GI Imaging - Exam 4 Flashcards
What color is air on Xray?
xray = air = black
xray = bone = white
Is there is contrast in an KUB xray?
YES! KUB xrays use contrast
How many cigarettes is equivalent to 1 CXR? pelvis XR? abdomen XR?
1 CXR = 1 cig
pelvis = 6 cig
abdomen = 7 cig
How many cigarettes is equivalent to 1 abdo/pelvis CT? chest CT?
abdo/pelvis CT = 140 cigs
chest CT = 7 cigs
What is the most likely diagnosis?
small bowel obstruction
What is the mostly likely diagnosis?
free air under the diaphragm
What is the medical term for free air under the diaphragm? Where is the air located?
pneumoperitoneum
gas or air trapped within the peritoneal cavity, but outside the lumen of the bowel
**What are the 2 causes of free air under the diaphragm?
1) bowel perforation
2) insufflation of gas (CO2 or air) during laparoscopy
A pt presents with an acute abdomen, what 2 imaging studies should be ordered?
upright and supine abdominal xray
What is the most likely diagnosis?
kidney stones
What is the most likely diagnosis?
pancreatic calcification
What is the most likely diagnosis?
fecal impaction
When concerned about constipation what position should the patient be placed in? What will the xray report show?
supine: abdomen and pelvis xray
presence of large fecal burden throughout the colon and a relative paucity or absence of luminal gas
**Ultrasound uses ______ to determine how far the object is, the size, shape and consistency
echoes
How does an US transducer work?
A transducer sends the sound waves and records the echoing waves.
When pressed against the skin, it sends small pulses of HIGH frequency sound waves into the body
As the sound waves bounce off the internal organs, fluids, and tissues, the receiver records tiny changes in the sound’s pitch and direction
What is echogenicity?
Echogenicity of the tissue refers to the ability to reflect or transmit US waves in the context of surrounding tissues
shows the relative brightness or darkness of a structure
**What is hypoechoic? What color will it appear on US? What type of tissue?
Tissue in body that is more dense or solid
Absorbs MORE US waves
LESS reflective and low amount of echoes
appears GRAY or darker than the surrounding tissue
made up of muscle/ fibrous CT
**What is hyperechoic? What color will it appear on US? What type of tissue?
Reflects sound waves of higher amplitude
Gives off more “echoes”
appears lighter or brighter than surrounding tissue
air, fat and gas
A fatty liver would show ______ spots on the liver
hyperechoic
What is anechoic? What color will they appear on US? What is it usually composed of?
structures that appear black because no internal echoes reflecting back
fluid and blood filled structures because the beam passes easily through these structures without significant reflection
What is the color scale of echogenicity?
Label this picture
white: liver
red: gallbladder
blue: hepatic artery
green: portal vein
pink: common bile duct
What should a normal liver US look like?
homogenous: same throughout
What is the most likely diagnosis?
fatty liver
What should a normal gallbladder look like on US?
smooth thin walls, less than 2mm with an anechoic lumen
What should a normal biliary tree look like on US?
narrow caliber, 6mm or less with uniform ductal walls
Label this picture
pink: gallbladder
yellow: cystic duct
purple: common bile duct
green: common hepatic duct
What is the normal common bile duct diameter?
less than 7mm
What is the most likely diagnosis?
Acute cholangitis
What is the most likely diagnosis
Acute cholecystitis
What is the most likely diagnosis?
gallstones
What are the 3 planes that cross-section the body during a CT?
Label 1-10
1: Lung
2: Liver
3: portal vein
4: duodenum
5: small bowel
6: ascending colon
7: ilium
8: air in sigmoid colon
9: pubis
10: symphysis pubis
Label this picture
1: heart
2: stomach
3: left colic flexture
4: splenic artery
5: pancreas
6: superior mesenteric vein
7: mesenteric vessels
8: small bowel
9: sigmoid colon
10: urinary bladder
11: left femoral artery
**Be able to label this picture
be able to label it
**Label this picture
What is the arrow pointing at?
normal appendix
What 3 things is a contrast CT good for?
imaging tumors
vascular abnormalities
urinary tract
**What is a non-contrast CT good for?
Best for evaluating stones
What is the most likely dx?
Acute Diverticulitis
When is a barium swallow most commonly used?
dysphagia
What is the most likely dx?
Schatzki’s ring
What is the most likely dx?
Diverticulosis
What is a MRCP? Do you use sedation?
Special type of MRI to produce detailed pictures of these ducts and organs
Powerful magnetic field, radio waves, and a computer to evaluate the liver, gallbladder, bile ducts, pancreas, and pancreatic ducts
Is noninvasive and NO sedation
What imaging study?
MRCP
What is an ERCP? Does it use sedation?
A diagnostic and interventional procedure technique using both endoscopy and fluoroscopy
Used for examination and intervention of the biliary tree and pancreatic ducts
It involves passing the endoscope to the descending duodenum and injecting contrast through the Ampulla of Vater
This will outline the biliary tree
YES to sedation
What imaging study?
ERCP
What is the biggest complication of ERCP? Why?
pancreatitis
Prolonged manipulation of the papillary orifice, difficult cannulation of the biliary tree, and repeated inadvertent instrumentation of the pancreatic duct result in ductal injury or injury to the ampulla.
Resultant papillary edema caused by mechanical or thermal injury is thought to obstruct the outflow of pancreatic secretion, resulting in pancreatitis.
