Revise Radiology GI Flashcards by Sami Al-Balasmeh

Rosary bead or corkscrew appearance on barium swallow

Diffuse oesophageal spasm

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Median arcuate ligament stenosis

Focal stenosis of coeliac trunk due to indentation at superior surface by the median arcuate ligament

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Incidental solitary bone lesion on CT Colon

Likely clinically unimportant, further follow up may be warranted

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Double target sign in liver

Pyogenic abscess

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Superficial spreading oesophageal carcinoma

Small plaque like nodularities which resemble pseudodiverticula

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Pancreatic tumours: Islet cell vs carcinoid

Carcinoid tumours are hypovascular

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Exophytic, heterogenously enhancing stomach mass

GIST

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Specific to venous gut ischamia

Mesenteric fat stranding and ascites

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Liver mass, non enhancing scar, normal AFP

Fibrolamellar HCC
FNH has delayed scar enhancement

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Aspirin before liver biopsy

Stop for 7-10 days

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Cholangiocarcinoma classification

Bismuth 1: Involves common hepatic duct
Bismuth 2: Confluence of right and left hepatic duct
Bismuth 3a: right hepatic duct
Bismuth 3b: left hepatic duct
Bismuth 4: Multifocal, right and left hepatic ducts
Bismuth 5: Junction of CBD and cystic duct.
1 and 2 are resectable

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> 3cm circumscribed area of fat stranding in mesentery with swirling vessels

Omental infarct

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Pancreatic tumoural growth into the GDA, prognosis

Can still be resected

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Gasless abdomen TOF

Can happen in type A and B

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Localised oesophageal pseudodiverticulosis

Can suggest peptic strictures or oesophageal cancer

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Tapering and nodularity of distal oesophagus

Oesophageal cancer

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C-rads scoring for ct colonoscopy

C0: Inadequate study
C1: Normal
C2: Indeterminate polyp 6-9mm, <3 in number. CTC in <3 years
C3: >10mm or >3 6-9mm or C2 gotten worse.
C4: >30mm mass likely malignant

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Killian Jamieson vs Zenker

Zenker are usually larger and more often symptomatic

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large, multilocular cystic lesion in pancreas with peripheral calcifications

Mucinous cystadenoma

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Non propulsive disorganised contractions in the oesophagus

Tertiary contractions

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Soft tissue mass around aorta, pushing aorta forwards

Lymphoma

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Decreased perfusion and contractility at rest, increased FDG uptake, redistribution of thallium

Hibernating myocardium

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Intense peripherally washout of liver lesion

Most specific for mets

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Cystic lesion, not arising from bowel

Lymphangioma

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Grade 3 splenic lac, not actively bleeding

Observation and conservative Rx

Posterior vaginal wall involvement of rectal cancer

Not considered high risk

Soft tissue mass arising from small bowel mesentery, mass effect on bowel

Mesenteric fibromatosis

Spongiform lesion with peripheral enhancement and gas locules 1 month post surgery with dense linear structures

Gossypiboma

High T1 signal within ablation zone (HCC)

Successful ablation

Caecal vs sigmoid volvulus

Caecal volvulus has haustral markings

Serous vs mucinous cystadenoma of pancreas

Serous consists of many smaller cysts with central stellate scar Mucinous of fewer bigger cysts

Cowden syndrome

Hamartomatous GI polups, skin, external mucous membranes. Increased risk of thyroid (follicular), oral, breast, skin and uterine malignancy

Intraluminal mass in ileum, spreads to mesentery by direct extension or lymphatic spread

Carcinoid

Most common small bowel tumour

Carcinoid

Regional nodes for rectal cancer

Mesorectal, Obturator, Internal iliac, Inguinal (if low rectal)

Inverted umbrella

Cone shaped caecum, narrowed TI, enlarged gaping IC valve) colonic TB

Malabsorbtion, abdominal pain, arthralgia, skin pigmentation

Whipple's disease

Thickening and nodularity of duodenal and proximal small bowel folds

Whipple's disease

FNH vs Fibrolamellar HCC

FNH scar is T2 hyperintense, Fibrolamellar is T2 hypo HCC has calcifications

T1 hypo. T2 hyperintense liver lesion with centrifugal enhancement

Peliosis hepatis

Attenuation around small bowel mesentery with preservation of fat around vessels and nodes

Sclerosing mesenteritis

?Adenomyosis on US, next step

Contrast US

Regenerative vs Dysplastic nodules

Dysplastic usually show arterial enhancement

Predictor of post op HCC recurrence and invastion

VICT2 Venous hypointensity Incomplete capsule Corona enhancement T2 hyperintensity peritumourally

Lateral outpouching at the lower oesophagus

Epiphrenic diverticulum

Polyposis syndrome with increased risk of endometrial cancer

HNPCC

Periappendicitis can cause

Small bowel obstruction

starry sky appearance of liver

Liver oedema

Ix to rule out malignancy with dermatomyositis

CTCAP

Low density liver lesions with continuous rim of enhancement

Mets

Dromedary hump vs prominent column of Bertin

Dromedary hump is a bulge facing outwards

Multiple, non enhancing, tiny T2 bright lesions in the liver

Bile duct hamartomas

Chronic PSC can lead to

Cirrhosis

Blunt trauma, CT shows contrast extravasation, next step

Laparotomy

HCC Peritumoural hypointensity in HPB phase

Suggests aggressive behaviour and vascular invasion

AIDS, thickened jejunal folds with jejunal spasm

Giardiasis

Flask shaped ulcers, cone shaped caecum

Entamoeba histolytica

Poorly defined heterogeneity and low density in spleen

Angiosarcoma

Commonest malignancy of spleen

Angiosarcoma

Multiple sessile polyps throughout jejunum and ileum

Peutz Jehger

Ventral embryonic pancreatic ducrt becomes

Distal main duct, aka duct of wirsung

Multilocular cyst posterior to rectum with no enhancement. Some T1 bright areas

Recto-rectal cystic hamartoma or tailgut cyst

RFA vs HCC Resection

RFA used for smaller lesions or non surgical candidates

MRI appearances of autoimmune pancreatitis

Diffuse diffusion restriction

May Thurner syndrome

LEFT common iliac vein compressed by RIGHT common iliac artery

Gallbladder wall thickening with discontinuous enhancement

Gangrenous cholecystitis

Most likely portion of bowel to perforate in intussception reduction

Rectum

Mass like area associated with diverticular disease on CT colon

Likely benign, repeat CTC in 5 years

Low T1/T2 liver lesion in cirrhosis

Ciderotic nodule

Desmoid tumours associated with

Gardners syndrome

RECIST criteria for measurable lesion

Must be larger than 10mm

Pseudosacculation in terminal ileum

Crohns

Commonest cause of pseudomyxoma peritonii

Appendix cystadenoma

Commonest location for carcinoid tumour

Distal ileum

3 polyps 6-9mm on CTC

Recall for colonoscopy

Hepatic adenoma enhancement

early arterial enhancement, hypointense on hepatobilliary phase

Parenchymal vs reticulendothelial pattern haemochromatosis

Parenchymal is primary, increased iron resorbtion (not transfusions) and spares spleen and bone marrow

Commonest cause of echogenic liver mets

Colon adenocarcinoma

Revise Radiology GI Flashcards

(78 cards)