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Radiology Review > Ultrasound Trivia > Flashcards

Ultrasound Trivia Flashcards

1
Q

GB wall thickening > 3 mm

A 
cholecystitis
GB CA
adenomyomatosis
PSC
AIDS cholangitis
Hepatitis
ascites
cirrhosis
Portal HTN
Hypoproteinemia
lymphatic obstruction
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2
Q

Cystic lesions in the porta hepatis

A 
hepatic cyst
enteric duplication cyst
pancreatic pseudocyst
biliary cysts
hepatic artery aneurysm
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3
Q

MC complication of choledochoceles

A

biliary and pancreatic calculus followed by cholangiocarcinoma

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4
Q

MCP of GB carcinoma

A

mass replacing a majority of GB lumen

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5
Q

Parvus tardus waveform

A

upstream stenosis

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6
Q

Treatment of GB polyps > 1 cm

A

surgery

FU imaging for polyps > 6 mm but < 10 mm

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7
Q

Reversal of portal vein flow in setting of chemo/radiation

A

Sinusoidal obstruction syndrome (venoocclusive disease)

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8
Q

Cholesterolosis

A

“balls on the wall” of the GB = cholesterol polyps

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9
Q

Speed of sound in ST

A

1540 m/s

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10
Q

What artifact can cause pseudo-sludge

A

side lobe artifact

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11
Q

Caroli disease

A

multiple coarse shadowing calcs in the liver within tubular anechoic structures (bile ducts)

assoc with ARPCKD, medullary sponge and cystic kidney

central dot sign

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12
Q

reverse target sign of liver

A

hypoechoic center and hyperechoic periphery = cavernous hemangioma

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13
Q

cluster of grapes sign of liver

A

pyogenic abscesses

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14
Q

Water-lily sign

A

echinococcal infections (membranes floating in water)

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15
Q

Target sign in liver

A

echogenic center with thick hypoechoic halo = suggestive of malignancy

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16
Q

ST mass in GB in setting of mets

A

Melanoma

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17
Q

Acoustic shadowing

A

absorption

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18
Q

shadowing at the edges of fluid filled structures

A

refraction

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19
Q

Ring down artifact

A

fluid trapped between multiple gas bubbles

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20
Q

Fresnel zone

A

near field US beam

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21
Q

Appendicitis on US

A 
> 6 mm in diamter
lack of compressibility
echogenic inflamed periappendiceal fat
hyperemia
appendicolith
adjacent fluid
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22
Q

Increasing transducer frequency

A

improve axial resolution (closely spaced objects)

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23
Q

pancreatic CA on US

A

hypoechoic and hypovascular

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24
Q

Plan - Do - Study - Act

A

Quality improvement

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25
Q

Pseudokidney sign

A

hypoechoic, concentric, long-segement wall thickening, central dirty shadowing = lymphoma of the colon

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26
Q

Multiple splenic calcs

A

Histoplasmosis
TB
Brucellosis

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27
Q

MCC of splenic cysts

A

Trauma

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28
Q

Anechoic pancreatic head lesion with lobulated margins and several internal septations that converge centrally (stellate scar appearance)

A

Pancreatic serous cystadenoma

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29
Q

Medullary nephrocalcinosis

A

echogenic renal pyramids with posterior acoustic shadowing = calcium deposits

  • primary hyperparathyroidism
  • RTA 1
  • medullary sponge kidney
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30
Q

MCC of CA in bladder

A

transitional cell carcinoma (90%)

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31
Q

Hyperechoic renal mass

A

usually AML, but can be RCC = get CT

30% of AMLs can have acoustic shadowing

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32
Q

Large anechoic peri-renal transplant fluid collection with a few internal septations

A

Peritransplant lymphocele MCC (1-3 wks after surgery)

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33
Q

Long term lithium and the kidney

A

Renal microcysts - multiple punctate echogenic foci in renal medulla and cortex

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34
Q

Drop out artifact

A

dead element in the US probe = dark band on the US that radiates from the surface

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35
Q

calcification of the renal cortex and medulla in normal sized kidneys

A

Oxalosis = liver and kidney transplant needed

36
Q

Bilateral perinephric rind-like hypoechoic tissue

A

renal lymphoma
retroperitoneal fibrosis
Erdheim-Chester disease

37
Q

disadvantage of harmonic imaging

A

decreased penetration

38
Q

what US should be done before surgery to remove a thyroglossal duct cyst

A

normal thyroid by US

39
Q

Warthin tumor and pleomorphic adenoma on US

A

circumscribed hypoechoic lesion with posterior acoustic enhancement
can have cystic change (usually warthin)
warthin more oval shape
Warthin bilateral 10-15%

40
Q

MI, TSI and TIB of US

A

Mechanical index = risk of damage by cavitation and radiation pressure

Thermal index soft tissue = potential risk of heat damage

Thermal index of bone

(THI = tissue harmonic imaging)

41
Q

how many gray levels are in US images

A

256 (or 2^8)

42
Q

On steroids for life with lumpy testicles

A

congenital adrenal hyperplasia = testicular adrenal rests

  • usually bilateral (cancer not usually bilateral)
  • sharply demarcated hypoechoic lesions
  • can get bigger = infertility and pain
43
Q

