B5.016 GI Imaging Flashcards
appropriate imaging for suspected cirrhosis
CT abdomen with contrast
US abdomen
MRI abdomen
all rated an 8 on the ACR appropriateness criteria
US findings of cirrhosis
heterogeneous liver coloration (should be homogenous grey) serrated surface (should be smooth and even)
how can you tell if a mass is potentially cancerous on US?
use Doppler feature to determine vascularization
white aorta on CT with contrast
arterial phase, a few seconds after administration of contrast
all contrast in arterial system, hasn’t had time yet for venous return
darker aorta on CT with contrast
delayed post-contrast image
equilibrium phase, several minutes after contrast
contract more evenly distributed in body
hepatocellular carcinoma findings on CT with contrast
these masses get blood primarily from hepatic artery while rest of liver primarily gets blood from portal vein
early phase appears brighter than rest of liver due to arterial flow
later phase appears darker than rest of liver due to AV shunting, contrast washed out more quickly because no capillary beds
hepatocellular carcinoma epidemiology
most common primary malignancy
strongly linked to chronic liver disease viral hep #1 cause, alcoholism #2
3rd most common cancer death worldwide
development of HCC
hepatocyte damage > regenerative nodule > dysplastic nodule > HCC
HCC diagnostic steps
US = screening
CT or MRI = diagnosis
can treat without tissue biopsy diagnosis
hematochezia
blood in stool
intussusception US findings
concentric circles of bowel
cecum = intussesception
terminal ileum = intussesceptum
treatment for intussusception
therapeutic air enema
what is intussusception
occurs when forward peristalsis results in invagination of the more proximal bowel into the lumen of the more distal bowel
overwhelming ileocolic
2 categories of intussusception
idiopathic (90%)
pathologic- meaning secondary to a definable abnormal lead point such as a Meckel diverticulum
epidemiology of intussusception
more common during winter months
occurs more commonly in girls versus boys
typical age of presentation is between 3 months and 1 year
