Superscan Phenomenon

This bone scan of a patient with metastatic disease demonstrates the “superscan” phenomenon. Tracer uptake is so avid in bone that there is almost no renal excretion – the kidneys are barely visualised. Submitted by Dr Rishu Sangal, Consultant Radiologist.

• Causes of superscan are as follows: renal osteodystrophy; osteomalacia; hyperparathyroidism; hyperthyroidism; diffuse skeletal metastases; myelofibrosis; haematological malignancy; extensive Paget’s disease.

Endometrial Hyperplasia Versus Endometrial Cancer

 29 yr old married nulliparous who has had D& C done 3 times that showed atypical hyperplasia of the endometrium. Ultrasound was done by the gynecologist and she queried a myoma. MRI was requested to rule out carcinoma endometrium with myometrial extension. 

In this patient entire endometrial cavity appears replaced by mixed signal intensity area which shows imhomogenous post gadolinium enhancement and non-enhancing areas, which are likely indicating endometrial hyerplasia with doubtful loss of interface with the myometrium in the posterolateral part. Uterus per se is enlarged. This thickened endometrium shows areas of high signal on DWI image provided but there is no corresponding signal suppression on ADC map, which may indicate T2 shine through. Low signal on ADC map in endometrium is usually the sign for differentiating hyperplasia from malignancy, which is not seen in this case. So, finally this case likely indicates extensive endometrial hyperplasia with no low signal on ADC map, and doubtful loss of interface in the posterolateral endo-myometrial junction. Clinical and histological correlation will help.

Radblogging Featured on "Imaging Biz"

Imaging Biz in its latest issue talks of Web2.0 and Radiology, with special reference to Radblogging and using my blog as one of the reference points. It goes on like - 

 When Sumer Sethi, MD, started his radiology site in 2004, the word blog was still a relatively recent invention, a shortening of the more formal term weblog. “In different fields, people had started to use weblogs as platforms for communicating with readers without the need for an expensive platform or publishing house,” Sethi (editor-in-chief of the Internet Journal of Radiology) says. “I thought, ‘A blog can be my platform to share my radiology cases and ideas online,’ and that got me started.”

Full article can be read here on Imaging Biz to get know the Inside of the world of Radblogging.

Osteopoikilosis

There are multiple areas of sclerotic foci in the femoral heads and acetabulum which likely indicate osteopoikilosis, benign condition characterized by numerous bone islands. Osteopoikilosis is an benign, autosomal dominant sclerosing dysplasia of bone. The radiographic appearance of osteopoikilosis on an x-ray is characterized by a pattern of numerous white densities of similar size spread throughout all the bones.