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Module 16 > Diagnostic Imaging of Digestive Tract > Flashcards

Diagnostic Imaging of Digestive Tract Flashcards

1
Q

in what situations does serosal detail decreases (3)

A
  1. decreased fat (immaturity, emaciation)
  2. increased soft tissue opacity in/around mesentery (free fluids, peritonitis, carcinomatosis, severe mesenteric lymphadenopathy)
  3. large abdominal masses
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2
Q

what allows delineation of serosal margins of abdominal organs

A

mesenteric fat

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3
Q

what can increase serosal detail

A

pneumoperitoneum will increase clarity of serosal markings

around caudal margin of diaphragm

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4
Q

what would ddx be for increased serosal detail (3)

A
  1. recent surgery or abdominal penetration
  2. GIT perforation
  3. iatrogenic (ex. during pneumocystogram)
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5
Q

what is shown here

A

pneumoperitoneum

caudal margin of diaphragm

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6
Q

what is the normal appearance of the liver

A

even soft tissue opacity

triangular shape on lateral

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7
Q

what is the shape of the liver on lateral

A

triangular shape

sharp margin caudoventrally

extends to caudal aspect of costal arch

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8
Q

what is the gastric axis

A

used to assess the size of the liver

normal: parallel to ribs or perpindicular to spine

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9
Q

what is the appearance of the liver on VD

A

triangular, more to the right

tip is at the level of the costal arch

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10
Q

what are the signs of hepatomegaly

A
  1. caudal rotation of gastric axis
  2. liver extends caudally beyond costal arch
  3. rounding of caudal border
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11
Q

what is shown here

A

hepatomegaly

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12
Q

what is the ddx for hepatomegaly (4)

A
  1. hepatitis
  2. neoplasia
  3. cushings
  4. steroid use
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13
Q

what are the signs of microhepatica

A
  1. cranial rotation of gastric axis
  2. reduced size or herniation
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14
Q

what is shown here

A

microhepatica

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15
Q

what can be the ddx of microhepatica (2)

A
  1. portosystemic shunt (PSS)
  2. diaphragmatic rupture
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16
Q

identify the organs

A

red: stomach
pink: small intestine
orange: large intestine

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17
Q

can intestinal wall thickness be assessed on radiograph accurately

A

no

interfeace between gas the fluid –> wall is not actually thickened, it could be fluid that makes it look thickened

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18
Q

what is the appearance of the stomach on RLR

A

lying with right side down gas will collect in the fundus

left side of abdomen is highest

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19
Q

what is the appearance of the stomach on LLR

A

when dog is turned over the pylorus is the highest part of the stomach and gas will sit and give the stomach a dumbell appearance

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20
Q

what is shown here and what is the ddx

A

enlarged abnormal shape

GDV

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21
Q

what is the normal diameter of small intestine in canines

A

<1x height of lumbar vertabral body

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22
Q

what is the normal diameter of small intestine in felines

A

~<12mm

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23
Q

where are the small intestines located in the abdomen

A

generally ventral mid abdomen

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24
Q

what a small intestine obstruction appear on radiograph

A

single or few dilated or thickened loops

may be easier to see when gassy

foreign body may not be clearly seen

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25
Q

what is shown here

A

foreign body

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26
Q

what is ileus

A

general dilation of small intestine

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27
Q

what can cause ileus

A
  1. peritonitis
  2. GDV
  3. dysautonomia
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28
Q

how could you diagnose a small intestinal mass on rads (3)

A

may not be clear but

  1. diffuse mild thickening
  2. mass (obscured by other loops)
  3. evidence of obstruction
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29
Q

what is the gravel sign

A

collection of mineralized matieral immediately above partial GI obstruction

indicates chronic partial obstruction

must be persistent

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30
Q

what is shown here

A

gravel sign

partial pyloric outflow obstruction

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31
Q

where is the large intestine present

A

dorsal abdomen

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32
Q

what is the diameter of normal large intestine

A

<1.5x length of L7

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33
Q

what is shown here

A

large intestine

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34
Q

what is shown here

A

megacolon

dense radioopaque fecal material

twice length of L7

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35
Q

what can GI contrast studies be used to diagnose (3)

A
  1. identify obstruction
  2. assess mucosal surface (neoplasia, etc)
  3. intestinal function (transit times)
36
Q

what is the diagnosis

A

serosal detail is very poor (skeletal mature –> free fluid)

distended intestinal loop that looks like there is fecal material to ventral to large colon –> has to be a distended small intestine

foriegn body in the small intestine

free gas –> perforated intestine and septic peritonitis

37
Q

what are the pros of ultrasound (4)

A
  1. major diagnostic tool
  2. good for soft tissues (assess internal structure/parenchyma)
  3. safe, non-invasive, cheap, rapid
  4. real-time imaging (functional assessment –> cardiac, peristalsis, guidance for FNA/biopsy)
38
Q

what are the cons of ultrasound (3)

A
  1. poor for bone and gas (lung, GI tract)
  2. need to clip hair
  3. operator (and machine) dependent
39
Q

what is the ultrasound appearance of the normal liver

A

hypoechoic to spleen (slightly grainy texture)

vascular structures: hepatic viens and portal veins

gall bladder

sharp margins

40
Q

where is the gall bladder on ultrasound

A

right to midline –> fluid filled, anaechoic

41
Q

how is liver size assess on US

A

subjective

rads easier

does it extend too far caudally?

is liver too small?

