STANFORD UNIVERSITY MEDICAL CENTER



Rotation:NeuroradiologyRotation Duration:4 wksMonth(s):5Institution:Stanford, VACall Responsibility:Evening and night residentsNight(s):covered by 2nd year and fellow (MRI)Responsible Faculty Member(s):Scott W. Atlas, MD, Section ChiefPat Barnes, MDHuy M. Do, MDNancy J. Fischbein, MDBart Lane, MD:Michael Marks, MD Zina Payman, MDKristen Yeom, MDGreg Zaharchuk, MD, PhDMichael Zeineh, MD, PhDLocation:SUH, LPCH, VA, Sherman AvePhone Numbers:Administrative Assts:Kari Guy: 723-7426Barbara Hargis: 723-6767Technologists/Technical Staff:Michele Thomas, Lead CT techTeresa Nelson, Lead MRI techPatrick Strain, FluoroTraining Level:Years 1 and 2: SUHYears 3 and 4: VA/ShermanGoals & ObjectivesThe Neuroradiology rotation gives the resident graduated clinical exposure to CT, MRI, and other diagnostic imaging studies of patients suspected of harboring diseases involving the brain, spine, and head and neck.Rotation OneMedical KnowledgeEmergency evaluation of pediatric and adult patients:Normal head CT Normal spine CTCT of intracranial hemorrhageCT of cerebral infarctionCT in head and spine traumaIndications for CT versus MRI versus cerebral angiographyUnderstand the rationale for ordering emergency head CTCT of the brain in non-traumatic emergency settings (e.g. seizures)CT of the spine in non-traumatic emergency settings (e.g. spinal cord compression)Contraindications to MRITreatment of contrast reactionsProcedures for MRI and CT in pregnancyProcessing and interpretation of Craniocervical CTABasic neck CT interpretation in adult and pediatric patients Other Knowledge Based Objectives: At the end of the rotation, the resident should be able to:Given normal neuro images, demonstrate a proficient knowledge of the anatomy of the head and neck, spine, and central nervous system.Discuss the basic principles of CT physics, artifacts and pitfalls.Describe, in considerable detail, CT and, to some extent, MR imaging protocols.Given an appropriate abnormal image, recognize basic neuropathology and give a differential diagnosis. Technical Skills: At the end of the rotation, the resident should be able to:Screen, protocol, and supervise routine neuroimaging procedures. Decision-Making and Value Judgment Skills: At the end of the rotation, the resident should be able to:Interact with primary care physicians and specialists (neurosurgeons, neurologists) in consultation when more common pathologies are at question.Provide guidance regarding appropriate imaging strategiesPatient CareThe resident arrives at the neuroradiology service at 8:30 -8:45 am, after a.m. conferenceGenerally there are at least two case readouts. These occur in the morning and afternoon, but specific readout times vary, depending on the attending, the specific assignment in neuroradiology, and the workload on any given day. Typically, morning readout begins around 9:00 am, and afternoon readout occurs around 3 pm.Residents are expected to have previewed all cases before the readout session begins. They are also expected to be readily available at all times, except when in resident teaching conferences, for consultations with clinicians, for questions about protocols from technologists, and for answering questions from medical students and visitors. The resident is expected to be familiar with all histories, reasons for scans, radiological findings, and changes from previous studies. The resident is also expected to have formulated a reasonable clinical differential diagnosis to explain the findings on the studies.For each case, the resident should be prepared with the requisition in hand, the history and the reason for the scan. During the interpretation of the study with the attending, the resident may be asked questions about findings, normal anatomy, or differential diagnosis. For the final interpretation, the resident should write down the pertinent findings as the attending has explained them, so that the dictations accurately reflect the discussion by the attending.Following the end of readout, the resident is expected to dictate all the cases that he has gone over with the attending.Intermittently, attendings or housestaff from other clinical services will come into the reading room to ask about their patients’ imaging studies. The First year Radiology resident is expected to provide a preliminary interpretation to these physicians ONLY if the case has been reviewed also with a fellow or attending. Residents are expected to protocol neuroradiology imaging studies with the assistance of fellows and attendings, as needed..Emergency CT scans are intermittently ordered by the Emergency Department. The resident should provide a preliminary report on these cases immediately upon their completion and later document the date, time, and to whom they spoke in the formal, dictated report.During downtimes, it is expected that the resident read about neuroradiology.Practice-Based Learning and ImprovementGoalResidents must demonstrate the ability to investigate and evaluate their care of patients, to appraise and assimilate scientific evidence, and to continuously improve patient care based on constant self-evaluation and lifelong learning. Residents are expected to develop skills and habits to be able to:Knowledge Objectives:Assess CT images for quality and suggest methods of improvement.Skill Objectives:Demonstrate independent self-study using various resources including texts, journals, teaching