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Diagnostic imaging and Radiology > Digestive system Radio > Flashcards

Digestive system Radio Flashcards

1
Q

What is the gold standard for diagnostics of CRC ?

A

Complete Colonoscopy

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2
Q

what is a possible alternative for patients suspected for CRC who can not undergo complete colonoscopy ?

A

Double contrast barium enema

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3
Q

How do we stage CRC ?

A

PET (FDG)-CT

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4
Q

what are the imaging techniques for metastasis of CRC in the Abdomen ?

A

US

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5
Q

what are the imaging techniques for metastasis of CRC in the Thorax ?

A

Radiography (x-ray)

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6
Q

what are the imaging techniques for metastasis of CRC to the bone?

A

Bone scintigraphy with Tc-99m + MDP

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7
Q

What do we use for preoperative staging for CRC ?

A

CT of abdomen, pelvis, and chest with IV contrast and oral contrast.

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8
Q

What is the most typical metastasis for CRC ?

A

Hepatic and pulmonary

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9
Q

what is the 1st level imaging for liver cirrhosis ?

A

US

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10
Q

What are some indirect signs we see of liver cirrhosis using US ?

A

Irregular margins of nodules, and portal vein dilatation

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11
Q

What is the 2nd level imaging for liver cirrhosis ?

A

CT

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12
Q

What sign of liver cirrhosis can we see using CT for diagnosing the disease ?

A

Right lobe volume reduction

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13
Q

What imaging technique can recognize nodular regeneration and dysplastic nodules of the cirrhotic liver ?

A

MRI + contrast

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14
Q

1st line imaging Liver Hemangioma ?

A

US

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15
Q

How do we see liver hemangioma on the US ?

A

Homogenous and hyperechoic

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16
Q

2nd line imaging for Liver Hemangioma ?

A

CT + contrast

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17
Q

How does Liver hemangioma appear in the arterial phase on CT and contrast ?

A

Hyperdense

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18
Q

3rd line imaging for Liver hemangioma ?

A

MRI - Hypointense in T1

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19
Q

What is the imaging we use for the first identification and surveillance of high risk pt for HCC ?

A

US + doppler

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20
Q

What is the 2nd line imaging when we assess HCC patient for new liver nodules ?

A

CT/MRI with contrast

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21
Q

What do we look for when using CT for the investigation of new liver nodules ?

A

Transient Hepatic Attenuation Differences (THAD)

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22
Q

What phase of the triphasic with CT study we can can see neo-angiogenesis ?

A

Arterial phase

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23
Q

What are the most common malignant hepatic lesions ?

A

Metastasis

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24
Q

Liver metastasis is caused by few important tumors, which are ;

A

Pancreas, breast, lung, and kidney tumors.

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25
Q

1st line imaging for liver metastasis ?

A

US

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26
Q

How many lesions do we see in the liver metastasis on US ?

A

single or multiple lesions

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27
Q

What are the second instance investigation for Liver metastasis ?

A

CT

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28
Q

In what method does liver metastasis is more recognizable when using CT ? how do they appear?

A

In the Portal phase and they appear Hypodense

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29
Q

How does Liver metastasis appear on CT when it is secondary to hypervascularized tumors ?
In what phase they are more evident ?

A

More evident in the arterial phase, and appear hyperdense, due to their rich vascularization

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30
Q

What is the 3rd choice for liver metastasis imaging ?

A

MRI- use in doubtful cases

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31
Q

How do we see Liver metastasis, using MRI T1 weighted ?

A

Hypointense

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32
Q

How do we see Liver metastasis, using MRI T2 weighted ?

A

Hyperintense

33
Q

what is the first line imaging used for billiary ?

A

US

34
Q

What are the GOLD STANDARD for the imaging of biliary pathways ?

A

ERCP & PTC

35
Q

ERCP stands for what ?

A

Endoscopic

Retrograde

Cholangio

Pancreatography

36
Q

PTC stands for what ?

A

Percutaneous

Transhepatic

Cholangiography

37
Q

What are the indication of ERCP and PTC ?

A
  1. Billiary obstruction

(location, extent, and malignant/ benign nature)

38
Q

How do we use CT/MRI in biliary pathways ?

A

In a Complementary manner

39
Q

In what cases do we prefer to use MRI in biliary imaging ?

A

Benign lithiasis-induced obstruction or when ERCP is contraindicated

40
Q

What is the main indication for MRCP ?

A

Distinguish benign and malignant nature of the obstruction

41
Q

if we use MRCP for biliary ducts, do we use T1/T2?

