Ultrasound Flashcards
Distinguishing characteristics between AMLs and hyperechoic RCCs?
AMLs tend to have acoustic shadowing. Hyperechoic RCCs may have cystic elements, calcifications, or hypoechoic halo.
Caudate lobe drains into what vein?
IVC via small veins separate from hepatic veins. Caudate veins function as collaterals in Budd-Chiari syndrome.
Distinguishing ultrasound features of peritoneal fluid collections versus simple ascites?
Fluid collections displace and distort adjacent structures. Ascites conforms to adjacent structures.
Causes of fatty liver infiltration?
Obesity. Alcohol abuse. TPN. Diabetes. Malnutrition. Steroid use. Hepatic toxins. Chemotherapy.
Usefull clue in located parathyroid adenomas and lymph nodes?
Parathyroid adenomas are medial to carotid arteries. Lymph nodes are usually lateral to carotids.
Baker’s cyst, most characteristic diagnostic feature at Ultrasound?
Neck that extends between medial head of gastrocnemius and semimembranosus tendon.
Syndrome caused by hepatic hemangioma that sequesters platelets?
Kasaback-Merritt syndrome.
What markers are elevated in a pancreatic pseudocyst aspirate compared to a pancreatic cystic neoplasm aspirate?
Pseudocyst aspirate elevated amylase. Neoplastic aspirate elevated carcinoembryonic antigen.
Funiculocele, what is it?
Spermatic cord hydrocele.
Difference between a replaced and an accessory artery?
Replaced: Artery arises from an anomalous source (1 anomalous artery). Accessory: one of atleast two arteries arises from an anomalous source (2 arteries present, 1 artery anomalous).
Which gallstones can float?
Cholesterol stones can float in high specific gravity bile.
What patient’s benefit from an carotid endarterectomy?
Symptomatic patients with stenosis >70%.
Best study to identify a splenule?
Sulfur colloid scan or heat-damaged tagged RBC scan.
Reversed flow in the internal mammary veins indicates?
Central venous obstruction
Solid renal neoplasms?
RCC. TCC. Renal medullary carcinoma. Renal sarcoma. Metastases. Lymphoma.
Sickle cell trait and solid renal neoplasm?
Renal medullary carcinoma.
When do hematomas and lymphoceles appear in renal transplant patients?
Hematoma: Immediately after transplant Lymphocele: 1 to 2 months posttransplant
Most common cause of calcified liver tumor?
Metastases.
Morton neuroma?
Benign mass of plantar digital nerves of the foot.
Which side is subclavian steal more common on?
Left.
What is normal portal vein velocity?
20 cm/s.
Pancreatic neoplasm almost exclusively seen in women?
Macrocystic neoplasm.
RCC stage when tumor invades renal vein or IVC?
At least IIIa
2 common liver locations for focal fatty infiltration?
Preportal. Anterior left lobe adjacent to ligamentum teres.
Resistive index (RI) formula?
RI = (S-D)/S
Parenchymal organ normal resistive index (RI)?
<0.7
Midline prostate cysts?
Utricle cyst. Mullerian cyst.
What replaced artery can be seen coursing through the ligamentum venosum?
Replaced left hepatic artery.
Mucinous macrocystic pancreatic neoplasm, common locations?
Body and tail of pancreas.
Distinguish between classic and limited microlithiasis of testis?
Classic: > 5 microliths on 1 view. Limited: less than 5 on 1 view.
Multilocular cystic nephroma, population?
Young boys (3 months - 4 years). Adult women (>30 years old).
2 most common masses in the hand?
Ganglion cyst. Giant cell tumor.
Does a giant cell tumor move with the associated tendon?
No, it arrised from the tendon sheath not the tendon.
TCC, most common anatomy involved?
Bladder > renal pelvis > ureter.
Pheochromocytoma’s 10% rule?
10% malignant. 10% extra-adrenal. 10% bilateral. 10% associated with MEN.
Vascular pattern of FNH at ultrasound?
Spokewheel pattern.
Most definitive means of diagnosing FNH?
Sulfur colloid scanning.
Chronic calcific pancreatitis is caused by?
Alcoholic abuse, not gallstones.
Focal fatty sparing within the liver commonly occurs where?
Around the gallbladder. At portal bifurcation.
What is Page kidney?
Renal subcapsular hematoma causing hypertension.
Effect of renal vein thrombosis on resistive index (RI) of renal artery?
