DI 3 Final Flashcards
Which of the following (organ or structure outline) can be visualized in the normal AP supine abdomen radiograph?
Spleen
Liver
Kidney
Urinary bladder
Describe the location of gas and/or barium in the stomach in the recumbent versus upright positions.
Upright position will see fluid line bubble.
Barium settles to the bottom and gas rises to the top.
Describe the appearance of gaseous distention of the small versus large intestine.
- Gas normal in Lrg. intestines, Abnormal in S.intestines
- Small intestinal (obstruction likely if >3cm); “stacked coin” or “coiled spring” appearance of mucosal folds
- Jejunum=feathery pattern
- Ileum=clumped pattern (if gas/obstruction present)
- Bubbles outside GI=abscess, necrosis;
- bubbles inside GI=benign
What is a sentinel loop?
Loops of small bowel distention
- indication of inflammatory process + halting of peristalsis
- dt acute pancreatitis MC
Posterior displacement of the magenblase (gastric air bubble) is suggestive of enlargement of which organ?
Liver
What is the normal orientation and position of the kidneys?
- Retroperitoneal
- Inf. pole is more lateral; Sup. pole is more medial
- Left kidney=higher=T11-L2
- Right kidney=lower=T12-L3
Describe the four different types of abdominal calcification patterns and common examples of each.
Concretions:
“lumen of vessel or hollow organ” (pelvic veins, GB, urinary tract) Homogeneously dense, round or oval
- Phleboliths=pelvic veins
- Gallstones
- Staghorn calculi (kidney)
- Bladder calculi
- Liver & spleen granulomas
- Pancreatic concretions
- Prostatic concretions
Conduit wall:
- Walls of hollow tubes/arteries
- Parallel tracks of calcification
- MC: abdominal aorta, common & internal iliac , splenic, and renal arteries, vas deferent calcification
- Parallel lines do NOT indicate aneurysm; usually dt atherosclerotic plaguing
Solid-Mass calcification:
- Irregular border & complex architecture
- Mottled density with radiolucencies within
- MC: mesenteric lymph nodes calcification dt TB
- MC in female pelvis: Uterine leiomyoma (fibroid)
What is a phlebolith?
*Normal calcification of pelvic veins, seen at pelvic brim (lateral portion of pelvis)
If seen midline, abnormal=> likely dt mass in pelvis displacing the veins
Is plain film the best modality for diagnosis of an abdominal aortic aneurysm? If not, what is/are the best choice(s)?
Ultrasound is best; 98% accurate
CT also OK, esp if leak suspected
X-ray shows 50-80% calcifications
Describe the appearance and location of pancreatic calcification. Give the most common cause.
- Numerous dense, discrete opacities that cross the midline at the level of L1-2 (conforms to the shape of the PN)
- Seen on plain film
*Dt chronic pancreatitis from alcoholism
What is a dermoid cyst?
Cystic teratoma
*MC ovarian tumor
20-40 y.o. females
Seen on plain film: tooth, bone or fat seen in area of ovary
Describe the appearance and location of a calcified uterine fibroma.
MC uterine tumor
Solid-mass calcification (irregular border and complex inner architecture, scattered radiolucencies)
Seen somewhat midline in pelvis
When small may look like LN
Describe the appearance and usual location of prostate calculi.
Concretion calcification
Dt chronic prostatitis
Sharply defined homogenous calcifications
Seen at pubic symphysis
