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Module 16 > Diagnostic Imaging of Digestive Tract > Flashcards

Diagnostic Imaging of Digestive Tract Flashcards

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1
Q

in what situations does serosal detail decreases (3)

A
  1. decreased fat (immaturity, emaciation)
  2. increased soft tissue opacity in/around mesentery (free fluids, peritonitis, carcinomatosis, severe mesenteric lymphadenopathy)
  3. large abdominal masses
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2
Q

what allows delineation of serosal margins of abdominal organs

A

mesenteric fat

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3
Q

what can increase serosal detail

A

pneumoperitoneum will increase clarity of serosal markings

around caudal margin of diaphragm

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4
Q

what would ddx be for increased serosal detail (3)

A
  1. recent surgery or abdominal penetration
  2. GIT perforation
  3. iatrogenic (ex. during pneumocystogram)
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5
Q

what is shown here

A

pneumoperitoneum

caudal margin of diaphragm

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6
Q

what is the normal appearance of the liver

A

even soft tissue opacity

triangular shape on lateral

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7
Q

what is the shape of the liver on lateral

A

triangular shape

sharp margin caudoventrally

extends to caudal aspect of costal arch

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8
Q

what is the gastric axis

A

used to assess the size of the liver

normal: parallel to ribs or perpindicular to spine

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9
Q

what is the appearance of the liver on VD

A

triangular, more to the right

tip is at the level of the costal arch

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10
Q

what are the signs of hepatomegaly

A
  1. caudal rotation of gastric axis
  2. liver extends caudally beyond costal arch
  3. rounding of caudal border
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11
Q

what is shown here

A

hepatomegaly

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12
Q

what is the ddx for hepatomegaly (4)

A
  1. hepatitis
  2. neoplasia
  3. cushings
  4. steroid use
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13
Q

what are the signs of microhepatica

A
  1. cranial rotation of gastric axis
  2. reduced size or herniation
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14
Q

what is shown here

A

microhepatica

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15
Q

what can be the ddx of microhepatica (2)

A
  1. portosystemic shunt (PSS)
  2. diaphragmatic rupture
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16
Q

identify the organs

A

red: stomach
pink: small intestine
orange: large intestine

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17
Q

can intestinal wall thickness be assessed on radiograph accurately

A

no

interfeace between gas the fluid –> wall is not actually thickened, it could be fluid that makes it look thickened

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18
Q

what is the appearance of the stomach on RLR

A

lying with right side down gas will collect in the fundus

left side of abdomen is highest

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19
Q

what is the appearance of the stomach on LLR

A

when dog is turned over the pylorus is the highest part of the stomach and gas will sit and give the stomach a dumbell appearance

