Table Of ContentSFECEODNDE ERDILTIOEN
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SHAABAN • BORHANI • FURLAN • HELLER
ii
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SECOND EDITION
Michael P. Federle, MD, FACR
Professor and Associate Chair for Education
Department of Radiology
Stanford University School of Medicine
Stanford, California
Siva P. Raman, MD Mitchell Tublin, MD
Assistant Professor of Radiology Professor and Vice Chair of Radiology
Department of Radiology Chief, Abdominal Imaging Section
Johns Hopkins University School of Medicine University of Pittsburgh School of Medicine
Baltimore, Maryland Pittsburgh, Pennsylvania
Akram M. Shaaban, MBBCh
Professor (Clinical)
Department of Radiology and Imaging Sciences
University of Utah School of Medicine
Salt Lake City, Utah
Amir A. Borhani, MD
Assistant Professor
Department of Radiology, Division of Abdominal Imaging
University of Pittsburgh School of Medicine
Pittsburgh, Pennsylvania
Alessandro Furlan, MD
Assistant Professor
Department of Radiology, Division of Abdominal Imaging
University of Pittsburgh School of Medicine
Pittsburgh, Pennsylvania
Matthew T. Heller, MD, FSAR
Associate Professor of Radiology
Division of Abdominal Imaging
University of Pittsburgh Medical Center
Pittsburgh, Pennsylvania
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1600 John F. Kennedy Blvd.
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EXPERTDDX: ABDOMEN & PELVIS, SECOND EDITION ISBN: 978-0-323-44287-9
Copyright © 2017 by Elsevier. All rights reserved.
No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including
photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher. Details
on how to seek permission, further information about the Publisher’s permissions policies and our arrangements with organizations
such as the Copyright Clearance Center and the Copyright Licensing Agency, can be found at our website: www.elsevier.com/
permissions.
This book and the individual contributions contained in it are protected under copyright by the Publisher (other than as may be
noted herein).
Notices
Knowledge and best practice in this field are constantly changing. As new research and
experience broaden our understanding, changes in research methods, professional practices,
or medical treatment may become necessary.
Practitioners and researchers must always rely on their own experience and knowledge in
evaluating and using any information, methods, compounds, or experiments described
herein. In using such information or methods they should be mindful of their own safety
and the safety of others, including parties for whom they have a professional responsibility.
With respect to any drug or pharmaceutical products identified, readers are advised to check
the most current information provided (i) on procedures featured or (ii) by the manufacturer
of each product to be administered, to verify the recommended dose or formula, the
method and duration of administration, and contraindications. It is the responsibility of
practitioners, relying on their own experience and knowledge of their patients, to make
diagnoses, to determine dosages and the best treatment for each individual patient, and to
take all appropriate safety precautions.
To the fullest extent of the law, neither the Publisher nor the authors, contributors, or
editors, assume any liability for any injury and/or damage to persons or property as a matter
of products liability, negligence or otherwise, or from any use or operation of any methods,
products, instructions, or ideas contained in the material herein.
Publisher Cataloging-in-Publication Data
Names: Federle, Michael P. | Raman, Siva P. | Tublin, Mitchell E.
Title: Expert DDx: Abdomen and pelvis / [edited by] Michael P. Federle, Siva P. Raman,
and Mitchell Tublin.
Other titles: Abdomen and pelvis.
Description: Second edition. | Salt Lake City, UT : Elsevier, Inc., [2016] | Includes
bibliographical references and index.
Identifiers: ISBN 978-0-323-44287-9
Subjects: LCSH: Abdomen--Anatomy--Handbooks, manuals, etc. | Pelvis--Anatomy--Handbooks, manuals,
etc. | MESH: Abdomen--anatomy & histology--Atlases. | Pelvis----anatomy & histology--Atlases.
Classification: LCC RC78.7.D53 D534 2016 | NLM WE 17 | DDC 616.07’54--dc23
International Standard Book Number: 978-0-323-44287-9
Cover Designer: Tom M. Olson, BA
Printed in Canada by Friesens, Altona, Manitoba, Canada
Last digit is the print number: 9 8 7 6 5 4 3 2 1
iv
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Dedications
To Lynne, my wife and partner of 45 years.
