Untitled Quiz

X-Ray Density

• Air is the least dense
• Fat is denser than air
• Soft tissue is denser than fat
• Bone is denser than soft tissue
• Metal is the densest

Imaging Methods

• Plain Radiography
• Contrast studies
• Ultrasound
• CT (multislice)
• MRI
• Radioisotopes (Nuclear medicine)
• PET CT

Plain Radiography

• Performed in Supine, Erect, or both positions
• Used to visualize structures in the abdominal cavity

Contrast Studies

• Barium (Suspension) is used
• Water Soluble Contrast (e.g. Gastrografin) is used
• Used to visualize the entire GIT, including the esophagus, stomach, small intestine, and large intestine.

Computed Tomography (CT)

• CT scanners can acquire large body volumes in very short times
• 3D image reconstruction is possible

Magnetic Resonance Imaging (MRI)

• Recently used to study the morphology and function of cardiac chambers
• MRCP helps visualize the biliary system.

Nuclear Medicine

• Studies the liver tissue and biliary tree
• Used to evaluate bile excretion function by time

Angiography

• Images the hepatic artery using contrast material under real-time fluoroscopic guidance
• Can be used for both diagnostic and therapeutic purposes

Techniques of Examination

• Plain radiography of the abdomen (KUB - Erect)
• Contrast studies: Ba Swallow, Ba Meal, Ba Follow Through, Ba Enema
• Abdominal & Pelvic Ultrasound
• CT of the Abdomen & Pelvis
• MRI
• Nuclear medicine
• PET CT

The Pharynx and Esophagus

• Normal Anatomy:

  • The esophagus connects the pharynx to the stomach
  • Has a smooth, tubular structure

• Abnormal Anatomy:

  • Foreign body:
    • can become lodged in the pharynx or esophagus.
  • Achalasia
    • Characterized by impaired relaxation at lower esophageal sphincter
    • Can cause dysphagia
    • Birds-beak appearance on barium swallow
  • Diffuse esophageal spasm (corkscrew esophagus)
    • irregular contractions of smooth muscles in esophagus leading to pain and dysphagia.
    • Corkscrew appearance on barium swallow
  • Esophageal diverticulum
    • Outpouchings of the esophageal wall
    • Can cause dysphagia, regurgitation, and food impaction
  • Esophageal carcinoma
    • Can cause dysphagia, weight loss, and chest pain
    • Irregular filling defect on barium swallow
  • Esophageal Varices
    • Dilated veins in the esophagus often caused by portal hypertension
    • Can cause bleeding

The Stomach and Duodenum

• Normal Anatomy

  • The stomach is a hollow, J-shaped muscular sac
  • Joins the esophagus through the lower esophageal sphincter
  • Connects to the small intestine through the pyloric sphincter
  • The duodenum is the first part of the small intestine
  • Has a C-shaped structure

• Abnormal Anatomy:

  • Hiatus hernia
    • Protrusion of the stomach into the chest cavity
    • Has multiple subtypes
  • Gastric cancer
    • Can be found in various parts of the stomach
    • Can be detected with a variety of modalities
    • Can cause abdominal pain, weight loss, and nausea
    • Depending on the location, there are different appearances on barium swallow
      • Intraluminal mass
      • Diffuse infiltration of the gastric wall (linitis plastica)
      • Malignant gastric ulcer

The Small Intestine

• Normal Anatomy:

  • Consists of duodenum, jejunum, and ileum
  • Primary site for absorption of nutrients

• Abnormal Anatomy:

  • Crohn's disease
    • Characterized by inflammation and thickening of the intestinal wall
    • Leads to narrowing of the bowel lumen and bowel obstruction
    • Can be diagnosed with imaging modalities
    • Indicates altered bowel habits, lower GIT bleeding, weight loss, or anemia

The Large Intestine

• Normal Anatomy:

  • Consists of the cecum, colon, rectum, and anus
  • Primary site for absorption of water and electrolytes

• Abnormal Anatomy:

  • Colonic polyposis
    • Benign growths on mucosal lining
    • Require evaluation
  • Colonic diverticulosis
    • Outpouchings of the colon walls
    • Can be asymptomatic
    • Can lead to diverticulitis, a dangerous complication
  • Colonic carcinoma
    • Malignant tumor in the colon
    • Can cause abdominal pain, bleeding, and bowel obstruction
    • Can have a "coffee-bean" shape on erect x-ray caused by volvulus
    • "Apple-core" appearance on barium enema due to tumor narrowing
    • Can be diagnosed with various modalities

Liver

• Normal Anatomy:

  • Largest gland in the body
  • Has various functions including bile production and detoxification

• Abnormal Anatomy

  • Cirrhosis
    • Chronic liver disease with scarring
    • Can occur in various conditions
    • Can lead to complications like portal hypertension
    • Can be diagnosed with various modalities
    • Can have a shrunken, shrunken with caudate hypertrophy, or enlarged shape
  • Portal hypertension
    • Increased pressure in the portal vein
    • Can occur due to liver disease
    • Can lead to complications like ascites and splenomegaly
  • Hepatocellular carcinoma (HCC)
    • Malignant tumor arising from liver cells
    • Can cause abdominal pain, jaundice, and weight loss
    • Can be diagnosed with various modalities

Gall Bladder

• Normal Anatomy

  • Sac that stores bile produced by the liver

• Abnormal Anatomy

  • Gall bladder stones
    • Can cause biliary colic, a painful condition
    • Can cause obstruction of the bile duct
    • Can be diagnosed with various modalities, including ultrasound, MRCP, and CT

Biliary Obstruction

• Can lead to jaundice, inflammation, and infection
• Seen as dilated CBD and intrahepatic biliary radicles dilatation on imaging
• Seen as signal void stone on imaging

Spleen

• Normal Anatomy

  • Lymphoid organ located in the upper left quadrant of the abdomen
  • Filters blood and removes old red blood cells

• Abnormal Anatomy

  • Splenomegaly
    • Enlarged spleen
    • Can occur due to various conditions
    • Can be diagnosed with ultrasound
  • Splenic focal lesion
    • Possible tumor, cyst, or abscess
    • Requires evaluation with imaging modalities

Pancreas

• Normal Anatomy

  • Gland located behind the stomach
  • Secretes digestive enzymes and insulin

• Abnormal Anatomy:

  • Acute pancreatitis
    • Inflammation of the pancreas
    • Can cause severe abdominal pain and nausea
    • Can be diagnosed with various modalities
  • Chronic pancreatitis
    • Long-term inflammation of the pancreas
    • Can be diagnosed with imaging modalities - Calcifications may be observed on imaging