files, and other resources on the internet, andFacilitate the learning of students and other health care professionals.Behavior and Attitude Objectives:Incorporate formative feedback into daily practice, positively responding to constructive criticism, andFollow-up interesting or difficult cases without prompting and share this information with appropriate faculty and fellow residents.Systems Based PracticeGoalResidents must demonstrate an awareness of, and responsiveness to, the larger context and system of health care, as well as the ability to call effectively on other resources in the system to provide optimal health care. Residents are expected to:Knowledge Objectives:Understand how their image interpretation affects patient care.Skill Objectives:Provide accurate and timely interpretations to decrease length of hospital and emergency department stay, Appropriately notify the referring clinician if there are urgent or unexpected findings and document such without being prompted; andPractice using cost effective use of time and support personnel.Behavior and Attitude Objectives:Advocate for quality patient care in a professional manner, particularly concerning imaging utilization issues.ProfessionalismGoalResidents must demonstrate a commitment to carrying out professional responsibilities and an adherence to ethical principles. Residents are expected to demonstrate:Knowledge Objectives:Understanding of the need for respect for patient privacy and autonomy, andUnderstanding of their responsibility for the patient and the service, including arriving in the reading room promptly each day, promptly returning to the reading room after conferences, completing the work in a timely fashion, and not leaving at the end of the day until all work is complete. If the resident will be away from a service (for time off, meeting, board review, etc.), this must be arranged in advance with the appropriate faculty and/or fellow. Skill Objectives:Sensitivity and responsiveness to a diverse patient population, including but not limited to diversity in gender, age, culture, race, religion, disabilities, and sexual orientation.Behavior and Attitude Objectives: Respect, compassion, integrity, and responsiveness to patient care needs that supersede self-interest.Interpersonal and Communication SkillsGoalResidents must demonstrate interpersonal and communication skills that result in the effective exchange of information and teaming with patients, their families, and professional associates. Residents are expected to:Knowledge Objectives:Know the importance of accurate, timely, and professional communication.Skill Objectives:Produce concise and accurate reports on most examinations, Communicate effectively with physicians, other health professionals, andObtained informed consent with the utmost professionalism.Behavior and Attitude Objectives:Work effectively as a member of the patient care team.II. Rotation 2 (CTA Stanford/LPCH) This is a relatively new rotation that will allow the resident a two-week block during which to focus on CTA processing and interpretation, as well as two weeks on pediatric neuroradiologyMedical KnowledgeKnowledge Based Objectives: At the end of the rotation, the resident should be able to:Recognize intracranial aneurysms on CTAAssess atherosclerotic disease on CTAUnderstand when CTA should be performedPeds neuro—recognize the appearance of a normal brain at various ages, as well as pathologies particular to the pediatric population such as child abuse, congenital malformations, and pediatric-specific neoplasms Technical Skills: At the end of the rotation, the resident should be able to:Post-process CTA to provide 3-D volume rendered images of Circle of Willis and carotid arteries. Peds neuro—interpret post-processed 3D images of the calvarium (craniosynostosis), facial bones (trauma, congenital syndromes), and spine (scoliosis)Decision-Making and Value Judgment Skills: At the end of the rotation, the resident should be able to:Interact with primary care physicians and specialists (neurosurgeons, neurologists) in consultation when more common pathologies are at question.Provide guidance regarding appropriate imaging strategiesIn the event that the resident does not understand the findings or feels uncomfortable providing such reports, the resident should ask for help, either from the fellows or attendings in neuroradiology.Patient CareThe resident arrives at the neuroradiology service at 8:30 -8:45 am, after a.m. conferenceGenerally there are at least two case readouts. These occur in the morning and afternoon, but specific readout times vary, depending on the attending, the specific assignment in neuroradiology, and the workload on any given day. Typically, morning readout begins around 9:00 am, and afternoon readout occurs around 3 pm.Residents are expected to have previewed all cases before the readout session begins. They are also expected to be readily available at all times, except when in resident teaching conferences, for consultations with clinicians, for questions about protocols from technologists, and for answering questions from medical students and visitors. The resident is expected to be familiar with all histories, reasons for scans, radiological findings, and changes from previous studies. The resident is also expected to have formulated a reasonable clinical differential diagnosis to explain the findings on the studies.For