Imaging of the abdominal viscera

Question 1

What are the different imaging modalaties for abdomen?

Answer 1

▶X-ray (plain film) / Fluoroscopy

▶Ultrasound (US)

▶Computed Tomography (CT)

▶Magnetic Resonance Imaging (MRI)

Question 2

What are the 2 types of MRI images?

Answer 2

▶Many types of image sequences, but T1 & T2 weighted are the most important

◦T1 : fluid is black

◦T2 : fluid is white

Question 3

How are these MRI images weighted?

Answer 3

Question 4

What is contrast?

Answer 4

▶Used to increase contrast resolution (ie. highlight specific areas/organs)

▶Is given intravenously (IV), or enteral (oral/PR) before a scan

▶Is either more or less dense than surrounding tissues (for XR/CT), or paramagnetic (for MRI)

Question 5

Complete the table on imaging modalities

Answer 5

Question 6

What is Intra-peritoneal vs Retro-peritoneal?

Answer 6

Question 7

What are the solid abdominal viscera and what is a good first line test for them?

Answer 7

liver, spleen, pancreas

US – a good first line test for solid viscera

Question 8

What are hepatic segements divided by?

Answer 8

◦Divided by portal vein (horizontally) & hepatic (vertically) veins

Question 9

Label the diagram

Answer 9

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Question 12

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Question 13

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Question 14

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Question 15

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Question 16

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Question 17

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Question 18

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Question 19

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Question 20

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Question 21

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Question 22

What is the pathology?

Answer 22

CT :gallstones

Question 23

What is the pathology?

Answer 23

CT : metastases

Question 24

What is the intervention?

Answer 24

Intervention: ERCP

Question 25

What is the intervention?

Answer 25

Intervention: PTC

Question 26

What is the intervention?

Answer 26

Intervention: DSA

Question 27

What imaging modalilty is this?

Answer 27

MRI

Question 28

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Question 30

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Question 31

What is the pathology?

Answer 31

Trauma : shattered spleen

Question 32

What is the pathology?

Answer 32

Tumour : Lymphoma

Question 33

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Question 34

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Question 35

What the diagnosis?

Answer 35

CT : Pancreatitis

Question 36

What imaging modalities are good for bowel?

Answer 36

◦X-ray – a good first line test for bowel (US cannot see through air) ◦CT & MRI increasingly useful for bowel (avoids endoscopy)

Question 37

What are the 5 densities on x-ray?

Answer 37

Question 38

Complete the table

Answer 38

Question 39

Where is the small bowel and large bowel?

Answer 39

Question 40

How can you identify small bowel?

Answer 40

Question 41

How can you identify large bowel?

Answer 41

Question 42

Whats in the black circles?

Answer 42

Question 43

Whats the diagnosis?

Answer 43

X-ray (bowel obstruction)

Question 44

Whats the diagnosis?

Answer 44

X-ray (bowel perforation)

Question 45

What type of imaging is this?

Answer 45

Fluoroscopy (screening) Single contrast: Barium follow through

Question 46

What type of imaging is this and what does it show?

Answer 46

Double contrast: Barium meal

Question 47

Why is a Double contrast: Barium enema Difficult for frail patients?

Answer 47

Have to tip them around

Question 48

Which test is relacing barium enema?

Answer 48

CT Colonography (replacing Ba enema)

Question 49

What imaging method is this?

Answer 49

CT Colonography (replacing Ba enema)

Question 50

What is the diagnosis?

Answer 50

MRI small bowel (inflammatory bowel disease)

Question 51

What is this MRI used for?

Answer 51

MRI rectal tumour staging