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DU PA GI Radiology

Duke PA GI Radiology

an imaging technique to obtain real time moving images of the patient fluoroscopy
patient ingests medium density barium and fluoroscopic images are obtained single contrast fluoroscopy
__ represents a pathologic narrowing that results in dysphagia Schatzki ring
patient ingests dense barium followed by effervescent granules and fluoroscopic images are obtained double contrast fluoroscopy
double contrast fluoroscopy evaluates fine mucosal detail that allow pathology from __ early inflammatory changes to tumor formation to be detected
contrast material may be used during the MRI to check __ blood flow, tumors, and areas of inflammation or infection
common indications for abdominal radiograph obstruction, ileus, free air
common indications for GI ultrasound cholecystitis, abdominal aortic aneurysm, liver cirrhosis, patency of hepatic vasculature, intussusception, appendicitis
common indications for GI fluoroscopy, barium swallow/UPGI aspiration/penetration, eophageal motility disorders, achalasia, hiatal hernias, strictures, masses, inflammation, viscus perforation, esophageal varices, duodenal atresia/stenosis, malrotation (infants)
common indications for GI fluoroscopy small bowel follow through jejunoilieal atresia (infants, small bowel obstruction, IBD, enteritis, small bowel lymphoma, adenocarcinoma, metasteses
common indications for GI fluoroscopy barium enema sigmoid and cecal volvulus, diverticulosis, and diverticulitis, colitis, colonic polyps/masses (failed colonoscopy), structural abnormalities (microcolon)
common indications for GI CT abdominal pain, trauma, unexplained wt loss, evaluation for hemorrhage, AAA and disection, complications of liver cirrhosis, bowel obstruction, evaluat/stage tumors, complications of pancreatitis, biliary tract obstruction, cholecystitis
common indications for GI MRI complications of liver cirrhosis, AAA, dissection, evaluate/stage abdominal tumors, biliary tract obstruction and anomolies, severity of iron deposition, patency of hepatic vasculature
common indications for nuclear medicine HIDA cholecystitis, biliary leak (usually following cholecystectomy)
common idication for tagged RBC scan acute lower GI bleed
differential for narrowing of the distal esophagus includes __ tumor, strictures, GERD, Chagas disease, post vagotomy effect
typical findings in a benign esophageal stricture tapered margins, concentric shape
__ causes an abrupt narrowing with irregular mucosa, prominent shoulders are characteristic on barium swallow squamous cell carcinoma of the esophagus
differential for long-segment stricture of the distal esophagus on barium swallow adenocarcinoma, reflux, caustic ingestion, radiation esophagitis
single contrast barium esophagram demonstrates sinuous tubular and nodular filling defects in the esophagus in the setting of cirrhosis, portal hypertension, and a history of upper GI bleeding Esophageal varices
barium esophagram demonstrates stiffness and narrowing of the distal esophagus. Several prominent sacculations are present indicating long standing and severe esophagitis reflux esophagitis
single contrast technique upper GI series reveals a lobulated filling defect in the antrum of the stomach gastric adenocarcinoma
upper GI series reveals narrowing of the body and antrum of the stomach. CT demonstrates marked thickening of the gastric wall with a homogeneous tumor. Lumen of the stomach is irregularly narrowed gastric lymphoma
upper GI series demonstrates a persistent barium collection that projects beyond the lumen of the base of the duodenal bulb with a well defined collar duodenal ulcer
spot view from an upper GI series shows two round smooth filling defects in the descending duodenum duodenal tumor
abdominal radiograph obtained five days after surgery demonstrates multiple loops of dilated bowel with no transition point adynamic ileus
CT of the RLQ shows the circumferential wall thickening of the terminal ileum that narrows the lumen, producing the string sign crohn's disease
CT scan shows classic sunburst appearance of radiating strands and messenteric mass carcinoid tumor
CT image shows eccentric wall thickening of multiple loops of the small bowel small bowel lymphoma
CT demonstrates circumferential thickening of small bowel loops caused by __ owing to portal vein thrombosis. Mesentery is edematous and congested small bowel ischemia
CT image through the pelvis in a patient with cervical carcinoma treated with radiation reveals long segments of small bowel with wall thickening and infiltrated mesentery radiation enteritis
