GU + Gynae + Breast Flashcards by Kestology KO

The following is suggestive of what age person:
Cervix larger than uterine fundus + Uterus is large

Neonate

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The following uterus is suggestive of what age person:
Tube like uterus, cervix & uterus are same size

Pre-puberty

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The following uterus is suggestive of what age person: Pear shaped uterus, fundus larger than cervix

Puberty

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The following is suggestive of what condition?
Aortic coarctation, horseshoe kidneys, pre-puberty uterus, and streaky ovaries

Turner syndrome

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What embryological structure forms the uterus, fallopian tubes and upper 2/3 of the vagina?

Mullerian ducts

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What embryological structure forms the bottom 1/3 of the vagina?

Urogenital sinus

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What embryological structure forms the vas deferens, seminal vesicles, and epidydimis?

Wolffian ducts

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What is the following describing?
1) Vaginal atresia (Upper 2/3)
2) Absent or rudimentary uterus (Unicornuate/Bicornuate)
3) Normal ovaries
4) Renal abnormality (Agenesis/ectopia)

Mullerian agenesis/MRKH syndrome

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What does the following describe?
Single uterine cavity +/- rudimentary horn

Unicornuate uterus

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What is a unicornuate uterus usually associated with?

Renal agenesis contralateral to the main uterine horn or ipsilateral to the rudimentary horn

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The following describes which uterine abnormality?
2 x cervix
2x Uterus
2 x upper 1/3 vagina, +/- vaginal septum

Uterine didelphys

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The following describes which uterine abnormality?
Unicollis/Bicollis + deep myometrial uterine cleft seperating the uterus
May have a vaginal septum
Fundal contour <5mm above tubal ostia

Bicornuate uterus

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What type of uterine anomaly is linked to DES (Sythentis oestrogen)?
What is the appearance?

T shaped uterus

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The following describes which uterine abnormality?
2x endometrial canals seperated by fibrous/muscular septum
Straight/convex uterine fundus
Normal fundal contour >5 mm above tubal ostia

Septate uterus

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What is the most common mullerian duct anomaly associated with miscarriage?

Septate uterus

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The following describes which uterine abnormality?
Smooth concavity of the uterine fundus

Does it have any associated risks?

Arcuate uterus

Not associated with infertility or obstetric complications

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The following describes which uterine abnormality?

Heart shaped - fundal contour <5 mm above tubal ostia

Bicornuate uterus

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The following describes which uterine abnormality?
Fundal contour normal >5 mm above tubal ostia

Septate uterus

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When is HSG performed?

Proliferative phase (Day 7-12) when the endometrium is thinnest and pregnancy least likely

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What are the contraindications to HSG?

Pregnancy
Acute pelvic infection
Active bleeding
Contrast allergy

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What are the causes of irregular filling defects on HSG? Linear, filling defects from uterine walls

Synechiae, scarring, intrauterine adhesions

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What causes round/oval filling defects on HSG?

Endometrial polyps
Fibroids (Distort the internal contour)

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What causes tubal occlusion on HSG - abrupt cut off with no distal opacification or dilated tubes with no free intraperitoneal spillage of contrast

Infection/PID

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What is the following describing?
Proximal 2/3 fallopian tube, nodular scarring

Salpingitis Isthmica Nodosa (Post inflammatory/infectious)

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What is Salpingitis Isthmica Nodosa associated with?

Infertility and ectopic pregnancy

What is the following describing? Doppler US - Serpiginous and/or tubular anechoic structures within myometrium with high velocity colour doppler flow

Uterine AVM

What is the following describing? on HSG - non-filling of uterus + multiple irregular linear filling defects (Lacunar pattern) + Unable to distend endometrial canal MR - T2 dark bands

Intrauterine adhesions (Ashermans)

What is the following describing? 2-5 days post delivery PROM or prolonged labour, fluid and thickened endometrial cavity +/- gas

Endometritis

What is the following describing? Bladder descent >1cm below the pubococcygeal line

Cystocele

What is the following describing? Descent of the cervix or posteiror vaginal fornix >1 cm below the pubococcygeal line

Uterine prolapse

What is the following describing? Abnormal rectal bulging

Rectocele (Due to weakened rectovaginal fascia)

What is the most common location for a uterine fibroid?

Intramural 2nd/3rd - Submucosal + Subserosal

What is the following describing? Uterine mass US - Hypoechoic, peripheral blood flow and venetian blind shadow pattern

Uterine fibroid

What is the following describing? CT - Pelvic mass with Peripheral calcifications

Fibroid

What is the following describing? Uterine mass MR - T1 dark, T2 dark, variable enhancement

Fibroid

What is the following describing? T1 dark, T2 dark, Homogenous contrast, uterine mass

Hyaline fibroid - Most common/classic

What is the following describing? T1 dark, T2 bright, Homogenous contrast, uterine mass

Hypercellular fibroid (Densely packed smooth muscle, not much connective tissue) Responds well to embolisation

What is the following describing? T1 bright, T1 fat sat dark, T2 bright, rim enhancement uterine mass

Lipoleiomyoma

What kind of fibroid degeneration do the following findings suggest? T1 dark, T2 dark & heterogenous, no contrast enhancement

Hyaline - fibroid outgrows blood supply, leading to accumulation of proteinaceous tissue

What kind of fibroid degeneration do the following findings suggest? T1 peripheral bright rim, variable T2, no contrast enhancement

Red degeneration (Due to venous thrombosis)

What kind of fibroid degeneration do the following findings suggest? T1 dark, T2 bright, Minimal contrast enhancement

Myxoid degeneration

What kind of fibroid degeneration do the following findings suggest? T1 dark, T2 bright, no contrast enhancement

Cystic degeneration

What are the features of malignant degeneration in a fibroid? What does it transform into?

Rapidly enlarging, areas of necrosis Uterine Leiomyosarcoma

What is adenomyosis? Where does it favour?

Endometrial tissue that has migrated into the myometrium Posterior wall, spares cervix

What does the following describe? Marked enlargement of the uterus, with preservation of the uterine contour. US - Heterogenous uterus (Hyperechoic foci with hypoechoic muscular hypertrophy)/Enlargeemnt of posterior wall

Adenomyosis

What does the following describe? Marked enlargement of the uterus, with preservation of the uterine contour. MR - Thickened junctional zone >12 mm, focal or diffuse + Small high T2 signal regions

Adenomyosis

What are the MR signal characteristics of the uterine anatomy?

T2 Bright - Endometrium T2 low - Junctional zone T2 medium - Myometrium

In which cases is the trilaminar pattern of the uterus not seen?

Pre-menarche, post-menopause, during pregnancy, postpartum

A patient with postmenopausal bleeding has an US, which shows an endometrium <5 mm. What is the likely cause?

