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Diagnostic Imaging FINAL > Ultrasound Liver and Spleen > Flashcards

Ultrasound Liver and Spleen Flashcards

1
Q

What is the scanning technique for the liver?

A

Use xyphoid cartilage as a reference.
Sagittal and transverse scanning.
**Intercostal approach for microhepatica or for deep chested breeds!

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2
Q

Transverse ultrasound views images

A

Left to right.

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3
Q

Sagittal images view..

A

Cranial to caudal.

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4
Q

Normal liver:

A

Cranial boarder: Hyperechoic diaphragm.

Uniform, slightly coarse echo texture.

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5
Q

Normal liver: vessels:

A

Portal: highly echogenic walls.
Hepatic veins: less distinct walls
Hepatic arteries are not visible!

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6
Q

Normal liver: vessels:

A

Portal: highly echogenic walls.
Hepatic veins: less distinct walls
Hepatic arteries are not visible!
*View ultrasound liver and spleen lecture; slide 5

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7
Q

Normal liver biliary structures:

A

Gall bladder is visible with various contents.
Intrahepatic bile ducts are not visible
Common bile ducts difficult to image in normal dogs, often visible in normal cats.

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8
Q

Studies have shown liver and spleen on ultrasound..

A

Liver hypoechoic
Spleen hyper-echoic

*View ultrasound liver and spleen lecture; slide 6

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9
Q

In felines the gallbladder maybe..

A

Bilobed!

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10
Q

In felines the gallbladder maybe..

A

Bilobed!

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11
Q

*View ultrasound liver and spleen lecture; slide 8

Appearance of sludge in the gallbladder.

A

Sludge/bile varies in appearance, especially in dogs.

Not organized**

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12
Q

Gallbladder wall thickness in dogs:

A

up to 3 mm
accurate in predicating gallbladder disease, although thickness under <1 mm cannot rule out mild or chronic inflammation.

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13
Q

Gallbladder wall thickness in cats:

A

thickness of >1 mm is accurate in predicating gallbladder disease, although thickness under <1 mm cannot rule out mild or chronic inflammation.

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14
Q

What is an abnormal liver on ultrasound?

A

Changes in the shape, size, echogenicity and echo texture.
Focal, multifocal or diffuse changes.
Changes associated with the biliary system.
Vascular changes.

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15
Q

A normal liver ultrasound does not..

A

RULE OUT HEPATIC DISEASE

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16
Q

A normal liver ultrasound does not..

A

RULE OUT HEPATIC DISEASE

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17
Q

Hyperechoic +/- hepatomegaly in dogs due to..

A

Steroid hepatopathy (cushings, iatrogenic)
Neoplasia (LSA)
Cirrhosis
Fatty liver (diabetes M)

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18
Q

Hyperechoic +/- hepatomegaly in cats due to..

A

Fat (normal)
Lipidosis
Cirrhosis
Neoplasia

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19
Q

Portal vessels in the liver are more difficult to see with..

A

Hyperechoic liver.

More easily seen (and see more) with hypoechoic liver.

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20
Q

Hyperechoic liver

A

Compared to spleen, compared to falciform fat.
Compared against your own standard.
Portal vessels not easily seen.
*View ultrasound liver and spleen lecture; slide 12

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21
Q

Hypo-echoic liver in dogs due to..

A

Neoplasia (lymphoma, mast cell), congestion, hepatitis, cirrhosis*

22
Q

Hypo-echoic liver in cats due to..

A

Neoplasia (lymphoma, mast cell tumor), Cholangiohepatits, and congestion.

23
Q

Hypo-echoic liver on ultrasound..

A

Compared to the spleen and falciform fat..
Compared against your own standard.
Portal vessels are visible.
Usually subjective.

*View ultrasound liver and spleen lecture; slide 14

24
Q

Abnormal liver, focal lesions..

A

Focal lesions are non-specific.

  • Can be hypoechoic, isoechoic, hyperechoic, or mixed echogenicity.
  • Can be cysts, neoplasia, abscess, hematoma, complex cysts, nodular hyperplasia, granuloma

*View ultrasound liver and spleen lecture; slide 15, 16 and 17.
In these cases you want to sample.

25
Q

Biliary lakes are also called..

A 
Psudocystic lesions (biliary lakes)
*View ultrasound liver and spleen lecture; slide 17
26
Q

Abnormal liver with focal lesions..

A

Need cultures or biopsies to diagnose what they are..

*View ultrasound liver and spleen lecture; slide 18 & 19

27
Q

Abnormal gallbladder ultrasound due to..

