Podcast
Questions and Answers
What is a characteristic feature of liver abscesses according to the text?
What is a characteristic feature of liver abscesses according to the text?
- Hypochogenic masses with strong back walls (correct)
- Hypoechoic masses with smooth back walls
- Hyperechogenic masses with irregular outline
- Hyperechoic masses with internal gas
How can subphrenic abscesses be identified using ultrasound?
How can subphrenic abscesses be identified using ultrasound?
- An echo-free area located between the capsule of the liver and the underlying liver parenchyma
- A hyperechoic mass with smooth outline near the liver parenchyma
- A predominantly echo-free, sharply delineated, crescentic area between the liver and the right hemidiaphragm (correct)
- A hypoechoic mass with irregular outline within the liver
What may be needed to differentiate haematomas from abscesses in the liver?
What may be needed to differentiate haematomas from abscesses in the liver?
- Clinical history and symptoms (correct)
- Surgical exploration
- Blood tests only
- Ultrasound imaging only
Where can subcapsular haematomas be located in the liver?
Where can subcapsular haematomas be located in the liver?
What should be examined when using ultrasound to search for the cause of pyrexia of unknown origin?
What should be examined when using ultrasound to search for the cause of pyrexia of unknown origin?
What is a common cause of a distended gallbladder?
What is a common cause of a distended gallbladder?
How can a distended gallbladder be diagnosed?
How can a distended gallbladder be diagnosed?
What can nonmobile internal echoes without shadowing indicate?
What can nonmobile internal echoes without shadowing indicate?
What is associated with acute cholecystitis?
What is associated with acute cholecystitis?
What should be searched for if there is no contraction of the gallbladder after a fatty meal?
What should be searched for if there is no contraction of the gallbladder after a fatty meal?
What is the preferred imaging method for assessing pancreatic calcification?
What is the preferred imaging method for assessing pancreatic calcification?
What can calcification within the pancreas produce on ultrasound?
What can calcification within the pancreas produce on ultrasound?
What is a common cause of calcification in the pancreas?
What is a common cause of calcification in the pancreas?
What is the normal maximum internal diameter of the pancreatic duct?
What is the normal maximum internal diameter of the pancreatic duct?
What condition is usually associated with jaundice and dilatation of the biliary tract?
What condition is usually associated with jaundice and dilatation of the biliary tract?
What is the preferred method for evaluating suspected biliary diseases?
What is the preferred method for evaluating suspected biliary diseases?
How wide is the normal gallbladder, according to the text?
How wide is the normal gallbladder, according to the text?
Where is the common hepatic duct usually recognizable?
Where is the common hepatic duct usually recognizable?
What are indications for gallbladder and biliary tract scanning?
What are indications for gallbladder and biliary tract scanning?
What is the maximum common bile duct diameter near its entrance into the pancreas?
What is the maximum common bile duct diameter near its entrance into the pancreas?
What imaging techniques are used to evaluate gallbladder disease?
What imaging techniques are used to evaluate gallbladder disease?
What is the normal gallbladder wall thickness on sonography?
What is the normal gallbladder wall thickness on sonography?
What conditions can lead to gallbladder wall thickening?
What conditions can lead to gallbladder wall thickening?
Which imaging technique is often used as the first method in patients with an acute abdomen?
Which imaging technique is often used as the first method in patients with an acute abdomen?
Why is careful clinical correlation needed for gallbladder wall thickness between 3 and 5 mm?
Why is careful clinical correlation needed for gallbladder wall thickness between 3 and 5 mm?
What is the main pancreatic duct (MPD) dilatation threshold for important ultrasound findings in high-risk individuals (HRIs)?
What is the main pancreatic duct (MPD) dilatation threshold for important ultrasound findings in high-risk individuals (HRIs)?
Which scanning maneuvers are important for both screening for PC and follow-up of HRIs?
Which scanning maneuvers are important for both screening for PC and follow-up of HRIs?
What can improve the poor visualization of the tail of the pancreas during ultrasound?
What can improve the poor visualization of the tail of the pancreas during ultrasound?
What do true pancreatic cysts appear as in ultrasound?
What do true pancreatic cysts appear as in ultrasound?
What may cause diffuse enlargement of the pancreas in ultrasound, associated with elevated serum amylase and local ileus?
What may cause diffuse enlargement of the pancreas in ultrasound, associated with elevated serum amylase and local ileus?
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Study Notes
- Ultrasound (US) is used widely for mass screening due to its simplicity and non-invasiveness, but visualizing the entire pancreas can be difficult due to its complicated anatomy, obesity, and gas
- US plays a crucial role in the diagnosis of pancreatic carcinoma (PC) with main pancreatic duct (MPD) dilatation (3 mm or more) and pancreatic cysts (5 mm or larger) being important US findings in high-risk individuals (HRIs), who should be monitored periodically
- Scanning maneuvers, such as right lateral decubitus, sitting, and upright positions, are important for both screening for PC and follow-up of HRIs
- US can be challenging to visualize the tail of the pancreas due to gas and stool, and poor visualization can be improved by the liquid-filled stomach method
- Normal pancreas has the same echogenicity as the adjacent liver and appears homogeneous; certain anatomical landmarks should be identified during scanning including the aorta, inferior vena cava, superior mesenteric artery, splenic vein, and superior mesenteric vein
- Pancreatic size and shape vary widely; a small, non-homogeneous pancreas may be due to chronic pancreatitis or a tumor
- Acute pancreatitis can cause diffuse enlargement of the pancreas, which may be normal or hypochogenic compared with the liver, and is associated with elevated serum amylase and local ileus
- Focal enlargement (noncystic) of the pancreas cannot be distinguished from focal pancreatitis or pancreatic tumor by US alone, and a biopsy may be necessary if the pattern is mixed
- True pancreatic cysts are rare and appear as smooth, echo-free cavities filled with fluid; pseudocysts following trauma or acute pancreatitis are not uncommon and can be complex in the early stages with ill-defined walls and internal echoes, but eventually become smooth-walled and echo-free.
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