Image from a double-contrast barium enema reveals the colonic mucosa to be carpeted with innumerable small polyps, seen as tiny filling defects family polyposis
long segment stricture is typical of __ rather than malignancy IBD
air contrast barium enema shows irregular narrowing of the lumen of the descending colon ulcerative colitis
Radiograph of the sigmoid colon from a double-contrast barium enema demonstrates a characteristic “apple core” constricting lesion colon adenocarcinoma
lumen of colon is markedly narrow and the shoulders cause a mass impression on the adjacent distended lumen colon adenocarcinoma
CT demonstrates marked thickening of the wall of the transverse colon. Ascites is present. This case was caused by cytomegalovirus infectious colitis
noncontrast CT scan demonstrates air-filled outpouchings in the sigmoid colon. Lack of soft tissue stranding or fluid in the adjacent fat indicating that no inflammation is present diverticulosis
CT scan demonstrates focal, marked thickening of the wall of the sigmoid colon. Stranding into the adjacent fat is indicative of inflammation diverticulitis
Noncontrast CT image shows a small gas-filled tubular structure with a blind end measuring <6mm in diameter normal appendix
graded compression US demonstrates a distended tubular structure with a blind end. diameter of 10mm appendicitis
on CT marked stranding in the adjacent fat is indicative of __ inflammation
Noncontrast CT image reveals air-density tubular structures extending to the periphery of the liver. portal venous gas
gas in the biliary tree is __ central
CT scan reveals atrophy of the liver with diffuse nodularity of its surface and splenomegaly cirrhosis
Contrast-enhanced CT of the liver demonstrates multiple hypodense nodules hepatocellular carcinoma
appear as numerous low-attenuation nodules of varying size on postcontrast CT liver metastases
Postgadolinium, T1W, fat-suppressed MR image of liver shows intense homogeneous enhancement hepatic adenoma, hepatocellular carcinoma
Postcontrast CT image reveals a thick-walled fluid collection in the right hepatic lobe liver abscess
Serial CT images obtained from a jaundiced patient demonstrate dilatation of the common bile duct choledocholithiasis
CT reveals numerous subtle low attenuation floating masses. nearly isodense with bile cholelithiasis
US demonstrates focal echodensities of varying size within the gallbladder lumen. acoustic shadows extend from the echodensities cholelithiasis
Postcontrast CT demonstrates fluid around the enhancing mucosa of the gallbladder, in a patient with severe RUQ pain cholecystitis
CT scan performed with rapid bolus administration of IV contrast demonstrates enhancement of only the distal body of the pancreas. The pancreatic head and neck did not enhance and are lost in the fluid necrotizing pancreatitis
air in th epancreatic bed is indicative of __ abscess and or fistula communication with the bowel
the supine view of the abdomenis referred to as __ KUB
the upright view is used to assess __ free air and fluid levels
__ view is used whe assessing for free air and fluid levels in a patient who cannot stand upright lateral decubitus
a barium swallow provides __ anatomic evaluation of the entire esophagus
a cross table lateral view will demonstrate air/fluid levels as well as free air and is most often used in __ infants
__ is used to coat the mucosal surface dense barium
__ can be performed to aid in the evaluation of aspiration. it is often used for stroke patients and is referred to as a speech study modified baium swallow
an upper gastrointestinal series (UGI) evaluates the __ esophagus below the level of the cricopharyngeus, as well as the stomach and duodenum
__ is performed as a single contrast study to evaluate the entire small bowel small bowel follow through
air contrast is administered per rectum along with dense barium to evaluate the __ mucosa
a single contrast barium enema is used for evaluation of function and obstruction single-contrast study
for a barium enema it is imperitive to have a clean colon b/c retained feces can resemle polyps
if bowel perforation is suspected __ is recommended because barium can cause peritonitis if a perforation is present a water soluble contrast agent (iodinated contrast material)
abdominal US is a helpful study for evaluation of the __ liver, pancreas, gallbladder, kidneys and reproductive organs
US is a useful tool to answer a yes or no question
a good systematic way to look at KUB bones, stones, gases, and masses
only about 25% of gallstones are radiopaque
