Special Population Flashcards
(36 cards)
What is tool used to screen, diagnose lump or symptoms in breast?
Mammography
What is the BI-RADs score in mammography?
5-6 not ideal further eval d/t concern for malignancy, get MRI or biopsy.
Use CAD-computer aided detection software with reporting database
What is seen on Mammography that is normal?
High density ducts- white.
Fibrous breast/thick will be hard to see mass.
What are views of Mammography?
Cranial-caudal. Medial and Lateral-side smush
Describe mass shapes?
Round, Oval. Lobulated-scalloped, Irregular, Architectural Distortion-creates indentation externally
Describe mass shapes?
Circumcised-pick up, Obscured- less edge, Microlobulated- many scallops, Ill defined- very irregular. Spiculated- crab like spikes coming out everywhere
Which margin and shape carry high suspicion on mammography?
Asymmetric density, Lobulated, irregular, architectural distortion microlobulated, ill defined, spiculated, grouped micro-calcifications
What are benin patho on mammography?
Fibroadenomas, cysts, abscess, hematoma, intraductal papilloma,
What are indication for Breast US?
Not indicated for cancer screening
Indication = diagnostic?
CANNOT see Microcalcifications
ONLY for cystic or solid
What will indicate a cyst on Breast US? What is follow up ?
Cyst are Anechoic-black fluid, thin walls.
F/U is MRI or biopsy bc cyst MOST of time are benign BUT NOT ALWAYS
What is reason for Breast MRI?
Indications
- visibility-extent of tumor
- Breast implant rupture
- Young pt’s, high risk -dense tissue
- abnormality that can be felt but not seen on mammogram or ULS
- Mammogram & ULS indeterminate/unsure
- After surgery or radiation - recurrence
What is seen on MRI that is often malignant?
Ring enhanced tumors
What is next step after suspicious mammogram and MRI?
PET SCANS!
- Cancer staging
- Recurrent breast CA
- Best- Large, aggressive tumors
- Looking for mets
What is 1st choice for male breast?
Ultrasound
2nd Mammography- challenging
What’re the imaging options for testicles?
-power Doppler (vascular flow) ultrasound is the procedure of choice
-nuclear medicine scan
-MRI
NEVER CT
INDICATIONS
-torsion -trauma -epididymitis -orchitis -tumors -hernia -hydrocele -abscess
Is a power Doppler the same as the simple color flow?
NOOOOOO! It’s more advanced
What’s the normal appearance for a testicle on ULS?
- fine, homogeneous echo texture
- should have good flow signals on power flow Doppler
Who gets testicular torsion?
Kids and young men
spermatic cord twists and leads to low flow/infarct.
ischemia causes severe pain.
How will testicular torsion appear on ULS?
- heterogenous with hypoechoic areas
- testicular enlarged
- low or no flow signals on Doppler -NO FLOW = SURGICAL EMERGENCY
What’re indications for prostate imaging?
- malignancy
- urinary retention
- strictures
What’re imaging modalities for prostate imaging?
- US bladder for post-void residual
- transrectal US
- CT/MRI
- retrograde urethrogram (good for strictures)
When would we US the bladder vs transrectal?
Bladder: post residual volume, evaluate urinary retention Transrectal: abnormal digital exam, high PSA, masses, calcifications
When is a CT/MRI of the prostate indicated?
- evaluate masses or malignancy
- extent, characteristics of masses
- calcifications
- relationship to adjacent structures
If you see a long bone fracture in an infant/toddler, is that relatively normal?
NO! Long bone fractures require high force and are very uncommon especially if the pt is non-ambulatory
<1yo from fall of bed ABN
