Flashcards in GB Abnormal Deck (138)
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1
What is the term for calcification of the GB wall?
porcelain GB
2
What is the cause of porcelain GB?
it is unknown
3
Porcelain GB occurs in association with _____ and may represent some form of _____.
gallstone disease
chronic cholecystitis
4
What determines the sonographic appearance of porcelain GB?
the degree and pattern of calcification
5
When the entire GB wall is thickly calcified, a _____ _____ line with dense posterior _____ _____ is noted.
hyperechoic semilunar
acoustic shadowing
6
Mild calcification of the GB wall appears as a(n) _____ line with variable degrees of _____.
echogenic
posterior acoustic shadowing
7
With calcification of the GB wall, the luminal contents may be _____ (visible/not visible), interrupted clumps of _____ appear as _____ foci with posterior shadowing.
visible
calcium
echogenic
8
Why is the WES sign absent with a porcelain GB?
Because the GB wall is calcified
9
What is another term for adenomyomatosis?
Rokitansky-Aschoff Sinuses
10
Adenomyomatosis can be either focal or _____. Is it benign or malignant?
diffuse
benign
11
What happens to the GB physiologically to cause adenomyomatosis?
The diverticula in the GB wall become clogged with stones or sludge
12
What is the most common U/S appearance of adenomyomatosis?
tiny echogenic foci in the GB wall that create comet-tail artifacts
13
What is the most common appearance of adenomymatosis with doppler U/S?
echogenic foci with ringdown or twinkling artifact
14
What is another term for ringdown artifact?
twinkling artifact
15
The comet-tail artifact with ringdown or twinkling from adenomyomatosis is located where in the GB?
in the Rokitansky-Aschoff sinuses
16
If you don't see twinkling artifact within the comet-tail artifact in the GB, what should be done?
Further study to rule out neoplasm.
17
Does not move, does not shadow =
polyps
18
Why is it important to distinguish between benign and malignant polyps?
Because benign are very common and malignant require early intervention to improve outcome.
19
What are the two most frequently used criteria to identify a polyp as benign?
multiplicity
size below 10mm
20
Malignancy of polyps has been documented in 37-88% of resected polyps that were
larger than 10mm
21
Other malignancy risk factors for a person with polyps are (6)
1) older than 60
2) single lesion
3) gallstone disease
4) rapid change in size
5) sessile morphology
6) doppler velocity of more than 20cm/sec and resistive index of less than 0.65
22
Approximately half of all polyps are _____ polyps.
cholesterol
23
This kind of polyp represents the focal form of GB cholesterolosis.
cholesterol polyp
24
Cholesterolosis results in the accumulation of _____ (such as _____ and _____) in the GB wall. It is a common _____ condition of the GB.
lipids
triglycerides
cholesterol
non-neoplastic
25
T or F? Polyps DO NOT roll and DO NOT produce posterior shadowing.
True
26
The diffuse form of cholesterolosis is called
strawberry GB
27
Where does strawberry GB get its name?
golden yellow lipid deposits agains the red GB mucosa
28
Cholesterolosis is usually asymptomatic but if there are symptoms, it is usually in the form of
colicky abdominal pain
29
Although cholesterolosis and adenomyomatosis appear similar, the main difference is that cholesterolosis doesn't have
comet tail reverberation artifact (ring down or twinkling)
30
