Random_7 Flashcards
Adrenal CORTICAL carcinoma
as opposed to the medullary - pheochromocytoma
Adrenal protocol
- ROI has to be at least 1/2-2/3 of the adrenal gland
- relative washout = enhanced-delayed/enhanced
- >40% benign
- absolute washout = enhanced-delayed/enhanced-unenhanced
- >60% benign
- if not benign, then it is INDETERMINATE
- can go for biopsy
- or 6/12 follow up
- or NM study - MIBG study
- DO NOT suggest adrenal MR, as MR is same as CT on adrenals
Adrenal cortical carcinoma
- often huge and ugly looking
- grows super fast

Stages of SLAC wrist
These begin at the radial aspect of the radioscaphoid joint (due to its major function in wrist loading), then the remainder of the radioscaphoid joint, and ultimately the capitolunate joint.
- Stage 1
- radial aspect of radioscaphoid joint
- Stage 2
- entire radioscaphoid fossa
- Stage 3
- narrowing and sclerosis of capitolunate joint and entire entire radioscaphoid fossa

Staging of bladder tumor
T0: No tumor is found in the bladder.
Ta: The tumor is only found on the inner lining of the bladder.
T1: the tumor has invaded the lamina propria (tissue under the lining of the bladder)
T2: The tumor has grown into the muscle layer of the bladder, either superficially (stage T2a) or deeply (stage T2b). Stage 2 and higher tumors are considered to be invasive cancers.
T3: The tumor has grown through the bladder muscle into the fat layer surrounding the bladder.
T4: The tumor has spread to surrounding organs, such as the prostate, bowel, vagina, or uterus
Staging of RCC
- T
- T1 - limited to the kidney. T1a - <4cm; T1b 4-7cm
- T2 - limited to kidney, >7cm
- T3 -extends to the renal veins or infradiaphragmatic IVC
- T4 - ispsilateral adrenal gland or beyond the Gerota’s fascia
- N
- N0 - no nodal involvement
- N1 - nodal involvement
- M
- M0 - no metastasis
- M1 - distant metastasis
Stercoral ulcer
Stercoral ulcer is an ulcer of the colon due to pressure and irritation resulting from severe, prolonged constipation. It is most commonly located in the rectum.
Most commonly missed things on abdo CT
- PE in the lower lobes
- DVT
Types of endoleak of an endovascular stent graft
- Type 1
- inadequate seal
- most common in thoracic aneurysm repair
- Type 2
- collateral vessels
- most common in abdominal aorta
- Type 3
- defect in the fabric of the graft - actual mechanical failure of the graft
- Type 4
- generally porous graft - intentional design of the graft
- Type 5
- endotension
PRES
- posterior reversible encephalopathy syndrome
- posterior - parietal, occipital, and cerebellum; in the subcortical regions; usually bilateral
- spares basal ganglia and the brainstem
- mechanism: hypertension (eclampsia) or cytotoxic drugs/immunosuppressive drugs –> destroy capillary permeability and cap leakage and destroy autoregulation –> edema; may be complicated by infarct or hemorrhage
Pellergrini-Stieda Disease

- post-traumatic calcification/ossification of the proximal MCL
- adjacent to the margin of the medial femoral condyle
- grades of MCL injury
- grade 1 - interstitial tear - adjacent soft tissue T2 hyperintensity
- grade 2 - partial tear - T2 hyperintensity within the MCL itself
- grade 3 - complete tear
Saying
In a patient with no prior history of malignancy and given the conspicuity of this lesion despite its small size, it likely represents a small hepatic cyst or hemangioma.
In a patient with no prior history of malignancy and given the conspicuity of this lesion despite its small size, it likely represents a small hepatic cyst or hemangioma.
Portal venous phase
< 37 HU
Adrenal adenoma!!!
Medullary nephrocalcinosis is more common than
cortical nephrocalcinosis

- medullary nephrocalcinosis (95%), vs cortical nephrocalcinosis (5%)
- affected kidney is typically normal in size and contour
- often asymptomatic
- earliest sonographic finding in medullary nephrocalcinosis is the absence of hypoechoic papillary structures –> then become hyperechoic
- most common cause - Hyperparathyroidism

DDX for medullary nephrocalcinosis
- HOMERS
- Hyperparathyroidism
- Oxyuria, hypercalcemia, hypervitaminosis D, milk alkali syndrome
- Medullary sponge kidney
- E…
- Renal tubular acidosis
- Sarcoidosis

Ochronosis
- multilevel vertebral disc calcification
- multilevel vertebral disc space narrowing
- syndesmophytes

Neonatal alloimmune thrombocytopenia
NAIT
- NAIT is an uncommon cause of neonatal thrombocytopenia with variable presentation due to placental transfer of maternal antibodies against paternally inherited fetal platelet antigens.
- Imaging findings aid in the diagnosis of NAIT. Consider NAIT in the setting of multiple intracranial hemorrhages of varying ages and in the absence of other sequela of congenital infection or trauma.
- Chronic hematomas may not exert significant mass effect.
- MR appearance of blood products aids in approximating their actual chronicity.
Serum tumor markers for
carcinoid
CJD
- Carcinoid - 5-HIAA
- CJD - EEG, 14-3-3 protein, S100
How to calculate ovarian volume?
A x B x C x 0.523
Normal:
- premenopasual < 20cm3
- postmenopausal < 10cm3
2 things that can cause
hepatic or portal venous thrombosis
- HCC
- abscess
What does melanoma like to go?
- 3S’s
- spleen
- subcutaneous soft tissue
- small bowel (serosal surface)
Pouchitis
Common
small bowel is not made to hold stool
Small bowel mesentery
- suspends the jejunum & ileum
- extends like a fan obliquely across the abdomen from the ligament of Treitz in the LUQ to the region of right SI joint
- contains branches of the SMA and SMV, and mesenteric lymph nodes
- Dz originating from above the liagment is directed towards the RLQ
Greater omentum
- a double layer of peritoneum
- hangs from the greater curvature of the stomach
- descends in front of the abdominal viscera
- encloses fat and a few blood vessels
- serves as fertile ground for implantation of peritoneal metastases
