Endometrial atrophy

A patient with postmenopausal bleeding has an US, which shows an endometrium >5 mm. What is the likely cause?

Hypertrophy or cancer Refer to gynae for biopsy

What is the normal endometrial thickness in a pre-menopausal endometrium?

up to 20 mm

What type of ovarian cancer can cause endometrial thickening?

Granulosa cell tumours of the ovary, due to oestrogen secretion

Which conditions can increase the risk of endometrial cancer?

HNPCC (Hereditary non-polyposis colon cancer

What is the most common cause of endometrial cancer?

Adenocarcinoma

What are the steps for assessment of endometrial cancer? PMB presentation Extent of local disease Distal mets

PMB presentation - US & referral for biopsy if endometrium >4 mm Extent of local disease - MRI Distal mets - PET CT

What is MRI used for in endometrial cancer staging?

- Myometrial invasion depth - Cervical stromal invasion

The following MR findings in the endometrium suggest what? Diffusion restriction T2 intermediate signal (Brighter than junctional zone) Enhances less than myometrium

Endometrial cancer

The following findings suggest what? MR T1 post contrast images - normal dark cervical stroma with enhancement of the cervical mucosa

No cervical invasion so stage 1 endometrial cancer

Acts like oestrogen in pelvis, blocks oestrogen in breast Increases risk of endometrial cancer Subendometrial cysts, development of endometrial polyps + thickened endometrium

Effects of tamoxifen on the endometrium

What do the following changes suggest? Subendometrial cysts, development of endometrial polyps + thickened endometrium

Tamoxifen changes

What do the following findings suggest? Bleeding, thickened endometrium, solitary HYPER echoic lesion, single feeding vessel on doppler

Endometrial polyps

What is the most common cause of cervical cancer?

Squamous cell cancer due to HPV

What are the treatment options for the following cervical cancers? - No Parametrial invasion IIa - Parametrial invasion IIb/lower 1/3 of vagina

No parametrial invasion IIa -- Surgery Parametrial invasion IIb - Chemo/radiation

What is the following describing? Fibrous band separating the supravaginal cervix from the bladder, between broad ligament layers Uterine artery runs inside it

Parametrium

What does the following suggest? Loss of definition of the T2 dark ring to denote the cervix

Parametrial invasion

What are the causes of endometrial fluid in post-menopausal women?

Cervical stenosis Obstructing mass

What is the most common cancer in the vagina?

Squamous cell carcinoma - associated with HPV

What cancer are women with T shaped uterus and exposure to DES prone to?

Clear cell adenocarcinoma

What is the most common tumour of the vagina in children?

Vaginal rhabdomyosarcoma

What does the following suggest? 2-6 yr old girl with mass in anterior wall of vagina near cervix, may invade uterus, solid T2 high signal + enhancing mass

Vaginal Rhabdomyosarcoma

The following mets suggest which cancer origin? Met to vagina in anterior 1/3 upper wall Met to vagina in posterior 1/3 lower wall

Met to vagina in anterior 1/3 upper wall = Upper genital tract Met to vagina in posterior 1/3 lower wall = GI Tract

The following describes which type of cystic vaginal/cervical mass? Cervical high T2 signal

Nabothian cyst Inflammation causing epithelium plugging of mucous glands

The following describes which type of cystic vaginal/cervical mass? Anterior lateral wall of upper vagina

Gartner duct cyst Incomplete regression of Wolffian ducts

The following describes which type of cystic vaginal/cervical mass? High T2 signal mass below the pubic symphysis + posterior

Bartholin gland cyst Due to obstruction of the Bartholin glands (Mucin secreting glands of urogenital sinus)

The following describes which type of cystic vaginal/cervical mass? Inferior & Lateral cystic structure

Skene gland cyst Cyst in periurethral glands

What is the significance of the following pre-menopausal ovarian cysts? <1 cm 1-2 cm >3 cm

<1cm = Follicle 1-2 cm = Dominant follicle >3 cm = Cyst

What do the following findings suggest? Collection of cells in mature dominant follicle protrudes into the follicular cavity

Cumulus oophorus

What do the following findings suggest? Large cysts >2 cm Ovary with multilocular cystic spoke wheel appearance

Theca Lutein cyst (Due to overstimulation from bHCG)

What causes Theca lutein cysts?

Multifoetal pregnancy GTD Ovarian hyperstimulation syndrome

What do the following findings suggest? Theca lutein cysts Ascites Pleural effusions

Ovarian hyperstimulation syndorme

What do the following findings suggest? Cyst in adnexa Separate from ovary

Paraovarian cyst

What size ovarian cyst is concerning?

Post-menopausal - >5cm

What do the following findings suggest? Simple ovarian cyst > 7 cm Change/Resolve in 6 weeks

Functioning ovarian cysts

What do the following findings suggest? Dominant follicle Solid hypoechoic Ring of fire (Intense peripheral blood flow) on doppler Thin echogenic rim Moves with the ovary

Corpus luteum cyst

What do the following findings suggest? Cystic mass Thick echogenic rim Ring of fire (Intense peripheral blood flow) Moves separate from the ovary

Ectopic pregnancy

What do the following findings suggest? Pre-menopausal woman Rounded mass Homogenous low level internal echoes Increased through transmission Fluid-fluid levels

Endometrioma

What is the most sensitive imaging feature on MRI for malignancy in endometrioma?

Enhancing mural nodule

What is the most common location for solid endometriosis?

Uterosacral ligaments

What cancers do endometriomas transform to?

Endometriod or clear cell carcinoma

What do the following findings suggest? Ovarian mass T1 bright (Blood) T2 dark/shading (Iron/T1 bright lesion getting dark) Fat saturation will not suppress the signal

Endometrioma

What do the following findings suggest? Homogenous ovarian mass Enhanced through transmission Fishnet appearance Absent doppler flow T1 bright No fat saturation, No enhancement

Haemorrhagic cyst

How can a haemorrhagic cyst be differentiated from an endometrioma?

Haemorrhagic cyst will go away in 1-2 menstrual cysts (Repeat in 6 weeks)

What should be considered if you have a postemenopausal woman with a haemorrhagic cyst?

Malignancy

What do the following findings suggest? Cystic ovarian mass Hyperechoic solid mural nodule (Rokitansky nodule) May have septations Dot dash pattern - hair within cyst T1 bright, T2 bright, Fat suppression

Dermoid cyst

What do ovarian dermoids transform into?

Squamous cell cancer

What do the following findings suggest? >10 peripheral simple cysts <5mm String of pearls appearance Enlarged ovaries >10 cc Infertility, hirsutism, DM

Polycystic ovarian syndrome

What is the most common type of ovarian malignancy?

