Abdominal Radiology Quiz
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Questions and Answers

What is the maximum normal diameter of the small bowel according to the 3, 6, 9 rule?

  • 12cm
  • 9cm
  • 3cm (correct)
  • 6cm

Which type of fluoroscopy contrast is used for evaluating the small bowel mucosa?

  • Barium swallow (correct)
  • Barium enema
  • Barium meal
  • Barium follow through

What is the best radiological modality for evaluating the cause of bowel obstruction?

  • Fluoroscopy
  • MRI
  • CT scan (correct)
  • X-ray

In a suspected case of colon cancer, which radiological finding is specific to the diagnosis?

<p>Apple core appearance (C)</p> Signup and view all the answers

What is the normal diameter of the large bowel in a horizontal X-ray in the supine position?

<p>6cm (B)</p> Signup and view all the answers

What is the main disadvantage of fluoroscopy in evaluating abdominal pathologies?

<p>Radiation exposure (B)</p> Signup and view all the answers

Which imaging technique is considered safe in pregnancy and provides excellent soft tissue details for diagnosing abdominal solid organ lesions?

<p>MRI (D)</p> Signup and view all the answers

What does the presence of air fluid levels in the large bowel suggest?

<p>Intestinal obstruction (D)</p> Signup and view all the answers

What type of contrast is used to assess bowel perforation?

<p>Barium (B)</p> Signup and view all the answers

What does free air under the diaphragm indicate?

<p>Perforation of the gastrointestinal tract (C)</p> Signup and view all the answers

Which imaging technique is excellent in evaluating extra-luminal lesions but uses radiation?

<p>CT scan (C)</p> Signup and view all the answers

What is a relative contraindication for MRI?

<p>Early pregnancy and renal failure without IV contrast (B)</p> Signup and view all the answers

Which imaging technique reveals specific characteristics of the small bowel and liver in X-ray imaging?

<p>Oral contrast (B)</p> Signup and view all the answers

What type of studies are used to assess the esophagus, stomach, small bowel, large bowel, and rectum?

<p>Barium swallow, meal, follow through, and enema studies (A)</p> Signup and view all the answers

What is the main advantage of X-ray in diagnosing free air in the abdomen?

<p>Widely available and cheap (C)</p> Signup and view all the answers

What does the color grey represent in X-ray interpretation?

<p>Soft tissue (B)</p> Signup and view all the answers

What is a major disadvantage of X-ray in abdominal imaging?

<p>Poor soft tissue details (A)</p> Signup and view all the answers

When is the presence of air in X-rays considered normal?

<p>When it is confined to the lungs (D)</p> Signup and view all the answers

What is an indication for using X-ray in abdominal imaging?

<p>Abdominal pain (A)</p> Signup and view all the answers

What does white color represent in X-ray interpretation?

<p>Bone and calcification (A)</p> Signup and view all the answers

What is a contraindication for using X-ray in abdominal imaging?

<p>Pregnancy (A)</p> Signup and view all the answers

What is an advantage of X-ray in diagnosing bowel obstruction?

<p>Good in diagnosing bowel obstruction (C)</p> Signup and view all the answers

What does black color represent in X-ray interpretation?

<p>Air (C)</p> Signup and view all the answers

What is a major disadvantage of using X-ray for pregnant patients?

<p>Risk of radiation exposure to the fetus (D)</p> Signup and view all the answers

Flashcards

Stomach X-ray appearance

Usually contains air; normal diameter is 3cm in a horizontal X-ray.

Small bowel X-ray

Contains a small amount of air in 2 or 3 loops; normal diameter is 3cm in a horizontal X-ray.

Large bowel X-ray

Contains air in the rectum and sigmoid, varying gas in other parts; normal diameter is 6cm in a horizontal X-ray (cecum), 6cm and 9cm for supine/standing large bowel, respectively.

