Evaluation of a Radiation Oncology Microclerkship as a Component of Medical Student Education.

Compared to most oncologic subspecialties, radiation oncology (RO) lacks a natural pathway for incorporation into the clinical clerkships, and few students ever complete a formal rotation in RO. The feasibility, and perceived value, of a 1-day "microclerkship" exposure in RO during other related clerkships was evaluated in this study. At a single institution, the RO clerkship director partnered with clerkship directors in medical oncology, palliative care, and radiology so that every 3rd or 4th year student would spend 1 day in RO during those clerkships.

USMLE Step 2 CK Scores and Radiology Residency Applications: Does it Affect Diversity in Selection of Trainees?

Rationale And Objectives: As residency programs in diagnostic radiology aspire to broaden trainee diversity, reliance on certain criteria may affect the selection of candidates from underrepresented groups. With the conversion of reporting of the United States Medical Licensing Examination (USMLE) Step 1 scores to pass/fail, programs may rely more on numerical USMLE Step 2 Clinical Knowledge (CK) scores. The purpose of our investigation is to assess the effects of Step 2 CK scores on the selection of underrepresented minority (URM) and female candidates.

Double Aortic Arch in an Asymptomatic Adult.

We present a rare double aortic arch (DAA) diagnosis incidentally on CT in a 60-year-old male who presented with pneumonia. DAA is a vascular ring that typically manifests in infants or children due to compression of the esophagus or trachea, resulting in dysphagia or dyspnea. Diagnosis of DAA in adulthood is usually due to the delayed emergence of obstructive symptoms.

Urachal Remnant Calcification: A Rare Cause of Calcification Within the Urinary Bladder.

Calcification of the urachal remnant is a rare cause of urinary bladder calcification. We present a case of calcification of the urachal remnant found incidentally on computed tomography (CT) scan in the setting of trauma. Our case clearly illustrates that reformatting images in the sagittal plane can clearly delineate the median umbilical ligament and its relationship to the calcification for confirmation of the diagnosis.

Left brachiocephalic vein vascular ring on CT: A rare venous anomaly.

We present a case of a vascular ring formed by the left brachiocephalic vein. A left brachiocephalic vein ring or circum-aortic left brachiocephalic vein is a rare congenital vascular variant. Although it is usually an incidental finding on chest imaging studies, left brachiocephalic vein anomalies, particularly the ring variant, can be clinically significant during procedures requiring installation of transvenous implantable devices such as pacemakers.

Embolized fibrin sheath material presenting as intraluminal calcifications within the pulmonary arteries on CT.

Fibrin sheath formation is a well-described sequela of an indwelling central venous catheter. Fibrin sheaths may also develop around other foreign bodies within the venous system. We describe a case of fibrin sheath formation within the left brachiocephalic vein secondary to automatic implantable cardioverter-defibrillator (AICD) leads with subsequent embolization of sheath material presenting as calcifications within the pulmonary vasculature on computed tomography (CT).

Isolated Ascites on CT After Blunt Trauma: A Sign of Intraperitoneal Bladder Rupture.

We report a case of intraperitoneal bladder rupture in a 24-year-old man who was struck by a motorcycle. Initial contrast-enhanced CT scan shortly after presentation to our emergency department demonstrated simple free fluid within the upper abdomen and pelvis. Delayed CT scan of the pelvis showed contrast extravasation into the perineal cavity.

Does Objective Scoring of Applications for Radiology Residency Affect Diversity?

Rationale And Objectives: It is important to recognize if reliance on certain factors in applications affects selection of trainees from under-represented groups. Our purpose is to determine if objective scoring of radiology residency applications based on quantifiable data regarding academic performance, United States Medical Licensing Examination (USMLE) scores and research productivity affects selection of female and under-represented minority (URM) candidates.

Materials And Methods: We reviewed 502 applications from three successive match cycles from United States allopathic medical students.

Pneumomediastinum From Vacuum Disc and Vertebral Trauma.

We present a case of pneumomediastinum associated with an endplate fracture adjacent to a vacuum disc. Pneumomediastinum from trauma can be due to damage to the lungs, airway, or esophagus. In this case, we present a unique complication of the vacuum disc phenomenon in which vertebral injury at the site of a vacuum disc releases gas bubbles into the mediastinum.

Inferior vena cava filter fracture with strut migration on CT with volume rendering.

We present the computed tomography findings in a patient with a fractured IVC filter and migration of a broken strut to the right lower quadrant. The filter morphology and strut fragment are well demonstrated on volume rendered images confirming the value of volumetric 3D computed tomography imaging to evaluate IVC filter integrity and identify migrated filter fragments.

Clostridial Mycotic Aneurysm Leading to Emphysematous Aortitis.

Mycotic aneurysms account for less than 5% of all aneurysms of the aorta, with most cases linked to infection with either or species. Emphysematous aortitis is a rare consequence of mycotic aneurysms and is associated with high morbidity and mortality. It typically occurs from infection superimposed on already damaged endothelium, which is commonly seen in conditions such as atherosclerosis.

Migrating Pericardial Cyst Mimicking a Pleural Pseudotumor.

We discuss an atypical presentation of a pericardial cyst appearing as a mobile lesion extending into and out of the right pulmonary major fissure. With the patient in the supine position, the cyst mimicked a pleural pseudotumor along the right oblique fissure. In the left lateral decubitus position, the cyst migrated to the right cardiophrenic angle and assumed an appearance more characteristic of a pericardial cyst.