Serous ovarian/Cystadenocarcinoma

What do the following findings suggest? Unilocular ovarian cyst Few septations Can be bilateral May have papillary projections Associated with peritoneal carcinomatosis

Serous ovarian neoplasm

What do the following findings suggest? Large ovarian mass Multiloculated Thin septa Low level echoes

Mucinous ovarian cystadenocarcinoma

Which is the most common ovarian cancer?

Serous Endometrioid Mucinous

What do the following findings suggest? Ovarian mass Endometrial thickening

Endometrioid cancer Granulosa-Theca cell tumour (Produce oestrogen so endometrial hyperplasia)

What do the following findings suggest? Middle aged woman Hypoechoic and solid ovarian mass T1 & T2 dark Band of T2 dark signal around tumour on all planes Calcification rare

Fibroma/Fibrothecoma

What do the following findings suggest? Ascites Pleural effusion Benign ovarian tumour (Fibroma)

Meig syndrome

What do the following findings suggest? Tumour like enlargement of ovaries due to ovarian fibrosis T1 & T2 dark signal Black garland sign - T2

Fibromatosis

What do the following findings suggest? Fibrous ovarian mass - T2 dark Calcifications present

Brenner tumour

What do the following ovarian findings suggest? Multilocular cystic mass Intensely enhancing solid component Low T2 in cystic areas

Struma Ovarii (Patient should be hyperthyroid)

What is the most common primary to met to the ovary?

Colon Gastric Breast

What is a Krukenberg tumour?

Metastatic tumour to the ovaries from the GI tract (Usually stomach)

What do the following findings suggest? Unilateral enlarged ovary >4cm Mass on ovary Peripheral cysts +/- fluid-debris level Free fluid Lack of arterial/venous flow

Ovarian torsion

What do the following findings suggest? Cogwheel appearance - longitudinal folds of the fallopian tube become thickened String sign - incomplete septa Waist sign = tubular mass with indentations

Hydrosalpinx

What do the following findings suggest? Tubular structure - dilated fallopian tube Ill defined margins of uterus

PID

What do the following findings suggest? Round/Oval Simple cyst Does not distort the adjacent ovary, can indent the ovary

Paraovarian cyst

What do the following findings suggest? Post partum woman Acute pelvic pain + fever Most likely on right Tubular structure with enhancing wall & low attenuation thrombus Location of ovarian vein

Ovarian vein thrombophlebitis

What do the following findings suggest? Prior pelvic surgery Complex fluid collection within pelvic recesses containing the ovary May have septations, loculations Lacks walls, conforms to surrounding structures Surrounds the ovary

Peritoneal inclusion cyst

What do the following findings suggest? Entire placenta No fetus Snowstorm appearance - Echogenic, solid, highly vascular mass Bunch of grapes = Vesicles enlarge into individual cysts

Complete hydatiform mole

What do the following findings suggest? Only portion of placenta Fetus present - Triploid Enlarged placenta Areas of multiple diffuse anechoic lesions May have fetal parts

Partial Hydatifiorm mole

What do the following findings suggest? Invasion of molar tissue into myometrium Post treatment of hydatidiform mole Echogenic tissue in myometrium MR - Focal myometrial mass, dilated vessels, haemorrhage and necrosis

Invasive mole

What do the following findings suggest? Spreads into myometrium/parametrium then mets distantly Elevated serum bHCG, post evacuation of molar pregnancy Highly echogenic solid mass

Choriocarcinoma

What is a penile fracture?

Fracture of the corpus cavernous and its sheath (Tunica albuginea)

What are the signal characteristics of the anterior fibromuscular gland?

Dark on T1 and T2

Which zone of the prostate is brightest on T2?

Peripheral zone is most T2 bright

What is the most common location of adenocarcinoma of the prostate?

Peripheral zone

What are the zones of the prostate from the centre out?

Transition zone (Inner) Central zone (Middle) Peripheral zone (Outer)

What is the location of hyperplasia in the prostate (BPH)?

Central gland (Transitional zone + Central zone)

How does prostate cancer appear on MRI?

Prostate cancer is dark on T2 Dark on ADC (Restricted diffusion) Enhancement (Washout - Type 3 curve)

What do the following findings suggest? Prostate Dark on T2 Low T1 Dark on ADC Type 3 enhancement

Prostate cancer

What is the difference between stage 2 and 3 in prostate cancer?

Stage II = Confined by capsule Stage III = Extension through capsule

What do the following findings suggest? Prostate volume >30 cc Transitional zone involvement Central gland enlarged J shaped ureter - distal ureter curving around enlarged prostate

BPH

What do the following findings suggest? Prostate Transitional zone T2 Heterogenous May restrict diffusion, less ADC dark Can enhance

BPH

What do the following findings suggest? Prostate T2 dark T1 bright (Sometimes) ADC Less dark No enhancement

Peripheral zone haemorrhage (Post biopsy)

The following male pelvic cysts are found where? Prostatic utricle Mullerian duct cyst Ejaculatory duct cyst

Midline

The following male pelvic cysts are found where? Seminal vesicle cyst Diverticulosis of the ampulla of vas deferens

Lateral

What do the following findings suggest? Unilateral cyst lateral to the prostate Prior prostate surgery

Seminal vesicle cyst

What do the following findings suggest? Focal dilatation of prostatic urethra Associate with hypospadias Midline Pear shaped, small Does not extend above base of prostate Communicates with urethra

Prostatic utricle cyst

What do the following findings suggest? Failed regression of caudal ends of mullerian ducts Does not communicate with urethra Midline Tear drop shaped Extends above base of prostate Does not communicate with the urethra, should not opacify on a RUG

Mullerian duct cyst

What do the following findings suggest? Thick walled, septated, heterogenous Cystic lesion in the prostate

Prostate abscess

What do the following findings suggest? Hypoechoic testicle Asymmetrically enlarged Increased resistance + decreased diastolic flow

Testicular torsion

Abnormal high attachment of the tunica vaginalis Increases mobility and predisposes to torsion Usually bilateral

Bell clapper deformity

What do the following findings suggest? Increased epipdymal head size Hyperaemia

Epididymitis

What is the most common location of epidymitis?

Tail

What do the following findings suggest? Multiple small dark hypoechoic nodules in enlarged testic

Miliary TB

The following describe which teticular pathology? Disrupted tunica albuginea, heterogenous testicle, poorly defined testicular outline Intact tunica albuginea, linear hypoechoic band across the parenchyma of the testicle, well defined testicular outline

Rupture: Disrupted tunica albuginea, heterogenous testicle, poorly defined testicular outline Fracture = Intact tunica albuginea, linear hypoechoic band across the parenchyma of the testicle, well defined testicular outline

What do the following findings suggest? Male 18 - 35 Testicular lump Hx of undescended testicle

Seminoma

What are the non-seminoma testicular tumours?

Teratoma Yolk sac Mixed germ cell

What are the non germ cell testicular tumours?

