Body Ct Radiology

Front 1

question

Back 1

answer

Front 2

A burst fracture of the C1 ring?

Back 2

jefferson fracture

Front 3

any break in the bony ring of a vertebra that occurs on a slice that shows the __________ _______ is a spondylolysis until proved otherwise?

Back 3

basivertebral plexus

Front 4

Helps distinguish myositis ossificans from parosteal osteosarcoma?

Back 4

Parosteal sarcoma demonstrates central clumps of calcification and myositis ossificans has peripheral ossification/calcification.

Front 5

Define disk bulge, sequestered or free fragment?

Back 5

Disk bulges can be diffuse, broad based, or focal but are attached to the disk. Sequestered or free fragments occur when disk material migrate from parent disk.

Front 6

Distinguishing a free fragment from a Tarlov cyst or conjoined nerve root?

Back 6

A free fragment is hyperdense to thecal sac and Tarlov cyts and conjoined nerve roots are isodense to thecal sac.

Front 7

Lateral disk protrusion affects what nerve root?

Back 7

A nerve rooth that has already exited the neuroforamen at a more cephalad level.

Front 8

Congenital causes of spinal stenosis?

Back 8

Achondroplasia, Morquio's disease, idiopathic spinal stenosis

Front 9

Acquired spinal stenosis causes?

Back 9

Degenerative disk disease, post-traumatic stenosis, postsurgical stenosis, Paget's disease, calcification of posterior longitudinal ligament.

Front 10

Anatomic classification of spinal stenosis?

Back 10

Central canal stenosis, neuroforaminal stenosis, lateral recess stenosis.

Front 11

Most useful CT criteria for diagnosing central canal stenosis?

Back 11

Obliteration of epidural fat, flattening of thecal sac.

Front 12

Pars interarticularis defect?

Back 12

Spondylolysis

Front 13

Anterior displacement of a cephalad vertebral body with respect to a caudad vertebral body?

Back 13

Spondylolisthesis. Grade I (<25%), II (25-50%), III (50-75%), IV (75-100%).

Front 14

Most common site for coalition?

Back 14

Calcaneonavicular joint.

Front 15

Finding causing the greatest concern for metastatic bone disease or multiple myeloma involvement?

Back 15

A permeative process.

Front 16

Spinal hemangioma CT features?

Back 16

vertical trabecular thickening, may contain fat, may see phleboliths.

Front 17

Schmorl's node?

Back 17

Herniation of disk material through end plate of vertebral body.

Front 18

Tarlov cysts?

Back 18

Nerve sheath dilatations of fluid density at CT, when large enough can cause bone erosion, particulary within the sacrum.

Front 19

Paget's disease on CT?

Back 19

Purely lytic or sclerotic or mixed. Bone overgrowth, Cortical thickening, disorganized trabecular thickening, in pelvis-thickenign of iliopectineal or ilioischial lines.

Front 20

Fibrous dysplasia?

Back 20

Congenital disorder of bone, fibrous tissue, chondral tissue, and even cysts within bone. Non-aggressive appearance.

Front 21

Common right-sided anomalous pulmonary venous return insertions?

Back 21

SVC azygos vein, IVC, Right atrium.

Front 22

Common left-sided anomalous pulmonary venous return insertions?

Back 22

Left brachiocephalic vein, persistent left SVC, Coronary sinus.

Front 23

CT features that suggest lung cancer?

Back 23

Irregular or spiculated margine, Lobulated contour, Air bronchograms or cysts within nodule, Nodular cavitation, > 2 cm.

Front 24

Lung hamartoma CT features?

Back 24

Smooth, rounded, or lobulated contour. Fat 60% Fat and calcification 30% Diffuse calcification 10%--"popcorn".

Front 25

4 findings of rounded atelectasis?

Back 25

1. Ipsilateral pleural thickening or effusion. 2. Contact between lung lesion and pleural surface. 3. "comet tail" sign. 4. Volume loss of lobe involved.

Front 26

Air-crescent sign?

Back 26

Lung mass capped by a crescent of air. Most typical of mycetoma (fungus ball). Fungus ball (Aspergillus) forms in preexisting cyst or cavity.

Front 27

Lung abscess CT features?

