Gopal Punjabi

Radiologist @HennepinHC. All views & opinions my own, nothing to do with employer. I share my experience with Spectral CT, 3D CT, learning cases.

[Gopal Punjabi @CtSpectral]

Clinical cases will not have patient identifying info.
Timing may be recent or years ago.
Gender, age, clinical details, diagnosis may be changed.
Respect patients always.
Cases all based on experience, but do not assume actual people or recently seen.
Thanks, @DocPNW!

[Ana Villanueva @AnaVillanuevaCa]

Attention to #spectral images! @CtSpectral

⚠️ The endobronchial content is enhancing --> solid!

1️⃣Virtual non-contrast (VNC)= 39HU
2️⃣Conventional= 71UH (>20UH compared to VNC)
3️⃣ Iodine density =1.26 mg/ml

[Gopal Punjabi @CtSpectral]

@danatsouza @BrighamRad @FOAMrad @RCObsGyn @acog @SAR_RFS @futureradres @CBRadiologia Call GYN!

[Gopal Punjabi @CtSpectral]

@mspairport Line at immigration about 1 hour now. 3 agents working. I have been here for 30 minutes and barely moved halfway. Families with kids and older folks here.

[Adrià Roset Altadill @ARosetAltadill]

#12 The Many Faces of Organizing Pneumonia (OP) 🎭

1⃣ OP is a term used to describe a nonspecific response to lung injury (infection, drugs, RT, autoimmunity, cryptogenic...) 🫁

Radiological features of OP are wide: consolidation, GG, nodules & other more specific features ➡️🧵

[Gopal Punjabi @CtSpectral]

@mahjabeenmahmoo I work on the Philips platform

[Gopal Punjabi @CtSpectral]

Mimic of LV "ischemia" on CT: LV anterior/apical hypodensity from fatty metaplasia, NOT from decreased enhancement.
Easily resolved with #SpectralCT: Abnormal area is fat density on virtual non-contrast.

[Gopal Punjabi @CtSpectral]

@northwoods1980 Yes, confirmed on echo.

[Gopal Punjabi @CtSpectral]

Small LV thrombus, much easier to see on iodine map and overlay with #SpectralCT.
Can be hard to see on echo. #radres, you may save a life when you call this on CT!

[Gopal Punjabi @CtSpectral]

Acute MI on #SpectralCT. Much easier to see on low-keV image and iodine overlay.
#FOAMed #radres

[Gopal Punjabi @CtSpectral]

Nondisplaced left transverse process fractures on 3D CT of the lumbar spine.
#FOAMed

[Jonathan Chung, MD @jonherochung]

For anyone who wants to view this offline, here is a pdf copy. I took out some of the animated images, so there is a slide or two that is incomplete, but nearly complete. https://t.co/slJUlhgyeS

[Jonathan Chung, MD @jonherochung]

Excited to share that our educational exhibit on the current state of interstitial lung disease imaging was awarded a MAGNA CUM LAUDE award by @RSNA. Please come check it out. @UChicagoRADS @UCSDRadRes @ChestXrayDoc @UWiscRadiology @CURadiology @UKyRadiology @OHSURadiology

[Gopal Punjabi @CtSpectral]

Rounded atelectasis can occur anywhere!
Indeterminate RUL lung nodule, with pleural thickening (red arrows). Oblique parasagittal recon nicely shows "comet-tail" sign.
On #SpectralCT, characteristic intense iodine uptake.
Stable on follow up for several years. #radres #FOAMed

[Waleed Abdellatif, MD,MS,MSc @EmergRad]

A very informative and comprehensive review of “Multi-Energy CT of acute abdominal Emergencies” by Dr. Gopal Punjabi

@ERadSociety #ASER23 #ERad #Radiology #Radres

[Dr. Glaucomflecken @DGlaucomflecken]

Contrast induced nephropathy

[Gopal Punjabi @CtSpectral]

Anterior column fracture of the acetabulum on 3D CT.
Classification of acetabular fractures so much easier on 3D CT.
#FOAMed

[Gopal Punjabi @CtSpectral]

Partial duplication of ureter on 3D CT urogram.
#FOAMed

[Gopal Punjabi @CtSpectral]

@AnaVillanuevaCa @EsgarSociety @nicoalmeidaa Congratulations on a job well done!

[Ana Villanueva @AnaVillanuevaCa]

Thank you @EsgarSociety for the Magna Cum Laude award of this #Esgar2023.

This award is not only mine but also from my colleagues Dra.Canales, Dra. Garcia Latorre and @nicoalmeidaa and great collaboration of @CtSpectral

[Gopal Punjabi @CtSpectral]

Adrenal nodule?
Tiny speck of air shows up on lung windows (red arrow), confirming this is a gastric fundal diverticulum, likely congenital.
More common than literature suggests, easily misdiagnosed as adrenal lesion.
#FOAMed #radres