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NME > Imaging of the Abdominal Viscera > Flashcards

Imaging of the Abdominal Viscera Flashcards

1
Q

Abdominal radiography has a lower ———- and ———- than CT but still retains a useful role in diagnosis

A

Sensitivity and specificity

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2
Q
A
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3
Q

Abdominal radiography (AXR) features:

A
  • patient supine
  • exposure taken on expiration
  • should include diaphragm, pubic symphysis, lateral flank lines
  • sof tissue structures and bony detail should be well demonstrated
    0 no overlying artefacts eg clothing, zips
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4
Q

Valid reasons for referral for abdominal radiography (AXR) (8):

A
  • clinical suspicion of obstruction
  • acute exacerbation of IBD
  • palpable mass (specific circumstances)
  • constipation (elderly)
  • acute and chronic pancreatitis (specific circumstances)
  • sharp/poisonous body eg battery
  • blunt or stab injury
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5
Q

For abdominal pain only what imaging mode is appropriate?

A
  • AXR not usually indicated
  • US, erect CXR, CT KUB, CT abdomen
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6
Q

Inappropriate requests for abdominal radiography (AXR) (5):

A
  • abdominal pain only
  • Right or left iliac fossa pain
  • Right upper quadrant pain
  • Epigastric pain
  • Altered bowel habits
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7
Q

Normal appearances of abdominal radiography (AXR)?

A
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8
Q
A
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9
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10
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11
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12
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13
Q
A

Large bowel and rectum = normal
Contains faeces and air giving a mottled appearance

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14
Q
A
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15
Q

Why refer to abdominal CT (5)?

A
  • to assess tumour staging
  • to determine disease eg cirrhosis
  • to determine site and causes of obstruction
  • to identify perforation - free air
  • trauma
  • for biopsy or other interventional procedure
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16
Q

What is shown?

A
  • abdominal axial CT
  • distended colon
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17
Q

Axial CT abdomen

A
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18
Q
A
19
Q

What modality?

A

CT colonoscopy

20
Q

CT colonoscopy (5):

A
  • known as CTC or virtual colonoscopy
  • can replace barium enemas for patients whom colonoscopy has failed
  • assess for strictures/ Carcinoma of the colon
  • minimally invasive low dose of radiations
  • comparable accuracy to optical colonoscopy
21
Q

CT colonoscopy can be viewed as a virtual colonoscopy by

A

Images obtained in all planes can be reconstructed to 3D

22
Q

CT colonoscopy requirements:

A
  • bowel must be empty; high dose laxative
  • distended with gas via rectal tube
  • IV contrast given to demonstrate tumours
23
Q
A
24
Q

Who can refer for MRI abdomen?

A
  • not usually from primary care; outpatient/inpatient most common
  • liver, gynaecological, prostate, MRI bowel most common
  • patients must be able to lie still and be MRI safe
25
Q

MRI of the bowl: generally called?

A

MR Enterography

26
Q

MR enterography:
- commonly used to
- comparison to barium Studies
- assess for (4)

A
  • commonly used to evaluate the extent of Crohn’s disease
  • more sensitive and specific than barium studies
  • assess for thickening of bowel wall, fistulae, abscesses, inflammatory changes
27
Q

MR Enterography requires

A
  • patients to starve for 4-6 hours
  • drink 1.5L contrast to distend the bowel to evaluate the bowel wall
28
Q

Which modality shown below?

A

Axial MRI abdomen
MR Enterography

29
Q

Which modality shown below?

A

MR Enterography

30
Q

MRCP stands for

A

Magnetic resonance cholangiopancreatography

31
Q

MRCP (5):

A
  • non invasive
  • to assess biliary tree, pancreatic ducts; stones, strictures tumours
  • replaces ERCP for some patients
  • data obtained and reformatted to create 3D images
  • breath hold technique used
32
Q

Which imaging modality shown below?
What does the white arrows show?

A

MRCP

33
Q

Abdominal ultrasound

A
  • good first line test for solid viscera
  • referral reasons should be specific and appropriate; jaundice, suspected gallbladder disease, mass
  • all abdominal organs scanned in both transverse and longitudinal planes
34
Q
A
35
Q

What pathology? AXR

A

Small bowel obstruction

36
Q

What pathology? AXR

A

Large bowel obstruction
Distended over gem

37
Q

Perforation: what do the arrows show? What sign?

A
38
Q

If abdominal perforation, exr may be appropriate & is seen by

A

A thin crescent of air under right hemidliaphragm, which is a normal finding in post operative period

39
Q

What pathology shown below?

A
  • Abdominal perforation
40
Q

What pathology shown below?

A

Yellow-raunde=kidneystones
Red= larger = edge of liver over kidney = gallstones

41
Q

Abdominal aortic aneurysm

A
  • more than 5 1/2cm
  • risk of rupture increases with size
  • result in massive haemorrhage
  • surgical repair
  • sometimes an incidental finding
42
Q

What imaging modality? What pathology?

A

Abdominal radiography (AXR)
Abdominal aortic aneurysm

43
Q

What imaging modality? What pathology?

A

Abdominal axial CT
Abdominal aortic aneurysm

44
Q

What imaging modality? What pathology?

A

Coronal volume CT with contrast
Abdominal aortic aneurysm

NME (52 decks)

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