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Diagnostic imaging and Radiology > Digestive system Radio > Flashcards

Digestive system Radio Flashcards

1
Q

What is the gold standard for diagnostics of CRC ?

A

Complete Colonoscopy

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2
Q

what is a possible alternative for patients suspected for CRC who can not undergo complete colonoscopy ?

A

Double contrast barium enema

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3
Q

How do we stage CRC ?

A

PET (FDG)-CT

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4
Q

what are the imaging techniques for metastasis of CRC in the Abdomen ?

A

US

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5
Q

what are the imaging techniques for metastasis of CRC in the Thorax ?

A

Radiography (x-ray)

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6
Q

what are the imaging techniques for metastasis of CRC to the bone?

A

Bone scintigraphy with Tc-99m + MDP

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7
Q

What do we use for preoperative staging for CRC ?

A

CT of abdomen, pelvis, and chest with IV contrast and oral contrast.

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8
Q

What is the most typical metastasis for CRC ?

A

Hepatic and pulmonary

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9
Q

what is the 1st level imaging for liver cirrhosis ?

A

US

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10
Q

What are some indirect signs we see of liver cirrhosis using US ?

A

Irregular margins of nodules, and portal vein dilatation

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11
Q

What is the 2nd level imaging for liver cirrhosis ?

A

CT

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12
Q

What sign of liver cirrhosis can we see using CT for diagnosing the disease ?

A

Right lobe volume reduction

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13
Q

What imaging technique can recognize nodular regeneration and dysplastic nodules of the cirrhotic liver ?

A

MRI + contrast

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14
Q

1st line imaging Liver Hemangioma ?

A

US

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15
Q

How do we see liver hemangioma on the US ?

A

Homogenous and hyperechoic

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16
Q

2nd line imaging for Liver Hemangioma ?

A

CT + contrast

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17
Q

How does Liver hemangioma appear in the arterial phase on CT and contrast ?

A

Hyperdense

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18
Q

3rd line imaging for Liver hemangioma ?

A

MRI - Hypointense in T1

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19
Q

What is the imaging we use for the first identification and surveillance of high risk pt for HCC ?

A

US + doppler

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20
Q

What is the 2nd line imaging when we assess HCC patient for new liver nodules ?

A

CT/MRI with contrast

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21
Q

What do we look for when using CT for the investigation of new liver nodules ?

A

Transient Hepatic Attenuation Differences (THAD)

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22
Q

What phase of the triphasic with CT study we can can see neo-angiogenesis ?

A

Arterial phase

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23
Q

What are the most common malignant hepatic lesions ?

A

Metastasis

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24
Q

Liver metastasis is caused by few important tumors, which are ;

A

Pancreas, breast, lung, and kidney tumors.

