Lesson 1C (Part 2) Flashcards
Where do you commonly see bull eyes or target patterns?
With lung cancer
What is the sonographic appearance of a bull eyes or target pattern?
Hypoechoic peripheral halo
- hyperechoic centre
What are calcified metastases marked by? (2)
- Echogenicity
2. Distal acoustic shadowing
What is shadowing in the liver caused by? (4)
- Calcifications
- clean shadow - Air
- dirty shadow - Stones
- Fat containing lesions
What are the most common causes of a calcified liver tumour?
Metastases
What are 3 examples of cystic mets?
- Necrosis
- sarcomas - Cystadenocarcinoma of ovary & pancreas
- Mucinous carcinoma of colon
What is the sonographic appearance of cystic metastases? (5)
- Mural nodules
- Thick walls
- Fluid-fluid levels
- Internal septations
- Extensive necrosis
Where are infiltrative mets seen?
- Breast
- Lung
- Malignant melanoma
What is the sonographic appearance of infiltrative metastatic disease? (2)
- Diffuse disorganization of parenchyma
- may be confused with cirrhosis or fatty liver - Chemotherapy may make liver fatty
Kaposi sarcomas
Arise from connective tissue but can spread to liver
- rare
CEUS
Contrast enhancement ultrasound
What is the major role for contrast enhancement ultrasound? (2)
- Diagnosis
2. Detection of mets
What does CEUS involve?
The use of microbubble contrast agents and specialized imaging techniques
- tiny bubbles in an injectable gas
What are benefits to CEUS? (6)
- Shows sensitive blood flow and tissue perfusion
- Are not nephrotoxic
- No ionizing radiation
- Similar results as CT and MRI
- Determines vascularity in metastases
- Biopsy establishes the primary tissue site
What is a normal variant for hepatomegaly?
Reidels lobe
What are 9 causes of hepatomegaly?
- Liver Trauma ***
- alcohol abuse - Passive liver congestion
- Fatty liver
- Viral infections
- Hepatitis A, B and C - Mononucleosis
- Hemochromatosis
- Primary liver cancer
- Leukemia
- Lymphoma
Hepatomegaly
Enlargement of the liver
- can feel the liver edge below the rib cage
What is the normal range of the right lobe?
13-17cm
Where is Reidels lobe more common?
In women
Reidels lobe
Tongue shaped process of the liver
- gets mistaken for an enlarged liver
What are symptoms of hepatomegaly? (4)
- Abdominal pain
- Swelling
- Feeling of fullness
- Jaundice
What are diagnostic tests that can be taken for hepatomegaly? (5)
- Ultrasound
- X-ray
- CT scan
- Liver function blood tests
- Biopsy
What can hepatic trauma cause?
Enlargement
What is the sonographic appearance of fresh hemorrhage?
Echogenic
- after 1 week its hypoechoic
What is passive liver congestion caused by?
Stasis of the blood within the liver parenchyma
What are some negative side effects of passive liver congestion? (2)
- Hepatic venous drainage is compromised
2. Common complication of congestive heart failure
Why does the liver get enlarged with passive liver congestion?
Sinusoids dilate to accommodate back flow of the blood
Portal venous gas
Accumulation of gas in the peripheral portal venous system
What is portal venous gas caused by?
- Ischemic, necrotic, ulcerated bowel
- Colorectal carcinoma
- Inflammatory bowel disease
- Perforated peptic ulcer
- GI issues