Sertoli Leydig cell

What do the following findings suggest? Age 25yrs Testicular mass Homogenous hypoechoic round mass Replaces entire testicle T2 dark homogeneously

Seminoma (Most common)

What is the most common testicular tumour?

Seminoma

What do the following findings suggest? Young age Testicular tumour Heterogenous - Solid and cystic Large calcifications

Non-seminomatous germ cell tumour

What do the following findings suggest? Small testicular mass Tiny calcification

Burned out testicular tumour (Still viable)

What do the following findings suggest? Testicular tumour Diffusely enlarged Ill defined hypoechoic testicle Age >60 yrs Bilateral disease

Testicular lymphoma

What do the following findings suggest? Age > 60 yrs Multiple hypoechoic testicular masses

Testicular lymphoma

What is the most common bilateral testicular tumour?

Testicular lymphoma

What type of lymphoma is usually found in the testicle?

Diffuse B cell subtype

Where do testicular tumours metastasise to?

Retroperitoneal nodes (Para-aortic, caval region)

Which testicular tumours have elevated bHCG?

Seminoma Choriocarcinoma (NSGCT)

Which testicular tumours have elevated AFP?

Mixed germ cell (NSGCT) Yolk sac tumour (NSGCT)

What do the following findings suggest? Hypoechoic region in testicle No doppler blood flow Hx of acute pain No trauma

Testicular infarct

What do the following findings suggest? Testicular pain Heterogenous massess No increased internal flow on doppler within the masses Hx of trauma Follow up shows resolution

Testicular haematoma

What do the following findings suggest? Onion skin mass - Alternating hypoechoic and hyper echoic rings Non-vascular

Epidermoid cyst (Benign)

What do the following findings suggest? Bilateral Older men Cystic dilatation next to the mediastinum testes

Tubular ectasia of the rete testes

The following in pregnancy suggest what? CR Length >7 mm no heartbeat Mean sac diameter >25 mm + No embryo No embryo with heartbeat >2 weeks post scan which had gestational sac without yolk sac

Pregnancy failure

What do the following placental findings suggest? 2 x near equal sized lobes Connected by thin strip

Bilobed placenta Increased risk of T2 vasa praevia, PPH

What do the following placental findings suggest? >1 small accessory lobes

Succenturiate lobe Increased risk of T2 vasa praevia, PPH from retained placental tissue

What do the following placental findings suggest? Rolled placental edges with smaller chorionic plate

Cicumvallate placenta High risk for placental abruption + IUGR

What do the following placental findings suggest? Premature separation of placenta from myometirm Anechoic/mixed echogenicity beneath placenta Disruption of retroplacental complex

Placental abruption (Painful)

What do the following placental findings suggest? Low implantation of the placenta Painless vaginal bleeding in 3rd trimester

Placenta praevia Described based on relation to the cervical os

What do the following placental findings suggest? Abnormal insertion of the placenta, invading the myometrium Vascular channels extending from placenta to myometrium Turbulent flow on doppler

Placenta Creta

Which of the following placenta creta are described here: 1. Most common and mild; villi attach to myometrium, without invading 2. Villi partially invade myometrium 3. Villi penetrate through myometrium or beyond serosa

1. Placenta Accreta 2. Placenta Increta 3. Placenta Percreta

What do the following placental findings suggest? Well circumscribed hypoechoic mass near cord insertion Flow pulsating at fetal heart rare

Placenta Chorioangioma

What is contained in the posterior pararenal space?

Fat pads only

The following are found in which anatomic space? Kidneys Proximal ureters Adrenals

Peri-renal space

The following are found in which anatomic space? Pancreas Duodenum Ascending/Descending colon

Anterior pararenal space

What is Gerota's fascia? What is Zuckerkandls fascia?

Gerota = Anterior renal fascia Zuckerkandl = Posterior renal fascia

The following describe what? 1. Cortical space between renal medulla 2. Renal pyramids 3. Tip of medulla projecting into the calyx

Column of Bertin = Cortical space between renal medulla Medulla = Renal pyramids Papilla = Tip of medulla projecting into the calyx

What do the following renal findings suggest? Focal bulge in left kidney Due to adjacent spleen

Dromedary hump

What do the following renal findings suggest? Hypertrophied cortical tissue located between pyramids Splaying of the renal sinus Enhancement same as renal parenchyma + Echogenic cortex Middle 1/3 location

Prominent column of Bertin

What do the following renal findings suggest? Renal surface indentations which overlie the space between the pyramids

Fetal lobulation

What do the following renal findings suggest? Renal surface indentations overlying dilated/blunted calyces Favours upper/Lower poles

Renal Reflux scarring

The following are associated with which abnormality? Unicornuate uterus Absence of ipsilateral epididymis/vas deferens

Unilateral renal agenesis

What do the following renal findings suggest? Elongated pancake adrenal gland

Congenital absence of kidney

The following suggests contrast in which phase? Contrast in vascular system and extracellular interstitial space Enhanced cortex, medulla not enhanced

Corticomedullary phase 40s

The following suggests contrast in which phase? Contrast through loops of Henle and filtered Uniform enhancement of cortex and medulla

Nephrogenic phase 70-180s

The following suggests contrast in which phase? Contrast excreted into the urinary/collecting system Decrease in nephrogram

Excretory phase >180 s

Which phase of contrast is most sensitive for detection of renal cell carcinoma?

Nephrogenic phase

Which phase of contrast is useful to evaluate the renal arteries and veins and to characterise renal tumour enhancement?

Corticomedullary phase

Which phase of contrast is useful for evaluating papilla pathology, and collecting system lesions?

Excretory phase

What do the following renal findings suggest? Renal mass >15 HU contrast enhancement Calcifications Microscopic fat

Renal cell carcinoma

What type of mets does RCC produce?

Hypervascular mets Lytic bone mets

How can RCC's with macroscopic fat be distinguished from AMLs?

RCCs with macroscopic fat nearly always have calcification/ossification

What is the most common type of RCC? 2nd?

Clear cell 2nd = Papillary

What do the following renal findings suggest? Cystic mass with enhancing components Enhances equal to cortex on corticomedullary phase Microscopic fat or calcification High T2, loss of signal in/out phase

Clear cell RCC

Which type of RCC is associated with VHL?

Clear cell RCC

What do the following renal findings suggest? Less vascular - will not enhance equal to cortex on corticomedullary phase T2 dark

Papillary RCC

What do the following renal findings suggest? Associated with sickle cell trait Large renal mass Young patient

Medullary RCC

Which type of RCC is associated with Birt Hogg Dubbe?

