Abdomen/Pelvis

Question 1

What is the peritoneum? What is the difference between males and females?

Answer 1

membranous sac containing most anteriorly placed abdominal and pelvis organs. males have a closed sac, females have one that opens inferiorly through the fallopian tubes, uterus, and vagina

Question 2

What organs are in the retroperitoneum?

Answer 2

duodenum, kidneys, ureters, bladder, pancreas, uterus, prostate

Question 3

What is the amount of PO contrast and delay before scanning for:

1. distal intestines
2. proximal intestines
3. prox int & stomach

Answer 3

1. 450 mL, 90-120 minutes
2. 300-450 mL, 30 minutes
3. 300-450 mL, 30 minutes, and extra 150-250 mL just prior to scan

Question 4

What is the normal HU range for an un-enhanced liver?

Answer 4

45-65 HU; slightly more dense than the spleen

Question 5

T/F: Most common hepatic malignancies are metastases. They appear hypodense.

Answer 5

True

Question 6

What is the most common malignant neoplasm of the liver and how do they appear on a contrasted study?

Answer 6

hepatocellular carcinomas; they appear isodense. because of this, HCCs require a multiphase study

Question 7

What is steatosis?

Answer 7

fatty liver. HU measuring at least 10 lower than that of the spleen

Question 8

For the liver, when is the arterial phase of contrast enhancement, and what is best demonstrated?

Answer 8

25-35 seconds; hypervascular tumors supplied by the hepatic artery are enhanced while the rest of the hepatic parenchyma are not

Question 9

For the liver, when is the portal venous phase of contrast enhancement, and what is best demonstrated?

Answer 9

60-70 seconds; liver parenchyma and hypovascular lesions are well enhanced

Question 10

For the liver, when is the early arterial phase of contrast enhancement, and what is best demonstrated?

Answer 10

15-20 seconds; good for demonstrating hepatic arterial supply without enhancing hypervascular lesions

Question 11

For the liver, when is the delayed phase of contrast enhancement, and what is best demonstrated?

Answer 11

5-20 minutes; hemangiomas become isodense

Question 12

What is an FNH?

Answer 12

focal nodular hyperplasia; benign, vascular lesion of the liver; usually forming on the surface of the liver and appears with a hyopense central scar until delayed imaging when it will appear hyperdense

Question 13

What is cholecystitis and how does it appear on CT?

Answer 13

inflammation of the gallbladder; CAN appear as contrast-enhanced and thickened wall, with distension, and gallstones

Question 14

What is the HU measurement of the non-enhanced spleen?

Answer 14

40-60 HU, roughly 10 less than that of the liver

Question 15

What is the preferred phase to scan the spleen?

Answer 15

portal venous phase

Question 16

T/F: The spleen is the second most injured abdominal organ from blunt trauma.

Answer 16

False, spleen is first, liver is second

Question 17

How do pancreatic tumors appear?

Answer 17

hypodense compared to the rest of the contrast enhanced pancreas.

Question 18

When is the pancreatic phase?

Answer 18

35-45 seconds, also called “delayed arterial phase”

Question 19

What are the two most important reasons to scan the pancreas?

Answer 19

(1) to find and assess neoplasms and (2) what surrounding vessels are affected

Question 20

What is the HU measurement of the adrenal glands?

Answer 20

25-40 HU; similar to that of muscle

Question 21

Which 3 phases are typically scanned for the adrenal glands? Why?

Answer 21

1. pre-contrast: to show benign masses (<10HU)
2. portal venous: normal filling study
3. delayed (10-15 min): tumor characterization

Question 22

What slice thickness is used for a CT of the adrenals?

Answer 22

0.5-2.0 mm; the thinner the better

Question 23

The epithelial lining of the urinary tract is called what? What common renal malignancy originates here? Which contrast phase best demonstrates this lining?

Answer 23

urothelium; transitional cell carcinoma; excretory phase

Question 24

What is the recommended slice thickness for CT of the genitourinary system?

Answer 24

3-5 mm

Question 25

Name the three primary malignancies that metastesize to the kidneys.

Answer 25

1. lung
2. breast
3. colon

Question 26

Name the three phases of contrast enhancement of kidneys and what each demonstrate.

Answer 26

1. corticomedullary phase: late arterial: 30-40 sec. best shows cortex and renal veins
2. nephrographic phase: 70-90 sec. best shows renal parenchyma
3. excretory phase: 3 minutes. best shows calyces, renal pelvis, ureters, and bladder

Question 27

Define abscess.

Answer 27

collection of pus caused by infection or inflammatory process

Question 28

For what conditions is IV contrast indicated for the bowel?

Answer 28

bowel wall thickening, mass lesions (diverticulitis), inflammatory processes, and vascular perfusion abnormalities like bowel ischemia

Question 29

Define ileus.

Answer 29

an area of intestine that has lost normal contractile motion, resulting in an obstruction

Question 30

For a study of the gastrointestinal, what is the recommended delay for optimal IV contrast enhancement?

Answer 30

portal venous phase

Question 31

What is a hydrocele of the testes?

Answer 31

an abnormal collection of fluid around a testicle

Question 32

How do the seminal vesicles appear in CT?

Answer 32

as a bow tie posterior to the bladder

Question 33

Which layer of the uterus enhances well after IV contrast?

Answer 33

myometrium; due to its highly vascular composition

Question 34

What is an “Adnexa”? What is an example of one?

Answer 34

an appendage of an organ, like the fallopian tubes of the uterus.

Question 35

The aorta bifurcates into the _______ arteries at the vertebral level of ____.

Answer 35

common iliac; L4

Question 36

The femoral vein is located _____ to the iliac vein.

Answer 36

medially (and slightly posterior)

Question 37

What percent ofa barium-sulfate solution is used in a CT Enterography?

Answer 37

1-3%

Question 38

What tumor is also called a nephroblastoma? What age group does it affect?

Answer 38

Wilms tumor; pediatric ages 1-5