Podcast
Questions and Answers
What abdominal imaging modality is most suitable for assessing biliary obstruction?
What abdominal imaging modality is most suitable for assessing biliary obstruction?
Which condition is characterized by inflammation and thickening of the terminal ileum with minimal ascites?
Which condition is characterized by inflammation and thickening of the terminal ileum with minimal ascites?
What appearance is commonly associated with colonic carcinoma on imaging?
What appearance is commonly associated with colonic carcinoma on imaging?
What is a key indicator of splenomegaly in imaging?
What is a key indicator of splenomegaly in imaging?
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Which imaging finding is associated with acute pancreatitis?
Which imaging finding is associated with acute pancreatitis?
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Which imaging method uses barium suspension for examining the gastrointestinal tract?
Which imaging method uses barium suspension for examining the gastrointestinal tract?
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What does a single contrast study primarily utilize in gastrointestinal imaging?
What does a single contrast study primarily utilize in gastrointestinal imaging?
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Which method of examination provides real-time imaging of the hepatic artery?
Which method of examination provides real-time imaging of the hepatic artery?
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In what imaging technique is three-dimensional image reconstruction commonly used?
In what imaging technique is three-dimensional image reconstruction commonly used?
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Which type of contrast is often preferred for studies involving the small and large intestines?
Which type of contrast is often preferred for studies involving the small and large intestines?
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What is the primary purpose of using water soluble contrast in the GIT?
What is the primary purpose of using water soluble contrast in the GIT?
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Which imaging technique can evaluate the morphology and function of cardiac chambers?
Which imaging technique can evaluate the morphology and function of cardiac chambers?
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What does the term 'echogenicity' commonly refer to in ultrasound imaging of the abdomen?
What does the term 'echogenicity' commonly refer to in ultrasound imaging of the abdomen?
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Study Notes
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
- Foreign body:
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
- Hiatus hernia
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
- Crohn's disease
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
- Colonic polyposis
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
- Cirrhosis
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
- Gall bladder stones
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
- Splenomegaly
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
- Acute pancreatitis
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