Hepatoiliary imaging Flashcards
Indications for imaging
H&P
Laboratory
Acute ab pain
TTP (RUQ, epigastric)
Fever, Jaundice, ascites, spleno
Leukocytosis
Hyperbilirubinemia
Elevated AST/ALT, Alk Phos/GGT. lipase
First line imaging modality
items such as
ultrasound
Gallstones BD dilation Cirrhosis Vasculature HCC Screening
CT
Most common modality for _____
Not sensitive for ______
Best for evalutation complications of ______
evaluating ab pain
gall stones
pancreatitis
MRI
Best imaging modaility for _____ patho
Excellent eval of _____/____
Hepatobiliary and pancreatic pathology
Bile/pancreatic ducts
Gallstones findings
US
CT
MR
US- echogenic, posterior shadowing
CT- cholesterol stones not seen, pigmented are
MR- filling defect in GB/BD
Acute cholecystitis key findings
Best overall finding
Gallstones
Wall thickening
Pericholecystic fluid/stranding
+ sonographic Murphy’s
Choledocolithiasis key findings
US
Lab values
Sequela
Gallstone in CBD
BD dilation
Inc Alk Phos/GGT/bilirubin
Acute pancreatitis, cholangitis
Positive ultrasound for dilated CBD, next step is
Findings on MRCP
ERCP Management of choledocholithiasis
ERCP/MCRP
Stones in GB, CBD, BD dilation
Sphincterotomy/balloon sweep
Pancreatitis dx- 3 features
Imaging findings
Necrotizing indicated by
Chronic indivated with
Inc lipase, epigastric pain, imaging findings
Peripancreatic stranding
Pancreatic necrosis
Peripancreatic collections
Walled off necrosis
Normal lipase, epigastric pain, CALCIFICATION
Cirrhosis key findings
Liver surface nodules Heterogenous liver Ascites Splenomegaly Pleural effusion Portosystemic collaterals
Portal HTN
Ascites Splenomegaly Pleural effusion Paraesophageal varices Recanalized umbilical vein
HCC key findings
Screening modality
interval
On US
Arterial enhancement/washout
pseudocapsule
greater than 10mm
US, 6mnths
Coarse, nodule, hypoechoic lesions
Treatments for HCC
transplant, ablation
