Radiological Procedures for Biliary and Reproductive Systems

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Questions and Answers

Which imaging technique allows for multiple liver scans after a single contrast injection due to fast imaging times?

  • Fluoroscopic screening
  • MRI
  • ultrasound
  • PET scan
  • Helical CT scan (correct)

Hepatic arterial phase and FSE T2-weighted sequences are the most sensitive sequences for the detection of...

  • Hepatic metastases (correct)
  • Hepatic fat
  • Hepatic hematoma
  • Hepatic biliary stones
  • Hepatic abscess

One of the indications of post-operative T tube cholangiography is .........

  • Hepatocellular carcinoma
  • Gallstones
  • Pancreatitis
  • Acute hepatitis
  • to exclude biliary tract calculi (correct)

Which technique is used to demonstrate the intra- and extrahepatic biliary tree and pancreatic duct ?

<p>Heavily T2 sequence (B)</p> Signup and view all the answers

The fasting or fluid restriction in ultrasound of the liver is required...

<p>When the gallbladder should also be examined (C)</p> Signup and view all the answers

After the infusion of a cholangiography agent for computed tomographic cholangiography, how long should the CT scan be obtained?

<p>35 minutes after the infusion of the contrast agent</p> Signup and view all the answers

All of the followings are indications of ultrasound of the gallbladder and biliary except

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

What is the characteristic enhancement pattern of hemangiomas in liver CT during arterial phase?

<p>Peripheral discontinuous nodular enhancement (D)</p> Signup and view all the answers

Most liver metastases on T1-weighted images are...

<p>Hypo to isointense (C)</p> Signup and view all the answers

Which magnetic resonance imaging pulse sequence is commonly used for investigating patients with suspected fatty liver?

<p>T1-weighted spoiled gradient echo (GRE) with in phase/out-of-phase imaging (D), T1-weighted GRE fat-suppressed volume acquisition (E)</p> Signup and view all the answers

According to ultrasound of the pancreas the body of the pancreas is located.... To the splenic vein in a transverse epigastric scan.

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

Which equipment is necessary for performing intra-operative cholangiography?

<p>Operating table with CR/DR available (A)</p> Signup and view all the answers

Regarding to the examination of pancreas..... cost and time implications .

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

What complications can arise due to the technique of injecting contrast medium during percutaneous transhepatic cholangiography?

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

Regarding biliary drainage, what is a potential complication can occur during the passage of a guidewire above the stricture?

<p>Perforation of bile duct (C)</p> Signup and view all the answers

In the intraoperative cholangiography, glucagon, propantheline or amyl nitrite should be used

<p>When a spasm of the sphincter of Oddi is occurrence (A)</p> Signup and view all the answers

What information can be obtained from contrast-enhanced spoiled GRE images in magnetic Resonance angiography?

<p>Blood vessel details (A)</p> Signup and view all the answers

...... is used to localize small lesions (e.g. islet cell tumours prior to resection).

<p>Intraoperative ultrasound (E)</p> Signup and view all the answers

During what phase does single-phase contrast-enhanced computed tomography image the liver?

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

Regarding MRCP on magnetic resonance imaging of the biliary tree and pancreatic duct :

<p>All of the above (D)</p> Signup and view all the answers

During intraoperative cholangiography, one of the following equipment's must be used :

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

The volume of intravenous contrast used in computed tomography of the pancreas typically ranges from:

<p>100 to 150 mL</p> Signup and view all the answers

Which of the following is not a routine indication for a plain film of the hepatobiliary system?

<p>Assessment of liver function (B)</p> Signup and view all the answers

Contraindications of percutaneous extraction of retained biliary calculi include:

<p>All of the above (E)</p> Signup and view all the answers

In T1-weighted fat-suppressed gradient-echo images, how does the normal pancreas appear compared to the normal liver?

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

Regarding intra-operative cholangiography, which of the followings is false:

<p>Performed before cholecystectomy (E)</p> Signup and view all the answers

Which of the following is the best slice thickness for image reconstruction in the pancreatic phase of computed tomography of the pancreas?

<p>0.625-1.25 mm (B)</p> Signup and view all the answers

What is the main indication for a single-phase contrast-enhanced computed tomography of the liver

<p>Staging known primary or secondary malignancy (E)</p> Signup and view all the answers

Which of the following statements is true regarding the portal vein during ultrasound examination of the liver ?

<p>Walls are of increased reflectivity in comparison to parenchyma (B)</p> Signup and view all the answers

The indication(s) of liver CT scan is/are

<p>All of above (E)</p> Signup and view all the answers

One of the indications of percutaneous transhepatic cholangiography is ........

<p>Place a percutaneous biliary stent (B)</p> Signup and view all the answers

Which of the following is the best combination of phases for imaging patients with suspected hepatocellular cancer using multiphasic contrast-enhanced computed tomography?

