GI imaging Flashcards

Question

double contrast barium enema (DCBE)

Answer 1

-REPLACED BY CT Colonography -Old Indications: -Evaluation of colonic mucosa for inflammatory bowel disease, polyps, neoplasm, incomplete colonoscopy -Contraindications: -Toxic megacolon -Immediately after full-thickness colonoscopic biopsy

Answer 2

-Perforated ulcer or free air in the abdomen- Plain films may demonstrate as little as 1 to 2 mL of air -small bowel obstruction- Plain films have a sensitivity of 69 to 82 percent for revealing high-grade small bowel obstruction -Moderate or severe abdominal tenderness, suspicion of bowel obstruction, ingestion of foreign body or penetrating foreign bodies (gunshot wounds)

Answer 3

-Uses sound waves to create images of organs -Differentiation of cystic versus solid lesions of the liver and kidneys -Detection of intra- and extrahepatic biliary ductal dilation, cholelithiasis, gallbladder wall thickness, pericholecystic fluid, peripancreatic fluid and pseudocyst, hydronephrosis, abdominal aortic aneurysm, appendicitis, ascites, primary and metastatic liver carcinoma

Answer 4

-Evaluate the function of the gallbladder and the bile ducts -Given with CCK to assess gallbladder emptying -> ejection fraction -Anatomic and functional information -Used with RUQ pain, nausea, vomiting

Answer 5

-Ultrasound transducers incorporated into the tip of a flexible endoscope -Ultrasound images are obtained of the gut wall and adjacent organs, vessels, and lymph nodes -Very high resolution images are obtained -Provides the most accurate preoperative local staging of esophageal, pancreatic, and rectal malignancies

Answer 6

-Bile duct stones -Gallbladder disease -Submucosal gastrointestinal lesions -Chronic pancreatitis -Can bx exoluminal lesions -> pancreatic cysts via FNA

Answer 7

-Endoscope is passed through the mouth to the duodenum -Ampulla of Vater is identified and cannulated with a thin plastic catheter -Radiographic contrast material is injected into the bile duct and pancreatic duct under fluoroscopic guidance -Sphincter of Oddi can be opened via endoscopic sphincterotomy -Stones retrieved from ducts -Biopsies obtained -Strictures dilated and stented -Therapeutic and diagnostic procedure especially for ductal strictures and CBD stones

Answer 8

-With or without contrast agent -Oral contrast* (usually) agent before abdominal or pelvic scans helps delineate the bowel -IV contrast is used to obtain vascular and tissue enhancement -Most helpful in evaluating retroperitoneum (pancreas, kidney, nodes, aorta), liver, appendicitis, bowel disease (inflammation, diverticular disease, masses, hernias, obstruction

Answer 9

-Indications: -Evaluation for possible colonic polyps and masses -Incomplete colonoscopy -Not stable for colonoscopy-anesthesia -Contraindications: Pregnancy

Answer 10

-No IV contrast needed or anesthesia -Has ability to evaluate extracolonic intraabdominal disease (AAA, renal cell cancer, kidney stones).

Answer 11

-Diagnostic not therapeutic -Still need prep -Retained fecal material limits study -If polyps or masses are found, patient will need to undergo colonoscopy or sigmoidoscopy for tissue diagnosis. -Can’t asses for AVM or treat them -$ not covered - need a failed attempt -full cat scan of everything -6mm or more

Answer 12

-MRI provides better soft-tissue contrast than CT -not covered commonly -Detection of adrenal lesions, tumor staging, abdominal masses, examination of almost all intraabdominal organs and retroperitoneal structures, and differentiation of benign adenoma from metastasis -Aids CT in evaluation of liver lesions- Benign from malignant liver tumors

Answer 13

-Evaluation of intra- and extra-hepatic biliary and pancreatic duct dilatation, and the cause of obstruction -Evaluates choledocholithiasis, retained gallstones, pancreatobiliary neoplasms, strictures, primary sclerosing cholangitis, and chronic pancreatitis -ERCP may be needed after -usually ordered with MRI of abdomen

Answer 14

-assess small bowel -this is commonly used -rule in or out crohns disease -Indications: -Assess for extent of IBD, postoperative adhesions, and small bowel tumors -Contraindications: -CT: Pregnancy -MR: cardiac pacemakers, intraocular metallic foreign bodies, intracranial aneurysm clips, cochlear implants, and some artificial heart valves

Answer 15

CTE -Takes 10 seconds -More cost effective -Do not have to hold breath -No glucogon used -Iodine based IV contrast -Radiation exposure -Obesity and respiratory disease does not limit exam MRE** -Takes 30 minutes -Twice as expensive -Have to hold breath -Glucagon +/- nausea/vomiting -Non iodine based IV contrast -No radiation exposure -Obesity or respiratory problems can limit exam