Chromophobe RCC

What upstages RCC to: Stage 3 Stage 4

Stage 3 = Inside Gerota's fascia + Renal vein/IVC invasion Stage 4 = Beyond Gerota's fascia + Ipsilateral adrenal

What do the following renal findings suggest? Bilateral enlarged kidneys Small low attenuation cortically based solid nodules/masses Enhancement less than surrounding renal cortex High density on unenhanced CT Lymphadenopathy Preserve normal reniform shape

Renal lymphoma

What do the following renal findings suggest? Smooth enlarged bilateral kidneys Hypodense cortically based lesions Little involvement of medulla

Renal leukemia

What do the following renal findings suggest? Renal lesion with macroscopic fat Heterogenous enhancement No calcifications If lipid poor - T2 dark

Angiomyolipoma

A renal lesion with the following features is what? Fat with calcifications Fat with no calcifications

Fat with calcifications = RCC Fat with no calcifications = Likely AML

What do the following renal findings suggest? Solid mass with central scar Enhances equal to cortex on corticomedullary phase Spoke wheel vascularity on US

Renal Oncocytoma

How can RCC be distinguished from Oncoytoma on imaging?

They cannot, treat as RCC until histology proves otherwise

What do the following renal findings suggest? Non-communicating fluid filled locules Thick fibrous capsule No solid component or necrosis Protrudes into the renal pelvis Young boys 4yrs or 40yr old women

Multilocular cystic nephroma

What do the following findings suggest? Increased body habitus + Incomplete bladder emptying Fatty lesion in the perirectal and perivesicular spaces Bladder displaced anteriorly and superiorly Pear shaped bladder

Lipomatosis

What do the following findings suggest? Fat containing retroperitoneal lesion Calcification Solid components No fat saturation

Liposarcoma

What do the following findings suggest? Child Heterogenous, enhancing, soft tissue mass in retroperitoneum

Rhabdomyosarcoma

What do the following findings suggest? Soft tissue masses in paravertebral region Hx of Myleofibrosis, leukemia etc

Extra-medullary haematopoeisis

What do the following findings suggest? Lymphadenopathy - Large Non-continuous Involving mesentery

NHL

What do the following findings suggest? Para-aortic lymphadenopathy Continuous

What do the following findings suggest? 50-70HU lesion in the retroperitoneal space

Retroperitoneal haemorrhage

What do the following findings suggest? Bilateral symmetric sclerosis of the metaphysis Spares the epiphysis

Erdheim Chester

What do the following findings suggest? Simple renal cyst <15 HU No enhancement

Bosniak I

What do the following findings suggest? Hyperdense renal cyst <3cm Thin calcifications Thin septations No enhancement

Bosniak II

What do the following findings suggest? Renal cyst Hyperdense >3cm Thin calcifications >2 thin septations

Bosniak 2F

What do the following findings suggest? Renal cyst Thick septations Mural nodule Enhancing septa

Bosniak III

What do the following findings suggest? Renal cyst Any enhancement >15HU Mural nodule - enhancing

Bosniak IV

What do the following findings suggest? Hyperdense renal cyst >70 HU Homogenous

Hyperdense cysts (Haemorrhagic/Proteinacious)

What do the following findings suggest? Progressive enlargement of kidneys Multiple cystic renal lesions Haemorrhagic cysts with calcific walls Seminal vesicle cysts

ADPKD

What do the following findings suggest? Normal to small volume kidneys Innumerable renal tiny cysts 2-5mm Hx of bipolar disorder

Lithium nephropathy

What do the following findings suggest? Pancreatic cysts, NET Phaeochromocytoma Haemangioblastoma of cerebellum RCC

Von Hippel Lindau

What do the following findings suggest? LAM Rhabdomyosarcoma SEGA AML RCC

Tuberous Sclerosis

What do the following findings suggest? Renal cyst - round fluid/fluid level near collecting system (Contrast layered under urine) Seen on excretory phase Non-con = Fluid debris level (Milk of calcium)

Calyceal diverticulum

The following appear as what on T2 MR? Lipid poor AML Haemorrhagic cyst - T1 bright Papillary subtype RCC

Dark

What do the following findings suggest? No functioning renal tissue Contralateral VUR or UPJ obstruction No communication with cystic spaces and renal pelvis

Multicystic dysplastic kidney

What do the following findings suggest? Originates from parenchyma Compress collecting system Bulge into the renal parenchyma

Para-pelvic cyst

What do the following findings suggest? Originates from the renal sinus Delayed phase - shows cysts around renal pelvis

Peri-pelvic cyst

What do the following findings suggest? Vague focally reduced areas of enhancement Perinephric stranding Excretory phase - striated nephrogram (Wedge shaped hypo enhancement - all the way to the capsule)

Pyelonephritis

What do the following findings suggest? Striated nephrogram (Wedge shaped hypo enhancement does not extend to the capsule) Cortical rim sign - spares capsule Flip flop enhancement - Region of hypo density on early phases becomes hyaperdense on delayed imaging

Renal infarct

The following are differentials for which appearance? Acute ureteral obstruction Acute renal vein thrombosis Hypotension

Striated nephrogram

What do the following findings suggest? How is pyelonephritis with obstruction managed?

Urgent decompression - Nephrostomy

What do the following findings suggest? Round/Geographic low attenuation collections No enhancement centrally Enhancing thick wall

Renal abscess

What do the following findings suggest? Echogenic foci with dirty shadowing on US kidneys May have air in the perinephric space

Emphysematous pyelonephritis

What do the following findings suggest? Gas localised to the renal collecting system Gas outlining the ureters and dilated calyces

Emphysematous pyelitis

What do the following findings suggest? Filling defects in the calyx Linear streaks of contrast inside the papillae - Lobster claw sign

Papillary necrosis

What is the following describing? Ischaemic necrosis of the renal papillae, involving medullary pyramids Most common in diabetes

papillary necrosis

What do the following findings suggest? Staghorn calculus Bear paw appearance in kidney

Xanthogranulomatous Pyelonephritis

What do the following findings suggest? HIV Enlarged kidneys Echogenic kidneys Loss of renal sinus fat appearance

HIV Nephropathy

What do the following findings suggest? Calyceal blunting - moth eaten calyx Calyx distortion/papillary necrosis Cavity formation in the medulla Focal stenosis of infundibulum (Absent opacification of calyx)

Renal TB

What do the following findings suggest? Punctate curvilinear calcifications in the kidney Autonephrectomised kidney - Putty kidney Calcified mesenteric lymph nodes

Renal TB (End stage)

What are the most common type of renal stones?

Calcium oxalate

Which renal stones are associated with HIV and not visible on CT?

