Ultrasound: Liver, Spleen, & Urinary Tract

Question 1

Compare the appearance of the spleen and the liver on ultrasound

Answer 1

Spleen more hyperechoic (whiter) than liver
Liver has bright/well-defined portal vein walls

Question 2

Answer 2

Normal gallbladder

Question 3

Answer 3

Hypoechoic liver

Question 4

What diseases cause a hypoechoic liver?

Answer 4

Congestion
Lymphoma/round cell neoplasia
Acute heptatitis
Histoplasmosis
Rickettsia
IMHA

Question 5

Answer 5

Hyperechoic liver

Question 6

What diseases cause a hyperechoic liver?

Answer 6

Steroid hepatopathy
Vacuolar hepatopathies
Lymphoma
Lipidosis
Cholestasis
Amyloidosis
Cirrhosis

Question 7

Answer 7

Liver - mixed echogenicity

Question 8

What diseases cause a mixed echogenicity liver?

Answer 8

Carconima
Lymphoma
Vacuolar hepatopathy with nodular regeneration
Chronic hepatitis
Cirrhosis

Question 9

Answer 9

Liver nodular hyperplasia

Question 10

What does liver nodular hyperplasia look like on ultrasound?

Answer 10

Multiple nodules (usually)
Hypoechoic (but can be anything)

Question 11

Answer 11

Hepatic neoplasia (melanoma mets)

Question 12

What does hepatic neoplasia look like on ultrasound?

Answer 12

Solitary nodule/mass, multiple nodules, diffuse infiltrate
Many different patterns/echogenicities

Question 13

Answer 13

Hepatocellular carcinoma

Question 14

Answer 14

Normal spleen

Question 15

What does a normal spleen look like on ultrasound?

Answer 15

Most hyperechoic organ
Homogenous
Finely stipled parenchyma
Capsule seen as distinct hyperechoic line

Question 16

What causes splenomegaly (without parenchymal change)?

Answer 16

Sedation/anesthesia
Anemias
Lymphoid hyperplasia
Extramedullary hematopoeisis
Round cell/hematopoetic neoplasia
GSDs (normal breed variant)

Question 17

What causes splenomegaly (with diffuse or nodular parenchymal change)?

Answer 17

Lymphoid hyperplasia
Extramedullary hematopoeisis
Round cell/hematopoetic neoplasia
Hemangiosarcoma/hemangioma
Metastatic neoplasia
Granulomatous disease
Amyloidosis

Question 18

Answer 18

Splenomegaly with parenchymal change

Question 19

Answer 19

Splenic lymphoma

Question 20

What does splenic lymphoma look like on ultrasound?

Answer 20

Poorly defined to well-defined hypoechoic nodules
“Swiss cheese”
Lymphadenopathy

Question 21

What does splenic hemangiosarcoma look like on ultrasound?

Answer 21

Variably sized mass with variable echogenicity
+/- cavitation

Question 22

Answer 22

Splenic hemangiosarcoma

Question 23

Answer 23

Splenic hemangiosarcoma

Question 24

What are the normal measurements of the kidney on ultrasound?

Answer 24

Cats: 3.0 - 4.4cm
Dogs: variable

Question 25

Answer 25

Normal liver

Question 26

Answer 26

Normal kidney

Question 27

What can cause focal changes to the kidney on ultrasound?

Answer 27

Nodules/masses Mineralization Cortical defects Cysts

Question 28

Answer 28

Diffuse hyperechoic renal cortices

Question 29

Answer 29

Diffuse hyperechoic renal cortices

Question 30

Answer 30

Hyperechoic, heterogenous splenic mass *Sarcoma*

Question 31

Answer 31

Hyperechoic, heterogenous splenic mass *Sarcoma*

Question 32

What are rule outs for solid splenic nodules/masses?

Answer 32

Most commonly neoplasia, less likely granuloma, pyogranuloma, abscesses, or hematomas

Question 33

What are rule outs for complex splenic nodules/masses?

Answer 33

Hematoma, abscess, granuloma, neoplasia

Question 34

Answer 34

Incidental renal mass

Question 35

Answer 35

Renal lymphoma

Question 36

Answer 36

Renal lymphoma

Question 37

What are ultrasound characteristics of renal cysts?

Answer 37

Smooth margins Ovoid/spherical Usually anechoic contents

Question 38

Answer 38

Decreased corticomedullary distinction with cyst

Question 39

Answer 39

Incidental renal cyst

Question 40

Answer 40

Polycystic kidney disease

Question 41

What are common ultrasound findings of chronic kidney disease?

Answer 41

Decreased corticomedullary distinction Hyperechoic cortex +/- medulla Cortical defects/irregular margins Decreased size Focal mineralization Pelvic dilation

Question 42

Answer 42

CKD

Question 43

Answer 43

CKD

Question 44

Answer 44

Urinary bladder

Question 45

Answer 45

Urinary bladder with debris

Question 46

Answer 46

Focal renal mineralization

Question 47

Answer 47

Single stone in urinary bladder

Question 48

Answer 48

Urinary bladder - cystitis *Thickened wall, worse cranioventrally*

Question 49

Answer 49

Urinary bladder - TCC