Normal U/S abdomen Flashcards
(49 cards)
T/F: Gastric gas hampers evaluation
TRUE
Where do you clip fur for an abdominal ultrasound?
10th-12th ICS
What veins/arteries are visible in the abdomen?
- Veins are Visible, arteries are not
- Portal veins
- hyperechoic wall
- enlarged = possible liver disease
- Hepatic veins
- isoechoic wall
- enlarged = possible CHF (congestion)
What are the arrows pointing to?
What 6 things should you evaluate when examining the liver?
- Size
- Margins
- Margination
- Echogenicity
- Architecture
- Lesions
T/F: Parenchymal changes are often unspeific and a biopsy should be taken for definitive diagnosis.
TRUE
When evaluating parenchymal changes, what other changes should you look for?
- Hepatomegaly
- Irregular margins
- Lymph node changes
- Ascites
- Assessment of other organs
What are the differential diagnoses for a diffusely hypoechoic parenchyma?
- Acute hepatitis
- Venous congestion (would also see enlarged hepatic veins)
- Lymphosarcoma
What are the differential diagnoses for a diffusely hyperechoic parenchyma?
- Diabetes mellitus
- Hyperadrenocorticism
- Hepatic lipidosis
- Lymphosarcoma
What diseases can be present even with a normal liver/parenchyma on an ultrasound?
- Acute hepatitis
- Toxic hepatopathy
- Diffuse infiltrative disease
What abdominal organ is this?
Gall bladder (both are normal–one on the right has ‘slush’)
What approaches can be used to examine the gall bladder on U/S?
- Retrocostal approach
- Intercostal approach
How does a normal gall bladder appear on U/S?
- The gall bladder is readily visualized
- Anechoic content, but sludge can be seen normally
- Gets bigger with anorexia or fasting
- Thin wall (1-2 mm), Isoechoic to liver parenchyma
Are intrahepatic biliary ducts normally seen on U/S?
No–they are not detected in the normal dog and cat
Can the common bile duct be seen in a normal U/S?
- Can be traced in the normal cat
- Usually not apparent in the normal dog due to overlying gas in the GI tract
How do the following appear on U/S of the gall bladder and biliary tree?
- Sludge
- Cholecystitis
- Choleliths
- Obstruction
- Sludge = normal
- Cholecystitis = thickened GB wall
- Choleliths = mineral: hyperechoic casting a clean shadow
- Obstruction = Dilation of GB and common bile duct
This is a normal gall bladder. What species is this?
Pussy cat
Where can you find the spleen for U/S?
- Splenic head fixated at the greater curvature of the stomach
- At the level of the costal arch
- Body and tail
- Position very variable
- Left and ventral abdominal wall
- The entire spleen must be examined!
What is the normal anatomy of the spleen on an U/S?
- Size very variable
- Hyperechoic capsule
- Smooth margins
- Splenic vein at hilus
- Homogenous fine granular appearance (liver has coarser appearance)
- Interior echo finer and denser than liver
- Compare echogenicity to left kidney
- Spleen > left kidney
What two organs are shown? Which has greater echogenicity?
Spleen and kidney
The spleen is hyperechoic to the kidney
What organ is this? is the structure outlined in red normal?
Spleen
Outlied structure is fat at the hilus–it is NORMAL!
What organ is this? What is represented by the red and blue areas?
Spleen (cat)
Red = artery, blue = vein (both at the hilus)
What is the normal ultrasonographic anatomy of the kidney?
- Renal medulla is segmented
- Clear cortico-medullary distinction
- Renal cortex < spleen
- Renal cortex > renal medulla
- Renal pelvis usually 1-2 mm wide
- Proximal ureter is enlarged if greater than 3-4 mm
T/F: Pelvic fat is causes the renal pelvis to be hypoechoic and is easily misdiagnosed.
FALSE–pelvic fat causes the renal pelvis to be HYPERechoic. DON’T misdiagnose this!
