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Soft Tissue Rad > Test #3 > Flashcards

Test #3 Flashcards

0
Q

What imaging agents are used primarily for the stomach & duodenum?

A

Barium (Upper GI series; esophagogastric junction to lig. of treitz)
CT scan: neoplasia & extent of ds

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1
Q

What imaging agents are used primarily for the pharynx & esophagus?

A

Barium: for morphology & motility

CT scan: Extent of the ds

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2
Q

What imaging agents are used primarily for the sm. intestine?

A

Plain film/CT scan: if obstruction is suspect
Barium: Intestinal ds
Enteroclysis
Retrograde Infusion

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3
Q

What imaging agents are used primarily for the colon?

A

Plain film: obstruction
CT Scan: extent of ds
Colonscopy: Lumen
Barium Enema: obstruction, diverticulitis, inflammatory bowel ds, primary neoplasm

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4
Q

What imaging agents are used primarily for liver & bile ducts?

A

MRI, Nuclear Scintigraphy, US, CT scan: mass lesion

US: obstruction or inflammatory ds of bile ducts

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5
Q

What imaging agents are used primarily for gallbladder?

A

Oral cholecystography(telopaque)/cholecystagogue: Filling defects & function
US: Acute & chronic gallbladder ds
CT scan: Abscess or carcinoma
HIDA AKA Cholescintigraphy: Tracks flow of bile

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6
Q

What does HIDA (hepatobiliary iminodiacetic acid scan) AKA cholescintigraphy test for?

A 
Bile duct obstruction
Bile leakage
Cholecystitis
Gallstones
Congenital abnormalities of the bile ducts
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7
Q

What imaging agents are used primarily for the pancreas?

A 
Plain film: calcfication, masses
CT scan: Done 1st when ds is suspected
US
Endoscopic retrograde pancreatography
Angiography
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8
Q

What are examples of special imaging used for the GU tract?

A

IVP/IVU (intravenous pyelography/urography)
Excretory pyelography/urography
Iodinated contrast films
Compression device over ureters

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9
Q

What is US used to visualize in the GU tract?

A

Kidney size
Parenchymal mass cysts
Dilatation of collecting system
Bladder

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10
Q

In the GU tract, doppler US is used to visualize what?

A

renal vasculature

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11
Q

In the GU tract, CT scan is used to visualize what?

A

Subtle density difference
Renal vessels
Charac. masses

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12
Q

In the GU tract, what is cystography used to visualize?

A

Traumatic rupture of bladder

Incontinence in female

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13
Q

What is usually used as the initial study for the ovaries & uterus?

A

Ultrasound

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14
Q

What is used to visualize the uterine tubes up to the ovaries?

A

Hysterosalpingography

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15
Q

What is used to visualize the prostate?

A

US

Retrograde urethrogram

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16
Q

What are risks assoc. w/ contrast nephropathy?

A

An acute impairment of renal function after exposure to a contrast medium
Rise in serum creatinine w/i 2-5 days of exposure
Rarely results in death

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17
Q

What type of pts are at greater risk for side effects of contrast nephropathy?

A

Pre-existing renal insufficiency
Insulin dependent diabetic w/ secondary renal ds
Repeated admin. of contrast over a short period of time
Transplant & renal dialysis pts
Total iodine dose is >100g w/i a 24 hr period

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18
Q

This is a ds that causes fibrosis of the skin & internal organs d/t the use of gadolinium in pts w/ renal insufficiency

A

Nephrogenic Systemic Fibrosis (Dermopathy)

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19
Q

What, generally, is visualized on a K.U.B.?

A

Bones
Bowel gas patterns
Soft tissue

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20
Q

What is the normal diameter of the small bowel?

A

2.5cm

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21
Q

What part of the bowel are fluid levels not normally seen?

A

Large bowel

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22
Q

What are you looking for on a supine abdominal view?

A

Bowel gas pattern
Mass
Calcification

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23
Q

What are you looking for on a prone abdominal view?

A

Air in rectosigmoid colon

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24
Q

What are you looking for on an upright abdominal view?

A

Free air

Air fluid levels in the bowel

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25
Q

What are you looking for on an upright PA chest in an acute abdominal series?

A

Free air
Pneumonia
Pleural effusion

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26
Q

What views are in an acute abdominal series?

