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Mosby CT review > Imaging Procedures HEPATOBILIARY > Flashcards

Imaging Procedures HEPATOBILIARY Flashcards

1
Q

What’s the whole goal in using MDCT for hepatobiliary evaluation

A

look for and characterize liver lesions

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2
Q

How does IV contrast help in MDCT hepatobiliary evaluation

A

differentiates between lesions and normal liver tissue

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3
Q

indications for non contrast imaging of the liver

A
  • look for hemorrhage
  • fatty infiltration
  • liver calcification
  • characterize lesion enhancement
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4
Q

hypo dense, hyper dense, iso-dense, hypo vascular, and hyper vascular are terms used to describe what ?

A

hypo dense &hyper dense: Describes density of soft tissue masses in relation to their surroundings

hypo vascular & hyper vascular: tumor vascularity

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5
Q

Unenhanced liver tissue has a CT density range of what?

Is its density greater or leas than blood vessels and spleen tissue ?

A

45-65 HU

greater

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6
Q

T/F . Hepatic mets are usually hyperdense.

A

F.

Hypodense

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7
Q

Tumors with densities equal to that of surrounding tissue are termed:

Give example

A

iso-dense

HCCs

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8
Q

3 Examples of hyper-vascular tumors

A
  • HCC’s -Hepatocellular carcinoma’s
  • FNH’s- Focal Nodular Hyperplasia’s
  • hyper-vascular mets
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9
Q

What technique can help you better visualize iso-dense tumors like HCCs

A

scanning during multiple phases of enhancement

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10
Q

Which growths are benign ? Malignant ?

Hepatocellular Carcinoma, Hemangioma, Focal Nodular hyperplasia, metastases, hepatic cyst

A

Benign

  • Focal nodular hyperplasia
  • cysts
  • hemangioma

Malignant

  • HCC’s
  • Metastases
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11
Q

Benign tumor characterized by peripheral globular enhancement

A

Hemangioma

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12
Q

Benign tumor located on liver surface. Has intense homogenous enhancement

A

Focal nodular hyperplasia

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13
Q

Benign tumor. Distinguished by thin , round/oval shape. Attenuation equal to water

A

hepatic cyst

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14
Q

The most common primary malignant growth

A

HCC

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15
Q

This tumor appears hyper dense during arterial imaging and hypo dense during noncontract scanning

A

HCC

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16
Q

Primary tumors that - commonly metastasize to the liver typically come from where ( list 5)

A 
stomach
colon 
lung 
pancreas 
breast
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17
Q

What is steatosis ?

A

A fatty liver

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18
Q

Indications for a MDCT scan of the liver

A
  • liver disease thats spread
  • trauma
  • infection
  • preop / post op
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19
Q

Two examples of diffuse liver disease

A

steatosis (fatty liver)

cirrhosis

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20
Q

Two causes of liver cirrhosis

A

alcoholism

hepatitis

21
Q

chronic disease characterized by portal hypertension , enlarged lobes, and invading fatty substance

22
Q

chronic disease that makes the liver appear less dense than the spleen

23
Q

Most commonly injured organ in trauma

second most common

A

spleen

liver

24
Q

Describe the dual blood supply of liver

A

75% from hepatic portal vein

25% hepatic artery

25
What are the four phases of contrast enhancement in the liver
arterial portal venous equilibrium
26
what time frame (seconds) is associated with each enhancement phase of the liver - arterial - portal venous - equilibrium
- arterial 25-35 sec - portal venous 60-70 sec - equilibrium 2-3 min
27
Hypervascular tumors are maximally enhanced at this phase
arterial
28
hypovascular lesions are maximally enhanced at this phase
portal venous
29
contrast enhancement begins to dissipate and you cant tell the difference between lesions and vasculature at this phase
equilibrium
30
What's the time difference between an arterial and early arterial phase
early arterial 15-20 after contrast admin arterial 25-35 seconds after
31
which phase occurs 5-20 mins after contrast admin? What is the purpose of this phase during MDCT of the liver?
delay represents complete fill of hemangioma
32
3 factors that influence the timing of hepatobiliary phases
- cardiac output - injection duration - Iodine [C]
33
What is the benefit of scanning the liver in multiple phases
improves visualization of hypo and hyper vascular lesions
34
The degree of liver tissue enhancement depends on what ?
dose of iodine delivered
35
T/F reduced cardiac output has no effect on peak arterial and tissue enhancement
false . Delays enhancement
36
How does a rapid injection rate benefit enhancement phases in the liver
provides more temporal separation between arterial and venous phases
37
Give example of increasing iodine dose both directly and indirectly
directly: use contrast with higher iodine [C] indirectly: use higher flow rate
38
T/F. it is important to scan the liver during the highest level of contrast enhancement
True
39
Describe gallbladder appearance on CT
oval sac, along inferior surface of the liver , within a fossa
40
The CT density of the gallbladder is near that of what substance ?
water
41
difference between cholelithiasis and cholecystitis
cholelithiasis is otherwise known as gall stones the other is inflammation of the gallbladder
42
How do calcified vs cholesterol vs mixed composite gall stones appear on a ct
calcified stones: easier to see cholesterol stones: less density than bile mixed composition: obscured on image
43
3 parts of the biliary tract
common hepatic duct common bile duct intrahepatic bile duct
44
What initial step can be used to look for gall stones
pre contrast image
45
what can be used to eliminate streaking artifact from positive contrast in duodenum
water
46
size of thins needed fro optimal images of GB and biliary tree
0.5 - 2 mm
47
indications for biliary tree CT
bile duct stones inflamed bile duct neoplasm in BD dilated or blocked duct
48
what is choledocholithiasis? | cholangitis ?
bile duct stones inflamed BD

Mosby CT review (8 decks)

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