A

T2

42
Q

what do we highlight when we use MRCP for imaging of biliary ducts ?

A

Static liquids i.e., like bile

43
Q

What is the use of Abdominal X-ray in the imaging of Biliary ducts ?

A

Used for specific pathologies:

Calcium bile

Radio opaque lithiasis

44
Q

Do we use contrast in MRCP (colangio RM) ?

A

No

45
Q

What is the most frequent pathology of the biliary tract ?

A

Biliary lithiasis (Gallstone disease)

46
Q

the two main Gallstone disease ?

A

cholecystolithiasis (gallstone in the gallbladder)

choledocholithiasis (gallstone in a bile duct)

47
Q

What is the first method of choice for suspected Biliary lithiasis ?

A

Ultrasound

48
Q

How do we see gallstones on US ?

A

Endoluminal

Hyperechoic

Posterior shadow cone

49
Q

In what cases of biliary duct imaging we prefer using MRI ?

A

Benign lithiasic obstruction / not possible to do ERCP

50
Q

How do we see gallstones on MRI ?

A

Oval or rounded formations of low signal

51
Q

How do we see gallstones on CT ?

A

hyperdense formations

“target aspect”

52
Q

How do we recognize biliary lithiasis with MR-CP ?

A

You will see a filling defect in the bile duct clouded by bile.

53
Q

1st line imaging in acute cholecystitis ?

A

US (low cost, highly available)

54
Q

What are some US signs we see with Acute cholecystitis ?

A

1.stones

2.overdistension of the lumen

3.Ultrasound Murphy’s sign

55
Q

What is the 2nd line of imaging we use for Acute cholecystitis ?

A

CT

Used to complement non-direct or doubtful ultrasound examination

56
Q

Acute cholecystitis common signs seen on CT without contrast

A

stones in the lumen, most often hyperdense

57
Q

Acute cholecystitis common signs seen on CT (after contrast injection) ;

A

focal/diffuse thickening of the gallbladder wall

Non-specific inflammatory hyperemia

58
Q

what are the 2 most common complications of Acute cholecystitis ?

A

1.Gangrenous cholecystitis

2.Perforation of the gallbladder

59
Q

Which method appears to be superior in the identification of biliary tract dilation, site of obstruction, and localization of the stone ?

A

MRI appears to be superior

60
Q

How do we access the biliary ducts with the ERCP technique ?

A

Through the papilla of Vater

61
Q

which technique will you use in order to perform stent or biliary flushing ?

A

ERCP

62
Q

initial diagnosis of acute pancreatitis ?

A

clinical and lab tests

63
Q

what is the system that classifies the the severity of acute pancreatitis ?

A

Balthazar

64
Q

What imaging is used for ACUTE PANCREATITIS staging ?

A

CT-Abdomen + IV contrast

65
Q

what is the balthazat classification for ?

A

Divides the severity of acute pancreatitis into 5 grades (A-E)

66
Q

How do you evaluate the severity of necrosis in acute pancreatitis?

A

US/CT - guided biopsy

67
Q

3 Complications of acute pancreatitis

A

Necrotizing pancreatitis

Walled-off necrosis

sepsis

68
Q

What are the labs seen in Acute pancreatitis ?

A

Increased Amylase and Lipase

69
Q

Imaging used for Endocrine Pancreas Tumors ?

A

CT and MRI

70
Q

what is considered the Gold-standard imaging for Acute pancreatitis ?

A

Contrast enhanced (IV) CT examination

***Allows to stage the severity of the disease

71
Q

How do we diagnose Appendecitis ?

A

Clinically and US

72
Q

What imaging technique can be used to study in detail the small intestine ?

A

Enteroclysis (with contrast)

it’s CT actually !!

73
Q

What is the main indication of Double contrast enema ?

A

Crohn’s disease (especially good for lesion depth evaluation)

*barium contrast

74
Q

Indications of Trans-rectal US

A

1.Prostate cancer

2.Anorectal pathologies

75
Q

What is the most adequate investigation we can perform for transmural extent of inflammation and intraperitoneal/extraintestinal complications of crohn’s and UC ?

A

CT

76
Q

What are the 2nd level investigations for Crohn’s disease ?

A

CT enterography and MR enterography

CT-more in emergency

results are quiet comparable, despite MRI has higher resolution !

77
Q

liver metastasis on US, how do we see it, hyper/hypo-echoic?

A

hypoechoic

78
Q

liver metastasis on US, how do we see the margins?

A

Well defined margins.

Diagnostic imaging and Radiology (6 decks)

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