A

Supine ab.
Prone ab.
Upright ab.
Upright PA chest

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27
Q

What are features of hepatomegaly on film?

A 
>15cm at midclavicular line (83%+)
Inf. hepatic flexure
Transverse colon below the R kidney
Liver shadow crosses R psoas margin
Elevated diaphragm
Riedel lobe
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28
Q

What are features of splenomegaly seen on film?

A

12cm longest axis
Should not project below 12 post. rib
Med. displacement of meganblasse
Inf. displacement of splenic flexure, L kidney inf. & med

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29
Q

What is the normal size of kidneys in an adult?

A

10-14cm
No more than 1.5cm difference side to side
R projects shorter than the L b/c the liver

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30
Q

What is the M/C renal parenchymal lesion & what age is effected most?

A

Simple Renal Cyst

Rare under 30yr old; found in 50% of adults over 50yr old

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31
Q

Can the urinary bladder be seen on film?

A

Yes, when full of urine
Males: round on top
Females: flat on top d/t uterus

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32
Q

What is it called when the sup. or inf.(M/C) poles of the kidney are connected by functioning or nonfunctioning (fibrous) tissue? M/C type of renal fusion anomaly

A

Horseshoe kidney

33
Q

What are complications of horseshoe kidney?

A

1/3rd have anomalies
1/3rd are asymptomatic
More susceptible to traumatic injury b/c the ureters pass over the connecting tissue
Often have poor drainage, leads to infection & stones

34
Q

What is it called when both the sup. & inf. poles of the kidney are connected?

A

Calxed (Caked) kidney

35
Q

What is it called when the kidney has bumps on the surface which are a residual from development?

A

Fetal lobulation

37
Q

Upper lat. aspect of L kidney is flattened d/t the spleen.

A

Dromedary hump

38
Q

What is the M/C etiology of mechanical small bowel obstruction?

A

Post surgical adhesions

39
Q

What are plain film findings assoc. w/ small bowel obstructions?

A

Upright - multiple air fluid levels >2.5cm inverted U dilated loops
Supine - Dilated loops >3cm, step ladder, stack of coins

40
Q

What is the most dilated segment w/ a mechanical large bowel obstruction?

A

Cecum (12-15cm may rupture)

41
Q

What are the M/C etiologies of a large bowel obstruction?

A

Colon CA

Diverticulitis

42
Q

What are the 4 common locations of extraluminal air in the abdomen?

A

Intraperitoneal (pneumoperitoneum)
Retroperitineal air
Air in the bowel wall (pneumatosis intestinalis)
Air in the biliary system (pneumobilia)

43
Q

What is the M/C etiology of extraluminal air in the abdomen?

A

Perforated gastric/duodenal ulcer

44
Q

What are radiographic findings assoc. w/ extraluminal air in the abdomen?

A

Air beneath the diaphragm
Visualization of both sides of the bowel wall (Rigler/double wall/gas relief sign)
Visualization of the falciform lig.

45
Q

Air in the biliary tree d/t a communication w/ the GI tract or skin is called what?

A

Pneumobilia

46
Q

What are etiologies assoc. w/ Pneumobilia?

A 
Surgery
Trauma
Biliary-enteric fistulas (M/C nonsurgical cause)
Infection
Anomalous development of duct
47
Q

What are radiographic findings assoc. Pneumobilia?

A

Tubular branching lucencies over the liver shadow

Air in the lumen of the gallbladder

48
Q

Obstruction of the intestine by an ectopic gallstone is called what?

A

Gallstone Ileus

49
Q

What gender is M/C’ly affected by a gallstone ileus?

A

Females7-8x

50
Q

A gallstone ileus larger than >3cm typically obstructs what?

A

ileocecal valve

51
Q

70% of small bowel obstructions in people over 70 yr old are caused by what?

A

Gallstone Ileus

52
Q

This is when all or part of the stomach herniates through the diaphragm

A

Hiatal hernia

53
Q

What are the different types of hiatal hernia?

A

Sliding (M/C): fundus & cardia
Paraesophageal (2nd M/C): fundus
Intrathoracic: entire stomach, not pylorus
Short esophagus: gastroesophageal junction

54
Q

What is the ddx assoc. w/ a hiatal hernia?