<p>Early and late arterial phase with portal venous phase (C)</p> Signup and view all the answers

The plain film of hepatobiliary system may incidentally demonstrate ......

<p>All of the above (E)</p> Signup and view all the answers

The contrast medium that is preferred for intra cholangiography imaging to avoiding obscuring any calculi is

<p>Low osmolar contrast medium LOCM 150 (B)</p> Signup and view all the answers

In CT cholangiography, the optimal time to obtain images after the infusion of a contrast agent is

<p>35min</p> Signup and view all the answers

Which of the following is the best plane for imaging pancreatic head tumors on MRI of the pancreas?

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

Which of the following is a possible cause of air within the biliary tree or portal venous system on plain films?

<p>All of the above (D)</p> Signup and view all the answers

Which imaging modality is significantly more sensitive than plain film radiography in evaluating renal tract calcifications?

<p>Computed Tomography (E)</p> Signup and view all the answers

In MR urography, the collecting systems are imaged during the excretory phase (10-20 min) using a

<p>All of the above (E)</p> Signup and view all the answers

What is the characteristic finding on opposed phase T1-weighted imaging in chemical shift imaging for lipid-rich benign adenomas?

<p>Decreased signal intensity compared to in-phase studies (E)</p> Signup and view all the answers

The most serious complication of bladder filling during micturating cystourethrography is ...

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

Flashcards

Which imaging technique allows for multiple liver scans after a single contrast injection due to fast imaging times?

A radiological imaging technique that utilizes fast imaging times, allowing for multiple liver scans after a single contrast injection.

Hepatic arterial phase and FSE T2-weighted sequences are the most sensitive sequences for the detection of....

Hepatic arterial and Fat-Suppressed Echo T2-weighted sequences are most effective in identifying cancerous growths within the liver.

One of the indication of post-operative T tube cholangiography is...

A post-operative procedure using contrast dye to visualize the biliary tree, is commonly used to rule out the presence of stones in the biliary tract.

Which technique is used to demonstrate the intra- and extrahepatic biliary tree and pancreatic duct?

A technique utilizing MRI to visualize the biliary system and pancreatic duct.

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The fasting or fluid restriction in ultrasound of the liver is required...

Fasting or fluid restriction before an ultrasound exam is necessary to allow for clearer visualization of the gallbladder.

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After the infusion of a cholangiography agent for computed tomographic cholangiography, how long should the CT scan be obtained?

The CT scan should be obtained 35 minutes after the infusion of the cholangiography agent to allow sufficient time for the contrast to distribute within the biliary system.

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All of the followings are indications of ultrasound of the gallbladder and biliary except...

Dysphagia, difficulty swallowing, is not a routine reason for a gallbladder or biliary ultrasound.

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What is the characteristic enhancement pattern of hemangiomas in liver CT during arterial phase?

In liver CT during arterial phase, hemangiomas exhibit a characteristic enhancement pattern where the inner portion fills in with contrast after the outer edges enhance.

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Most liver metastases on T1-weighted images are...

Liver metastases typically appear hypointense to isointense on T1-weighted images.

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Which magnetic resonance imaging pulse sequence is commonly used for investigating patients with suspected fatty liver?

The in-phase/out-of-phase imaging sequence is frequently used to detect fatty liver infiltration.

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According to ultrasound of the pancreas the body of the pancreas is located.... to the splenic vein in a transverse epigastric scan.

The body of the pancreas lies posterior to the splenic vein in a transverse epigastric scan.

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Which equipment is necessary for performing intra-operative cholangiography?

Fluoroscopy is necessary for performing real-time visualization during intraoperative cholangiography.

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Regarding to the examination of pancreas.... cost and time implications.

MRCP (Magnetic Resonance Cholangiopancreatography) is the most cost-effective and time-efficient technique for examining the pancreas.

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What complications can arise due to the technique of injecting contrast medium during percutaneous transhepatic cholangiography?

Biliary leaks, septicemia, and perforation of the bile duct are potential complications that can arise during percutaneous transhepatic cholangiography.

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Regarding biliary drainage, what is a potential complication can occur during the passage of a guidewire above the stricture?

Perforation of the bile duct is a potential complication that could occur when passing a guidewire above a stricture during biliary drainage.

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In the intraoperative cholangiography, glucagon, propantheline or amyl nitrite should be used...

Glucagon, propantheline, or amyl nitrite are used to treat spasms of the sphincter of Oddi during intraoperative cholangiography.

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What information can be obtained from contrast-enhanced spoiled GRE images in magnetic Resonance angiography?

Contrast-enhanced spoiled GRE images provide detailed information about blood vessels during magnetic resonance angiography.

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.... is used to localize small lesions (e.g. islet cell tumours prior to resection).

Endoscopic ultrasound is used to locate small lesions, such as islet cell tumors, prior to surgical removal.

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During what phase does single-phase contrast-enhanced computed tomography image the liver?