supine signs of free air are not sensitive but include the __ which is a large lucency in the middle of the abdomen, seen more often in children football sign
__ is persent when air is noted on both sides of the abdominal wall ( a well defined bowel wall) Rigler's sign
__ is most often associated with perforated bowel, usually from a duodenal or gastric ulcer pneumoperitoneum
post operative __ should resolve in 3-4 days pneumoperitoneum
small bowel should measure less than __ cm in diameter 3
large bowel should measure less than __ cm in diameter 6
cecum should measure less than __cm in diameter 9
__ is often helpful in evaluation of peritoneal fluid CT
on ultrasound serous ascities is __ sonolucent (few echoes)
US of exudative or malignant ascites may demonstrate __ echoes reflecting debris within the fluid
__ presents with a constellation of finding, including absence of paristalsis in the esophagus, increase resting pressure of the LES, and failure of the LES to relax with swallowing esophageal achalasia
__ is associated with multiple tertiary esophageal contractions, thickened wall, and chest pain. the most common cause is neuromuscular disorders such as cerebrovascular disease and stroke diffuse esophageal spasm
__ is a systemic disease characterized by progressive atrophy of smooth muscle and progressive fibrosis scleroderma
best way to make the diagnosis of gastroesophageal reflux monitoring with a pH probe for 24 hours
a protrusion of any part of the stomach into the thorax hiatal hernia
most common type of hiatal hernia sliding
food and liquid can become trapped in the posteriorly located __. Symptoms include halitosis, dysphagia, and regurgitation of food Zenker's diverticulum
double contrast radiographic findings of __ include thickened esophageal folds (>3mm), limited esophageal distensibility, abnormal motility, and mucosal plaques, nodules, erosions, and ulcerations esophagitis
mass lesions and filling defects of the esophagus are well demonstrated with __ barium studies
once mass lesions and filling defects are identified with with barium studies the extent of disease can fully be evaluated with __ CT
__ accounts for most cases of esophageal carcinoma squamous cell carcinoma
__ refers to rupture of the esophageal wall due to forceful vomiting. The tear is almost always the left posterior wall, near the left crus of the diaphragm Boerhaave's syndrome
__ involves only the esophageal mucosa, it is usually seen with endoscopy. Should be considered in a patient who presents with copious hematemesis after forceful vomiting Mallory-Weiss tear
it is important to __ the stomach for CT, b/c normal nodular thickening can mimic disease. distend
on CT the normal gastric wall should measure less than __mm in thickness 5
on CT the normal duodenal wall should measure less than __mm in thickness 3
__ is a full thickness defect in the mucosa ulcer
all __ should be examined either endoscopically or followed to resolution radiographically gastric ulcers
__ have irregular tumor mass, eccentric location in the tumor mound, shallow depth, width greater than depth and irregular shoulder edges malignant ulcers
__ have intact mucosa tot he edge of the crater, smooth ulcer mound with tapering edges, overhanging mucosal edges, and depth greater than width benign ulcer
__ is recommended for furhter evaluation of a malignant appearing ulcer CT
Ulcers that affect the __ apear more frequently, and are associated with acid hypersecretion duodenum
__ are true neoplasms with malignant potential. they are typically found in the antrum adenomatous polyps
__ occur in Peutz-Jeghers syndrome and have no malignant potential hamartomatous polyps
__ is excellent for further characterization of extrinsic masses CT
when a mass is found in the bulb 90% of the time it will be __ benign
folds are considered thickened if they exceed _mm in the fundus 1
folds are considered thickened if they exceed __mm in the antrum 5
folds are considered thickened if they exceed __mm in the duodenum 3
__ appear as smooth, lobulated filling defects that resemble thickened folds. CT can confirm the diagnosis as well as demonstrate cause varices
__ is the prefered method of examination of the small bowel enteroclysis
this portion of the small bowel has a feathery mucosal apperance, prominent valvulae conniventes, a wider lumen, and a thicker wall jejunum
this portion of the small bowel has less of a feathered mucosal patter, thinner walls, thinner and less frequent folds, and a narrower lumen ileum
bowel involvement by tuberculosis is best seen on __ CT
__ is the most common neoplasm in the small bowel carcinoid
radiographic features of __ are thickened, distorted folds, contractures, stenosis, skip lesions, involvement of the mesentery, fustulas, and sinus tract formation Chron's disease
