Ultrasound: Liver, Spleen, & Urinary Tract Flashcards
Compare the appearance of the spleen and the liver on ultrasound
Spleen more hyperechoic (whiter) than liver
Liver has bright/well-defined portal vein walls
Normal gallbladder
Hypoechoic liver
What diseases cause a hypoechoic liver?
Congestion
Lymphoma/round cell neoplasia
Acute heptatitis
Histoplasmosis
Rickettsia
IMHA
Hyperechoic liver
What diseases cause a hyperechoic liver?
Steroid hepatopathy
Vacuolar hepatopathies
Lymphoma
Lipidosis
Cholestasis
Amyloidosis
Cirrhosis
Liver - mixed echogenicity
What diseases cause a mixed echogenicity liver?
Carconima
Lymphoma
Vacuolar hepatopathy with nodular regeneration
Chronic hepatitis
Cirrhosis
Liver nodular hyperplasia
What does liver nodular hyperplasia look like on ultrasound?
Multiple nodules (usually)
Hypoechoic (but can be anything)
Hepatic neoplasia (melanoma mets)
What does hepatic neoplasia look like on ultrasound?
Solitary nodule/mass, multiple nodules, diffuse infiltrate
Many different patterns/echogenicities
Hepatocellular carcinoma
Normal spleen
What does a normal spleen look like on ultrasound?
Most hyperechoic organ
Homogenous
Finely stipled parenchyma
Capsule seen as distinct hyperechoic line
What causes splenomegaly (without parenchymal change)?
Sedation/anesthesia
Anemias
Lymphoid hyperplasia
Extramedullary hematopoeisis
Round cell/hematopoetic neoplasia
GSDs (normal breed variant)
What causes splenomegaly (with diffuse or nodular parenchymal change)?
Lymphoid hyperplasia
Extramedullary hematopoeisis
Round cell/hematopoetic neoplasia
Hemangiosarcoma/hemangioma
Metastatic neoplasia
Granulomatous disease
Amyloidosis
Splenomegaly with parenchymal change
Splenic lymphoma
What does splenic lymphoma look like on ultrasound?
Poorly defined to well-defined hypoechoic nodules
“Swiss cheese”
Lymphadenopathy
What does splenic hemangiosarcoma look like on ultrasound?
Variably sized mass with variable echogenicity
+/- cavitation
Splenic hemangiosarcoma
Splenic hemangiosarcoma
What are the normal measurements of the kidney on ultrasound?
Cats: 3.0 - 4.4cm
Dogs: variable
Normal liver
Normal kidney
What can cause focal changes to the kidney on ultrasound?
Nodules/masses
Mineralization
Cortical defects
Cysts
Diffuse hyperechoic renal cortices
Diffuse hyperechoic renal cortices
Hyperechoic, heterogenous splenic mass
Sarcoma
Hyperechoic, heterogenous splenic mass
Sarcoma
What are rule outs for solid splenic nodules/masses?
Most commonly neoplasia, less likely granuloma, pyogranuloma, abscesses, or hematomas
What are rule outs for complex splenic nodules/masses?
Hematoma, abscess, granuloma, neoplasia
Incidental renal mass
Renal lymphoma
Renal lymphoma
What are ultrasound characteristics of renal cysts?
Smooth margins
Ovoid/spherical
Usually anechoic contents
Decreased corticomedullary distinction with cyst
Incidental renal cyst
Polycystic kidney disease
What are common ultrasound findings of chronic kidney disease?
Decreased corticomedullary distinction
Hyperechoic cortex +/- medulla
Cortical defects/irregular margins
Decreased size
Focal mineralization
Pelvic dilation
CKD
CKD
Urinary bladder
Urinary bladder with debris
Focal renal mineralization
Single stone in urinary bladder
Urinary bladder - cystitis
Thickened wall, worse cranioventrally
Urinary bladder - TCC