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Gastrointestinal > 03.01 Radiology: Imaging of Common GI Disorders > Flashcards

03.01 Radiology: Imaging of Common GI Disorders Flashcards

1
Q

Accumulation of modified opacities throughout the segments of the colon which represent fecal material

A

Mottled densities

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2
Q

Abundant mottled densities

Presents with constipation

A

Fecal retention/stasis

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3
Q

Abundance of gas in small and large bowels
Generalized gas-filled distention
Impaired propulsion of GI contents > hypomotility of GI tract in the absence of mechanical bowel obstruction > accumulation of gas in the bowels > distention

A

Ileus/hypomotility

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4
Q

Bowel gas has not resolved after more than 3 days

A

Paralytic ileus

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5
Q

Collection of gas in one area
Focal inflammation in a given region
Inflammation at the epigastric region or RLQ

A

Sentinel loop

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6
Q

in large bowel obstruction, the colon is gas filled and dilated down to the level of sigmoid colon
Maybe diverticular stricture

A

Cut-off sign

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7
Q

Intra-abdominal inflammation, such as with pancreatitis, can lead to a localized ileus

A

Sentinel loop

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8
Q

Closed loop obstructions
Abundance of gas-filled bowel loops in the center of the abdomen
Valvulae conniventes/plicae circulares are evident
Intermittent abdominal pain, vomiting, RUQ mass

A

Coiled spring

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9
Q

Coiled spring pattern: without contrast

A

May represent obstruction

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10
Q

Coiled spring pattern with contrast

A

Intussusception

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11
Q

Small-bowel obstruction

Demonstrated only in upright position

A

Air-fluid leveling

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12
Q

Small bowel obstruction
Represents small pockets of trapped air within the superior walls of the bowel in the valvulae conniventes
Increased peristaltic activity
Ovoid appearance due to meniscal effect of fluid between the valvulae conniventes

A

String of pearls

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13
Q

Small bowel obstruction
Lucent areas that appear like vertical lines
Secondary to increased peristaltic activity

A

Stretch/slit sign

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14
Q

Obstruction at the duodenum

Stomach distention

A

Single bubble sign

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15
Q

Maximum normal diameter of SI

A

30mm

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16
Q

Maximum normal diameter of LI

A

50-60mm

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17
Q

Maximum normal diameter of cecum

A

90mm

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18
Q

Most common pathology presenting with a single bubble sign
Palpable lesion in the epigastric area among newborns
Non-bilous vomiting

A

Hypertrophic pyloric stenosis

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19
Q

Encountered when 2 bowel loops are involved
Obstuction beyond the stomach but probably at/around the area of the duodenum
Possible etiologies: atresia, obstuction, extrinsic compression by the region adjacent to the duodenum, periduodenal anomaly, anything that involves the distal portion of the duodenum
Presents with bilious vomiting

A

Double bubble sign

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20
Q

Jejunal obstruction
Encountered when there are 3 loops involved
Signify a possible obstruction on the jejunum

A

Triple bubble sign

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21
Q

Volvulus (twisting of loop of intestine around its mesenteric attachment)
Vomiting, alternating diarrhea and constipation

A

Coffee bean sign

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22
Q

Volvulus at right apex

A

Sigmoid volvulus

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23
Q

Volvulus at left apex

A

Cecal volvulus

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24
Q

Complication of intestinal malrotation
Present with bilious vomiting
Common among newborns

A

Midgut volvulus

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25
Q

Inflammatory focus
Secondary to a collection of abscess or an inflammatory focus
Normal, not distended gas filled bubble loops except at sudden interruption of air
Cancer, inflammation

A

Colon cut-off sign

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26
Q

Bowel loops in R hemiabdomen
Prominent liver shadow
Splenic flexuer is much more superior to hepatic flexure

A

Hematomegaly

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27
Q

Chest films are sometimes needed to confirm the possibility of a perforated gas-containing organ
Crescent shaped
Trauma, iatrogenic perforation, GI tract disease, inflammatory conditions

A

Pneumoperitoneum

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28
Q

Normal air under left hemidiaphragm (stomach air or gastric bubble)

A

Magenblase

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29
Q

Collection of air follows the configuration of bowel loops

Presence of haustrations, usually present with no symptoms, incidental finding

A

Chilaiditi’s sign

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30
Q

Chilaiditi’s sign + pain
One of the causes of pseudoperitoneum and occurs when bowel gas is interposed between the liver and the hemidiaphragm resulting in pain

A

Chilaiditi’s syndrome

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31
Q 
Lucent foci within the left hemithorax
Hernias represent gas containing bowel loops in the chest
Presence of borborygmi
Tachypnea
US
A

