By Jessie Aw, John Curtis
Half 2B of the FRCR exam for trainee radiologists comprises six 'long cases', which may include photographs of any physique process and any imaging modality: undeniable movie, CT, MRI, ultrasound, nuclear medication and distinction reviews. FRCR 2B: A advisor to the lengthy instances includes 60 hugely illustrated lengthy instances and solutions, organised into 10 units of 6 instances. The situations are in line with the structure of the examination and the solutions are on the point of aspect the candidate will be anticipated to supply within the time allotted. An introductory part explains the College's marking scheme and advises at the top method of the lengthy instances and the way to constitution a solution. A succinct subject evaluate is supplied with every one case. together edited through a profitable FRCR fellow and an skilled advisor radiologist, FRCR 2B: A advisor to the lengthy instances is vital examining for all examination applicants.
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7 cm. Bilateral hydronephrosis with dilatation of the superior part of both ureters. MCUG Small bladder with a thick and trabeculated wall. Hypertrophy of bladder neck. Elongated and dilated posterior part of the urethra. No contrast visible in the anterior urethra. Bilateral vesicoureteric reflux with dilated and tortuous ureters. Bilateral dilatation and blunting of the renal calcyces. Interpretation 1. Stenosis þ/À obstruction in the proximal urethra. 2. Bilateral vesicoureteric reflux – grade V.
Both infarction and abscess restrict on diffusion weighted imaging but often the pattern of restriction of early venous infarct is heterogeneous unlike an arterial infarct and can be similar to that of an abscess. References Atlas S W. Magnetic resonance imaging of the brain and spine, Vol I, 4th edn. Lippincott, Williams & Wilkins; 2008: 863–5, 965–98. Barkovich A J. Pediatric neuroimaging, 4th ed. Philadelphia: Lippincott Williams & Wilkins; 2005: 816–820 and 829–833. Ganeshan D, Narlawar R, McCann C et al.
No gas in the biliary tree. No stent seen in the lower oesophagus. Incidental degenerative changes are noted in the lower thoracic and lumbar spine. Diagnosis Small bowel obstruction The finding of the metallic density on the abdominal radiograph and the history of oesophageal stricture suggest that this may be due to migration of an oesophageal stent. Differential diagnosis Adhesions from previous abdominal surgery and rectal stent in situ. Management 40 (1) The case needs to be discussed urgently with the general surgical team as the large diameter of the small bowel indicates imminent perforation.