each case, the resident should be prepared with the requisition in hand, the history and the reason for the scan. During the interpretation of the study with the attending, the resident may be asked questions about findings, normal anatomy, or differential diagnosis. For the final interpretation, the resident should write down the pertinent findings as the attending has explained them, so that the dictations accurately reflect the discussion by the attending.Following the end of readout, the resident is expected to dictate all the cases that he has gone over with the attending.Intermittently, attendings or housestaff from other clinical services will come into the reading room to ask about their patients’ imaging studies. The First year Radiology resident is expected to provide a preliminary interpretation to these physicians ONLY if the case has been reviewed also with a fellow or attending. Residents are expected to protocol neuroradiology imaging studies with the assistance of fellows and attendings, as needed..Emergency CT scans are intermittently ordered by the Emergency Department. The resident should provide a preliminary report on these cases immediately upon their completion and later document the date, time, and to whom they spoke in the formal, dictated report.During downtimes, it is expected that the resident read about neuroradiology.Practice-Based Learning and ImprovementGoalResidents must demonstrate the ability to investigate and evaluate their care of patients, to appraise and assimilate scientific evidence, and to continuously improve patient care based on constant self-evaluation and lifelong learning. Residents are expected to develop skills and habits to be able to:Knowledge Objectives:Assess CT and CTA images for quality and suggest methods of improvement.Skill Objectives:Demonstrate independent self-study using various resources including texts, journals, teaching files, and other resources on the internet, andFacilitate the learning of students and other health care professionals.Behavior and Attitude Objectives:Incorporate formative feedback into daily practice, positively responding to constructive criticism, andFollow-up interesting or difficult cases without prompting and share this information with appropriate faculty and fellow residents.Systems Based PracticeGoalResidents must demonstrate an awareness of, and responsiveness to, the larger context and system of health care, as well as the ability to call effectively on other resources in the system to provide optimal health care. Residents are expected to:Knowledge Objectives:Understand how their image interpretation affects patient care.Skill Objectives:Provide accurate and timely interpretations to decrease length of hospital and emergency department stay, Appropriately notify the referring clinician if there are urgent or unexpected findings and document such without being prompted; andPractice using cost effective use of time and support personnel.Behavior and Attitude Objectives:Advocate for quality patient care in a professional manner, particularly concerning imaging utilization issues.ProfessionalismGoalResidents must demonstrate a commitment to carrying out professional responsibilities and an adherence to ethical principles. Residents are expected to demonstrate:Knowledge Objectives:Understanding of the need for respect for patient privacy and autonomy, andUnderstanding of their responsibility for the patient and the service, including arriving in the reading room promptly each day, promptly returning to the reading room after conferences, completing the work in a timely fashion, and not leaving at the end of the day until all work is complete. If the resident will be away from a service (for time off, meeting, board review, etc.), this must be arranged in advance with the Chief residents. Skill Objectives:Sensitivity and responsiveness to a diverse patient population, including but not limited to diversity in gender, age, culture, race, religion, disabilities, and sexual orientation.Behavior and Attitude Objectives: Respect, compassion, integrity, and responsiveness to patient care needs that supersede self-interest.Interpersonal and Communication SkillsGoalResidents must demonstrate interpersonal and communication skills that result in the effective exchange of information and teaming with patients, their families, and professional associates. Residents are expected to:Knowledge Objectives:Know the importance of accurate, timely, and professional communication.Skill Objectives:Produce concise and accurate reports on most examinations, Communicate effectively with physicians, other health professionals, andObtained informed consent with the utmost professionalism.Behavior and Attitude Objectives:Work effectively as a member of the patient care team.III. Rotation 3 (primarily MRI, Stanford)Medical Knowledge Knowledge Based Objectives: At the end of the rotation, the resident should be able to:Understand routine MR imaging protocols for brain and spine, and have some beginning exposure to head and neck imagingRecognize common pathophysiological entities on MRI, including strokes, brain tumors, demyelinating lesionsRecognize pathologies of the skull base, cavernous sinuses, and orbitsInterpret MRA of intracranial and extracranial circulationHave some understanding of MR perfusion techniques Technical Skills: At the end of the rotation, the resident should be able to: Screen, protocol, and supervise neuro MRI studiesCalculate GFR and address issues related to gadolinium-based contrast agentsPractice-Based Learning and ImprovementGoalResidents must demonstrate the ability to investigate and evaluate their care of patients, to appraise and assimilate scientific evidence, and to continuously improve patient care based on constant self-evaluation and lifelong learning. Residents are expected to develop skills and habits to be able to:Knowledge Objectives:Assess CT and MRI images for quality and suggest methods of improvement.Skill Objectives:Demonstrate independent self-study using various resources including texts, journals, teaching files, and other resources on the internet, andFacilitate the learning of students and other health care professionals.Behavior and Attitude Objectives:Incorporate formative feedback into daily practice, positively responding to constructive criticism, andFollow-up interesting or difficult cases without prompting and share this information with appropriate faculty and fellow residents.Systems Based PracticeGoalResidents must demonstrate an awareness of, and responsiveness to, the larger context and system of health care, as well as the ability to call effectively on other resources in the system to provide optimal health care. Residents are expected to:Knowledge Objectives:Understand how their image interpretation affects patient care.Skill Objectives:Provide accurate and timely interpretations to decrease length of hospital and emergency department stay, Appropriately notify the referring clinician if there are urgent or unexpected findings and document such without being prompted; andPractice using cost effective use of time and support personnel.Behavior and Attitude Objectives:Advocate for quality patient care in a professional manner, particularly concerning imaging utilization issues.ProfessionalismGoalResidents must demonstrate a commitment to carrying out professional responsibilities and an adherence to ethical principles. Residents are expected to demonstrate:Knowledge Objectives:Understanding of the need for respect for patient privacy and autonomy, andUnderstanding of their responsibility for the patient and the service, including arriving in the reading room promptly each day, promptly returning to the reading room after conferences, completing the work in a timely fashion, and not leaving at the end of the day until all work is complete. If the resident will be away from a service (for time off, meeting, board review, etc.), this must be arranged in advance with the appropriate faculty and/or fellow. Skill Objectives:Sensitivity and responsiveness to a diverse patient population, including but not limited to diversity in gender, age, culture, race, religion, disabilities, and sexual orientation.Behavior and Attitude Objectives: Respect, compassion, integrity, and responsiveness to patient care needs that supersede self-interest.Interpersonal and Communication SkillsGoalResidents must demonstrate interpersonal and communication skills that result in the effective exchange of information and teaming with patients, their families, and professional associates. Residents are expected to:Knowledge Objectives:Know the importance of accurate, timely, and professional communication.Skill Objectives:Produce concise and accurate reports on most examinations, Communicate effectively with physicians, other health professionals, andObtained informed consent with the utmost professionalism.Behavior and Attitude Objectives:Work effectively as a member of the patient care team.IV and V. Rotations 4 and 5 (VA Neuroradiology and Sherman Ave OP facility)Medical Knowledge Knowledge Based Objectives: At the end of the rotation, the resident should be able to:Demonstrate increased ability to recognize pathology and develop a differential diagnosis. Technical Skills: at the end of the rotation, the resident should be able to:Dictate neuroimaging studies after review with the attending neuroradiologist.Screen, protocol, and supervise, with an increasing level of responsibility, most neuroimaging procedures.Demonstrate proficiency in performance and interpretation of lumbar, thoracic and cervical myelograms.Demonstrate proficiency as an assistant angiographer for routine neuroangiography. Decision-Making and Value Judgment Skills: At the end of the rotation, the resident should be able to:Perform, in a responsible manner, pre-angiography patient consultations and post-procedure patient follow-ups, identifying patient conditions that require specific action on the part of the angiography team.Consult, with increasing confidence, with primary care physicians and neurologists/neurosurgeons in regard to most neuroimaging procedures.Patient CareArrive on service promptly, immediately after a.m. conferenceGenerally there are at least two case readouts. These occur in the morning and afternoon, but specific readout times vary, depending on the attending, the specific assignment in neuroradiology, and the workload on any given day. Typically, morning readout begins around 9:00 am, and afternoon readout occurs around 3 pm.Preview all cases before the readout session begins. Be readily available at all times, except when in resident teaching conferences, for consultations with clinicians, for questions about protocols from technologists, and for answering questions from medical students and visitors. Be familiar with