Indinavir

What do the following findings suggest? Hypodense non-enhancing renal rim Later develops thin cortical calcifications

Cortical nephrocalcinosis

What do the following findings suggest? Hypoechoic renal papilla/pyramids Calcifications within the renal medulla

Medullary neprhocalcinosis

The following cause what in the kidney? Hyperparathyroidism Medullary sponge kidney

Medullary Nephrocalcinosis

What do the following findings suggest? Cystic dilatation of collecting tubules of kidney Medullary nephrocalcinosis

Medullary sponge kidney

What do the following findings suggest? Subcapsular renal haematoma HTN (Due to renal compression) Previous Hx of trauma or renal biopsy

Page kidney

What is a delayed nephrogram?

One kidney enhances and the other doesn't

What do the following findings suggest? Renal doppler - reversed arterial diastolic flow Absent venous flow

Renal vein thrombosis

What do the following findings suggest? Necrosis only affecting renal cortex Reverse rim sign - non enhancing dark cortex, normal enhancement of renal medulla If chronic renal cortex calcifies

Acute cortical necrosis

What do the following findings suggest? 2 weeks post renal transplant Anechoic fluid collection with no separations Rapidly increasing in size Leak of contrast on delayed phase

Urinoma

What do the following findings suggest? 1-2 months post renal transplant Fluid collection medial to transplant (b/w graft and bladder) No leak of contrast on delayed phase

Lymphocele

When is renal artery thrombosis post renal transplant typically seen?

Within minutes to hours of the operation

What do the following findings suggest? Within 1 week post transplant Swollen kidney Reversed diastolic renal artery doppler flow No renal vein flow

Renal vein thrombosis

What is the most common site of ureteric calculus?

UPJ, UVJ, Pelvic brim

The following cause what in the ureters? TB Schistosomiasis

Calcifications in the wall

What do the following findings suggest? Ureteral sub epithelial fluid filled cysts within ureteric wall DM/Recurrent UTI

Ureteritis cystica

What do the following findings suggest? Multiple small outpouchings of the ureteric wall Bilateral Favour upper/middle 1/3

Ureteral pseudodiverticulosis

What do the following findings suggest? Soft tissue nodularity plaques in the bladder & ureters Chronic UTI's

Malakoplakia - not pre-malignant

What do the following findings suggest? Bladder*** more commonly involved Multiple mural filling defects

Leukoplakia (Pre-malignant related to Squamous cell cancer)

What cancer is Leukoplakia associated with?

Squamous cell carcinoma

What do the following findings suggest? Medial deviation of ureters May have ureteric obstruction Male Retroperitoneal soft tissue mass

Retroperitoneal fibrosis

The following cause deviation of the ureters in which direction? Retroperitoneal adenopathy Aortic aneurysm Psoas hypertrophy (Proximal)

Lateral deviation of ureters

The following cause deviation of the ureters in which direction? Retroperitoneal fibrosis Retrocaval ureter (Right side) Pelvic lipomatosis Psoas hypertrophy (Distal)

Medial deviation of ureters

What do the following findings suggest? Goblet/Champagne glass on CT IV pyelogram Soft tissue mass in the bladder

Transitional cell carcinoma

What are the most common locations of Urinary TCC?

Bladder Renal pelvis Ureter

What is the major predisposing factor for developing urinary tract squamous cell cancer?

Schistosomiasis

What do the following findings suggest? Filling defect in renal pelvis/proximal ureter Younger patient Smooth/Oblong mass Mobile

Fibroepithelial polyp (Treat as TCC as not certain on imaging)

Which part of the bladder has a peritoneal cover?

Dome of the bladder

What do the following findings suggest? Male Infant Deficiency of abdominal musculature Hydroureteronephrosis Cryptochordism

Prune belly/Eagle Barrett syndrome

What do the following findings suggest? Transient lateral protrusion of bladder into the inguinal canal Smooth walls Wide neck

Bladder ears

What do the following findings suggest? Soft tissue in the bladder (Favours base) Focal wall thickening/nodules May have focal arterial enhancement

Bladder cancer - TCC

What do the following findings suggest? Bladder trigone Smooth, solid, homogenous mass Young/middle aged person

Bladder Leiomyoma (Benign)

Which bladder TCC looks frond like?

Papillary TCC (Look like shrubs)

What do the following findings suggest? Heavily calcified bladder and distal ureters Favours trigone & lateral walls

Squamous cell carcinoma

What do the following findings suggest? Midline mass at bladder dome Urachal remnant Scattered calcifications

Bladder adenocarcinoma

What do the following findings suggest? Post c-section Echogenic collection draped over the bladder (Anterior)

Bladder flap haematoma

What do the following findings suggest? Long segment distal ureter injury/disease CT IVP with contrast filling the bladder, shows bladder moved up towards the psoas Upward projection of bladder towards psoas muscle

Psoas Hitch (Ipsilateral bladder stitched to psoas muscle)

What do the following findings suggest? Dirty bladder shadowing

Emphysematous cystitis

What do the following findings suggest? Thimble bladder Calcifications Thick contracted bladder

Bladder TB

What are the causes of bladder diverticulae?

Diverticulitis (Colovesical) Crohns (Ileovesical) Cancer (Rectovesical)

What do the following findings suggest? Small contracted bladder or atonic large bladder Pine cone bladder

Neurogenic bladder

What are the causes of pear shaped bladder?

Pelvic lipomatosis Haematoma

What do the following findings suggest? Trauma More common Molar tooth sign - Contrast surrounding bladder in space of retzius

Extraperitoneal bladder rupture

What is the gold standard imaging for bladder trauma?

CT or fluoro cystogram

What are extraperitoneal bladder ruptures associated with?

Pelvic fracture

What do the following findings suggest? Less common Trauma Contrast outlining bowel loops and paracolic gutters Dome of bladder disrupted

Intraperitoneal bladder rupture

The following are which parts of the urethra (Anterior v Posterior)? Penile + Bulbar urethra Membranous + Prostatic urethra

Anterior = Penile + Bulbar urethra Posterior = Membranous + Prostatic urethra

What do the following findings suggest? Ovoid mound that lies in the posterior wall of the prostatic urethra Prostatic utricle is in the centre

Verumontanum

If a patient has trauma and blood in the urethra meatus, which investigation is required?

RUG (Retrograde urethrogram) in order for fill the anteiror part of the urethra = Penile + Bulbar urethra

What do the following findings suggest? Trauma - Straddle injury Compression of urethra against inferior edge of pubic symphysis Short segment urethral stricture Bulbous urethra

Anterior urethral injury

What do the following findings suggest? Membranous + Bulbar urethra tear Anteiror + posterior urethra involved UG diaphragm ruptured Extraperitoneal + peritoneal rupture

Type 3 urethral rupture

What is the most common site of injury in straddle injury?

Bulbous urethra

What do the following findings suggest? Long irregular urethral stricture Distal bulbous urethra

Gonococcal urethral stricture

What do the following findings suggest? Short segment urethral stricture Bulbous urethra

Straddle injury

What is the most common cause of urethral cancer?