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20
Q

what is shown here and what is the ddx

A

enlarged abnormal shape

GDV

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21
Q

what is the normal diameter of small intestine in canines

A

<1x height of lumbar vertabral body

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22
Q

what is the normal diameter of small intestine in felines

A

~<12mm

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23
Q

where are the small intestines located in the abdomen

A

generally ventral mid abdomen

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24
Q

what a small intestine obstruction appear on radiograph

A

single or few dilated or thickened loops

may be easier to see when gassy

foreign body may not be clearly seen

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25
what is shown here
foreign body
26
what is ileus
general dilation of small intestine
27
what can cause ileus
1. peritonitis 2. GDV 3. dysautonomia
28
how could you diagnose a small intestinal mass on rads (3)
may not be clear but 1. diffuse mild thickening 2. mass (obscured by other loops) 3. evidence of obstruction
29
what is the gravel sign
collection of mineralized matieral immediately above partial GI obstruction indicates chronic partial obstruction must be persistent
30
what is shown here
gravel sign partial pyloric outflow obstruction
31
where is the large intestine present
dorsal abdomen
32
what is the diameter of normal large intestine
\<1.5x length of L7
33
what is shown here
large intestine
34
what is shown here
megacolon dense radioopaque fecal material twice length of L7
35
what can GI contrast studies be used to diagnose (3)
1. identify obstruction 2. assess mucosal surface (neoplasia, etc) 3. intestinal function (transit times)
36
what is the diagnosis
serosal detail is very poor (skeletal mature --\> free fluid) distended intestinal loop that looks like there is fecal material to ventral to large colon --\> has to be a distended small intestine foriegn body in the small intestine free gas --\> perforated intestine and septic peritonitis
37
what are the pros of ultrasound (4)
1. major diagnostic tool 2. good for soft tissues (assess internal structure/parenchyma) 3. safe, non-invasive, cheap, rapid 4. real-time imaging (functional assessment --\> cardiac, peristalsis, guidance for FNA/biopsy)
38
what are the cons of ultrasound (3)
1. poor for bone and gas (lung, GI tract) 2. need to clip hair 3. operator (and machine) dependent
39
what is the ultrasound appearance of the normal liver
hypoechoic to spleen (slightly grainy texture) vascular structures: hepatic viens and portal veins gall bladder sharp margins
40
where is the gall bladder on ultrasound
right to midline --\> fluid filled, anaechoic
41
how is liver size assess on US
subjective rads easier does it extend too far caudally? is liver too small?
42
what would diffuse hyperechoic changes in the liver be caused by (4)
1. steroid hepatopathy including cushings 2. chronic hepatitis 3. fatty liver 4. fibrosis
43
what would diffuse hypoechoic changes be due to (4)
1. acute inflamamtion 2. edema 3. lymphoma 4. congestion
44
what could focal abnormalities be due to in the liver (5)
1. masses, cysts, etc 2. neoplasia 3. regenerative hyperplasia 4. granulomas 5. abscess
45
what vascular abnormalities can be seen on US in the liver
1. venous congestion with right heart failure 2. portosystemic shunts
46
what are billiary abnormalities seen on US (3)
1. gall bladder sludge 2. cholecystitis 3. biliary obstruction
47
what are the layers of the GI tract (5)
1. serosa 2. muscularis 3. submucosa 4. mucosa 5. lumen
48
what is the approx thickness of the stomach in the long axis US view in dogs
3-5mm
49
what is the approx thickness of the stomach in the long axis US view in cats
1.1-3.6mm
50
what is the approx thickness of the duodenum in the long axis US view in dogs
5.1-6.0mm
51
what is the approx thickness of the duodenum in the long axis US view in cats
1.3-3.8mm
52
what is the approx thickness of the jejunum in the long axis US view in dogs
4.1-4.7mm
53
what is the approx thickness of the jejunum in the long axis US view in cats
1.6-3.6mm
54
what is the approx thickness of the colon in the long axis US view in dogs
2.0-3.0mm
55
what is the approx thickness of the colon in the long axis US view in cats
1.1-2.5mm
56
what does the stomach look like on long axis view US
kiwi fruit appearance
57
where can the duodenum be scanned
right dorsal flank
58
what is the duodenum a landmark for on US
pancreas and pylorus
59
what is the appearance of the duodenum on US
coffee bean appearance
60
where is the jejunum scanned
mid abdomen
61
what is the appearance of the ileum on US
prominent submucosal layer
62
where is the ileo-cecal junction
right mid abdomen
63
what is the approx wall thickness of the colon on US
2-3mm
64
what does an US GI tract assessment include (5)
1. function 2. obstruction (intussusceptions, contents, foreign material) 3. wall thickness and layers 4. neoplasia 5. enteritis
65
how can a GIT obstruction be seen on US
distention proximal and empty distal (two populations)
66
what is seen here
distended and fluid filled obstruction
67
how are solid foreign materials seen on US
often hyperechoic + shadowing distinct shape GIT conforms to shape
68
how are linear foreign bodies seen on US
short angular turns bunching of SI
69
what is shown here
foreign material in SI peach stem
70
what is shown here
linear foreign body string
71
what is the appearance of an intussusception on US
mutliple wall layers hyperechoic mesenteric fat
72
what is shown here
intussusception
73
what is the appearance of neoplasia on the GI tract (6)
1. loss of wall layers 2. markedly thickened walls 3. irregular lumen 4. lack of peristalsis 5. focal vs. generalized 6. continuity with adjacent GI tract
74
what changes can be subjectively seen with enteritis on US (5)
1. abnormal content 2. altered peristalsis 3. increased wall thickness 4. increased mucosal echogenicity 5. irregular lumenal interface
75
what is shown here
neoplasia
76
what is seen here
free fluid around intestinal loops enteritis
77
what are the landmarks for the pancreas on US (3)
1. stomach 2. transverse colon 3. spleen
78
what are the differences in the left and right limbs of the pancreas
left limb is bigger in cats and smaller in dogs right limb is bigger in dogs and smaller in cats
79
what is shown here
left limb of pancreas
80
what is the landmark of the right limb of the pancreas
duodenum
81
what is the appearance of the right limb of pancreas
similar/hypoechoic to surrounding fat may not be visible
82
what is shown here
right limb of pancreas
83
what is shown here
right limb of pancreas
84
how does pancreatitis change the appearance on US
1. edematous (hyperechoic) 2. surrounding peritonitis and free fluid
85
how does pancreatic neoplasia change the appearance on US (2)
1. mass/nodule 2. may appear similar to pancreatitis
86
what is shown here
pancreatitis edematous surroudning peritonitis and free fluid
87
what is shown here
pancreatic neoplasia

Module 16 (26 decks)

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