MCL of undescended tesitis

A

caudal to the external inguinal ring

44
Q

MC malignancy in undescended testits

A

Seminoma

45
Q

Mixed germ cell tumor of testitis

A

cystic and solid and calcified in younger person (DDX lymphoma and leukemia in older people)

46
Q

Pure seminomas

A

usually uniformly hypoechoic on US

47
Q

Bicornuate vs Septate vs Didelphys

A

look at fundal contour

- cleft > 1 cm = bicornuate or didelphys

48
Q

US parameters for < 10 wks gestation

A

TIS (Thermal index of ST) for < 10 wks

TIB (thermal index of bone) for > 10 wks

49
Q

Velamentous insertion of umbilical cord

A

insertion of cord beyond the placental edge

50
Q

Eccentric insertion of the umbilical cord

A

1 cm from placental edge

51
Q

Umbilical cord cysts

A

most found in 1st trimester resolve

thin walled cyst at fetal insertion of cord

52
Q

Decreasing mechanical index

A

Increase the center frequency of the beam (inversely proportion to MI)
set the focal zone further away from the transducer

53
Q

Highly echogenic yolk sac

A

calcified yolk sac = fetal demise

54
Q

If fetal myelomeningocele in spine

A

look in head for brain abnormalities

55
Q

Fetal ventriculomegaly

A

> 10 mm across the atria

56
Q

Chiari II malformation prenatal US

A 
Lemon sign (concave frontal bone deformity)
Banana sign (abnormal curve of the cerebellar hemispheres and smaller posterior fossa)
57
Q

MC fetal cardiac masses

A

rhabdomyoma
teratoma
fibroma

58
Q

Fetal cardiac masses most associated with what syndrome

A

Tuberous sclerosis

59
Q

What is the most important predictor of mortality in skeletal dysplasia

A 
Pulmonary hypoplasia
(short long bones = femur length < 5th percentile)
60
Q

Trisomy 18 (Edwards)

A

choroid plexus cysts
VSD
clenched hands

61
Q

RI in transplant hepatic artery

A

0.55 - 0.80
RI elevated in immediate post op due to edema
normalize in 72 hours
persistently low suggest arterial stenosis

62
Q

Reversal of diastolic flow in transplant kidney

A

Rejection
renal vein thrombosis
external compression
acute tubular necrosis

63
Q

MCC of vascular complication in orthotopic liver transplant

A

hepatic artery thrombosis

64
Q

Renal AVF after biopsy, recommend what?

A

do short term follow up US as most are small and resolve on their own

65
Q

what adjustments should be made to see slow flow in vessels

A

decrease the wall filter and RPF

66
Q

Lower frequency transducer does what to doppler shift

A

decreases doppler shift and reduces aliasing

67
Q

how to increase doppler sensitivity

A

increase dwell time (ensemble length)

68
Q

Expansile heterogeneous mass with central calcification in the IVC

A

highly suggestive of neoplasm than bland thrombus

Leiomyosarcoma MCC

69
Q

Increased peak systolic velocity that improves with inspiration

A

Median arcuate ligament compression (SMA gives collateral flow through pancreaticoduodenal arcade)

70
Q

Monophasic flow in a vein

A

raises suspicion for downstream thrombus or narrowing

71
Q

changing doppler scale changes what

A

PRF (pulse repetition frequency)

Decreasing RPF = improves doppler sensitivity

72
Q

AVF on US

A

show abnormal high velocity and low resistance waveforms (difficult to tell between artery and vein)

73
Q

Psudoaneurysms

A

yin yang flow

show to and fro waveforms with antegrade flow during systole and retrograde flow during diastole

74
Q

Blooming artifact

A

color beyond the vessel wall making it look larger

gain dependent = lowering gain = decrease blooming

75
Q

Large vessel extending from the left hepatic lobe in cirrhosis

A

recanalized paraumbilical vein
(look for hepatofugal flow in PV)
(also look for direction of flow in recanalized vein)

76
Q

Hepatic venous flow dampening

A

metastatic infiltration
cirrhosis
hepatic vein stenosis
venocclusive disease

77
Q

primary factor for grading carotid artery stenosis

A

Peak systolic velocity

normal = < 125 cm/s with no intimal thickening or plaque

78
Q

Augmentation during DVT studies

A

pushing on ipsilateral extremity distal to the transducer

79
Q

sign on acute DVT

A

vessel expansion

80
Q

Anisotropy artifact in tendon

A

beam off by >/= 5 degrees

81
Q

Cartilage interface sign

A

reflection of beam from the surface of the hyaline articular cartilage = MCC is full thickness tear of supraspinatous

82
Q

Baker cyst

A

distention of the semimembranosus-medial gastrocnemius bursa = must communicate with the joint space

83
Q

Increased flow in a tendinotic tendon on power doppler

A

neovascularity = severe tendinosis

84
Q

Plantar faciits

A

thickening of the facia > 4 mm

85
Q

Male with irregular peritoneal ST thickening and small volume ascites

A

GI primary is MCC of peritoneal carcinomatosis in men

86
Q

Sharply define deep lung margins on chest US

A

suspicious for lung tumor

Radiology Review (9 decks)

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