Gastrointestinal Tract ( IMAGES )

Question 1

Answer 1

Gastrosophageal junction.
Sagittal image of the left lobe and abdominal aorta (A)

Question 2

Answer 2

Gut signature.
1. Echogenic superficial mucosal layer.
2. Hypochoic deep mucosal layer.
3. Echogenic submucosal layer.
4. Hypochoic muscularis layer.
5. Echogenic serosa.

Question 3

Answer 3

Appendicitis.
Longitudinal and Transverse image of an inflamed appendix

Question 4

Answer 4

Appendicolith.
An obstructing stone that produces posterior shadowing is seen within the inflamed appendix

Question 5

Answer 5

Pyloric stenosis.
in the transverse often revealing the “doughnut” or “target” appearance of the enlarged sphincter muscle

Question 6

Answer 6

Pyloric stenosis.
Longitudinal image revealing the “cervix” appearance of the enlarged sphincter muscle

Question 7

Answer 7

Intussusception.
Transverse image through the right lower quadrant

Question 8

Answer 8

Bowel obstruction.
Distended, fluid-filled loops of bowel

Question 9

Answer 9

Diverticulitis.
An inflamed outpouching of the intestine

Question 10

Answer 10

Target or bull’s-eye sign.
Ultrasound images of the prominent colon.

Question 11

Answer 11

Transverse image of the left upper quadrant demonstrates a complex tumor in the region of the stomach, which was diagnosed as a leiomyoma.

Question 12

Answer 12

Sonographic images of a large heterogeneous cancerous mass within the stomach

Question 13

Answer 13

Lymphoma.
a large and poorly echogenic (hypochoic) mass, thickening of the gastric walls, and a spoke-wheel or bull’s-eye pattern

Question 14

Answer 14

Leiomyosarcoma.
A target-shaped hypochoic lesion is visible on sonography.
Although the pattern is variable, hemorrhage and necrosis may occur, causing irregular echoes or a cystic cavity.

Question 15

Answer 15

Metastatic disease.
A target pattern with circumscribed thickening or uniform widening of the stomach wall without layering is visible.

Question 16

Answer 16

Transverse image of prominent fluid-filled bowel loops.
B, The bowel is surrounded by ascitic fluid.
C, Inflammation of the bowel demonstrates prominent dilated loops of bowel shown as circular bull’s-eye or target structures in the lower abdomen.
D, Inflammatory reaction of the bowel.

Question 17

Answer 17

Acute appendicitis.
A, The appendix in the transverse plane should demonstrate a thickened muscular wall and increased appendiceal diameter.
B, Color Doppler will show the increased velocity secondary to the inflamed appendix.
C, Transvaginal imaging allows the sonographer to image the inflamed appendix without bowel interference.

Question 18

Answer 18

Mucocele.
The image varies according to the content of the mucocele,
which may be anechoic when mucoid material is more fluid.

Question 19

Answer 19

Meckel’s diverticulitis.
The wall of Meckel’s diverticulum consists of mucosal, muscular, and serosal layers.
Noncompressibility of the obstructed, inflamed diverticulum indicates that intraluminal fluid is trapped.

Question 20

Answer 20

Ulcerative colitis.
A, Small-bowel colitis.
B and C, Dilated colon with colitis.
D, Prominent colon with increased vascularity.

Question 21

Answer 21

Lymphoma.
A large, discrete mass with a target pattern, an exoenteric pattern with a large mass on the mesenteric surface of bowel, and a small anechoic mass representing subserosal nodes or mesenteric nodal involvement

Question 22

Answer 22

Metastatic disease.
A large solid mass containing necrotic areas anterior to solid viscus may be found;
color Doppler with demonstrate a low-velocity flow within the mass.