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104 Theme 1 > imaging abdominal viscera > Flashcards

imaging abdominal viscera Flashcards

1
Q

imaging modalities for the abdomen

A

Xray/fluroscopy
US
CT
MRI

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2
Q

what are the two types of imaging views

A

plain (superimposed front to back) and cross sectional (slices)
planes - axial cronal and sagittal

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3
Q

what are the differences in resolutions

A

spatial and contrast resolution

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4
Q

what are the images of MRI

A

Many types of image sequences, weighted T1 - fluid is black and T2- white

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5
Q

what is contrast

A

used to increase contrast resolution (eg highlight specific areas/organs)
given via IV or enteral (oral/PR) before scan
either more or less dense than surrounding tissues (XR/CT) or paramagnetic (MRI)

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6
Q

pros of xray

A 
cheap 
quick
easy for pt
high spatial resolution 
low radiation dose
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7
Q

cons of xray

A

poor contrast resolution

planar imaging

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8
Q

pros of CT

A

quick
widely available
cross sectional images
high contrast resolution

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9
Q

cons of CT

A

radiation dose

IV contrast risks

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10
Q

pros of US

A 
cheap
quick
no radiation 
cross sectional images 
US guided interventions
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11
Q

cons of US

A

saved images are only a snapshot of exam (operation dependant)

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12
Q

pros of MRI

A

contrast resolution
specific applications
no radiation

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13
Q

cons of MRI

A

limited availability
patient experience (time, space)
expense
magent/contrast risks

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14
Q

how does the structure of an organ affect imaging

A

solid (eg kidney) vs hollow (eg bladder) viscera

modalities look at different ones better, eg US can’t go through air in hollow viscera

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15
Q

how does positioning affect imaging

A

intra vs retroperitoneal (inside peritoneal layer, single layer or double surrounding)
determines how pathology spreads through abdomen

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16
Q

how does circulation affect imaging

A

systemic vs portal circulation

17
Q

what are the solid abdominal viscera

A

liver spleen pancreas

18
Q

what is the liver structure (basic)

A

RHV, LHV and MHV entering top to drain
CBD, HA and PV entering bottom, triad goes to 8 segments (divided by portal vein horizontally and hepatic veins vertically)
biliary system

19
Q

how is the liver imaged via US

A 
hepatic and portal veins 
 IVC 
 fluid movement via doppler flow
can see GB (useful for gallstones, shadowing white structure)
metastasis (dark blobs)
20
Q

How is the liver imaged by CT

A 
Hepatic veins (R, M, L) IVC, portal vein from celiac artery (axial)
downwards can see stomach via air and other organs 
can do contrast eg to see vessels
gallstones, dilated bile ducts and metastasis
21
Q

how else can the liver be imaged

A

intervention radiologists (real time imaging to diagnose and sort issues eg blocked vessels)
ERCP (endoscope with camera, also using xray to guide)
PTC (see bile system)
DSA (see arteries via catheter)
MRI (detail of biliary system)

22
Q

what is basic structure of the spleen

A

LUQ at tail of pancreas

splenic vein

23
Q

how is the spleen viewed

A

coronal above kidney

axial stomach and liver anterior

24
Q

imaging pathologies of spleen

A

spleen can be shattered by trauma and replaced by haematoma
lymphoma
lesions
CT

25
Q

basic structure of the pancreas

A

head of pancreas in curve of duodenum to boy and fungus
lobules
pancreatic duct to join CBD into duodenum

26
Q

how is the pancreas seen on US

A

courses round splenic vein

27
Q

how is the pancreas seen on CT

A

crisp outline with sup mes vein and artery

28
Q

how is pathology seen

A

loss of outline, enlarged, irregular and areas of lower density - acute inflammation (pancreatitis)

29
Q

hollow viscera of the abdomen

A

stomach, SB, LB

Xray good first line rest then MRI and CT (avoids endoscopy)

30
Q

imaging the bowel by xray

A 
normal calibre (LB 5cm and SB 3cm)
looking for free air, normal distribution of bowel gas
31
Q

how is the stomach seen on xray

A

LUQ, fundus under left hemidiaphragm, obliquely orientated
contains fluid and air
wall is regal folds
size variable

32
Q

how is the SB seen on xray

A 
central abdomen 
fluid and air contents 
encircling valvular conniventes- wider in ileum 
spaced out when distended 
<3cm diameter
33
Q

how is the LB seen on xray

A 
peripheral, LB frames SB
faeces (liquid and hard)
haustral folds 
spaced out when distended 
<6cm, <9cm caecum
34
Q

how can a chest xray be used

A

perforation (free gas in highest point, diaphragm)

35
Q

how is the bowel screened

A

fluoroscopy
single contrast barium follows through
works with gas for double contrast (barium enema, hard for frail and elderly)

36
Q

bowel imaging via CT scan

A

CT colonography

look for polyps or 3D fly through to prompt colonoscopy

37
Q

bowel imaging via MRI

A

Seen detail in bowel

IBD in SB and rectal tumour staging in LB

104 Theme 1 (18 decks)

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