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top 3 differentials > Gastrointestinal imaging > Flashcards

Gastrointestinal imaging Flashcards

1
Q

Hyperdense liver

A 
Amiodarone (iodine)
Haemochromatosis
Glycogen storage disease
Wilson disease
Historic: thorotrast and gold

Hypoattenuation:
steatosis, malignancy, amyloid

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2
Q

Nodular liver contour

A

Cirrhosis
Treated metastases (pseudocirrhosis)
Budd-chiari syndrome

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3
Q

Esophageal diverticulum

A

pulsion diverticulum: zenker/killian-jamieson/epiphrenic, false
traction diverticulum: mid oesophageal due to pulmonary fibrosis, true
pseudodiverticulae: associated with stricture, reflux and candida

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4
Q

Solitary hypodense, hypovascular liver mass

A

cyst: hydatid show rim calcification and daughter cysts
metastasis: mucinous may calcify
abscess
peripheral cholangiocarcinoma: showed delayed enhancement of fibrosis
biliary cystadenoma

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5
Q

Multiple hypoattenuating hepatic lesions

A

Cysts including caroli disease and biliary hamartomas
metastases
multiple abscess
cholagniocarcinoma

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6
Q

RUQ cystic mass in a child

A 
choledochal anomaly
pancreatic pseudocyst
duplication cyst
ovarian cystic lesion: teratoma/simple
mesenteric cyst/lymphangioma
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7
Q

Oesophageal submucosal mass/thickened folds

A

varices
refluc oesophagitis
varicoid carcinoma (fixed)
lymphoma

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8
Q

oesophageal dilatation

A 
Achalasia
Scleroderma
Chagas disease
Carcinoma (fixed)
Oesophagitis with stricture
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9
Q

oesophageal pseudodiverticulae

A

reflux oesophagitis
candida
superficial spreading carcinoma shows pseudodiverticula and diffuse mucosal nodularity
-do endoscopy

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10
Q

oesophageal ulcers

A 
HIV/CMV-large
Herpes-multiple small
Reflux oesophagitis
Carcinoma
drug induced or caustic oesophagitis
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11
Q

solid pancreatic mass

A

adenocarcinoma- hypovascular, head, distal ductal dilatation and parenchymal atrophy
NET-hypervascular: insulinoma/gastrinoma/non-functioning/glucagonoma/VIPoma/somatostatinoma
metastasis
lymphoma
SPEN: solid and papillary epithelial neoplasm
pancreatoblastoma
splenule

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12
Q

linitis plastica

A

gastric carcinoma
metastases: breast/lung/pancreas
lymphoma
crohns disease: “ram’s horn”

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13
Q

Gastric Ulcer

A

benign peptic: smooth margins, outpouching, NSAIDs/H. pylori
carcinoma: in-pouching of ulcerated mass, irregular margins
Lymphoma
Metastatic disease

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14
Q

Gastric fold thickening

A 
Gastritis
Gastric carcinoma
Lymphoma
Menetrier: protein losing hyperplastic gastropathy in boys and old men
Metastases
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15
Q

Caecal mass

A 
Appendiceal abscess
Caecal adenocarcinoma
Appendiceal mucocoele: mucous retention cyst, mucinous cystadenoma/adenocarcinoma
Lymphoma
Adnexal mass e.g. TOA
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16
Q

Mesenteric mass

A

Metastasis
Carcinoid: cicatrising, 70% calcified, dotatate (somatostatin receptor) or MIBG avid
Desmoid tumour (Gardner=desmoid/osteoma/papillary thyroid/epidermoids) /fibrosing (sclerosing) mesenteritis
Reactive lymphadenopathy: Tb, Whipple (duodenal and jejunal mural thickening with low attenuation LN)
Carcinomatosis/mesothelioma

17
Q

Terminal ileal mural thickening

A

Crohns
Infection: salmonella, campylobacter, yersinia, TB, CMV
Lymphoma

18
Q

Colonic mural thickening

A

Infectious colitis: diverticulitis, neutropenic colitis, pseudomembranous colitis
IBD: Crohn (transmural), UC (mucosal)
Carcinoma
Ischaemic colitis

Oedematous: infection/inflammatory/ischaemia
Soft tissue density: lymphoma
Blood: haemorrhage, air: pneumatosis

19
Q

Small bowel mural thickening

A

IBD: Crohns
Lymphoma
Oedema; ischaemia, vasculopathy, hypoproteinaemia, angioedema
Infection: Whipple

20
Q

Oesophageal stricture

A 
reflux oesophagitis
drug-induced
carcinoma
iatrogenic post NGT
caustic injection
radiation
21
Q

Small bowel dilatation

A

SBO
Ileus
Coeliac disease -jejunoileal fold reversal
Scleroderma (hidebound bowel)

22
Q

Cystic pancreatic lesion

A

Serous cystadenoma: “grandmother” >6 loculations, <2cm, head, central calcification
Mucinous cystic neoplasm: “mother” <6 loculations, >2cm, tail, peripheral calcifications in 20%
IPMN
Pseudocyst
Solid and papillary epithelial neoplasm

23
Q

Liver mass with central scar

A

FNH- T2 bright scar with delayed enhancement
Fibrolamellar HCC - T2 dark scar doesn’t enhance
Haemangioma
Adenoma
Hypervascular metastasis: MR CT NET

24
Q

Large Bowel Dilatation

A

LBO
Volvulus
Pseudo-obstruction/Olgilvie’s
Toxic megacolon

25
Q

Intrahepatic biliary ductal strictures

A

PSC
Ascending cholangitis (cause or complication)
AIDs cholangiopathy: strictures caused by CMV/cryptosporidium
IgG4 related sclerosing cholangitis
Cholangiocarcinoma/metastases
Post-transplant arterial ischaemia

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