Back 27

Necrosis or cavitation within area of pneumonia or dense consolidation.

Front 28

Satellite nodules and galaxy sign?

Back 28

Granulomatous lesions with smaller nearby nodules--satellite. In sarcoidosis, galaxy sign is a larger nodule with nearby grouped smaller nodules

Front 29

Benign pulmonary nodule calcification patterns?

Back 29

Diffuse (granuloma), Central "bullseye" (histoplasmosis), Popcorn (hamartoma), Concentric "target" (histoplasmosis).

Front 30

Benign pulmonary nodule doubling times?

Back 30

< 1 month, or > 16 months.

Front 31

What increase in diameter equals a doubling of volume?

Back 31

26% increase (10 mm to 12.6 mm)

Front 32

Differential, multiple large pulmonary nodules?

Back 32

Metastases Lymphoma Bronchogenic carcinoma Bacterial, fungal, and sometimes viral infections Granulomatous disease Sarcoidosis Wegener's granulomatosis Rheumatoid lung Amyloidosis Septic emboli

Front 33

Pulmonary metastasis characteristics?

Back 33

Typically round and well-defined. Cavitation and calcification can be seen.

Front 34

Signet ring sign?

Back 34

Bronchiectasis. Cross section of pulmonary artery branch adjacent to dilated, ring-shaped bronchus.Bronchus diameter exceeds adjacent artery's

Front 35

Bronchiectasis patterns in cystic fibrosis and allergic bronchopulmonary aspergillosis?

Back 35

CF-bilateral, upper lobes, most severe at parahilar lungs. ABPA-central bronchiectasis.

Front 36

Causes of interlobular septal thickening as predominant finding at HRCT?

Back 36

1. Lymphatic spread of carcinoma. 2. Interstitial pulmonary edema. 3. Alveolar proteinosis. 4. Sarcoidosis.

Front 37

Common causes of fibrosis and honeycombing as predominant HRCT findings?

Back 37

IPF 65%, Collage vascular diseases (RA, scleroderma), Drug-related fibrosis, Asbestosis, End-stage hypersensitivity pneumonitis, End-stage sarcoidosis.

Front 38

3 distributions of pulmonary nodules at HRCT?

Back 38

Perilymphatic nodules (pleural surface, large vessels and bronchi, interlobular septa, centrilobular regions), Random nodules (miliary TB, hematogenous metastases), Centrilobular nodules (tree-in-bud--endobronchial TB, MAC/MAI, CF, bronchiectasis, bronchopneumonia).

Front 39

CT features of pulmonary lymphangitic spread of carcinoma?

Back 39

Interlobular septal thickening, Peribronchial interstitial thickening, Thickening of fissures, Lymph node enlargement, Patchy distribution.

Front 40

CT features of pulmonary hematogenous spread of tumor?

Back 40

Random distribution, Fissures and pleural surface involvement, Bilateral, Large nodules.

Front 41

CT features of IPF (idiopathic pulmonary fibrosis--UIP is histology pattern)?

Back 41

Intralobular interstitial thickening, Honeycombing, Traction bronchiectasis and bronchiolectasis, Subpleural, posterior, and basal lungs, Ground-glass opacity.

Front 42

Nonspecific interstitial pneumonia (NIP, collagen vascular disease) CT features?

Back 42

Ground-glass opacity, Posterior basal lungs-sparing immediate subpleural lung, Reticulation, traction bronchiectasis and bronchiolectasis, Honeycombing-rare.

Front 43

Active sarcoidosis CT features?

Back 43

Perilymphatic nodules, Patchy, upper lobe predominance, Hilar, mediastinal node enlargement, Ground-glass opacity (small granulomas).

Front 44

HRCT findings in end-stage sarcoidosis?

Back 44

Irregular septal thickening, Architectural distortion, Parahilar conglomerate masses, Honeycombing, Hilar and mediastinal node enlargement.

Front 45

Pulmonary lymphangitic spread of carcinoma?

Back 45

Interlobular septal thickening, Peribronchial interstitial thickening Patchy or unilteral distribution Lymph node enlargement.

Front 46

Pulmonary hematogenous spread of tumor?