Fluoroscopy

Real-time moving video of internal tissues using X-rays; good for bowel lumen and mucosa but poor for extra-luminal issues.

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Fluoroscopy advantages

Excellent for evaluating bowel lining; provides real-time images.

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Fluoroscopy disadvantages

Uses radiation, less effective for issues outside the intestines.

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Barium swallow

X-ray study of the esophagus using barium contrast.

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Barium meal

X-ray study of the stomach using barium contrast.

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Bowel obstruction symptom

Air-fluid levels in large bowel indicate possible obstruction.

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GI Tract perforation

Free air under diaphragm suggests a leak in the gastrointestinal tract.

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Barium enema indication

Diagnosing colon mass/malignancy, especially apple core appearance.

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CT scan

Excellent for extra-intestinal lesions; good for soft tissue detail; expensive; uses radiation.

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MRI

Safe in pregnancy; excellent for soft tissue detail; more expensive, longer scan time.

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MRI indications

Diagnoses abdominal solid organ masses, motion sensitive cases and Inflammatory bowel disease.

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X-ray indications

Useful in many situations particularly with the use of oral contrast.

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Oral contrast

Reveals small bowel, liver characteristics in x-ray imaging.

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Contrast in suspected leaks

Barium is not recommended for use in suspected leaks.

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Contrast in bowel prep

Barium is not recommended for bowel preparations.

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Gravity's role in imaging

Affects air distribution in stomach and large bowel.

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Imaging of perforation

Free air under the diaphragm indicates a perforation.

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Imaging types

Different imaging techniques have varying indications, contraindications, radiation amounts

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Study Notes

â—Ž Stomach: usually contains air, normal diameter is 3cm in a horizontal X-ray â—Ž Small bowel: contains a small amount of air in 2 or 3 loops, normal diameter is 3cm in a horizontal X-ray â—Ž Large bowel: contains air in the rectum and sigmoid, with varying amount of gas in the rest of the large bowel, normal diameter is 6cm in a horizontal X-ray for the caecum and 6cm and 9cm for the large bowel in the supine and standing position, respectively â—Ž X-ray and fluoroscopy: same but fluoroscopy provides real-time moving video of internal tissues â—Ž Fluoroscopy: advantage is excellent in evaluating the bowel lumen and mucosa, disadvantage is radiation and poor in evaluating extra-luminal pathologies â—Ž Indications for fluoroscopy: assessing the mucosal outline, abdominal pain, gastroesophageal reflux, pregnancy, bowel obstruction, bowel perforation with barium type of contrast â—Ž Barium swallow, meal, follow through, and enema: different types of studies used to assess the esophagus, stomach, small bowel, large bowel, and rectum â—Ž Barium enema: indicates colon mass/malignancy with an apple core appearance, CT scan, multiple X-rays, and oral contrast are used for diagnosis â—Ž CT scan: indicates soft tissue details, excellent in diagnosing extra-luminal lesions, and diagnosing the cause of bowel obstruction, but it uses radiation and is relatively expensive â—Ž MRI: safe in pregnancy, gives much more soft tissue details, and is excellent in diagnosing abdominal solid organ lesions, but it is expensive and requires a long scanning time â—Ž Indications for MRI: diagnosing abdominal solid organ masses, sensitive to motion, and inflammatory bowel disease, but it is a relative contraindication in early pregnancy and renal failure without IV contrast. â—Ž X-ray, fluoroscopy, CT scan, and MRI: have different indications and contraindications for abdominal imaging. â—Ž Gravity affects the distribution of air in the stomach and the large bowel. â—Ž The oral contrast reveals the specific characteristics of the small bowel and the liver in X-ray imaging. â—Ž Air fluid levels in the large bowel suggest the presence of intestinal obstruction. â—Ž Free air under the diaphragm indicates perforation of the gastrointestinal tract. â—Ž Barium is not recommended for use in suspected leaks or bowel preparations due to its strong effect on the protein cavity.

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