Congenital diaphragmatic hernia

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32
Q

More common congenital diaphragmatic hernia
Left hemithorax
Defect in lateral and posterior sides

A

Bochdalek

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33
Q

Less common congenital diaphragmatic hernia
Right hemithorax
Defect in anterior (at sternocostal angle)

A

Morgagnie

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34
Q

Collection of calcifications in the mid-epigastric region at the level of L2
Further confirm by other imaging modalities
Round, hyperdense, middle portion of abdomen
Chronic pancreatitis, neoplasm, sub-intraparenchymal hemorrhage, hyperparathyroidism, cystic fibrosis

A

Pancreatic calcifications

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35
Q

Fat, forty, fecund, female

(+) Murphy’s sign and Collin’s sign

A

Cholelithiasis

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36
Q

Cholelithiasis: gold standard, cheap and readily available

A

US

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37
Q

Cholelithiasis: gives good accuracy and can detect different types of stones at different locations compared to ultrasound

A

CT sonogram

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38
Q

Created by stones in the gallbladder that are right beside each other

A

Mercedes Benz sign

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39
Q

Press the inferior portion of the liver, and if there is inspiratory arrest, this is positive

A

Murphy’s sign

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40
Q

Ask the patient to place their hand on back, thumbs up

Radiation of pain to inferior scapula

A

Collin’s sign

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41
Q

Filling defects at the distal segments of the esophagus > represents erosion secondary to reflux
X-ray with contrast
Caused by corrosion, infection, radiation therapy

A

Esophageal atresia

42
Q

EA is confirmed by

A

Barium enema

43
Q

Achalasia
Abnormal distension of entire esophagus then abrupt tapering distally
Failure of lower esophageal sphincter to relax
Possible defect: auerbach’s plexus, vagus nerve, dorsal motor nucleus of the vagus nerve

A

Bird’s beak/rat’s tail sign

44
Q

Complication of achalasia

Secondary to chronic esophageal irritation

A

Esophageal cancer

45
Q

Diagnosing using esophagogram

Outpouching containing contrast

A

Diverticulum

46
Q

Proximal

Between cricopharyngeus and inferior pharyngeal sphincter muscles

A

Zenker’s diverticulum

47
Q

Distal

Above the lower esophageal sphincter, more frequently on the right

A

Epiphrenic diverticulum

48
Q

Linitis plastica
Persistently narrow, not distensible bowel walls
May indicate serous adenocarcinoma

A

Old leather water bottle

49
Q

Intramural hemorrhage
Secondary to scleroderma, malabsorptive gastroenteropathies, vasculitis, trauma, coagulation defects, ischemia
Asymmetric atrophic longitudinal layer

A

Stack of coins

50
Q

Colon constriction
Abnormally constricted segment of sigmoid colon
Not distensible despite inflation with air
Demonstrated with air
May be due to mechanical small bowel obstruction, foreign bodies, tumors, chrohn’s disease, ulcerative colitits, adhesions, herniais, volvulus

A

Apple core deformity

51
Q

Contrast containing segment of the bowel loop that appears narrow or stenotic
Caused by Crohn’s disease, radiation enteritis, lymphoma, endometriosis, eosinophilic gastroenteritis, drug-induced, ulcerative colitis

A

Bowel stenosis

52
Q

Intermittent abdominal pain, previous travel to a developing country
Coral look > valvulae conniventes
Commonly at the jejunal segment

A

Ascariasis

53
Q

Gas-filled distension of bowels
Distal portion of intestinal tract
Absence of ganglionic cells in the distal colon or functional obstruction

A

Hirschprung disease/aganglionic megacolon

54
Q

Seemingly normal
Cecum is not in its normal position
Normal embryological process of bowel fixation and development is interrupted

A

Malrotation

55
Q

Acquired herniations of the mucosa and portions of the submucosa through the muscularis propria
Round opacities outline the colon walls

A

Diverticulosis

56
Q

Iodinated contrast

A

Hepatobiliary tree

57
Q

Abnormally distended commno bile duct + dilated radicles

5 types

A

Choledochal cyst

58
Q

Most common type

Fusiform dilatation of extrahepatic duct

A

Type 1

59
Q

Diverticulum along the common bile duct

A

Type 2

60
Q

Choledochocele

Outpouching inside the duodenum

A

Type 3

61
Q

Intrahepatic and extrahepatic ducts are dilated

Second most common

A

Type 4

62
Q

Intrahepatic ducts are dilated

Caroli’s disease

A

Type 5

63
Q

Modality of choice for the imaging of the hepatobiliary tree
For viewing of the intestines
Confirm disease of the intestinal tract
Appendicitis