Normal to increased RI.
Horseshoe kidney predispositions?
Urinary obstruction. Stone formation. Rrenal trauma. Questionable increase risk of Wilm’s tumor.
Upper limit of normal renal artery velocity?
180-200 cm/s.
Bile duct blood supply?
Hepatic artery. In liver transplant hepatic artery thrombosis bile ducts may form strictures due to ischemia.
Common factors that render pancreatic cancers nonresectable?
Lver metastases. Peripancreatic vessel invasion. Peritoneal spread.
Ultrasound signs of complete tendon rupture?
Blunt tendon tip (longitudinal view). Mass (transverse view). Refractive shadowing. Nonvisualization. Loss of fibrillar architecture. Fluid collection.
Sonographic signs of full-thickness rotator cuff tear?
Anechoic or hypoechoic defect. Focal superficial contour abnormality. Compressibility. Nonvisualization.
Characteristics of pseudoaneurysms on ultrasound?
Complex fluid collection. Single of multiple loculations. Visible pulsations on gray-scale imaging. Internal luminal flow on color Doppler. To and fro flow in the neck.
Characteristics of iatrogenic arteriovenous fistulas at ultrasound?
Usually located below femoral artery bifurcation. Perivascular tissue vibration. Low-resistance flow in supplying artery near fistula. High-velocity flow at site of communication. Turbulent and/or arterialized flow in draining vein near fistula.
Extremity artery waveform?
High-resistance flow. Typically triphasic waveform: Antegrade systole, retrograde early diastole, antegrade in mid diastole, absent flow in end diastole.
Extremity venous waveform?
Respiratory phasicity. Variable cardiac related pulsatility.
Factors that decrease chance of scrotal malignancy?
Extratesticular. Nonpalpable. Simple cystic appearance. No detectable vascularity.
Factors that increase chance of scrotal malignancy?
Intratesticular. Palpable. Solid or complex cyst. Detectable internal vascularity.
Germ cell tumor list?
Seminoma. Embryonal cell carcinoma. Teratoma. Choriocarcinoma. Yolk sac. Mixed germ cell.
Stromal testicular tumors?
Leydig cell tumor. Sertoli cell tumor.
Other non-germ cell and non-stromal testicular neoplasms?
Lymphyoma/leukemia. Metastases. Epidermoid cyst.
Testicular lesions mimicking tumors?
Focal orchitis. Focal atrophy/fibrosis. Infarcts. Abscess. Hematoma. Contusion. Sarcoid. Tuberculosis. Adrenal rest tissue.
Causes of enlarged hypoechoic testis?
Orchitis. Torsion. Lymphoma. Seminoma.
Of the four causes of enlarged hypoechoic testes, which have increased/decreased blood flow?
Increased flow: Orchitis. Lymphoma. Seminoma. Decreased (torsion).
Primary neoplasms of the bladder?
TCC. Adenocarcinoma. SCC. Pheochromocytoma.
Causes of bladder wall lesions from adjacent neoplasms?
Rectum. Prostate. Cervix. Uterus.
Causes of bladder wall lesions from inflammation from adjacent organs?
Diverticulitis. Crohn’s disease. PID. Appendicitis.
Other bladder wall lesions?
Ureteroceles. Urachal cyst. Cystitis cystica. Endometriomas. Fistulas. Malakoplakia. Leukoplakia. Tuberculosis. Shistosomiasis.
Frequency of prostate cancer per anatomical zone?
Peripheral zone 75%. Transitional zone 20%. Central zone 5%
Percentage of prostate cancers that are hypoechoic?
Hypoechoic 70%. Hyperechoic/mixed 30%.
Sonographic characteristics of seminoma?
Homogeneous and hypoechoic.
Most common scrotal mass?
Spermatocele.
Causes of hydroceles?
Idiopathic (most common). Tumors. Torsion. Inflammatory disorders. Trauma.
Varicocele percentage on the left?
Left-sided 85%. Right-sided 15%.
Scrotal mass with peripheral calcification and/or onion peel appearance?
Epidermoid cyst.
Testicular microlithiasis and germ cell tumor relevance?
Isolated microlithiasis increases risk of germ cell cancer. Annual physical exam recommended.
Besides absent blood flow, other signs of testicular torsion?
Enlarged hypoechoic testis. Torsion knot. Reactive hydrocele. Scrotal wall thickening.