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Module 12 > Interpretation of Diagnostic Images > Flashcards

Interpretation of Diagnostic Images Flashcards

1
Q

what is the 3 stage approach

A
  1. recognition: systemic search of the image, systemic scan of entire organ
  2. report: identify and describe abnormalities
  3. interpretation/analysis: make diagnosis, generate systemic differential diagnostic list
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2
Q

what are the key points in recognition

A

systemic search of entire image (system by system, area by area)

don’t get distracted by obvious lesions

2 orthogonal views required

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3
Q

what are the changes to be described in the reporting stage (7)

A
  1. size
  2. shape/margin
  3. number
  4. position/location
  5. opacity/echogenicity/signal
  6. internal structure (contrast studies, ultrasound, advanced imaging)
  7. function (dynamic studies, ultrasound)
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4
Q

what are possible causes of increase size

A

hypertrophy, hyperplasia, inflammation, neoplasia, edema, congestion, torsion, cystic disease

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5
Q

what are possible causes of decreased size

A

atrophy, hypoplasia, congenital

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6
Q

what are altered shape/margin causes

A

trauma, hypertrophy, hyperplasia, neoplasia, abscess, necrosis, ulceration, hematoma

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7
Q

what are causes of loss of visibility

A

surrounding disease (free fluid, altered opacity of adjacent structure)

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8
Q

what are causes of altered number or normal structure

A

increased: accessory development centres, congenital anomaly
decreased: anomaly, ectopia, previous surgery

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9
Q

what does the number of lesions indicate

A

primary vs secondary

malignancy

disseminated infection/inflammatory disease

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10
Q

what does the position of structures indicate

A

adjacent mass or organ/space enlargement

traction

torsion

hernia/rupture

ectopia

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11
Q

what does increased opacity mean

A

fluid/soft tissue accumulation

mineralization (soft tissue calcification, calculi)

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12
Q

what is decreased opacity mean

A

air accumulation

decreased bone density

fat accumulation (lipoma)

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13
Q

what is done in the interpretation phase (3)

A
  1. generate differentials for all abnormalities found
  2. structured list (most likely first)
  3. consider all clinical findings (may influence differential list)
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14
Q

what is VITAMIN D

A

V: vascular

I: inflammatory, infectious

T: traumatic, toxic

A: anomalous (congenital)

M: metabolic (endocrine)

I: iatrogenic, idiopathic

N: neoplasia, nutritional

D: degenerative

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15
Q

what are the imaging report components(6)

A
  1. patient and study details (patient ID, breed, age, date of study, images obtained)
  2. image quality: is it good enough to make a diagnosis?
  3. description: record/describe abnormal findings
  4. summarize and differentials: recap major abnormalities and generate differentials for abnormalities
  5. refine differentials lists: incorperate other information (history, clinical exam, bloods) etc to reduce/refine differential lists
  6. plan: suggest further investigations to get definitive diagnosis or plan treatment based on imaging findings
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16
Q

what is the difference between informed and blind interpretation

A

informed: aware of history –> better ability to recognize and dismiss incidental lesions, earlier refinement of differential lists, risk of bias (over-reading, expecting specific findings, temptation to finish exam)
blind: no info on patient, no bias, less likely to terminate exam early, longer and less structured differential lists

17
Q

what are search errors (7)

A
  1. missed
  2. interpreted as normal
  3. failure to examine entire image
  4. not noting absence of normal structure
  5. inadequate image quality
  6. failure to fully assess complex area (skull)
  7. reliance on pattern recognition
18
Q

what are under-reading errors

A
  1. failure to identify lesion
  2. failure to consider appropriate differentials (preconceived ideas, identifying a certain combo of changes as a specific diagnosis, failing to reconsider differentials when presented with new evidence)
19
Q

what are over-reading errors (4)

A
  1. not recognizing breed/species variations
  2. identifying normal feature as pathology
  3. failure to recognize non-diagnostic images
  4. mistaking incidental finding for significant pathology
20
Q

what are analysis errors

A
  1. generation of incorrect or incomplete differential list
  2. inappropriate further investigation

Module 12 (8 decks)

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