department of Radiology
- Thomas Jefferson University Hospital
- Philadelphia, PA, USA
- Elizabeth R Tang MD
- Fellow
- Department of Radiology
- Thomas Jefferson University Hospital
- Philadelphia, PA, USA
- Hisham Tchelepi MD
- Associate Professor
- Department of Radiology
- Keck School of Medicine
- University of Southern California
- Los Angeles, CA, USA
- Tapas Tejura MD
- Associate Professor
- Department of Radiology
- Keck School of Medicine
- University of Southern California
- Los Angeles, CA, USA
- John V Thomas MD
- Professor
- Chief, Body MRI
- Director, Body Imaging Fellowship
- Department of Radiology
- University of Alabama at Birmingham School of Medicine
- Birmingham, AL, USA
- Joel Thompson MD
- Assistant Professor
- Department of Imaging Sciences
- University of Rochester School of Medicine
- Rochester, NY, USA
- Khoa D Tran MD
- Department of Radiology
- University of Alabama at Birmingham
- School of Medicine
- Birmingham, AL, USA
- Mark Tran MD
- Assistant Clinical Professor
- Department of Radiology
- University of California, Irvine
- School of Medicine
- Orange, CA, USA
- Benjamin L Triche MD
- Department of Radiology
- University of Alabama at Birmingham
- School of Medicine
- Birmingham, AL, USA
- Daphne K Walker MD
- Assistant Professor
- Department of Radiology
- Keck School of Medicine
- University of Southern California
- Los Angeles, CA, USA
- Peter Wang MD
- Director of Body CT and MRI
- Assistant Residency Program Director
- Department of Radiology
- Einstein Medical Center
- Philadelphia, PA, USA
- Gilbert Whang MD
- Clinical Associate Professor
- Department of Radiology
- Keck School of Medicine
- University of Southern California
- Los Angeles, CA, USA
- Felix Y Yap MD
- Department of Radiology
- Keck School of Medicine
- University of Southern California
- Los Angeles, CA, USA
- Jessica Zarzour MD
- Associate Professor
- Department of Radiology
- University of Alabama at Birmingham
- School of Medicine
- Birmingham, AL, USA
Medical books come in numerous forms. Most rely on in-depth discussion of related disease entities, and specifically in Radiology, correlation of pathological findings with those found on imaging. Clinical Ultrasound: A Case-based Approach is a departure from that norm. It provides the reader with a host of real-life cases that are well illustrated and cover essentially all of the areas in which one would apply ultrasound in today's clinical practice. While there are numerous texts on diagnostic ultrasound, perhaps the most unique and interesting feature of this book is the simple fact that the case report format is actually enjoyable reading! Each case challenges us to come up with our own answer, based on the images themselves and a relevant clinical history. It essentially mimics what we do as Radiologists in our everyday practice, which I trust most of us do find enjoyable.
The individual chapters include a broad sampling of pathological entities and are organized by anatomical region. The cases range from commonly seen abnormalities to rare diseases. Newer techniques such as contrast-enhanced ultrasound are featured prominently. The format is that of an unknown case, for which a brief clinical history and key ultrasound images are provided, prompting the reader to form an opinion before reading further. The subsequent pages include the correct diagnosis and a reasonable set of differential diagnostic possibilities followed by a discussion which includes imaging findings, multimodality correlation, when applicable, and clinical management. The areas covered are sufficiently broad that simply reading the book provides an in-depth exploration of the entire field of ultrasound.
Edward G Grant MD FACR
Professor and Chairman
Department of Radiology
Keck Hospital of USC
USC Norris Cancer Center
University of Southern California
Los Angeles, CA, USA
Preface
From fuzzy, dream-like scattered pixels that ebb and flow like tides, like storms, like emotions, to the raucous “whoosh- whoosh” of the artery sounding like an prelude to a dubstep jam, Ultrasound is the poetry and the dreams of radiology.
This book is a compendium of 125 cases that brings these dreams (and nightmares) to life. Beneficial to the practicing radiologist, invaluable to the resident, and dismissed but secretly lusted after by the fellow, this book contains the lock and key to ultrasound nirvana .
But seriously, this book is a comprehensive review of a myriad of cases, a practical board review, a resource for maintenance of certification, and an interesting read with relevant images. The cases are real-life examples seen by radiologists around the United States. In practice, ultrasound images are not always “pretty” and pathology is not always “typical” in appearance; therefore, it is important to be familiar with a variety of presentations of disease. Our goal is for this book to help prepare you for practice and beyond.
Happy dreaming!
Corinne Deurdulian
Mark E Lockhart
Acknowledgments
We are especially thankful to Shri Jitendar P Vij (Group Chairman), Mr. Ankit Vij (Managing Director), Mr. MS Mani (Group President), Ms. Chetna Malhotra Vohra (Associate Director—Content Strategy), Ms. Pooja Bhandari (Production Head), and Ms. Nedup Denka Bhutia (Development Editor) of M/s Jaypee Brothers Medical Publishers (P) Ltd, New Delhi, India, for giving the go-ahead at the very beginning and helping us in every way possible to bring out this book.