ct

Question 1

hepatic abscess

Answer 1

ring enhancing mass on CT (mimics met). on MRI- central hyperintesnity on T2 weighted images with irregular wall that enhances late. perlesional enhancement may be present.

Question 2

cirrhosis

Answer 2

expansion of the preportal space. atrophy of the medial segment of the leg thematic lobe in early cirrhosis causes increased fat anterior to the right main portal vein. caudate to right lobe size ratio of >0.65. empty gallbladder fossa.
secondary: splenomegaly, portosystimc collaterals and varices. gb wall thickening. gamma sandy bodies: splenic micro hemorrhages.

Question 3

regenerative nodule

Answer 3

doesn’t enhance in arterial phase
low signal intensity on T2, variable on T1. rarely T1 hyper intense bc glycogen deposition
same enhancement on MRI

Question 4

dysplastic

Answer 4

variable signal T1, low T2 but can be T2 hyper intense

Question 5

sideritic nodule

Answer 5

hypintense on T1 and T2. hyper attenuating on CT.

Question 6

HCC

Answer 6

arterial phase enhancement. encapsulated mass that enhances on arterial phase and washes out on portal venous phase. on MRI, characteristically T2 hyperintense
locally invasive- invade in portal veins, IVC, bile ductts. mets are less invasive.

Question 7

fibrolamellar hcc

Answer 7

young pts w/o cirrhosis. on MRI: large heterogeneous mass. fibrotic central scar classic- hypintense on T1 and T2 ( note- focal nodular hyperplasia T2 hyperintese scar that enhances late). no capsule.

Question 8

hepatic mets

Answer 8

hypovascular- best appreciated on portal venous. hyper vascular mets: neuroendocrine, renal cell, thyroid, melanoma, and sarcoma. hypo T1 and hyper T2.

Question 9

pseudocirrhosis

Answer 9

treat breast cx common.

Question 10

what can cause capsular retraction

Answer 10

mets (post tx), fibrolammelar, bcc, epithelial hemanioendothelioma, intrahepatic cholangioca, confluent hepatic fibrosis

Question 11

focal nodular hyperplasia

Answer 11

central area of of T2 hyperintense ductules and venues. delayed enhancement. avidly enhances on arterial phase and washed out quickly. kuppfer cells- sulfur colloid study. bile duct cells- HIDA scan.

Question 12

hemangioma

Answer 12

peripheral, discontinuous, progressive, nodular enhancement. CT- hypoattenuating.

Question 13

hepatic adenoma

Answer 13

ct- heterogeneous hypo attenuating. no bile ducts so can use HIDA scan to differentiate from FNH. multiple in von gierkes disease hyper vascular on arterial. microscopic fat.

Question 14

pancreatic adeno

Answer 14

hypotenuse (late arterial CT), T1 hypointesense ill defined hypo vascular mass causing ductal obstruction and atrophy of the pancreatic tail.

Question 15

if no ductal dilatation of pancreas consier

Answer 15

autoimmune pancreatitis, groove pancreatitis, cystic pancreatic tumor, neuroendocrine tumor, duodenal GIST, peripancreatic lymph node, pancreatic met, lymphoma.

Question 16

acinar cell ca

Answer 16

lipase hyper secretion syndrome: subs fat necrosis, bone infarcts causing polyarthralgias, and eosinophilia.

Question 17

serous cystadenoma- grandmother tumor

Answer 17

many small cysts with solid appearance due to apposition of many cyst walls.

Question 18

mutinous mother tumor

Answer 18

single or few large cysts. body or tail. has capsule.

Question 19

SPEN daughter tumor

Answer 19

large mass with heterogeneous solid and cystic areas. hemorrhage. capsule.

Question 20

IPMN- grandfather elderly males.

Answer 20

cystic intrapanreatic lesion in contiguity with he cut or side branch. nodular or enhancing then be concerned for malignancy. >3cm or MPD >10mm.