Back 46

Random distribution, Involvement of fissures and pleural surfaces, Bilateral distribution, Large nodules.

Front 47

Idiopathic pulmonary fibrosis CT features?

Back 47

Intralobular thickening, Honeycombing, Traction bronchiectasis and bronchiolectasis, Predominant subpleural, posterior, basal lung regions, Ground-glass opacity.

Front 48

Nonspecific interstitial pneumonia CT features?

Back 48

Ground-glass opacity, Predominant posterior and basal lung, sparing the immediate subpleural lung, Reticulation, traction bronchiectasis and bonchiolectasis, Honeycombing.

Front 49

Collagen vascular disease as lung disease?

Back 49

Rheumatoid lung, scleroderma, and other collagen disease (UIP, NSIP, BOOP)

Front 50

Active pulmonary sarcoidosis CT features?

Back 50

Perilymphatic nodules, Patchy, Upperlobe predominance, Hilar, mediastinal nodes, Ground-glass opacity, small granulomas.

Front 51

End-stage sarcoidosis?

Back 51

Irregular septal thickening, Architetural distortion, Parahilar conglomerate, honeycombing, Hilar, mediastinal nodes.

Front 52

Silicosis and Coal Worker's pneumoconiosis?

Back 52

Perilymphatic nodules, Symmetric distribution, Posterior lung predominance, Upper lobe predominance, Conglomerate masses, Hilar, mediastinal nodes (egg-shell calcification).

Front 53

Pulmonary Tuberculosis CT features?

Back 53

Endobronchial spread (centrilobular nodules, tree-in-bud, focal areas of consolidation, bronchial wall thickening or bronchiectasis, pathcy or focal), Miliary spread (random nodules, 1-5 mm, Usually diffuse).

Front 54

Pulmonary alveolar proteinosis?

Back 54

Filling of alveolar spaces with lipid-rich proteinaceous material, Patchy or geographic ground-glass opacity, smooth, interlobular septal thickening in ground-glass--"crazy paving"".

Front 55

Hypersensitivity pneumonitis, subacute stage CT features?

Back 55

Patchy or geographic ground-glass opacity, Poorly defined centrilobular nodules or ground-glass opacity, Mosaic perfusion, Air trapping.

Front 56

Bronchiolitis obliterans organizing pneumonia, causes?

Back 56

Idiopathic, infections, toxic exposures, drug reactions, autoimmune disease.

Front 57

HRCT features of bronchiolitis obliterans organizing pneumonia?

Back 57

Patchy or nodular consolidation, Patchy or nodular ground-glass opacity, Peripheral and peribronchial distribution.

Front 58

Chronic eosinophilic pneumonia?

Back 58

Filling of alveoli by mixed inflammatory infiltrate (eosinophils), similar to BOOP--patchy consolidation or ground-glass, peripheral distribution.

Front 59

Histiocytosis (aka Langerhans histiocytosis or eosinophilic granuloma)?

Back 59

Centrilobular nodules (may cavitate), Thin-walled, irregular lung cysts, Normal appearing intervening lung, Upper lobe predominance, Spares costophrenic angles.

Front 60

Lymphangiomyomatosis?

Back 60

Women of child bearing age, can occur in Tuberous sclerosis, too, Thin-walled, round lung cysts, Normal-appearing intervening lung, Lymph node enlargement, Diffuse distribution without sparing lung bases.

Front 61

List 4 types of emphysema?

Back 61

Centrilobular (upper lobes, smokers, most common form), Panlobular (less common, alpha1-antitrypsin, most severe at lung bases), Paraseptal (subpleural lung, adjacent to chest wall and mediastinum), Bullous (Large bullae, young men).

Front 62

Split pleura sign?

Back 62

Thickened visceral and parietal pleural layers are split apart and surround an empyema.

Front 63

Extension of an empyema to involve the chest wall is termed?

Back 63

empyema necessitatis.

Front 64

Lung abscess versus empyema CT characteristics?

Back 64

Abscess (poorly defined, irregular wall, spherical, multiple cavities, acute angles, vessels not displaced), Empyema (well defined, smooth, uniform wall, elliptical, split pleura, acute or obtus angles, vessels displaced).

Front 65

CT features of a malignant effusion?

