Chirag PatelSunnybrook Health Sciences Centre

University of Toronto

MISTAKES WE ALL MAKE – ABDOMINAL IMAGING

DECLARATION

• No financial disclosures or affiliations with commercial organisations

• No discussion of investigational or “off-label” use of medical devices, products or pharmaceuticals

OBJECTIVES

At the end of this session, participants should be able to:

 

• Identify common blind spots in abdomen pelvic ultrasound, CT and MRI. (CanMEDS Roles: Scholar, Medical Expert)

• Recognise and avoid common misinterpretations in abdominal imaging. (CanMEDS Roles: Scholar, Medical Expert)

• Develop personal strategies for avoiding common mistakes. (CanMEDS Roles: Scholar, Medical Expert)

“From the errors of others, a wise man corrects his own”

- Publilius Syrus -

CASES

CASE 1

April 2012

April 2012

May 2012

Colonoscopy

Adenocarcinoma

Low Anterior

ResectionMay 2012

Sept 2012

Sept 2012

Sept 2012

Feb 2013

Feb 2013

Feb 2013

Jun 2013 Oct 2013

Jun 2013 Oct 2013

Sep 2012

Jun 2013Oct 2013

Local Recurrence – Rectal Ca – Unresectable

T1wFS - Gad Nov 2013

CASE 2

CT Angiogram

Geographic focal fat

CTA – Liver windows Dec 2014

Dec 2014

Mar 2015CT – PV phase

Cholangiocarcinoma - Unresectable

Mar 2015

CASE 3

Arterial

Arterial Coronal

Arterial Axial

Mycotic aneurysms

CASE 4

T2w

Pertioneal Carcinomatosis

STRATEGIES

M U L T I -

R E F O R M A T S

P L A N A R

Metastatic Colorectal Ca – Isolated Sacral Met

O L D I M A G I N G

June 2014T1-FS Gad

Aug 2014

Post-op

Mar 2015

Dec 2014

Oct 2014

Apr 2015

T1wFS Gad

Recurrent Penile Ca

W I N D O W I N G

W:160 L: 60

W:400 L: 40

Soft-tissue windows Liver windows

Local Recurrence – Rectal CaLocal Recurrence – Penile Ca

W:400 L: 40

W:160 L: 60

Perip

hery

CT ScoutMR Scout

Multiple PEs

CTPA

Invasive Breast Ca

US

Lymphoma

MRI

Develop imaging list

Sunnybrook Discrepancy Meeting

You missed a 2mm peritoneal nodule!!!

chirag.patel@sunnybrook.ca

Dr Caitlin McGregor

Dr Paul Hamilton

THANK YOU