MPF
To my loving wife, Janani Venkateswaran,
who has been at the heart of all my successes.
To my young son, Jay Raman, who inspires me to do better every day.
To my colleagues at Johns Hopkins, whose support and
guidance have been invaluable.
SPR
To my wife, Mary, and our sons, Daniel, Josh, and Andrew.
Your love and support sustain me.
MT
v
Contributing Authors
Aya Kamaya, MD, FSRU, FSAR Gregory E. Antonio, MD, FRANZCR
Associate Professor of Radiology Clinical Professor (Honorary)
Co-Director, Stanford Body Imaging Fellowship Department of Imaging and Interventional Radiology
Stanford University School of Medicine The Chinese University of Hong Kong
Stanford, California Hong Kong, People’s Republic of China
Hee Sun Park, MD, PhD Eric K.H. Liu, PhD, RDMS
Associate Professor Adjunct Associate Professor
Department of Radiology Department of Imaging and Interventional Radiology
Konkuk University School of Medicine The Chinese University of Hong Kong
Seoul, South Korea Hong Kong, People’s Republic of China
Jade Wong-You-Cheong, Ashish P. Wasnik, MD, FSAR
MBChB, MRCP, FRCR Assistant Professor of Radiology
Professor Director, Medical Student Education
Department of Diagnostic Radiology and Nuclear Medicine Division of Abdominal Imaging
University of Maryland School of Medicine University of Michigan Health System
Director of Ultrasound Ann Arbor, Michigan
University of Maryland Medical Center
Baltimore, Maryland
Narendra Shet, MD
Assistant Professor
Maryam Rezvani, MD Assistant Program Director
Associate Professor of Radiology Radiology Residency Program
Department of Radiology Department of Diagnostic Radiology and
University of Utah School of Medicine Nuclear Medicine
Salt Lake City, Utah University of Maryland School of Medicine
Baltimore, Maryland
Fauzia Vandermeer, MD
Katherine To’o, MD
Assistant Professor of Diagnostic Radiology
Associate Program Director, Radiology Residency Staff Radiologist
Department of Diagnostic Radiology and Veterans Affairs Palo Alto Health Care System
Nuclear Medicine Palo Alto, California
University of Maryland School of Medicine
Baltimore, Maryland
L. Nayeli Morimoto, MD
Clinical Assistant Professor
Shweta Bhatt, MD Department of Radiology
Associate Professor Stanford University School of Medicine
Department of Imaging Sciences Stanford, California
University of Rochester Medical Center
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Rochester, New York
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Preface
Radiologists are frequently confronted with challenging imaging
interpretations, armed only with knowledge of the patient’s clinical
presentation (e.g., right upper quadrant pain) or an imaging finding (e.g.,
a cystic pancreatic mass). In order to narrow the differential diagnosis, the
radiologist will attempt to recall information learned during one’s training
or in more recent venues, such as CME meetings. The diligent may seek
assistance with a standard radiology text, but these are often organized by
specific diseases or disorders and may not be helpful or efficient in quickly
generating a useful differential diagnosis. Internet searches are certainly
expedient, but one is likely to wade through numerous unvetted and
unreliable sources before coming up with valid content.
Our series of Expert Differential Diagnosis (“DDx”) books draw on the
accumulated experience and expertise of our Amirsys/Elsevier authors,
most of whom have authored and helped edit the encyclopedic Diagnostic
Imaging books. Our goal is to identify the most common and important
clinical and imaging challenges and to provide a list of the common, less
common, and rare causes for such challenges. These causes are accompanied
by characteristic imaging studies, along with the key clinical and imaging
features that allow one to distinguish among the possible etiologies.
The second edition of Expert DDx: Abdomen has been substantially expanded
to become Expert DDx: Abdomen & Pelvis, and we have significantly added
to our coverage of the male and female pelvis. In addition to the generic
imaging patterns (e.g., “cystic renal mass”), we have added many modality-
specific modules, especially focusing on disorders best or typically evaluated
by ultrasonography or MR (e.g., “cystic adnexal mass”).
We hope that you will find this to be a valuable resource as we seek to add
value to our work as radiologists.
Michael P. Federle, MD, FACR
Professor and Associate Chair for Education
Department of Radiology
Stanford University School of Medicine
Stanford, California
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