all histories, reasons for scans, radiological findings, and changes from previous studies. Formulate a reasonable clinical differential diagnosis to explain the findings on the studies.For each case, the resident should be prepared with the requisition in hand, the history and the reason for the scan. During the interpretation of the study with the attending, the resident may be asked questions about findings, normal anatomy, or differential diagnosis. For the final interpretation, the resident should write down the pertinent findings as the attending has explained them, so that the dictations accurately reflect the discussion by the attending.Following the end of readout, the resident is expected to dictate all the cases that he has gone over with the attending.Intermittently, attendings or housestaff from other clinical services will come into the reading room to ask about their patients’ imaging studies. The Radiology resident is expected to provide a preliminary interpretation to these physicians and to protocol neuroradiology imaging studies with the assistance of fellows and attendings, as needed..Emergency CT scans are intermittently ordered by the Emergency Department. The resident should provide a preliminary report on these cases immediately upon their completion and later document the date, time, and to whom they spoke in the formal, dictated report.During downtimes, it is expected that the resident read about neuroradiology.Practice-Based Learning and ImprovementGoalResidents must demonstrate the ability to investigate and evaluate their care of patients, to appraise and assimilate scientific evidence, and to continuously improve patient care based on constant self-evaluation and lifelong learning. Residents are expected to develop skills and habits to be able to:Knowledge Objectives:Assess CT images for quality and suggest methods of improvement.Skill Objectives:Demonstrate independent self-study using various resources including texts, journals, teaching files, and other resources on the internet, andFacilitate the learning of students and other health care professionals.Behavior and Attitude Objectives:Incorporate formative feedback into daily practice, positively responding to constructive criticism, andFollow-up interesting or difficult cases without prompting and share this information with appropriate faculty and fellow residents.Systems Based PracticeGoalResidents must demonstrate an awareness of, and responsiveness to, the larger context and system of health care, as well as the ability to call effectively on other resources in the system to provide optimal health care. Residents are expected to:Knowledge Objectives:Understand how their image interpretation affects patient care.Skill Objectives:Provide accurate and timely interpretations to decrease length of hospital and emergency department stay, Appropriately notify the referring clinician if there are urgent or unexpected findings and document such without being prompted; andPractice using cost effective use of time and support personnel.Behavior and Attitude Objectives:Advocate for quality patient care in a professional manner, particularly concerning imaging utilization issues.ProfessionalismGoalResidents must demonstrate a commitment to carrying out professional responsibilities and an adherence to ethical principles. Residents are expected to demonstrate:Knowledge Objectives:Understanding of the need for respect for patient privacy and autonomy, andUnderstanding of their responsibility for the patient and the service, including arriving in the reading room promptly each day, promptly returning to the reading room after conferences, completing the work in a timely fashion, and not leaving at the end of the day until all work is complete. If the resident will be away from a service (for time off, meeting, board review, etc.), this must be arranged in advance with the appropriate faculty and/or fellow. Skill Objectives:Sensitivity and responsiveness to a diverse patient population, including but not limited to diversity in gender, age, culture, race, religion, disabilities, and sexual orientation.Behavior and Attitude Objectives: Respect, compassion, integrity, and responsiveness to patient care needs that supersede self-interest.Interpersonal and Communication SkillsGoalResidents must demonstrate interpersonal and communication skills that result in the effective exchange of information and teaming with patients, their families, and professional associates. Residents are expected to:Knowledge Objectives:Know the importance of accurate, timely, and professional communication.Skill Objectives:Produce concise and accurate reports on most examinations, Communicate effectively with physicians, other health professionals, andObtained informed consent with the utmost professionalism.Behavior and Attitude Objectives:Work effectively as a member of the patient care team.Where to goGenerally, the radiology resident reports to the inpatient reading room in Stanford Hospital adjacent to the MRI Suite. Exceptions occur when the resident is assigned to pediatric neuroradiology, for which he reports to the MRI Reading Room in the basement of LPCH; when the resident is assigned to outpatient neuroradiology, for which he reports to the Neuroradiology Reading room at Sherman Avenue; and when the resident is assigned to VA Neuroradiology, for which he reports to the Diagnostic Radiology Center at