Back 65

Nodular pleural thickening, pleural thickness > 1 cm, concentrically involves the pleura, encasing the lung, thickening of mediastinal pleura.

Front 66

CT findings for chest wall invasion?

Back 66

Extensive contact between tumor and chest wall (> 3cm or ratio > 0.7), Obtuse angles, Chest wall mass, Bone destruction

Front 67

What passes through the aortic hiatus?

Back 67

Aorta, azygos, hemiazygos, thoracic duct, intercostal arteries, splanchnic nerves.

Front 68

What passes through the esophageal hiatus?

Back 68

Esophagus, vagus nerve, small blood vessels.

Front 69

Anterior mediastinal node groups?

Back 69

Internal mammary nodes, Paracardiac nodes, Prevascular nodes.

Front 70

Middle mediastinal node groups?

Back 70

Pretracheal or paratracheal nodes, Aortopulmonary nodes, Subcarinal noes, Peribronchial nodes.

Front 71

Posterior mediastinal node groups?

Back 71

Paraesophageal nodes, Inferior pulmonary ligament nodes, Paravertebral nodes.

Front 72

Upper limits of normal for subcarinal lymph node diameter?

Back 72

1.5 cm

Front 73

Egg-shell calcified mediastinal lymph node, differential?

Back 73

Silicosis, Coal worker's pneumoconiosis, Sarcoidosis, Tuberculosis.

Front 74

Calcified mediastinal lymph node, differential?

Back 74

Prior granulomatous disease (TB, histo, fungal, sarcoidosis), Silicosis, Coal worker's pneumoconiosis, treated Hodgkin's disease, Metastasis

Front 75

Mediastinal lymph node enhancement?

Back 75

Castleman's disease, Angioimmunoblastic lymphadenopathy, Vascular metastases, TB, Sometimes sarcoidosis.

Front 76

Left upper lobe cancers involve what mediastinal lymph node group?

Back 76

Aortopulmonary window nodes

Front 77

Lower lobe lung cancers involve what mediastinal lymph node group?

Back 77

Subcarinal nodes

Front 78

Resectability non-small cell lung cancer stages?

Back 78

Stage IIIb-IV, contralateral lymph nodes are N3, unresectable

Front 79

Sarcoidosis thoracic adenopathy features?

Back 79

Symmetric hilar adenopathy, Lymphoma is typically asymmetrical.

Front 80

Prevascular space tumors?

Back 80

4Ts: thymoma, teratoma, thyroid tumor, terrible lymphoma. Other germ-cell tumors, parathyroid masses, lymphangioma

Front 81

Castleman's disease

Back 81

aka angiofollicular lymph node hyperplasia Focal form (Enhancing hilar or mediastinal lymph nodes) Diffuse form (Enhancing mediastinal, hilar, axillary, abdominal, and inguinal node)

Front 82

CT features of thymoma?

Back 82

Prevascular or paracardiac location, Typically unilateral, Calcification or cystic degeneration can be present

Front 83

Thymic masses?

Back 83

Thymoma, thymic carcinoma, thymic carcinoid tumor, thymolipoma, thymic cyst thymic hyperplasia and rebound (after cessation of chemotherapy)

Front 84

Three main categories of germ-cell tumors?

Back 84

1. Teratoma and dermoid cyst, 2. Seminoma (radiosensitive), 3. Non-seminomatous germ-cell tumors (poor prognosis: choriocarcinoma, endodermal sinus tumor, mixed tumors).

Front 85

Teratoma versus dermoid cyst?

Back 85

Teratoma contains ecto-, meso-, and endodermal origins (can be cystic, contain fat, have fat-fluid level, or calcify). Can be mature or immature (malignant). Dermoid cyst primarily from epidermal tissue.

Front 86

Lymphangioma types?

Back 86

Simple--small, thin-walled with connective tissue. Cavernous--dilated lymphatic channels. Cystic--hygromas, single or multiple cystic masses filled with serous or milky fluid.

Front 87

Saber-sheath trachea features?

Back 87

Narrowed lateral dimension of intrathoracic trachea. COPD, repeated trauma from coughing

Front 88

Concentric tracheal narrowing causes?