A
  • Obsturctuion/biliary calculi
  • Contents
  • Wall thickening
  • Emphysematous chleocysytsis
28
Q

Gallbladder luminal distention due to..

A

Obstruction, fasting (not emptying) and inflammation

*View ultrasound liver and spleen lecture; slide 21

29
Q

Gallbladder wall thickness with edema due to..

A

Often mimicked by free abdominal fluid which accumulates around the gallbladder.
Choleocystis? or free abdominal fluid?

*View ultrasound liver and spleen lecture; slide 22

30
Q

*View ultrasound liver and spleen lecture; slide 23

View chlecystoltith

A

Stone/minerals.

31
Q

*View ultrasound liver and spleen lecture; slide 24 & 25

Gallbladder mucocele

A

Unorganized sludge is OK, Organized sludge is impending mucocele.

*Looks like kiwi

32
Q

*View ultrasound liver and spleen lecture; slide 27

A

View emphysematous cholecystitis

Gas in the gallbladder and fluid.

33
Q

*View ultrasound liver and spleen lecture; slide 27

A

View emphysematous cholecystitis

Gas in the gallbladder and fluid.

34
Q

*View ultrasound liver and spleen lecture; slide 28

A

View mineralization of the bile ducts (calculi)

35
Q

*View ultrasound liver and spleen lecture; slide 28

A

View enlarged bile ducts

36
Q

*View ultrasound liver and spleen lecture; slide 29 and 30

A

Differentiae blood vessels from bile ducts..

Ducts don’t Doppler!!**

37
Q

What are the various materials that can get caught in the common bile duct?

A 
Calculus 
Fluid dilation
Sludge
Stenosis of the papillae at the duodenum
*View ultrasound liver and spleen lecture; slide 31
38
Q

In cats a bile duct greater then what is considered to be consistent with extrahepatic biliary obstruction?

A

4mm

Probably the same in dogs.

39
Q

*View ultrasound liver and spleen lecture; slide 34

Portosystemic shunts

A

Very difficult to ID.

Portal vein and azygous vein.

40
Q

Spleen scanning techniques

A

High frequency probe.
Keep the transducer perpendicular to the skin.
Gentle pressure
Organ location in the abdomen may change.

41
Q

Normal spleen location..

A

Variable location and size.
Finer and more echogenic than the liver.
Splenic vessels are identified entering the hilus.
Splenic capsules are identifiable.

42
Q

What is myelolipoma (spleen)

A

Normal fat globs around the splenic vessels..

*View ultrasound liver and spleen lecture; slide 38

43
Q

What is myelolipoma (spleen)

A

Normal fat globs around the splenic vessels..
*View ultrasound liver and spleen lecture; slide 38 & 39

Strongly hyperechoic nodules along the mesenteric border of the spleen, with our without distal acoustic shadowing, are a common incidental finding especially in older dogs.
These lesions are myelopomas, appear deeper in the splenic parenchyma, commonly along vessels, very greatly.

44
Q

Cat spleen normal limits measurements used by some..

A

Head: 1.7 cm
Mid: 2.6 cm

45
Q

Differentials for a large spleen?

A

Subjective
Sedation
Congestion
Infiltration (benign or malignant)

46
Q

Spleen too small?

A

???

47
Q

Diffuse changes to the spleen (hypoechoic)

A

Torsion, congestion, neoplasia, hemolytic anemia, inflammation

*View ultrasound liver and spleen lecture; slide 42, 43

48
Q

Spleen multifocal lesions?

A

Nodular hyperplasia, hematomas, neoplasia, splenitis

*View ultrasound liver and spleen lecture; slide 45

49
Q

Focal lesions of the spleen?

A

Hematoma, infarct, neoplasia, abscess, nodular hyperplasia.

  • View ultrasound liver and spleen lecture; slide 46 (benign hyperplasia)
  • View ultrasound liver and spleen lecture; slide 48
50
Q

Splenic masses on ultrasound and radiographs..

A

Hemangiosarcoma, hemangioma and hematoma..
All look alike!!
*View ultrasound liver and spleen lecture; slide 47

*other tumors, fibrous histiocytoma and mast cell tumors.

51
Q

Vascular lesions of the spleen..

A

No flow with Doppler.
Vascular thrombus
Splenic torsion

  • ID the Doppler in the screen (green box)
  • View ultrasound liver and spleen lecture; slide 49 + 50

Diagnostic Imaging FINAL (10 decks)

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