the Palo Alto VA Hospital. If there is no faculty member covering VA Neuro, the resident should report to the outpatient neuroimaging reading room at Sherman Ave.All rotations start following morning conference at 8:30 am. Inpatient Reading Room: Stanford Hospital HD001Outpatient Reading Room: Sherman Avenue Imaging centerLPCH Reading Room: Radiology /BasementCath-angio Room 8: Second floor – Cath-angioStudies performed:1. CT scans of the brain, spine, and head and neck, including CT angiography2. MRI scans of the brain, spine, and head and neck, including MR angiography3. Myelography4. Cerebral angiography5. CT-guided or MR-guided biopsyPreparing Cases Except for occasional myelograms and angiograms, all cases are interpreted on a PACS monitor. All cases are interpreted with any relevant previous studies for comparison. Residents are expected to have ascertained the clinical history and reason for the study. It is also expected that the resident preview all cases and comparisons prior to readout with the attending.Resident Conference Schedule/FormatTitleDayTimeLocationNeuro case conferenceTuesday7:30 AMLucasNeuro core conferenceMondayNoonLucasWORK/EDUCATIONAL/INTERDISCIPINARY CONFERENCESStanford HospitalDAYTIMEFREQUENCYTITLE/DEPARTMENTVENUEMonday7:30 a.m.WeeklyPediatric Neuro-Oncology ConferenceLPCHS Conf. RoomWednesday4:00 p.m.WeeklyNeurology Case ConferenceH3150Thursday10:00 a.m.WeeklyENT Tumor Staging ConferenceCancer CenterFriday12:00 noonWeeklyNeuro-oncology ConferenceH3150VA HospitalWednesday8:30 a.m.WeeklyNeurosurgery Case ConferenceDRC Reading RoomThursday8:30 a.m.WeeklySpinal Cord ConferenceSpinal Cord Conference RoomFriday8:30 a.m.WeeklyRehab. Med. Case Conference DRC Reading RoomMethod of Assessment of Performance:Written evaluation of resident by responsible faculty members monthlyVerbal feedback to resident by faculty ACR In-Training Service Exam annuallyRecommended Comprehensive and Reference ReadingMagnetic Resonance Imaging of the Brain and Spine; SW Atlas, editor, 3rd edition, Lippincott Williams and Wilkins, 2002.Head and Neck Imaging; P. Som and H. Curtin, editors, 4th edition, Mosby, 2002.Pediatric Neuroimaging; J. Barkovich, editor; 3rd edition, Williams and Wilkins, 1999.4. Teaching atlas of brain imaging / Nancy J. Fischbein, Thieme, 2000. On reserve at LaneAdditional readings, with a focus on a comprehensive introduction to neuroradiology as well as excellent case reviews:Neuroradiology: The Requisites by Robert Grossman and David YousemMuch less inclusive than the Diagnostic Imaging series (Amirsys, see below), with fewer images and far fewer pages. It is however an efficient introduction to neuroradiology. The introductory chapters on Neuroradiology in the Brant and Helms textbook are also a useful introduction.Diagnostic Imaging: Brain, by Ann Osborn et alAn extensive case review with excellent illustrationsDiagnostic Imaging: Head and Neck, by Ric Harnsberger et alAnother entry in the outstanding Amirsys series of case-based reviewsDiagnostic Imaging: Spine, by Jeffrey Ross et alThe spine entry in the Amirsys seriesThe Neuroradiology attendings are also happy to discuss additional reading options for residents and to provide materials from their own personal libraries for resident use.Appendix:Neuroradiology curriculum in RadPrimerRADPRIMER HEAD & NECKSeqNamePre-call???????1AOM with Complication???2Fractures, Trans-facial (LeFort)???3Suppurative Lymph Nodes???4Abscess, Retropharyngeal Space???5Abscess, Subperiosteal, Orbit???6Abscess, Tonsillar/Peritonsillar???7Bell Palsy???8Cellulitis, Orbit???9Foreign Body, Esophagus???10Foreign Body, Trachea???11Fracture, Inferior Orbital Blowout???12Fracture, Medial Orbital Blowout???13Fracture, Skull Base???14Fracture, Naso-orbital-ethmoidal???15Fracture, Zygomaticomaxillary Complex???16Fractures, Temporal Bone???17Fungal Sinusitis, Invasive???18Optic Neuritis???19Ossicular Dislocation???20Parotitis, Acute???21Retinal Detachment???22Sialadenitis, Sublingual Gland???23Sialadenitis, Submandibular Gland???24Supraglottitis???25Fracture, General???26Thrombosis, Jugular Vein, Neck???27Trauma, General???28Trauma, Larynx???29Trauma, OrbitHead and Neck????Cerebellopontine Angle-Internal Auditory Canal??Congenital????30Epidermoid Cyst, CPA-IAC???31Arachnoid Cyst, CPA-IAC???32Neurofibromatosis Type 2, CPA-IAC???33Sarcoidosis, CPA-IAC??Inflammation???Vascular?????34Aneurysm, CPA-IAC???35Superficial Siderosis, CPA-IAC??Neoplasm, Benign???36Vestibular Schwannoma???37Meningioma, CPA-IAC??Neoplasm, Malignant???38Metastases, CPA-IAC?Temporal Bone????Congenital/Genetic???39External Ear Dysplasia, Congenital???40Congenital Cholesteatoma, Middle Ear???41Congenital Cholesteatoma, Petrous Apex???42Oval Window Atresia???43Internal Carotid Artery, Aberrant???44Labyrinthine Aplasia???45Large Vestibular Aqueduct (IP-II)??Infection?????46Necrotizing External Otitis???47Acute Otomastoiditis with Abscess???48Apical Petrositis??Inflammation????49Cholesteatoma, EAC???50Chronic Otomastoiditis with Tympanosclerosis???51Acquired Cholesteatoma, Pars Flaccida???52Labyrinthine Ossificans???53Cholesterol Granuloma, Petrous Apex???54Trapped Fluid, Petrous Apex??Neoplasm, Benign???55Paraganglioma, Glomus Tympanicum???56Venous Malformation (Hemangioma), Facial Nerve, T-Bone???57Schwannoma, Facial Nerve, T-Bone???58Schwannoma, Intralabyrinthine???59Endolymphatic Sac Tumor??Neoplasm, Metastatic???60Perineural Parotid