Back 88

Intubation, Polychondritis, Wegener's granulomatosis, Amyloidosis, Tracheobronchopathia osteochondroplastica

Front 89

Bronchogenic and esophageal duplication cyst features?

Back 89

Anomalous budding of foregut. Most commonly within subcarinal space. Esophageal duplication cyst indistinguishable from bronchogenic, except they always contact the esophagus

Front 90

Paravertebral neurogenic tumor divisions?

Back 90

1. Peripheral nerve or nerve sheath (neurofibroma, neurilemmoma--young adults). 2. Sympathetic ganglia (ganglioneuroma, neuroblastoma--children). 3. Paraganglionic cells (pheochromocytoma, chemodectoma).

Front 91

Most common cause of posterior mediastinal mass in patients with neurofibromatosis?

Back 91

Meningocele

Front 92

Granulomatous mediastinitis causes?

Back 92

Histoplasmosis, TB, Sarcoidosis, Chronic mediastinal lymph node enlargement with fibrosis. Calcification of lymph nodes common

Front 93

Sclerosing mediastinitis versus granulomatous mediastinitis

Back 93

Similar but no calcification with sclerosing mediastinitis.

Front 94

Pericardial cyst features?

Back 94

60% anterior right cardiophrenic angle, 30% left cardiophrenic angle, 10% occur higher in mediastinum.

Front 95

Morgagni hernia features?

Back 95

Anteromedial diphragmatic foramen of Morgagni. Cardiophrenic angle mass, 90% occur on right. Usually contains liver or omentum.

Front 96

Right upper lung lobe segments?

Back 96

Apical Posterior Anterior

Front 97

Left upper lung lobe segments?

Back 97

Apicoposterior Anterior Superior lingula Inferior lingula

Front 98

Right middle lung lobe segments?

Back 98

Medial Lateral

Front 99

Right lower lung lobe segments?

Back 99

Superior Anterior Medial Lateral Posterior

Front 100

Left lower lung lobe segemnts

Back 100

Superior Anteromedial Lateral Posterior

Front 101

Egg-shell calcification of thoracic lymph nodes?

Back 101

Silicosis, Sarcoidosis, TB

Front 102

Pulmonary agenesis versus pulmonary aplasia?

Back 102

Aplasia has rudimentary bronchus.

Front 103

Pulmonary arteriovenous fistula features?

Back 103

Single dilated vascular sac or tangle of dilatated tortuous vessels. Mostly subpleural, Rapid enhancement and rapid washout.

Front 104

Pulmonary sequestration features?

Back 104

Cystic or solid, Majority left posteromedial lung. All have anomalous systemic arterial supply

Front 105

Intralobar sequestration versus Extralobar sequestration?

Back 105

Intralobar: diagnosed in adults, recurrent or chronic infection, region of hyperlucent lung, cystic or multicystic structure with air-fluid levels, consolidated or collapsed lung. Extralobar: diagnosed in infants or children, almost always solid mass that rarely contains air. Venous drainage usually via systemic veins.

Front 106

Hypogenic lung sydrome (scimitar)?

Back 106

almost always on right side, hypoplasia of lung, hypoplasia of ipsilateral pulmonary artery, Anomalous pulmonary venous return (scimitar vein) to vena cava or right atrium. Anomalous systemic arterial supply to portion of hypoplastic lung

Front 107

Extraperitoneal space communicates with?

Back 107

Retroperitoneal space, retropubic space of Retzius continuous with posterior pararenal space and extraperitoneal fat of abdominal wall.

Front 108

Perineum

Back 108

Lies below pelvic diaphragm, includes ischiorectal fossa

Front 109

Normal fertile ovary dimensions?

Back 109

2 x 3 x 4 cm.

Front 110

Bladder carcinoma CT features?

Back 110

Focal thickening of bladder wall, Weakly enhancing mural nodule, Calcifications 5%, Perivesical fat spread, Pelvic lymph nodes > 10 mm

Front 111

Uterine leiomyoma CT features?

Back 111

40% of women > 30 yo, homogeneous, heterogeneous masses, hypodense,isodense, or hyperdense, dystrophic, mottled calcifications, cystic degeneration

Front 112

Carcinoma of cervic features?