42
Q

what would diffuse hyperechoic changes in the liver be caused by (4)

A
  1. steroid hepatopathy including cushings
  2. chronic hepatitis
  3. fatty liver
  4. fibrosis
43
Q

what would diffuse hypoechoic changes be due to (4)

A
  1. acute inflamamtion
  2. edema
  3. lymphoma
  4. congestion
44
Q

what could focal abnormalities be due to in the liver (5)

A
  1. masses, cysts, etc
  2. neoplasia
  3. regenerative hyperplasia
  4. granulomas
  5. abscess
45
Q

what vascular abnormalities can be seen on US in the liver

A
  1. venous congestion with right heart failure
  2. portosystemic shunts
46
Q

what are billiary abnormalities seen on US (3)

A
  1. gall bladder sludge
  2. cholecystitis
  3. biliary obstruction
47
Q

what are the layers of the GI tract (5)

A
  1. serosa
  2. muscularis
  3. submucosa
  4. mucosa
  5. lumen
48
Q

what is the approx thickness of the stomach in the long axis US view in dogs

A

3-5mm

49
Q

what is the approx thickness of the stomach in the long axis US view in cats

A

1.1-3.6mm

50
Q

what is the approx thickness of the duodenum in the long axis US view in dogs

A

5.1-6.0mm

51
Q

what is the approx thickness of the duodenum in the long axis US view in cats

A

1.3-3.8mm

52
Q

what is the approx thickness of the jejunum in the long axis US view in dogs

A

4.1-4.7mm

53
Q

what is the approx thickness of the jejunum in the long axis US view in cats

A

1.6-3.6mm

54
Q

what is the approx thickness of the colon in the long axis US view in dogs

A

2.0-3.0mm

55
Q

what is the approx thickness of the colon in the long axis US view in cats

A

1.1-2.5mm

56
Q

what does the stomach look like on long axis view US

A

kiwi fruit appearance

57
Q

where can the duodenum be scanned

A

right dorsal flank

58
Q

what is the duodenum a landmark for on US

A

pancreas and pylorus

59
Q

what is the appearance of the duodenum on US

A

coffee bean appearance

60
Q

where is the jejunum scanned

A

mid abdomen

61
Q

what is the appearance of the ileum on US

A

prominent submucosal layer

62
Q

where is the ileo-cecal junction

A

right mid abdomen

63
Q

what is the approx wall thickness of the colon on US

A

2-3mm

64
Q

what does an US GI tract assessment include (5)

A
  1. function
  2. obstruction (intussusceptions, contents, foreign material)
  3. wall thickness and layers
  4. neoplasia
  5. enteritis
65
Q

how can a GIT obstruction be seen on US

A

distention proximal and empty distal (two populations)

66
Q

what is seen here

A

distended and fluid filled

obstruction

67
Q

how are solid foreign materials seen on US

A

often hyperechoic + shadowing

distinct shape

GIT conforms to shape

68
Q

how are linear foreign bodies seen on US

A

short angular turns

bunching of SI

69
Q

what is shown here

A

foreign material in SI

peach stem

70
Q

what is shown here

A

linear foreign body

string

71
Q

what is the appearance of an intussusception on US

A

mutliple wall layers

hyperechoic mesenteric fat

72
Q

what is shown here

A

intussusception

73
Q

what is the appearance of neoplasia on the GI tract (6)

A
  1. loss of wall layers
  2. markedly thickened walls
  3. irregular lumen
  4. lack of peristalsis
  5. focal vs. generalized
  6. continuity with adjacent GI tract
74
Q

what changes can be subjectively seen with enteritis on US (5)

A
  1. abnormal content
  2. altered peristalsis
  3. increased wall thickness
  4. increased mucosal echogenicity
  5. irregular lumenal interface
75
Q

what is shown here

A

neoplasia

76
Q

what is seen here

A

free fluid around intestinal loops

enteritis

77
Q

what are the landmarks for the pancreas on US (3)

A
  1. stomach
  2. transverse colon
  3. spleen
78
Q

what are the differences in the left and right limbs of the pancreas

A

left limb is bigger in cats and smaller in dogs

right limb is bigger in dogs and smaller in cats

79
Q

what is shown here

A

left limb of pancreas

80
Q

what is the landmark of the right limb of the pancreas

A

duodenum

81
Q

what is the appearance of the right limb of pancreas

A

similar/hypoechoic to surrounding fat

may not be visible

82
Q

what is shown here

A

right limb of pancreas

83
Q

what is shown here

A

right limb of pancreas

84
Q

how does pancreatitis change the appearance on US

A
  1. edematous (hyperechoic)
  2. surrounding peritonitis and free fluid
85
Q

how does pancreatic neoplasia change the appearance on US (2)

A
  1. mass/nodule
  2. may appear similar to pancreatitis
86
Q

what is shown here

A

pancreatitis

edematous

surroudning peritonitis and free fluid

87
Q

what is shown here

A

pancreatic neoplasia

Module 16 (26 decks)

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