Lecture 25: Radiology and Ultrasound of Pancreas and Adrenal Gland Flashcards
what is the best modality to evaluate pancreas
ultrasound
T or f: can see normal pancreas on rads
false
abnormal pancreas displaces duodenum __
peripherally
The portal vein crosses _- to the body of the pancreas
dorsal
where does the left limb of the spleen sit
Triangle between spleen, stomach and colon
what are some indications for pancreatic ultrasound
- Suspect pancreatitis
- Undiagnosed or non-responsive vomiting
3, mass detect in region - Suspect biliary obstruction
- Abdominal pain
t or f: difficult to ultrasound normal pancreas
true
t or f: pancreatic ultrasound lack specificity: inflammatory vs neoplasia
true
identify 1-5 and what wrong and how do you know
- Liver
- Stomach
- Spleen
- Pancreas
- Colon
Problem with pancreas because only thing between stomach and colon and pushes colon dorsally
ultrasound of pancreas- what circled
Pancreatic duct
how does pancreatitis look on ultrasound
hypoechoic mass dorsomedial to duodenum, caudal to stomach
What wrong and how do you know
pancreatitis- C- shaped duodenum pushed to periphery
ultrasound of pancreas what wrong
pancreatitis
which is more likely to have more fluid- pancreatitis or pancreatic neoplasia on ultrasound
neoplasia
what are some complications of pancreatitis
- Pseudo cyst
- Abscessation
- Bile duct obstruction
Patient dx with pancreatitis what is indicated by 1
pseudocyst
what are some examples of neoplasias of pancreas
- Adenocarcinoma
- Insulinoma
what do you see with adenocarcinoma of pancreas on ultrasound
- Carcinomatosis
- Hepatic metastasis
- Fluid
what do you see on ultrasound of insulinoma and what is classic BW finding
hypoechoic mass
Hypoglycemia
Ultrasound of pancreas what wrong
metastatic carcinoma- very nodular mesentery
Also fluid
patient presents with extreme hypoglycemia- take ultrasound of pancreas and see this what likely dx
Insulinoma
what are the landmarks for adrenal gland
- Caudal to adrenal gland- left renal artery
- Cranial to adrenal gland- cranial mesenteric artery
what are some landmarks for right and real gland
between caudal vena cava and aorta
the left adrenal gland is bilobed in __
Small dogs
the left adrenal gland is __in larger dogs
elongated ellipse
what is the normal width of dog left adrenal gland
0.75cm/7.5mm or less
what is shape of cat adrenal gland
oval
what is normal width of cat adrenal gland
0.4cm/4.0mm
what circled
adrenal gland
what are some adrenal gland, liver, and biliary abnormalities seen with pituitary dependent hyperadrenocorticism/ cushings
- Normal
- Bilateral adrenomegaly
- Hepatomegaly
- Biliary debris
what neoplasia are associated with adrenal gland
- Adenoma, adenocarcinoma (mineralizes)
- Pheochromocytoma
patient presents with alopecia, pendulous belly- do ultrasound of adrenal gland and see this- based on size what is likely dx
Pituitary dependent hyperadrenocorticism
what wrong
adrenal gland tumor
Patient presented with tachycardia, tachypnea ultrasound adrenal gland and see mass invading caudal vena cava. What likely dx
Pheochromocytoma