Back 112

SCC 85%, ADCA 15%, hypo or isodense to normal cervix, Pelvic fluid collections, Direct extension (thick irregular tissue strands), Enlarged lymph nodes > 10 mm

Front 113

Endometrial malignancy features?

Back 113

hypodense mass within endometrial cavity, surgical staging method of choice, Enlarged pelvic lymph nodes > 1 cm

Front 114

Ovarian cancer features?

Back 114

cystic 66%, bilater 25%, Nonfunctional 85%, Cystic with thick, irregular walls and internal septations. Peritoneal implants, Ascites, Omental cake (irregular, thick greater omentum), follow gonadal lymphatics

Front 115

Normal ovarian follicle size?

Back 115

<3 cm

Front 116

Functional ovarian cyst features?

Back 116

Benign follicular or corpus luteum cysts, well-defined, thin walled, < 3 cm

Front 117

PID CT features?

Back 117

Thickening of fallopian tubes (early), Enlargement and abnormal enhancement of ovaries, Dilated fallopian tubes filled with high-density fluid (advanced-pyosalpinx), Complex adnexal fluid collections (abscess).

Front 118

Adnexal torsion, CT features?

Back 118

Most cases involve mass (benign cystic teratoma, hydrosalpinx, functional cyst), Thickening fallopian tube wall, ascites, deviation of uterus to affected side

Front 119

Testicular cancer lymph node involvement?

Back 119

Gonadal lymphatics (testicular veins and renal hilar nodes), external iliac chains to para-aortic nodes. Inguinal nodes involved only when scotrum invaded.

Front 120

Aberrant right subclavian artery?

Back 120

Left arch, last branch (diverticulum of Kommerell), courses behind esophagus

Front 121

Two types of right aortic arch?

Back 121

Right arch with aberrant left subclavian, Mirror image right arch (almost always associated with congenital heart disease).

Front 122

Double aortic arch?

Back 122

Vascular ring with dysphagia, no innominate artery (subclavians and carotids come off separately)

Front 123

Ascending aortic aneurysm causes?

Back 123

atherosclerosis, Marfan's syndrome, cystic medial necrossi, syphilis, aortic valvular disease

Front 124

3 common locations for aortic trauma?

Back 124

Aortic root level of ligamentum arteriosum diaphragm and aortic hiatus

Front 125

Stanford aortic dissection types?

Back 125

Type A--involves ascending aorta (treated surgically: possibility of retrograde dissection and rupture within pericardium or occlusion of coronary or carotid arteries), Type B--Do not involve arch, arise distal to left subclavian artery (treated medically).

Front 126

DeBakey's aortic dissection types?

Back 126

Type I--entire aorta, Type II--ascending aorta only, Type III--descending aorta only

Front 127

Three mediastinum compartments?

Back 127

supra-aortic mediastinum, subaortic mediastinum, paracardiac mediastinum

Front 128

Mediastinal spaces and recesses?

Back 128

Pretracheal space, Prevascular space, Superior pericardial recess, Azygoesophageal recess, Subcarinal space

Front 129

Persistent left superior vena cava features?

Back 129

Failure of cardinal vein to regress, Lateral to left common carotid artery, enters coronary sinus posterior to left atrium.

Front 130

Azygos or hemiazygos continuation of IVC?

Back 130

Hemiazygos (polysplenia), Azygos (asplenia), dilated azygos, hemiazygos systems, Diaphragmatic IVC drains hepatic veins only.

Front 131

Causes of SVC syndrome?

Back 131

Most commonly bronchogenic carcinoma, sarcoidosis, fibrosing mediastinitis, tuberculosis, mediastinal radiation.

Front 132

Pulmonary artery diameter in pulmonary hypertension?

Back 132

>3 cm, or > ascending aorta

Front 133

Difference in pulmonary dilatation in pulmonary hypertension and pulmonic stenosis?

Back 133

Pulmonic stenosis--main and left pulmonary arteries dilated. Pulmonary hypertension--mian, left, and right pulmonary arteries dilated.

Front 134

Acute PE versus chronic PE at CT?

Back 134

acute PE--clot centered in lumen, outlined by contrast [doughnut sign (cross section) and railroad track sign (same plane)], Chronic PE--clot adherent to wall, located peripherally.

