Abnormal GIT Imaging (PDF)

Imaging of abnormal GIT Dr/ Alaa Reda, MD Assistant professor of Radiodiagnosis Quick revision X-ray machine X-ray tube Different x-ray densities 1-air 2-fat 3-soft tissue 4-bone 5-metal X-ray image display 1- on film 2- on computer Methods of Examination of the GIT Pl...

Imaging of abnormal GIT Dr/ Alaa Reda, MD Assistant professor of Radiodiagnosis Quick revision X-ray machine X-ray tube Different x-ray densities 1-air 2-fat 3-soft tissue 4-bone 5-metal X-ray image display 1- on film 2- on computer Methods of Examination of the GIT Plain x-ray Contrast studies Ultrasound CT (multislice) MRI Radioisotopes (Nuclear medicine) PET CT 1- Plain Radiography E r e c Supine t Supine Erect Normal X-ray of the Abdomen 2- Contrast studies of the GIT Contrast Studies of the GIT Esophagus  Contrast Swallow Stomach  Contrast Meal Small Intestine  Contrast Follow Through Large Intestine  Contrast Enema Contrast Used Barium (Suspension) Water Soluble (e.g. Gastrografin) Barium Sulphate Water Soluble contrast Single Contrast Double Contrast 3-CT (Multislice): recently CT scanners which can acquire large body volume in very short time , 3D images reconstruction Axial  4-MRI: also a recent modality in the imaging of the cardiac chambers morphology and function. MRCP 5-Nuclear medicine: imaging modalities that study the liver tissue and biliary tree in their function of bile excretion by time. 6-Angiography: imaging of hepatic artery using contrast material under real time fluoroscopic guidance which may be ….diagnostic or therapeutic Techniques of Examination Plain Radiography Plain x-ray 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 PET CT The pharynx & oesophagus Normal Anatomy Normal Oesophagus (Ba Swallow) (Single Contrast) Normal Oesophagus (Ba Swallow) Normal Oesophagus (Ba Swallow) The Stomach & Duodenum The Small Intestine Anatomy The Large Intestine Anatomy Liver Gall bladder Spleen Pancreas Pancreas Pancreas Foreign Body : FB pharynx: FB esophagus : Achalasia: Achalasia: Diffuse esophageal spasm (corkscrew esophagus): Esophageal diverticulum : Esophageal carcinoma: Barium swallow demonstrate an irregular filling defect (white arrows) , narrowing the lumen. There is shouldering (red arrows). Esophageal varices: Normal Barium study of the stomach : Hiatus hernia: Barium meal showing sliding hiatus hernia. Gastric cancer : A) intraluminal mass. B)Diffuse infiltration of the gastric wall (linitis plastica): c) Malignant gastric ulcer :  Modalities of imaging: Barium follow through Ultrasound. CT & CT enterography. MR & MR enterography. Crohn’s disease: Inflammation & thickened wall of the terminal ileum ,stranding of the surrounding fat planes & minimal ascites.  Indications: 1- Altered bowel habits 2- Lower GIT bleeding. 3-Weight loss or anemia Colonic polyposis: Colonic diverticulosis: Colonic carcinoma: Apple core appearance : CT of cancer colon: Erect Plain x-ray of the abdomen show multiple air fluid levels. Markedly dilated loop of colon with a coffee-bean shape (sigmoid volvolus).  Cirrhosis: Portal hypertension : Portal vein thrombosis Cirrhotic liver ,dilated portosystemic collaterals and minimal ascites (arrow). Cirrhosis ,ascites and Shrunken cirrhotic liver ,portal hypertension &splenomegaly marked caudate hypertrophy. Hepatocellular carcinoma (HCC):  Gall bladder stones: 1-ultrasound 2-MRCP 3-CT Biliary obstruction: Signal void stone is seen at the distal CBD ,Dilated CBD & intrahepatic biliary radicles dilatation. Splenomegaly : Splenic length more than 14 cm. Splenic focal lesion: Acute Pancreatitis:  Pancreatic calcifications in chronic pancreatitis. Next time is normal chest with Dr/ Yousra Fouad Thank You SUE