Liver, Biliary Tree, and Gallbladder

Question 1

What is the current method of choice for most hepatic imaging?

Answer 1

Dynamic bolus contrast-enhanced MDCT

Question 2

What modality is used as a screening method for patients with abdominal symptoms and suspected diffuse or focal liver disease?

Answer 2

Ultrasound

Question 3

Modality used in the characterisation of cavernous hemagiomas and focal nodular hyperplasia.

Answer 3

Radionuclide imaging

Question 4

Maximum enhancement of the liver occurs on what phase? (MDCT protocols)

Answer 4

Portal venous phase - to demonstrate hypovascular lesions as low-attenuating masses on a background of brightly enhanced parenchyma.

Question 5

Maximum enhancement of the liver parenchyma occurs how many seconds after hepatic arterial enhancement?

Answer 5

60 to 120 seconds

Question 6

What divides the liver into right and left lobes?

Answer 6

A longitudinal plane through the middle hepatic vein, inferior vena cava, and gallbladder fossa.

Question 7

Portal venous flow may be altered by what circumstances?

Answer 7

1. Portal blockade by tumour or thrombus
2. Extrinsic compression caused by ribs or diaphragm stocks slips, or tumors of the liver capsule
3. “Third inflow” from systemic veins in the pericholecystic, paramilitary, and epigastric-paraumbilical venous system

Question 8

Increased hepatic arterial flow me be due to what situations?

Answer 8

1. Focal hypervascular lesions
2. Inflammation of adjacent organs (cholecystitis and pancreatitis)
3. Aberrant hepatic arterial supply

Question 9

The echogenicity of the liver parenchyma is homogeneous and equal to or slightly greater than what structure?

Answer 9

Kidney

Question 10

What is the preferred screening method for biliary obstruction?

Answer 10

Ultrasound

Question 11

What modality or method is used primarily to guide therapy such as stent placement for biliary strictures, stone extraction, or sphincterectomy?

Answer 11

Endoscopic retrograde cholangiography

Question 12

What method is mainly used to guide therapy when the biliary tree cannot be accessed endoscopically such as when the patients have choledochojejustomy?

Answer 12

Percutaneous transhepatic cholangiography

Question 13

Bile ducts arise at what structures?

Answer 13

As bile capillaries between hepatocytes and join progressively larger two main trunks are formed draining the right and left lobes of the liver.

Question 14

The ducts of the left hepatic lobes are located in what position in relation to the right hepatic lobe?

Answer 14

More anterior

Question 15

Failure to fill the biliary ducts (on contrast study) before gravitational repositioning must not be interpreted as?

Answer 15

As evidence of obstruction

Question 16

These are small folds in the cystic duct

Answer 16

Spiral valves of Heister

Question 17

A gallbladder greater than how many cm in diameter is considered enlarged (hydronic)?

Answer 17

Greater than 5 cm

While a gallbladder less than 2 cm is considered contracted