Front 135

Acute pancreatitis CT findings?

Back 135

Enlargement decrease in density blurring of margins peripancreatic stranding blurring of fat planes thickening of retroperitoneal fascia

Front 136

Complications of acute pancreatitis?

Back 136

Fluid collections Pseudocysts Necrosis (lack of enhancement) Phlegmon (mass of edema and inflammation) Abscess Hemorrhage Pseudoaneurysms Thrombosis (splenic vein) ascites

Front 137

Chronic pancreatitis features?

Back 137

Causes (alcohol, autoimmune, tropical pancreatitis) Calcifications 50% Atrophic Duct strictured and dilated segments, "beaded" Pseudocysts

Front 138

CT features of pancreatic adenocarcinoma?

Back 138

hypodense mass 96% head > body > tail

Front 139

Signs of pancreatic adenocarcinoma resectability?

Back 139

Isolated pancreatic mass Double duct sign without mass

Front 140

Signs of pancreatic adenocarcinoma unresectability?

Back 140

Involvement of major arteries or veins. Extension of tumor beyond margins of pancreas, invasion of adjacent organs, Ascites (presumtive peritoneal carcinomatosis)

Front 141

Appendicitis CT features?

Back 141

Distended appendix >6 mm, enhancing thickened walls, appendicolith within phlegmon or abscess

Front 142

Differential of RLQ pain without abnormal appendix or appendicolith?

Back 142

Crohn's disease, cecal diverticulitis, perforated cecal carcinoma, mesenteric adenitis, PID

Front 143

Complications associated with perforated appendicitis?

Back 143

Phlegmon (periappendiceal soft-tissue mass), abscess (> 3cm surgical or catheter drainage).

Front 144

Mucocele of appendix?

Back 144

Distended, mucus-filled appendix without inflammation. >2 cm, usually caused by mucinous neoplasm

Front 145

Diverticulitis CT features?

Back 145

Small, round collections of air, feces, or contrast, wall thickening, hyperemic enhancement, sinus tract or fistual formation, Abscess formation

Front 146

Colitides?

Back 146

Ulcerative colitis, Crohn's colitis, Pseudomembranous colitis, Typhlitis, Ischemic colitis (splenic flexure, rectosigmoid) Radiation colitis, Infectious colitis, Toxic megacolon

Front 147

CT features of islet cell tumors?

Back 147

Small tumors (<4 cm) enhance. Large tumors heterogeneous with calcification, cysts, necrosis, vascular invasion, tumor extension (generally nonfunctioning)

Front 148

Functioning islet cell tumors' malignant potential?

Back 148

80% glucagonoma 60% gastrinoma 10% insulinoma

Front 149

CT features of pancreatic lymphoma?

Back 149

Focal tumor, homogeneous and weakly enhancing. Diffuse infiltrative tumor resembles pancreatitis. Peripancreatic lymphadenopathy. No or minimal dilatation of pancreatic duct. Lymphadenopathy below renal veins in lymphoma but not in pancreatic adenocarcinoma?

Front 150

Metastases to pancreas CT features?

Back 150

Round or ovoid Most heterogeneous, can be diffuse, solitary, or multiple nodules

Front 151

Intraductal papillary mucinous neoplasm CT features?

Back 151

Diffuse or segmental dilation of pancreatic duct, atrophy of pancreas, cystic ectasia of branch ducts "bunch of grapes", intraductal papillary solid mass, multicystic mass.

Front 152

Pseudocyst CT features?

Back 152

Most common cystic lesion in and around pancreas, low-density collections of fluid, debris, or blood, Distinct walls with occasional calcifications, Generally unilocular, Signs of pancreatitis usually present.

Front 153

Pancreatic mucinous cystic neoplasm CT features?

Back 153

Middle-aged women, Multiloculated cysts, 6 or less cysts > 2 cm are typical, May have calcifications, Most common in tail, Do not communicate with pancreatic duct.

Front 154

Pancreatic serous cystadenoma CT features?

Back 154

Benign, well-circumscribed mass of innumerable small cysts. May have central stellate scar with central calcification. With larger cysts may have honeycomb appearance, Unilocular form indistinguishable from mucinous cystic neoplasms.