Computed Tomography Appearance of Unusual Nonaortic Thoracic Aneurysms and Pseudoaneurysms.

Although aneurysms of the thoracic aorta are easily recognized on computed tomography (CT), nonaortic intrathoracic aneurysms and pseudoaneurysms are unusual and not often encountered by radiologists. These lesions can result in complications such as hemorrhage or symptoms from mass effect. In some cases, patients may be asymptomatic and the aneurysms may represent incidental findings.

Partial Anomalous Left Pulmonary Artery Sling in an Adult.

We report a case of a partial anomalous left pulmonary artery sling in an adult patient as an incidental finding on computed tomography. There is a normal bifurcation of the pulmonary trunk into right and left pulmonary arteries with anomalous origin of the left upper lobe pulmonary artery from the right pulmonary artery. The anomalous vessel passes between the trachea and esophagus forming a partial left pulmonary artery sling without airway compression.

Calcification of tricuspid valve chordae tendineae on echocardiography and computed tomography.

We present the appearance of chordae tendineae calcification on transthoracic echocardiography and ECG-gated cardiac computed tomography in a 75 year-old woman. While the etiology is unclear, the abnormality can be clearly delineated on a properly performed CT study. We also discuss modification of the cardiac CT protocol to optimize visualization of the tricuspid valve apparatus.

The Azygos Vein From A to Z.

Congenital and acquired abnormalities of the azygos vein can affect its size and position. Alteration of contrast material flow dynamics of the azygos vein on computed tomography can be an indication of superior vena cava obstruction. Recognition and accurate characterization of abnormalities of the azygos vein on imaging studies is critical to facilitate prompt diagnosis and direct workup when necessary.

Computed Tomography Appearance of Uncorrected Congenital Heart Disease in Adults.

The incidence of congenital heart disease (CHD) is about 4 to 10 per 1000 live births. While severe forms of CHD are usually diagnosed in infancy or childhood, milder and more survivable CHD may first manifest in the adult or may be discovered incidentally on imaging studies performed for other reasons. It is important to identify CHD in adults to implement appropriate treatment and prevent complications such as progression of pulmonary hypertension and development of heart failure.

22q11 Deletion Syndrome with Vascular Anomalies.

DiGeorge syndrome, also termed 22q11.2 deletion syndrome, represents a spectrum of disorders that include thymic aplasia/hypoplasia, parathyroid aplasia/hypoplasia, conotruncal vascular anomalies, and velocardiofacial (Shprintzen) syndrome. This case report describes a novel constellation of cardiovascular anomalies in a 31-year-old patient with 22q11.

Pulmonary hemorrhage in acute heroin overdose: a report of two cases.

Diffuse alveolar hemorrhage (DAH) is a clinical syndrome characterized by pulmonary hemorrhage, respiratory failure, and high early mortality rates. DAH typically appears on chest radiographs as bilateral parenchymal consolidations. To our knowledge, pulmonary hemorrhage associated with heroin overdose has not been reported.

Is visual assessment of thyroid attenuation on unenhanced CT of the chest useful for detecting hypothyroidism?

Aim: To determine if visual assessment of the attenuation of morphologically normal appearing thyroid glands on unenhanced computed tomography (CT) of the chest is useful for identifying patients with decreased thyroid function.

Materials And Methods: This was a retrospective study of 765 patients who underwent both unenhanced CT of the chest and thyroid function tests performed within 1 year of the CT examination. Attenuation of the thyroid gland was visually assessed in each patient relative to the attenuation of the surrounding muscles to categorise the gland as "low attenuation" (attenuation similar to surrounding muscles) or "high attenuation" (attenuation greater than surrounding muscles).

Interrupted aortic arch with post-interruption aneurysm and bicuspid aortic valve in an adult: a case report and literature review.

Interrupted aortic arch in adults is rare with a limited number of reported cases. We describe a case of a 53-year-old woman with interrupted aortic arch, bicuspid aortic valve, and post-interruption saccular aneurysm of the aorta. To our knowledge, this is only the second report of an adult patient with all 3 abnormalities.

Levoatriocardinal Vein: An Unusual Cause of Right-to-Left Shunting.

We present a case demonstrating an anomalous vessel connecting the left brachiocephalic vein and the left superior pulmonary vein, found incidentally on computed tomography (CT) imaging. This pulmonary-systemic venous connection, known as a levoatriocardinal vein, is a rare anomaly. In previous descriptions, this vessel has typically been associated with left-to-right shunt.

Celiomesenteric and hepatosplenomesenteric trunks: characterization of two rare vascular anomalies with CT.

Objective: The purpose of this retrospective investigation is to characterize and illustrate the appearances of celiomesenteric trunk (CMT) and hepatosplenomesenteric trunk (HSMT) using CT with three-dimensional volume-rendering with attention to the proximal branching patterns. We also correlate our results with an embryologic model and assess the accuracy of radiologists in recognizing these entities.

Methods: CT studies on 36 adult subjects with CMT and 10 with HSMT were analyzed to determine the proximal branching patterns and lengths of the common vascular trunks.

Hydatid cyst embolization to the pulmonary artery: CT and MR features.

Hydatid cyst embolization to the pulmonary arteries is rare especially in the Western regions of the world. However, it can be mistaken for pulmonary embolism based on the similar clinical manifestations of cough, hemoptysis, and acute onset of chest pain. We report a case of a 32-year-old man presenting with these symptoms who was initially suspected of having pulmonary embolism.