Single-phase contrast-enhanced CT imaging of the liver is performed during the arterial phase.

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Regarding MRCP on magnetic resonance imaging of the biliary tree and pancreatic duct:

MRCP is a noninvasive technique using heavily T2-weighted images to visualize the biliary tree and pancreatic duct.

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During intraoperative cholangiography, one of the following equipment’s must be used:

Fluoroscopy is used for real-time visualization during intraoperative cholangiography.

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The volume of intravenous contrast used in computed tomography of the pancreas typically ranges from:

The typical volume of intravenous contrast used in computed tomography of the pancreas ranges from 150 to 250 mL.

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Which of the following is not a routine indication for a plain film of the hepatobiliary system?

Assessing liver function is not a routine indication for a plain film of the hepatobiliary system.

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Contraindications of percutaneous extraction of retained biliary calculi include:

Retained biliary calculi extraction is contraindicated in cases involving a small T-tube, extensive proximal biliary ductal dilation, and a high risk of bleeding or complications.

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Study Notes

Special Radiological Procedures for Biliary and Reproductive Systems

  • Imaging Technique for Multiple Liver Scans: PET scan allows for multiple liver scans after a single contrast injection due to fast imaging times.
  • Most Sensitive Sequences for Hepatic Detection: Hepatic arterial phase and FSE T2-weighted sequences are the most sensitive for detecting hepatic abscesses.
  • Post-Operative T Tube Cholangiography Indication: One indication is to rule out biliary tract calculi.
  • Technique for Intra- and Extrahepatic Biliary Tree Demonstration: Heavily T2 sequence is used to demonstrate the intra- and extrahepatic biliary tree and pancreatic duct.
  • Fasting/Fluid Restriction in Liver Ultrasound: Fasting or fluid restriction in liver ultrasound is required when the gallbladder should also be examined.
  • CT Cholangiography Scan Timing: CT scan should be obtained immediately after infusion of the contrast agent.
  • Ultrasound of Gallbladder and Biliary Indications: Indications for ultrasound include stones, jaundice, fever of unknown origin, and right upper quadrant pain.
  • Hemangioma Enhancement Pattern in Liver CT: Hemangiomas typically show peripheral continuous enhancement in arterial phase liver CT.
  • Liver Metastases on T1-Weighted Images: Most liver metastases appear hyperintense on T1-weighted images.
  • Magnetic Resonance Imaging for Fatty Liver: T1-weighted GRE fat-suppressed volume acquisition sequences are commonly used.
  • Pancreatic Body Location: The pancreas body is located to the splenic vein in a transverse epigastric scan.
  • Intraoperative Cholangiography Equipment: Equipment includes an operating table with CR/DR available.
  • Pancreas Examination Costs and Implications: Various methods like MRI, MRCP, and CT, are used depending on the examination needed.
  • Percutaneous Transhepatic Cholangiography Complications: Biliary leaks and adverse reactions are potential complications during contrast injection.
  • Biliary Drainage Potential Complication: Guidewire placement above a stricture can cause blockage of catheters.
  • Magnetic Resonance Cholangiopancreatography (MRCP): This is a noninvasive procedure that uses heavily weighted T2 images to depict stones and obstruction in the biliary and pancreatic ducts.
  • Intraoperative Cholangiography: This procedure is performed before cholecystectomy and is performed before cholecystectomy.
  • Optimal CT Scan Slice Thickness for Pancreatic Imaging: Between 0.625 mm to 1.25 mm best for the pancreatic phase.
  • CT Imaging Phase for Liver: The single-phase contrast-enhanced computed tomography image correctly depicts the liver during the arterial phase.
  • Ultrasound Portal Vein Examination: The best approach is a transverse intercostal or epigastric.
  • Liver CT Indications: Suspected focal or diffuse liver lesions, staging of malignancy, and other abnormalities such as pain or masses.
  • Percutaneous Transhepatic Cholangiography Indications: One of the indications is to place a percutaneous biliary stent.
  • Imaging for Hepatocellular Carcinoma: The best combination of phases for imaging is early and late arterial, portal venous and delayed phases.
  • Contrast Medium for Cholangiography: Low osmolar contrast medium (LOCM) is preferred to avoid obscuring any calculi.
  • Imaging Plane for Pancreatic Head Tumors: Oblique coronal plane is the best plane for these types of tumors.
  • Causes of Air in Biliary Tree: Possible causes include biliary-enteric anastomosis or biliary fistula.
  • Imaging for Renal Tract Calcifications: Magnetic resonance imaging is significantly more sensitive than plain film radiography.
  • MR Urography Imaging Phase: Collecting systems are imaged during excretory phase (10-20 min) using 3D gradient echo and fat suppression.
  • Chemical Shift Imaging Characteristic for Lipid-Rich Benign Adenomas: Decreased signal compared to in-phase studies.
  • Cystourethrography Complication: Perforation is the most serious complication of bladder filling during the procedure.

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