Radiology Flashcards
What radiographic abdominal series variation is indicated given a clinical exam?
KUB - for specific question (tube placement, stone)
KUB supine/upright series - for small or large bowel obstruction
Acute abdominal series - if bowel perf suspected
What is the normal size of the small bowel?
<3 cm
What are the four common indications for a KUB?
abdominal pain
suspected bowel obstruction
suspected renal stone
suspected swallowed foreign body
What is pneumoperitoneum a sign of?
bowel perf
What is the test of first choice for suspected pneumoperitoneum?
actute abdominal series
CXR most useful film
What are radiographic findings of mechanical small bowel obstruction?
small bowel dilatation (>3cm)
paucity of distal small bowel and colon gas
air-fluid levels on upright view
CT if diagnosis still uncertain
What are radiographic findings of paralytic ileus?
mild dilatation of small bowel and colon without paucity of colon gas or with prominent colon gas
gas in rectum
What is a difference between the appearance of gallstones and renal stones on KUB?
gallstones are faceted
What are three common indications for a barium swallow?
dysphagia
chest pain, non-cardiac
GERD symptoms
What are four common diagnoses made by barium swallow?
esophageal carcinoma - irregular stricture w sharp overhanging edges
esophagitis - multiple ulcerations
hiatal hernia - stomach above diaphragm
achalasia - LES dysfunction, dilation of esophagus and narrowing at LES
What are four common indications for a UGI?
abdominal pain
suspected duodenal or gastric ulcer
suspected hiatal hernia
suspected gastric mass
What UGI findings suggest a duodenal ulcer?
persistent contrast collection, smooth mound of surrounding edema and thickened folds radiating to edge of ulcer crater
What UGI findings suggest a benign gastric ulcer?
smooth craters, smooth folds radiating to edge, smooth mounds of surrounding edema
What UGI findings suggest a malignant gastric ulcer?
irregular crater and mass around it, irregular edges and folds not radiating to edge
What are the five common indications for a small bowel follow through (SBFT)?
small bowel obstruction - intermittent or partial (not acute) small bowel mass suspected chronic GI bleed without source malabsorption syndromes/diarrhea IBD suspected
What are six common indications for a barium enema?
chronic GI bleed/hemoccult positive stools suspected large bowel obstruction left lower quadrant pain suspected diverticulosis/diverticulitis constipation or diarrhea suspected IBD
What barium enema patterns suggest colon cancer?
polypoid mass or irregular stricture
apple core lesion
What barium enema patterns suggest colonic polyp?
filling defect, mass protruding into colon
need laxative prep first
What barium enema patterns suggest diverticulosis and what suggest diverticulitis?
osis - smooth round contrast collections protruding from colon
itis - intramural or pericolonic abscesses, bowel wall thickening
most common in sigmoid
What barium enema patterns suggest ulcerative colitis?
shallow ulcerations, loss of haustral markings, granular mucosa, collar-button ulcers
What are the common indications for an abdominal ultrasound?
RUQ pain (suspected gallstone) jaundice increased LFTs screen for liver masses evaluate for hepato and splenomegaly
What are the two indications for a tagged RBC study?
acute GI bleeding
liver hemangioma
When are tagged RBC studies useful with GI bleeding?
only when ACTIVE
When are HIDA or DISIDA scans done?
acute cholecystitis - esp if acalculous
biliary leak or biloma
How can nuclear imaging confirm ACUTE cholecystitis as opposed to chronic?
cystic duct completely obstructed in acute but not chronic
If you see the gallbladder, it is not…
acute cholecystitis
What are some common indications for MRI?
other imaging studies done and questions persist
contraindications like IV contrast
liver mass characterization, esp confirmation of hemangiomas
adrenal mass characterization
What are four common indications for abdominal angiography?
AAA
mesenteric ischemia
acute or chronic GI bleed - active, brisker than nuclear RBC
abdominal vascular trauma
