Locate an ACVR Radiologist or Radiation Oncologist in your area.
ACVR News
Calendar
June 08, 2013
Intermediate Abdominal, Ft. Collins, CO (Universal)
June 18, 2013
Echocardiography, Arlington, TX (Sound-Eklin)
June 22, 2013
Scanning Lab - Abdominal, Bedford Hills, NY (Universal)
2012 Radiology Exam - Spec Proced/NM Case 1
Signalment: 9-year old MC Pug
History: 12 month history of progressive hind limb ataxia.
Imaging Studies: 3 lateral views and 3 VD views of a thoracolumbar myelogram were provided to the candidate.
Lateral Myelogram
VD Myelogram
Observations
- Lateral views: Attenuation of both contrast columns over vertebral body T12. Bulbous widening of dorsal contrast column dorsal to caudal T12 – T13 vertebral bodies. (Mild dorsal deviation of ventral contrast column over several intervertebral disc spaces).
- Ventrodorsal views: Bulbous widening (“teardrop shape”) of left contrast column over caudal half of T12 vertebra; attenuation of contrast columns cranially. Spinal cord compressed and displaced to the right.
Synthesis
- Subarachnoid cyst/diverticulum at T12 (left-sided and dorsal) resulting in spinal cord compression; (incidental multifocal disc bulges).
Case Management
- Surgery to decompress spinal cord (Candidates did not lose points if additional imaging such as CT was recommended prior to surgery, but ultimate recommendation should have been surgery).
Challenges
- Inability to determine location of lesion (intramedullary vs. intradural-extramedullary vs. extradural).
- Inability to recognize that lesion represents dilation of subarachnoid space rather than an intradural-extramedullary mass.
- Failure to recommend surgical decompression due to compressive nature of the lesion.