Malignancy, T-Bone??Tumor-Like Lesions???61Fibrous Dysplasia, T-Bone???62Paget Disease, T-Bone???63Langerhans Cell Histiocytosis, T-Bone??Trauma????Miscellaneous/Idiopathic???64Semicircular Canal Dehiscence???65Fenestral Otosclerosis???66Cochlear Otosclerosis?Skull Base????Normal Variant???67Jugular Bulb, Dehiscent??Vascular?????68Dural Sinus Thrombosis, Skull Base???69Dural A-V Fistula, Skull Base??Neoplasm, Benign???70Paraganglioma, Glomus Jugulare???71Schwannoma, Jugular Foramen???72Meningioma, Jugular Foramen???73Meningioma, Skull Base???74Schwannoma, Trigeminal, Skull Base??Neoplasm, Malignant???75Chordoma, Clivus???76Chondrosarcoma, Skull Base??Tumor-Like Lesions???77Fibrous Dysplasia, Skull Base???78Paget Disease, Skull Base???79Langerhans Cell Histiocytosis, Skull Base??Trauma???Orbit?????Congenital/Genetic???80Coloboma???81Persistent Hyperplastic Primary Vitreous???82Dermoid and Epidermoid, Orbit???83Neurofibromatosis 1, Orbit???84Lymphatic Malformation, Orbit???85Orbital Cavernous Hemangioma???86Venous Varix, Orbit??Infection????Inflammation???Degenerative????87Phthisis Bulbi??Neoplasm, Benign???88Infantile Hemangioma, Orbit???89Meningioma, Optic Nerve Sheath???90Benign Mixed Tumor, Lacrimal??Neoplasm, Malignant???91Retinoblastoma???92Melanoma, Ocular???93Glioma, Optic Pathway???94Adenoid Cystic Carcinoma, Lacrimal???95Lymphoproliferative Lesions, Orbit??Tumor-Like Lesions???96Idiopathic Inflammatory Pseudotumor, Orbit??Trauma?????97Trauma, Ocular??Miscellaneous/Idiopathic???98Thyroid Ophthalmopathy?Nose & Sinus????Congenital/Genetic???99Choanal Atresia, Nasal???100Nasal Glioma???101Nasal Dermal Sinus???102Pyriform Aperture Stenosis, Congenital Nasal??Infection?????103Rhinosinusitis, Acute???104Rhinosinusitis, Complications???105Fungal Sinusitis, Mycetoma??Inflammation????106Polyposis, Sinonasal???107Polyp, Solitary, Sinonasal???108Mucocele, Sinonasal???109Fungal Sinusitis, Allergic???110Wegener Granulomatosis, Sinonasal??Neoplasm, Benign???111Juvenile Angiofibroma???112Inverted Papilloma, Sinonasal???113Osteoma, Sinonasal???114Ossifying Fibroma, Sinonasal??Neoplasm, Malignant???115SCCa, Sinonasal???116Esthesioneuroblastoma???117Non-Hodgkin Lymphoma, Sinonasal???118Undifferentiated Carcinoma, Sinonasal??Tumor-Like Lesions???119Fibrous Dysplasia, Sinonasal?Facial Bones????Trauma???Suprahyoid & Infrahyoid Neck??Pharyngeal Mucosal Space???120Tornwaldt Cyst???121Retention Cyst, PMS???122Tonsillar Inflammation???123Nasopharyngeal Carcinoma???124SCCa, Lingual Tonsil???125SCCa, Lingual Tonsil???126SCCa, Palatine Tonsil???127Non-Hodgkin Lymphoma, PMS??Lymph Node Diseases???128Tuberculosis, Lymph Nodes???129Reactive Lymph Nodes???130Non-Hodgkin Lymphoma, Lymph Nodes???131SCCa, Nodes???132Differentiated Thyroid Carcinoma, Nodal??Hypopharynx & Larynx???133Epiglottitis, Child???134Croup???135Laryngocele???136Lateral Hypopharyngeal Pouch???137SCCa, Pyriform Sinus???138SCCa, Larynx, Supraglottic???139SCCa, Larynx, Glottic???140SCCa, Larynx, Subglottic???141Chondrosarcoma, Larynx???142Vocal Cord Paralysis??Oral Cavity????143Lingual Thyroid???144Dermoid and Epidermoid, Oral Cavity???145Abscess, Oral Cavity???146Ranula???147Benign Mixed Tumor, Submandibular Gland???148Carcinoma, Submandibular Gland???149SCCa, Oral Tongue???150SCCa, Floor of Mouth???151SCCa, Retromolar Trigone???152Motor Denervation CN12??Mandible/Maxilla???153Cyst, Dentigerous (Follicular)???154Osteomyelitis, Mandible-Maxilla???155Ameloblastoma???156Odontogenic Keratocyst???157Osteosarcoma, Mandible-Maxilla??Temporomandibular Joint??Masticator Space???158Abscess, Masticator Space???159Schwannoma, CNV3, MS???160Chondrosarcoma, Masticator Space???161Sarcoma, Other, Masticator Space???162Perineural Tumor, CNV3, MS???163Motor Denervation CNV3??Paratid Space????164Benign Lymphoepithelial Lesions-HIV???165Sjogren Syndrome, Parotid???166Parotid Duct Obstruction, Calculus???167Benign Mixed Tumor, Parotid???168Warthin Tumor???169Mucoepidermoid Carcinoma, Parotid???170Adenoid Cystic Carcinoma, Parotid???171Perineural Tumor, CN7, PS??Carotid Space????172Dissection, Carotid Artery, Neck???173Fibromuscular Dysplasia, Carotid, Neck???174Paraganglioma, Glomus Vagale???175Paraganglioma, Carotid Body???176Schwannoma, Carotid Space???177Neurofibroma, Carotid Space??Retropharyngeal Space???178Suppurative Adenopathy, RPS???179Reactive Adenopathy, RPS???180SCCa, Nodal, RPS??Perivertebral Space???181Infection, Perivertebral Space???182Longus Colli Tendonitis, Acute Calcific???183Schwannoma, Brachial Plexus, PVS???184Metastasis, Vertebral Body, PVS??Visceral Space???185Thyroiditis, Chronic Lymphocytic (Hashimoto)???186Multinodular Goiter???187Differentiated Carcinoma, Thyroid???188Anaplastic Carcinoma, Thyroid???189Non-Hodgkin Lymphoma, Thyroid???190Diverticulum, Esophagopharyngeal (Zenker)??Posterior Cervical Space???191SCCa, Spinal Accessory Node???192Non-Hodgkin Lymphoma in Spinal Accessory Node?Trans-Spatial or Multi-Spatial & Peds??Congenital????1932nd Branchial Cleft Cyst???194Thyroglossal Duct Cyst???195Lymphatic Malformation???196Venous Vascular Malformation???197Dermoid and Epidermoid??Neoplasm, Benign???198Infantile Hemangioma???199Hemangiopericytoma???200Plexiform Neurofibroma??Neoplasm, Malignant???201Rhabdomyosarcoma??Tumor-Like Lesion???202Fibromatosis of H&N??Trauma?????203Fibromatosis ColliRADPRIMER SPINESeqNamePre-call???????1Anterior Compression Fracture, Thoracic???2Atlanto-Occipital Dislocation???3Intervertebral