A

Pulmonary cyst
Lung abscess
Diaphragm tumor

55
Q

What test is diagnostic for a hiatal hernia?

A

Barium swallow

56
Q

What are the 4 main types of calcification?

A

Cyst
Conduit
Concretion
Mass

57
Q

Cyst-type calcification is assoc. w/ what?

A 
Aneurysms
Porcelain gallbladder
w/i kidneys, adrenals, liver, ovary, mesentery
Some uterine fibroids
Bladder wall (rare)
58
Q

These are erosions on the vert. body assoc. w/ an abdominal aortic aneurysm (AAA)

A

Oppenheimer Erosions

59
Q

What is the imaging of choice for an AAA?

A

Ultrasound

60
Q

What are the charac. of a splenic artery aneurysm?

A

up to 10% of pt >60yr old
Etiologies: atherosclerosis, trauma, infection
Looks like a cyst

61
Q

These are caused by the larvae from the tape worm. M/C’ly found in the liver

A

Hydatid/Echinococcal Cysts

62
Q

Type of calcification w/i a channel that conveys fluid. May show as flecks of calcification along the route of a vessel, parallel tracts, branching tracks, or ring-like opacities

A

Conduit (linear or track-like) calcification

63
Q

Where are conduit calcifications typically seen?

A 
Urinary tract
Pancreatic ducts
Vas deferens
Fallopian tubes
Biliary ducts
Blood vessels
Porcelain gallbladder
64
Q

What is porcelain gallbladder?

A

Calcification in the gallbladder wall, caused by chronically inflamed & thickened wall.
M/C in females
Assoc. w/ stones, obstructed cystic duct, carcinoma
Ovoid or pear shaped

65
Q

Type of calcifications that form w/i a duct, conduit or hollow organ.

A

Concretion (lamellar, laminar) calcification

66
Q

How are concretion calcifications formed?

A

Typically formed by precipitation of calcium salts which form layers over time (pearl in oyster)

67
Q

Where are concretion calcifications seen?

A

Gallbladder: gallstones
Urinary tract: renal, ureteral bladder stones
Diverticulum/appendix: appendicolith, fecalith
Pelvic veins: phlebolith
Prostate

68
Q

Which type of gallstones occur most often in people?

A

Negative gallstones

69
Q

This is a type of kidney stone that is seen in females w/ recurrent UTI’s. Forms in the collecting system.

A

Staghorn caliculi

70
Q

Who is typically affected by bladder stones?

A

Older men

71
Q

Where is prostate calcification usually seen on plain film?

A

Around the pubic symphysis

72
Q

Where are appendoliths seen on plain film?

A

Over the R ilium

73
Q

What ddx is assoc. w/ appendoliths?

A

Bone islands

Gallstones

74
Q

These are caused by scar tissue from multiple injections in the butt. Look like phleboliths

A

Injection granulomas

75
Q

Type of calcification w/ a wide range of radiographic patterns. Typically a dense center w/ irregular margins

A

Mass (cloud-like, amorphous, popcorn) calcifications

76
Q

What typically forms mass calcifications?

A 
Calcified mesenteric lymph nodes (M/C)
Some uterine fibroids
Pancreatic lithiases
Adrenal calcification
Liver & kidney malignancies
Many benign tumors
77
Q

What is the M/C cause of pancreatic calcification?

A

Alcoholism (pancreatitis)

78
Q

These compose 10% of all ovarian tumors. Arise during active reproductive years

A

Ovarian dermoid cysts (mature teratomas/cystic teratomas)

79
Q

What are the radiographic charac. of ovarian dermoid cysts?

A

May contain teeth, bones, & other tissue
10% have marginal calcification
35% contain fat (as a solid mass, may be only x-ray finding)

80
Q

What type of calcifications are assoc. w/ leiomyoma, uterine fibroid, & uterine fibromas?

A

Popcorn/cauliflower like
Mottled or speckled
Coarse marginal rim
Cyst-like rim

81
Q

Adrenal calcification in a normal sized gland is M/C’ly secondary to what?

A

Neonatal hemorrhage

82
Q

What pathologies is adrenal calcification assoc. w/?

A

Addison’s
Hemangioma
Pheochromocytoma
Cortical carcinoma

Soft Tissue Rad (2 decks)

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