most common apperance of adenocarcinoma on barium studies is an __ of the small bowel apple core stricture
the most common congenital anomaly of the GI tract is __ Meckel's diverticulum
this is located in the antimesenteric border of the ileum up to 2 m from the ileocecal valve Meckel's diverticulum
is stasis of bowel contents ileus
diffuse symmetric gaseous distension of the bowel is noted on conventional films in the case of ileus
more loops of bowel are dilated with __ than with obstruction ileus
__ account for more than half of SBO in western society adhesions
the colon can be readily identified on CT due to its __ markings haustral
the colon wall is usually less than __mm in thickness 5
__ is the most common GI malignancy colorectal cancer
the most frequently encountered complication of colorectal cancer obstruction
__ is defined as a mass that projects fro the mucosa into the lumen polyp
polyps less than __mm are thought to be hyperplastic polyps with low risk of malignancy 5
polyps __mm in size are most often adenomas with a risk of malignancy of about 1% 5-10
polyps larger than __mm in size are malignant 50% of the time 20
__are an acquired condition in which the mucosa and the muscularis mucosa layer herniate through the muscularis propria of the colon wall, leading to the formation of a sac diverticula of the colon
diverticulosis is a cause of __ painless colonic bleeding that may be brisk and lifethreatening
diverticula are most common in the __ colon sigmoid
it is safe to performa barium enema in suspected diverticulitis except when signs of __ are present bowel perforation or sepsis
when the cecum dilates to greater than __cm in diameter it is at high risk for perforation with associated risks of peritonitis and septic shock 10
sigmoid volvulus is most often seen in the __ and is a result of the sigmoid colon's twisting around its mesentery elderly
in sigmoid volvulus barium enema shows __ an obstruction that tapers into a beak at the point of the twist
__ si the most common cause of obstruction seen in the elderly fecal impaction
the most common cause of acute abdomen acute appendicitis
__ is a terrific way to evaluate a patient for acute appendicitis CT
__ is not performed for evaluation of appendicitis barium enema
__ provides a reasonable screening study for liver, biliary tree, gallbladder as well as pancreas and spleen US
repsiratory motion and peristalsis make it difficult to obtain reproducible __ images of the liver, biliary tree, and gallbladder MRI
__ is a wonderful modality for examination of liver, biliary tree and gallbladder b/c of its reproducibility, speed, and ability to see many shades of gray CT
imaging results in hemochromatosis CT-diffuse increase in liver densitiy. MRI-signal loss on T2W images
__ is less useful for distinguishing between benign and malignant processes of the liver US
most tumors in the liver are __ mets
when imaging for blunt abdominal trauma __ is the modality of choice CT
imaging of the biliary tree is done most often with __ CT and US
signals of biliary dilation include __ multiple branching tubular round, or oval structures that course toward the porta hepatis. The common bile duct is dilated to greater than 6mm
imaging of the gallbladder is best performed with __ US
__ is useful in the diagnosis and staging of gallbladder carcinoma CT
sonographic Murphy's sign transducer pressure over the gallbladder causes pain
Acute Cholecystitis is readily diagnosed with __ US
gall bladder wall thickening is defined as greater than __mm in patients who have fasted more than 8 hours 3
acute pancreatitis is usually diagnosed __ clinically
what is the role of imaging in the scenario of suspected acute pancreatitis to clarigy the diagnosis when the clinical picture is unclear, assess the severity, determine prognosis, and detect complications
best assessment of acute pancreatitis is with __ imaging cross sectional CT
__ is the second most common cancer of the GI tract and is rapidly fatal with an average survival time of only 5-8 months pancreatic carcinoma
the parenchyma of the spleen is wll evaluated with either __ US or CT
US of the spleen usually reveals a __ homogenous echo pattern
CT of the spleen usually reveals the __ density of the spleen to be less than that of the liver
the most common neoplasm in the spleen is __ hemangioma
__ is the best modality for evaluating splenic trauma. The spleen is the most commonly injured intra-abdominal organ in blunt trauma contrast-enhanced CT
Created by: bwyche