Disc Herniation, Lumbar???4Epidural Paravertebral Abscess???5Spondylolisthesis???6Chance Fracture???7Traumatic Disc Herniation???8Hyperflexion-Rotation Injury, Cervical???9Hematoma, Epidural-Subdural???10Hematoma, Subdural, Traumatic???11Hyperextension Injury, Cervical???12Hyperflexion Injury, Cervical???13Jefferson C1 Fracture???14Ligamentous Injury???15Occipital Condyle Fracture???16Odontoid C2 FractureSpine?????Congenital and Genetic Disorders??Congenital????17Chiari II Malformation???18Lipoma, Spinal???19Dermoid Cysts???20Epidermoid Cysts???21Tethered Spinal Cord???22Caudal Regression Syndrome???23Meningocele, Anterior Sacral???24Teratoma, Sacrococcygeal???25Diastematomyelia???26Klippel-Feil Spectrum???27Os Odontoideum???28Chiari I Malformation???29Neurofibromatosis Type 1???30Neurofibromatosis Type 2???31Achondroplasia???32Mucopolysaccharidoses???33Sickle Cell???34Osteogenesis Imperfecta???35Thanatophoric Dwarfism???36Coccygeal Dimple, Simple???37Myelomeningocele???38Lipomyelomeningocele???39Failure of Vertebral Formation???40Partial Vertebral Duplication???41Vertebral Segmentation Failure???42Incomplete Fusion, Posterior Element???43Neurenteric Cyst??Scoliosis?????44Scoliosis?Trauma?????Vertebral Column, Discs, and Paraspinal Muscle???45Burst Fracture, C2???46Hangman's C2 Fracture???47Posterior Column Injury, Cervical???48Insufficiency Fracture, Sacral???49Compression Fractures??Cord, Dura, and Vessels???50Dissection, Vertebral Artery???51Dissection, Carotid Artery???52SCIWORA???53Post-traumatic Syrinx???54Spinal Cord Injury???55Spinal Cord Herniation?Degenerative Disease and Arthritides??Degenerative Diseases???56Intervertebral Disc Extrusion, Foraminal???57Facet Joint Synovial Cyst???58DISH???59OPLL???60Periodontoid Pseudotumor???61Spondylosis, Cervical???62Disc Bulge???63Intervertebral Disc Herniation, Cervical???64Intervertebral Disc Herniation, Thoracic???65Scheuermann Disease???66Stenosis, Acquired Spinal, Lumbar??Spondylolisthesis and Spondylolysis???67Spondylolysis??Inflammatory, Crystalline and Miscellaneous Arthritides???68Rheumatoid Arthritis, Adult???69Juvenile Idiopathic Arthritis???70Spondyloarthropathy, Seronegative???71Gout???72CPPD???73Neurogenic (Charcot) Arthropathy???74Ankylosing Spondylitis?Infection and Inflammatory Disorders??Infections????75Pyogenic Osteomyelitis, Spine???76Granulomatous Osteomyelitis, Spine???77Viral Myelitis???78Abscess/Myelitis, Spinal Cord???79Meningitis, Spinal??Inflammatory & Autoimmune???80Guillain-Barre Syndrome???81Multiple Sclerosis, Spinal Cord???82Neuromyelitis Optica???83Degeneration, Subacute Combined???84ADEM, Spinal Cord?Neoplasms, Cysts, & Other Masses??Neoplasms????85Metastases, Blastic Osseous???86Metastases, Lytic Osseous???87Osteoid Osteoma???88Osteoblastoma???89Aneurysmal Bone Cyst???90Giant Cell Tumor???91Osteochondroma???92Chondrosarcoma???93Osteosarcoma???94Chordoma???95Ewing Sarcoma???96Plasmacytoma???97Multiple Myeloma???98Langerhans Cell Histiocytosis???99Meningioma???100Schwannoma???101Neurofibroma???102Astrocytoma, Spinal Cord???103Ependymoma, Cellular, Spinal Cord???104Ependymoma, Myxopapillary, Spinal Cord???105Hemangioma???106Lymphoma???107Leukemia???108Malignant Nerve Sheath Tumors???109Metastases, CSF Disseminated???110Paraganglioma???111Hemangioblastoma, Spinal Cord??Non-Neoplastic Cysts and Tumor Mimics???112Arachnoid Cyst???113Fibrous Dysplasia???114Perineural Root Sleeve Cyst?Vascular and Systemic Disorders??Vascular Lesions???115Type I DAVF???116Cavernous Malformation, Spinal Cord???117Spinal Cord Infarction???118Type II AVM???119Type III AVM???120Type IV AVF??Spinal Manifestations of Systemic Diseases???121Paget Disease???122Renal Osteodystrophy???123Extramedullary Hematopoiesis?Peripheral Nerve and Plexus??Plexus & Peripheral Nerve Lesions???124Brachial Plexus Traction Injury?Spine Post-procedural Imaging??Post-Procedural Imaging and Complications???125Arachnoiditis, Lumbar???126Peridural Fibrosis???127Intervertebral Disc Herniation, Recurrent???128Post-Operative InfectionPediatric Neuroradiology Brain????Congenital Malformations??195Cavernous Malformation??196Sturge-Weber Syndrome??197The Dandy Walker Malformation??198Callosal Dysgenesis??199Schizencephaly??200Chiari 2??201Tuberous Sclerosis??202Sturge-Weber Syndrome??203Neurofibromatosis Type 1??204The Holoprosencephalies??205Hemimegalencephaly??206Lissencephaly?Cysts and Neoplasms??207Colloid Cyst??208Juvenile Pilocytic Astrocytoma??209Craniopharyngioma??210Choroid Plexus Tumors?Traumatic and Vascular Lesions??211Diffuse Cerebral Edema??212Periventricular Leukomalacia??213Vein of Galen Aneurysmal Malformation??214Cavernous Malformation?Metabolic, Infectious, and Inflammatory Disorders??215TORCH Infections, Overview??216Acute EncephalitisSpine????Congenital Spinal Malformations??217Caudal Regression Syndrome??218Tethered Spinal Cord?Neoplasms???219Sacrococcygeal Teratoma?Inflammatory Lesions?Trauma????220Chance FractureHead and Neck???Nasal and Oral Cavity??221Choanal Atresia??222Congenital Nasal Pyriform Aperture Stenosis??223Nasolacrimal Duct Mucocele??224Juvenile Nasopharyngeal Angiofibroma??225Lingual Thyroid?Orbit????226Retinoblastoma?Temporal Bone?Syndromes with Craniofacial Involvement Neck Masses??227Thyroglossal Duct Cyst??2282nd Branchial Cleft Anomaly??229Acute Parotitis??230Infantile Hemangioma??231Rhabdomyosarcoma??232Fibromatosis Colli ................
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