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25
1st line imaging for liver metastasis ?
US
26
How many lesions do we see in the liver metastasis on US ?
single or multiple lesions
27
What are the second instance investigation for Liver metastasis ?
CT
28
In what method does **liver metastasis** is more recognizable when using **CT** ? how do they appear?
In the **Portal phase** and they appear **Hypodense**
29
How does **Liver metastasis** appear on **CT** when it is **secondary to hypervascularized** tumors ? In what phase they are more evident ?
More evident in the **arterial phase**, and appear **hyperdense**, due to their rich vascularization
30
What is the 3rd choice for liver metastasis imaging ?
MRI- use in doubtful cases
31
How do we see Liver metastasis, using MRI T1 weighted ?
Hypointense
32
How do we see Liver metastasis, using MRI T2 weighted ?
Hyperintense
33
what is the first line imaging used for billiary ?
US
34
What are the GOLD STANDARD for the imaging of biliary pathways ?
ERCP & PTC
35
ERCP stands for what ?
Endoscopic Retrograde Cholangio Pancreatography
36
PTC stands for what ?
Percutaneous Transhepatic Cholangiography
37
What are the indication of ERCP and PTC ?
1. Billiary obstruction (location, extent, and malignant/ benign nature)
38
How do we use CT/MRI in biliary pathways ?
In a Complementary manner
39
In what cases do we prefer to use MRI in biliary imaging ?
**Benign lithiasis-induced obstruction** or when **ERCP is contraindicated**
40
What is the main indication for MRCP ?
**Distinguish benign and malignant nature of the obstruction**
41
if we use MRCP for biliary ducts, do we use T1/T2?
T2
42
what do we highlight when we use MRCP for imaging of biliary ducts ?
Static liquids i.e., like bile
43
What is the use of **Abdominal X-ray** in the imaging of **Biliary ducts** ?
Used for specific pathologies: **Calcium bile** **Radio opaque lithiasis**
44
Do we use contrast in MRCP (colangio RM) ?
No
45
What is the most frequent pathology of the biliary tract ?
Biliary lithiasis (Gallstone disease)
46
the two main Gallstone disease ?
cholecystolithiasis (gallstone in the gallbladder) choledocholithiasis (gallstone in a bile duct)
47
What is the first method of choice for suspected Biliary lithiasis ?
Ultrasound
48
How do we see gallstones on US ?
Endoluminal Hyperechoic Posterior shadow cone
49
In what cases of biliary duct imaging we prefer using MRI ?
Benign lithiasic obstruction / not possible to do ERCP
50
How do we see gallstones on MRI ?
Oval or rounded formations of low signal
51
How do we see gallstones on CT ?
hyperdense formations "target aspect"
52
How do we recognize biliary lithiasis with MR-CP ?
You will see a filling defect in the bile duct clouded by bile.
53
1st line imaging in acute cholecystitis ?
US (low cost, highly available)
54
What are some US signs we see with Acute cholecystitis ?
1.stones 2.overdistension of the lumen 3.Ultrasound Murphy's sign
55
What is the 2nd line of imaging we use for Acute cholecystitis ?
CT Used to complement non-direct or doubtful ultrasound examination
56
**Acute cholecystitis** common signs seen on **CT** **without contrast**
**stones** in the lumen, most often **hyperdense**
57
Acute cholecystitis common signs seen on CT (**after contrast injection**) ;
focal/diffuse thickening of the gallbladder wall Non-specific inflammatory hyperemia
58
what are the 2 most common complications of Acute cholecystitis ?
1.Gangrenous cholecystitis 2.Perforation of the gallbladder
59
Which method appears to be superior in the identification of biliary tract dilation, site of obstruction, and localization of the stone ?
MRI appears to be superior
60
How do we access the biliary ducts with the ERCP technique ?
Through the papilla of Vater
61
which technique will you use in order to perform stent or biliary flushing ?
ERCP
62
initial diagnosis of acute pancreatitis ?
clinical and lab tests
63
what is the system that classifies the the severity of acute pancreatitis ?
Balthazar
64
What imaging is used for ACUTE PANCREATITIS staging ?
CT-Abdomen + IV contrast
65
what is the balthazat classification for ?
Divides the severity of acute pancreatitis into 5 grades (A-E)
66
How do you evaluate the severity of necrosis in acute pancreatitis?
US/CT - guided biopsy
67
3 Complications of acute pancreatitis
Necrotizing pancreatitis Walled-off necrosis sepsis
68
What are the labs seen in Acute pancreatitis ?
Increased Amylase and Lipase
69
Imaging used for Endocrine Pancreas Tumors ?
CT and MRI
70
what is considered the Gold-standard imaging for Acute pancreatitis ?
Contrast enhanced (IV) CT examination ***Allows to stage the severity of the disease
71
How do we diagnose Appendecitis ?
Clinically and US
72
What imaging technique can be used to study in detail the small intestine ?
Enteroclysis (with contrast) it's CT actually !!
73
What is the main indication of Double contrast enema ?
Crohn's disease (especially good for lesion depth evaluation) *barium contrast
74
Indications of Trans-rectal US
1.Prostate cancer 2.Anorectal pathologies
75
What is the most adequate investigation we can perform for transmural extent of inflammation and intraperitoneal/extraintestinal complications of crohn's and UC ?
CT
76
What are the 2nd level investigations for Crohn's disease ?
**CT enterography** and **MR enterography** CT-more in emergency | results are quiet comparable, despite MRI has higher resolution !
77
liver metastasis on US, how do we see it, hyper/hypo-echoic?
hypoechoic
78
liver metastasis on US, how do we see the margins?
Well defined margins.

Diagnostic imaging and Radiology (6 decks)

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