A

UTZ

64
Q

Distension of small bowels
Fluid-filled bowel loops
Presence of anechoic areas in affected bowel segments

A

Ileus

65
Q

Blind ended tubular structure
Trilaminated wall with targetoid appearance
Appendicolith

A

Acute appendicitis

66
Q

Hyperchoic focus at the tip of the appendix

Calcified deposit of material within the appendix

A

Appendicolith

67
Q

Abnormal telescoping of one segment into another

Palpable sausage-like mass lesion

A

Intussusception

68
Q

Intussusception signs on transverse cut

A

Target sign
Bull’s eye
Crescent-in-doughnut

69
Q

Intussusception signs on longitudinal cut

A

Pseudokidney
Hayfork sign
Bull’s eye

70
Q

Most common location of intussusception in pedia

A

Ileocecal

71
Q

Protrusion of contents of the abdominal cavity through the inguinal canal

A

Inuinal hernia

72
Q

In CT scan, the landmarks of hernia

A

Hesselbach’s triangle

  • base: inguinal ligament
  • lateral: epigastric artery
  • medial: rectus sheath
73
Q

Landmarks of direct hernia

A

Enters within Hesselbach’s triangle

74
Q

Landmarks of indirect hernia

A

Enters at the deep ring > inguinal canal > upper pole of testis

75
Q

Echogenic structure same as surrounding tissues
Antenatal ultrasound can diagnosis this
Anterior abdominal wall defect through which abdominal contents freely protrude

A

Gastrochisis

76
Q

Organs remain enclosed in visceral peritoneum

A

Omphalocele

77
Q

Increased echogenicity of the liver

Reversible, multifactorial disease, due to improper diet/alcoholism

A

Fatty liver

78
Q

Accumulation of fluid in the peritoneum
Secondary to many etiologies
Appears as anechoic areas in spaces between organs

A

Ascites

79
Q

Ascites in hepatorenal space

A

Morrison’s pouch

80
Q

Well-circumscribed anechoic focus in the liver parenchyma

Can’t determine if benign or malignant on UTZ

A

Livery cyst/nodule

81
Q

Upper limits of normal size on UTZ

A

Length: 12 cm
Width: 7 cm
Height: 5 cm

82
Q

Anechoic

Splenic vein, aorta, IVC, celiac artery

A

Pancreas/ pancreatic cyst

83
Q

Distendeded gall bladder (> 10 x 5 x o,3)

A

Cholecystitis

84
Q

Types of cholecystitis

A

Calculous (with stones)

Acalculous (no stone)

85
Q

Stones in the gallbladder appear hyperechoic on an anechoic background
Stones are round, well-circumscribed foci with posterior shadowing

A

Cholelithiasis

86
Q

Can demonstrate exact site of obstruction
To check for abnormal gas pattern
To determine the cause of obstruction
Abnormal fluid collection

A

CT Scan

87
Q

On CT, thickened bowels hyperdensities

On XR, apple core deformity

A

Colon constriction

88
Q

Round structure with contrast outside: diameter is thickened, air and inflammation, appendicitis

A

Soft tissue lesions

89
Q

Stone enters intestinal tract

A

Gallbladder ileus

90
Q

Heterogenous pancreas

Hypodensities which enhance with contrast

A

Acute pancreatitis

91
Q

Using CT for prognostication

A

Balthazar score

92
Q

Abnormal fluid collection at tail of pancrease

Creates colon cut-off sign

A

Abscess formation

93
Q

Better demonstrates the cause of the obstruction

A

CT scan

94
Q

On lateral side of abdominal wall

A

Spigelian hernia

95
Q

Similar to standard/rigid colonoscopy but invasive

Bowel preparation and lying down are rquired

A

Virtual colonoscopy/CT colonoscopy

96
Q

Confirmatory examination in pregnancy, history of allergic reaction to contrast material
Equivocal findings in CT

A

MRI

97
Q

Pattern of contrast would make one lesion more unique than the other
Liver nodules

A

Mass lesions in liver

98
Q

Plaques

Filling defects

A

Gallbladder stone

99
Q

Isolate the biliary tract and reconstruct the image
Filling defects = stones
Static fluid = bright against low signal
Requires no contrast

A

MR cholangiopancreatography

100
Q

Indicated in pregnant

Hyperintense signal surrounded by hypointense backgound on T2

A

Appendicitis

101
Q

Indicated in those who have allergic reactions to contrast, renal failure
Hyperintense

A

Pancreatitis

Gastrointestinal (9 decks)

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