Squamous cell cancer

What is the most common cause of cancer in the prostatic urethra?

Transitional cell cancer

What do the following findings suggest? Middle 1/3 of urethra Outpouching involving posterolateral wall Female patient Saddle bag configuration

Female urethral diverticulum

What are the most common sites of TCC?

Renal pelvis Distal 1/3 of ureter Middle 1/3 of ureter Proximal 1/3 of ureter is least likely

What is the anatomical distribution of the adrenal cortex?

(Outer) Zona Glomerulosa = Aldoesterone Zone Fasciculata = Cortisol (Inside) Zona Reticularis = Androgens

What is the function of the adrenal medulla?

Makes Catecholamines

What do the following findings suggest? Suprarenal region Hypoechoic outer aspect Hyperechoic inner aspect Triple stripe appearance

Normal US appearance of adrenal glands Dark cortex - Bright medulla - Dark cortex

What do the following findings suggest? Child Enlarged adrenal gland Hyperechoic component Complex cystic mass

Neuroblastoma

What do the following findings suggest? Enlarged adrenal gland Anechoic component Hx of stress/trauma

Adrenal haemorrhage

What do the following findings suggest? Bilateral solid testicular masses Congenital adrenal hyperplasia

Adrenal rests

What do the following findings suggest? Adrenal limb >4 mm Central hyper echoic stripe Genital ambiguity or salt losing pathology (Boys)

21 Hydroxylase deficiency causing adrenal hypertrophy

What can cause bilateral adrenal gland hyperplasia?

Cushing syndrome/disease

In terms of the adrenal gland what does the following suggest: Non-contrast CT <10 HU

Adrenal adenoma No further imaging required

When is contrast required in a patient with ?Adrenal adenoma?

When the lesion is >10 HU on non contrast CT

What is absolute washout for adrenal adenoma?

(Enhanced - Delayed)/(Enhanced - Unenhanced) x 100

What is relative washout for adrenal adenoma?

(Enhanced - Delayed)/(Enhanced) x 100

What % of absolute and relative washout suggests an adrenal adenoma on imaging? What MR features fit?

Absolute = >60% Relative = >40% Drop out on in and out of phase MR

The following suggests what in an adrenal lesion? Portal venous HU > 120

suggests adrenal metastases/Phaeochromocytoma

What do the following findings suggest? Large adrenal mass >3cm Variable presentation Heterogenous mass with avid enhancement (>120HU) T2 bright

Phaeochromocytoma

Which imaging is used to diagnose pheochromocytoma?

Octreotide MIBG can also be used

Which syndromes are associated with Phaeochromocytoma?

VHL Men II A Men II B

Extra-adrenal phaechromocytoma GIST Pulmonary chondroma (Hamartoma)

Carneys triad

What do the following findings suggest? Adrenal mass Fat containing - discontinuous diaphragm artifact May have calcifications

Myelolipoma

What do the following findings suggest? Adrenal cystic mass Unilateral Thin walled No enhancement

Adrenal cyst

Which primary cancers metastasise to the adrenal gland?

Breast Lung Melanoma

What do the following findings suggest? Bilateral enlarged calcified adrenals

Woman disease - Fat metabolism error

What do the following findings suggest? Parathyroid hyperplasia Pituitary adenoma Pancreatic tumour (Gastrinoma)

MEN 1

What do the following findings suggest? Medullar thyroid cancer Parathyroid hyperplasia (Hypercalcaemia) Phaeochromocytoma

MEN 2

What do the following findings suggest? Medullary thyroid cancer Phaeochromocytoma Mucosal neuroma Marfanoid body habitus

MEN 2B

What do the following findings suggest? Flushing, RHF Mets to liver Ileum hyper vascular mass

Carcinoid syndrome

Is nipple enhancement on breast MRI normal?

Yes

What is the majority of the blood flow to the breast?

Internal mammary artery

If a lesion is in the medial breast which views will it be seen on?

Seen on CC May not be seen on MLO

If a lesion is in the inferior posterior posterior breast which views will it be seen on?

Seen on MLO May not be seen on CC

What do the following findings suggest? A lesion seen on MLO only and rises on true lateral (ML)

Medial on the CC film

What do the following findings suggest? A lesion seen on MLO only and falls on the true lateral (ML)

Lateral on the CC film

Are the following benign or malignant calcifications? Segmental fine calcifications Fine linear/Branching Grouped Fine pleomorphic calcifications

Malignant

Are the following benign or malignant calcifications? Regional Scattered/Diffuse Rod like

Benign

What do the following findings suggest? Calcifications Stay in same place on CC and MLO

Dermal calcifications (Superficial on tangential view)

What do the following findings suggest? Popcorn calcifications OR Coarse heterogenous calcifications

Degenerating fibroadenoma

What do the following findings suggest? Rod like calcifications with a lucent centre Dashes Point toward the nipple Post menopausal patient

Secretory calcifications

What do the following findings suggest? Egg shell calcifications - lucent center

Fat necrosis/Oil cysts

What do the following findings suggest? Irregular shaped calcifications Lucent center Previous Hx of trauma, radiation, or surgery

Dystrophic calcifications

What do the following findings suggest? Tea cup appearance on lateral view CC - powdery spread out calcifications MLO - Layering

Fibrocystic change - Milk of calcium

What do the following findings suggest? Fine linear/branching calcifications

DCIS most likely Secretory or vascular calcifications

What do the following findings suggest? Thombosed vein - tender palpable cord Thombosed vessel on US

Mondor disease NSAIDs + Warm compress

What do the following findings suggest? Appears as discrete breast tissue within the breast

Hamartoma

What do the following findings suggest? Lactating woman Subareolar Fat/fluid level Cystic/solid mass

Galactocele

What do the following findings suggest? Peripheral calcification

Oil cyst/Fat necrosis

What do the following findings suggest? Radiolucent with no calcifications

Lipoma

What do the following findings suggest? Large >4cm Solid Oval shaped Well defined borders

PASH (Pseudoangiomatous stromal hyperplasia) Follow up in 12 months

What do the following findings suggest? Any age Oval Circumscribed mass with homogenous hypoechoic echo texture Central hyper echoic band MR - T2 high, Type 1 enhancement

Fibroadenoma

What should be done to a new fibroadenoma in a postmenopausal woman?

Biopsy, may be cancer

What do the following findings suggest? Fast growing breast mass Older age >40yrs Oval Circumscribed mass with homogenous hypoechoic echo texture Central hyper echoic band

Phyllodes

Where do Phyllodes metastasise to?

