Anatomy and Imaging in endocrine disease

Question 1

Which form of imaging is the pituitary gland well seen on?

Answer 1

MRI

Question 2

The pituitary gland is a ___line structure, found in the _____ ________. It has _____ and _______ parts. It is connected to the brain via a _______ _____. It is closely related to the _____ sinus. It is found inferior to the ____ _____ and _____.

Answer 2

The pituitary gland is a midline structure, found in the sella turcica. It has anterior and posterior parts. It is connected to the brain via a pituitary stalk. It is closely related to the sphenoid sinus. It is found inferior to the Optic Chiasm and hypothalamus.

Question 3

Which form(s) of imaging is the thyroid well visualized on?

Answer 3

CT
Ultrasound

(also imaged with nuclear medicine)

Question 4

The thyroid gland has two lobes, the ___ and ____ lobes. These lobes are joined by the _____. It lies anterior to the ______ and the ______ and deep to the ____ _______. The thyroid gland is medial to the ______ ______ _______ and _____ ______ ______.

Answer 4

The thyroid gland has two lobes, the right and left lobes. These lobes are joined by the isthmus. It lies anterior to the trachea and thee oesophagus and deep to the strap muscles. The thyroid gland is medial to the common carotid arteries and internal jugular veins.

Question 5

Which structures may be at risk during thyroid surgery?

Answer 5

Recurrent laryngeal nerves

Parathyroid Glands

Question 6

What are the positives to using ultrasound to image the thyroid gland?

Answer 6

Safe, no ionising radiation, well tolerated

Can be combined with Fine Needle Aspiration
i.e. Ultrasound-guided FNA

Question 7

When is a thyroid Ultrasound used?

Answer 7

Euthyroid patients with goitre/palpable nodules
and
Hyperthyroid patients with focal masses/radioisotope uptake

Question 8

In Thyroid Scintigraphy, Tc __m is used locally, injected IV and patients imaged after __ mins.

Answer 8

In Thyroid Scintigraphy, Tc 99m is used locally, injected IV and patients imaged after 20 mins.

Question 9

Thyroid Scintigraphy images are assessed for…

Answer 9

PATTERN and QUANTITY of tracer uptake

Question 10

What does homogenously increased tracer uptake indicate may be the diagnosis?

Answer 10

GRAVES disease

Question 11

What does homogenously reduced tracer uptake indicate?

Answer 11

Thyroditis

Question 12

What does focal tracer uptake in the righ upper pole indicate?

Answer 12

Multi-nodular goitre with dominant nodule

Question 13

The adrenal glands are ________ structures, largely in a _________ position. They are readily seen on __ and __.

Answer 13

The adrenal glands are retroperitoneal structures, largely in a suprarenal position. They are readily seen on CT and MRI.

Question 14

The adrenal glands have two limbs, ____ and ______. The right adrenal lies posterior to the _____________. The left adrenal lies lateral to the ____ and _________.

Answer 14

The adrenal glands have two limbs, medial and lateral. The right adrenal lies posterior to the inferior vena cava. The left adrenal lies lateral to the aorta and the left diaphragmatic crus.

Question 15

What is the 10% rule regarding adrenal gland tumours.

Answer 15

~ 10% are extra-adrenal

~ 10% are bilateral

~ 10% are found in children

~ 10% are familial

~ 10 % arenotassociated with hypertension