GI Imaging - Exam 4 Flashcards by Johannah Crumpton

What color is air on Xray?

xray = air = black

xray = bone = white

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Is there is contrast in an KUB xray?

YES! KUB xrays use contrast

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How many cigarettes is equivalent to 1 CXR? pelvis XR? abdomen XR?

1 CXR = 1 cig

pelvis = 6 cig

abdomen = 7 cig

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How many cigarettes is equivalent to 1 abdo/pelvis CT? chest CT?

abdo/pelvis CT = 140 cigs

chest CT = 7 cigs

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What is the most likely diagnosis?

small bowel obstruction

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What is the mostly likely diagnosis?

free air under the diaphragm

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What is the medical term for free air under the diaphragm? Where is the air located?

pneumoperitoneum

gas or air trapped within the peritoneal cavity, but outside the lumen of the bowel

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**What are the 2 causes of free air under the diaphragm?

1) bowel perforation

2) insufflation of gas (CO2 or air) during laparoscopy

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A pt presents with an acute abdomen, what 2 imaging studies should be ordered?

upright and supine abdominal xray

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What is the most likely diagnosis?

kidney stones

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What is the most likely diagnosis?

pancreatic calcification

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What is the most likely diagnosis?

fecal impaction

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When concerned about constipation what position should the patient be placed in? What will the xray report show?

supine: abdomen and pelvis xray

presence of large fecal burden throughout the colon and a relative paucity or absence of luminal gas

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**Ultrasound uses ______ to determine how far the object is, the size, shape and consistency

echoes

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How does an US transducer work?

A transducer sends the sound waves and records the echoing waves.

When pressed against the skin, it sends small pulses of HIGH frequency sound waves into the body

As the sound waves bounce off the internal organs, fluids, and tissues, the receiver records tiny changes in the sound’s pitch and direction

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What is echogenicity?

Echogenicity of the tissue refers to the ability to reflect or transmit US waves in the context of surrounding tissues

shows the relative brightness or darkness of a structure

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**What is hypoechoic? What color will it appear on US? What type of tissue?

Tissue in body that is more dense or solid

Absorbs MORE US waves

LESS reflective and low amount of echoes

appears GRAY or darker than the surrounding tissue

made up of muscle/ fibrous CT

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**What is hyperechoic? What color will it appear on US? What type of tissue?

Reflects sound waves of higher amplitude
Gives off more “echoes”

appears lighter or brighter than surrounding tissue

air, fat and gas

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A fatty liver would show ______ spots on the liver

hyperechoic

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What is anechoic? What color will they appear on US? What is it usually composed of?

structures that appear black because no internal echoes reflecting back

fluid and blood filled structures because the beam passes easily through these structures without significant reflection

What is the color scale of echogenicity?

Label this picture

white: liver

red: gallbladder

blue: hepatic artery

green: portal vein

pink: common bile duct

What should a normal liver US look like?

homogenous: same throughout

What is the most likely diagnosis?

fatty liver

What should a normal gallbladder look like on US?

smooth thin walls, less than 2mm with an anechoic lumen

What should a normal biliary tree look like on US?

narrow caliber, 6mm or less with uniform ductal walls

Label this picture

pink: gallbladder yellow: cystic duct purple: common bile duct green: common hepatic duct

What is the normal common bile duct diameter?

less than 7mm

What is the most likely diagnosis?

Acute cholangitis

What is the most likely diagnosis

Acute cholecystitis

What is the most likely diagnosis?

gallstones

What are the 3 planes that cross-section the body during a CT?

Label 1-10

1: Lung 2: Liver 3: portal vein 4: duodenum 5: small bowel 6: ascending colon 7: ilium 8: air in sigmoid colon 9: pubis 10: symphysis pubis

Label this picture

1: heart 2: stomach 3: left colic flexture 4: splenic artery 5: pancreas 6: superior mesenteric vein 7: mesenteric vessels 8: small bowel 9: sigmoid colon 10: urinary bladder 11: left femoral artery

**Be able to label this picture

be able to label it

**Label this picture

What is the arrow pointing at?

normal appendix

What 3 things is a contrast CT good for?

imaging tumors vascular abnormalities urinary tract

**What is a non-contrast CT good for?

Best for evaluating stones

What is the most likely dx?

Acute Diverticulitis

When is a barium swallow most commonly used?

dysphagia

What is the most likely dx?

Schatzki’s ring

What is the most likely dx?

Diverticulosis

What is a MRCP? Do you use sedation?

Special type of MRI to produce detailed pictures of these ducts and organs Powerful magnetic field, radio waves, and a computer to evaluate the liver, gallbladder, bile ducts, pancreas, and pancreatic ducts Is noninvasive and NO sedation

What imaging study?

MRCP

What is an ERCP? Does it use sedation?

A diagnostic and interventional procedure technique using both endoscopy and fluoroscopy Used for examination and intervention of the biliary tree and pancreatic ducts It involves passing the endoscope to the descending duodenum and injecting contrast through the Ampulla of Vater This will outline the biliary tree YES to sedation

What imaging study?

ERCP

What is the biggest complication of ERCP? Why?

pancreatitis Prolonged manipulation of the papillary orifice, difficult cannulation of the biliary tree, and repeated inadvertent instrumentation of the pancreatic duct result in ductal injury or injury to the ampulla. Resultant papillary edema caused by mechanical or thermal injury is thought to obstruct the outflow of pancreatic secretion, resulting in pancreatitis.