Lungs and bone

What do the following findings suggest? Numerous skin nodules Peri-areolar location

NF 1 - Neurofibromas

What do the following findings suggest? Hard, non-mobile, painless mass Irregular, high density mass Indistinct or speculated mass Pleomorphic calcifications Posterior acoustic shadow with echogenic halo

IDC (Invasive ductal carcinoma)

What do the following findings suggest? Small speculated slow growing mass Associated with radial scar

Tubular IDC

What do the following findings suggest? Complex cystic and solid mass in breast

Papillary IDC

What do the following findings suggest? Multiple primaries in same quadrant

Multifocal breast cancer

What do the following findings suggest? Multiple primaries in different quadrants

Multicentric breast cancer

What do the following findings suggest? Confined to the duct Linear branching or fine pleomorphic calcifications Microlobulated mildly hypoechoic mass with ductal extension Normal acoustic transmission Non mass enhancement on MR

DCIS

What do the following findings suggest? Skin changes and palpable lump US - May have mass MRI - Abnormal nipple enhancement and linear clumped enhancement

Pagets of the breast

What do the following findings suggest? Ill defined area of shadowing without mass (US) Architectural distortion without central mass May only be on one view

Invasive lobular cancer

Which breast cancer is MRI used to characterise?

Invasive lobular cancer

What do the following findings suggest? Architectural distortion without a central mass

ILC Radial scar Surgical scar

What do the following findings suggest? No focal palpable mass Skin thickening on mammogram Hypoechoic multiloculated collection Breast feeding woman

Mastitis/Breast abscess

What do the following findings suggest? No focal palpable mass Skin thickening on mammogram Solid mass on US or no focal mass

Inflammatory breast cancer - biopsy (Punch or core)

What are the following lesions, what is the management of them? Radial scar Atypical ductal hyperplasia LCIS Atypical lobular hyperplasia Papilloma

High risk lesions Must be excised

What do the following findings suggest? Dense fibrosis around ducts Architectural distortion

Radial scar

What do the following findings suggest? DCIS but <2 ducts involved

Atypical ductal hyperplasia Will get upgraded to DCIS

What do the following findings suggest? intraductal mass lesion Bloody discharge Supra-areolar region location Normal mammo, or calcification US - Well defined smooth walled hypoechoic mass, maybe cystic with solid components, duct dilation

Papilloma

What do the following findings suggest? intraductal mass lesion Bloody discharge Supra-areolar region location Mammo - Cluster of masses/calcifications US - Well defined smooth walled hypoechoic mass, maybe cystic with solid components, duct dilation Multiple

Multiple papillomas

What do the following breast findings suggest? Hyperdense mass Solitary Larger May have axillary nodes

Primary breast lymphoma

What do the following findings suggest? Non-focal skin thickening/breast oedema

CHF or Renal failure

What do the following findings suggest? Milky discharge

Thyroid issues or Prolactinoma

What are the benign causes of discharge?

Pre-menopausal = Fibrocystic change Post menopausal = Ductal ectasia

What are the suspicious causes of discharge?

Intraductal papilloma DCIS

What do the following findings suggest? Multiple dilated ducts near subareolar region Post menopausal woman

Ductal ectasia

What do the following findings suggest? Axillary US Cortical thickness >2.5cm Loss of central fatty hilum Irregular outer margins

Abnormal axillary lymph nodes

What do the following findings suggest? Snowstorm appearance in lymph nodes

Silicone adenopathy (Leaking silicone or rupture)

What do the following findings suggest? Flame shaped hypoechoic mass behind the nipple - radiating posterior Bilateral but asymmetric May be painful

Gynecomastia

What do the following findings suggest? Male Dendritic - like branching pattern, hypoechoic Diffuse glandular subareolar tissue on mammogram - looks like breast tissue

Gynecomastia

What do the following findings suggest? Increase in fat tissue of the breast (Not glandular tissue) No discrete palpable finding Mound of tissue not concentric to the nipple

Psuedogynecomastia

What do the following findings suggest? Eccentric to nipple Unilateral Abnormal lymph nodes Calcifications - coarse associated with mass

Male breast cancer

What do the following findings suggest? Rounding or distortion of breast implant

Capsular contracture (Secondary contraction of the fibrous capsule)

What do the following findings suggest? Dense silicone seen outside capsule Snowstorm - echogenic with no posterior shadowing in axillary lymph nodes T1 dark + T2 bright

Intracapsular with extra capsular rupture

What do the following findings suggest? Linguine sign

Intracapsular rupture

What do the following findings suggest? Folds always attach to shell Thick folds

Radial folds

What do the following findings suggest? Red plaques or skin nodules Skin thickening - T2 bright

Secondary angiosarcoma

What do the following findings suggest? Breast MRI kinetics Continued rise "persistent"

Type 1 curve (Benign)

What do the following findings suggest? Breast MRI kinetics Rise then plateau

Type 2 curve (Malignant)

What do the following findings suggest? Breast MRI kinetics rise then washout

Type 3 curve (malignant)

What do the following findings suggest? T2 bright Round Non-enhancing septa Type 1 curve

Fibroadenoma

What do the following findings suggest? Breast MRI Clumped, ductal linear or segmental Non-mass enhancement

DCIS

What do the following findings suggest? Breast MRI Speculated irregular shaped masses With heterogenous enhancement and type 3 curve

IDC

What imaging is used to stage prostate cancer? What imaging is used to assess for recurrence?

Prostate MRI + Tc99m Bone scan (Bone Mets) FDG PET is used to detect recurrence

What does the following describe? Testicular cyst Well defined, epididymal cyst Hypoechoic + Posterior acoustic enhancement Irregular, fine low level echoes

Spermatocele (Cystic dilatation of tubules of efferent ductules in head of epididymis)

Which sequence on MR is most suggestive of prostate cancer?

Low ADC

What is used to screen high risk breast cancer patients with BRCA mutations? What happens age >40?

MRI Annually Mammography added

Which MRI sequence is useful for determining parametrial invasion in pelvic malignancy?

T2 Axial

What is the following describing: 55yo F US Lump in right breast - 1.5cm irregular hypoechoic mass with hyper echoic margins Posterior acoustic enhancement A. Breast abscess B. Fibroadenoma C. Phyllodes D. Galactocele E. Mucinous carcinoma

Mucinous carcinoma

Which breast cancer is likely to be occult on mammogram or US?

Lobular cancer

What is the age range for the NHS breast screening programme?

50-71 years, 3 yearly mammograms

The following cause which kind of renal calcification? Renal cortical necrosis Chronic glomerulonephritis Alport syndrome

Cortical

The following cause which kind of renal calcification? Medullary sponge kidney Hyperparathyroidism RTA Hyper Vit D

Medullary

What do the following findings suggest? Unilateral medial deviation of right ureter

Retrocaval ureter

What do the following findings suggest? Lateral deviation of ureters

Lymphadenopathy AAA Retroperitoneal mass

What do the following findings suggest? Bladder cancer in a child

Rhabdomyosarcoma

GU + Gynae + Breast Flashcards

(403 cards)