Front 155

Splenic cysts?

Back 155

Posttraumatic cyst (most common), Congenital epidermoid cyst, Echinococcal cysts, Pancreatic pseudocyst.

Front 156

Splenic microabscesses CT features?

Back 156

Multiple low-density lesions, differential: lymphoma, kaposi's sarcoma, sarcoidosis, metastases.

Front 157

Most common neoplasm of spleen?

Back 157

Hemangioma

Front 158

Rare primary malignancy of spleen?

Back 158

Angiosarcoma

Front 159

Multiple small focal splenic calcifications?

Back 159

Histoplasmosis or TB.

Front 160

Features of esophageal carcinoma?

Back 160

Lack of serosa, early spread, poor prognosis. 90% SCC 10% ADCA (Barrett's) Irregular wall thickening >3 mm Intraluminal polypoid mass Eccentric narrowing of lumen Proximal dilatation Metastases to lymph nodes and liver

Front 161

Esophageal leiomyoma features?

Back 161

Smooth, well-defined mass. Eccentric wall thickening, Leiomyosarcoma (heterogeneous, ulcerate)

Front 162

Esophageal varices, CT features?

Back 162

Well-defined, enhancing nodular and tubular densities adjacent to esophagus

Front 163

Esophagitis causes?

Back 163

Candida, herpes simplex, cytomegalovirus, TB

Front 164

Paraesophageal hernia?

Back 164

Gastric cardia and gastroesophageal junction below esophageal hiatus, Fundus of stomach above hiatus, adjacent to distal esophagus

Front 165

Gastric hernia rotations?

Back 165

Organoaxial (long axis rotation). Mesenteroaxial (upside down stomach)

Front 166

Gastric varcies without esophageal varices?

Back 166

hallmark findikng of splenic vein thrombosis.

Front 167

Small bowel malignant tumors?

Back 167

Lymphoma (masses, nodular wall thickening), Hematogenous metastases (melanoma, breast lung, RCC), Carcinoid (appendix, mesenteric small bowel, fibrosing reaction) Adenocarcinoma (duodenum) Leiomyosarcoma (large, exophytic, necrosis)

Front 168

Crohn's disease CT features?

Back 168

Terminal ileum 80%, Circumferential thickening (target and double halo), Marked wall enhancement, "comb sign" hyperemic vasa recta, Segmental strictures, Skip areas, Fistulas and sinus tracts, abscesses.

Front 169

Complete mechanical SBO?

Back 169

Dilatation of SB > 2,5 cm, distinct transition zone

Front 170

Paralytic ileus?

Back 170

Dilatation of distal and proximal SB without transition zone

Front 171

Partial mechanical SBO?

Back 171

Transition zone less distinct, small bowel feces

Front 172

Sclerosing mesenteritis features?

Back 172

Inflammatory disorder of unknown cause, chronic inflammation, fat necrosis, fibrosis, misty mesentery

Front 173

Cystic mesenteric masses?

Back 173

Cystic lymphangiomas, Cystic mesothelioma (rare, benign tumor) cystic teratomas (fat, calcification)

Front 174

Mesenteric neoplasms?

Back 174

Lymphoma (most common), Metastases (more common than primary tumors), Mesenteric fibromatosis (desmoid tumor), GISTs (large, hemorrhage, necrosis) Sarcomas (leiomyosarcoma, fibrosarcoma, malignant fibrous histiocytoma,liposarcoma)

Front 175

Colon volvulus types?

Back 175

Sigmoid volvulus (most common, mesenteric whirl), Cecal volvulus, Cecal bascule (folding rather than twisting of cecum)

Front 176

Fibrolammelar Carcinoma CT features?

Back 176

Large mass in healthy liver Enhances prominently and heterogeneously Central scar Difficult to distinguish from FNH

Front 177

Liver lymphoma CT features?

Back 177

Diffuse infiltration, Well-defined, homogeneous low-density nodules, Numerous small nodules resembling microabscesses

Front 178

Hepatic adenoma CT features?

Back 178

Young women on oral contraceptives. Men on anabolic steroids. Glycogen storage disease (multiple). Surgical removal for fear of rupture or malignant transformatoin. Unenhanced, isodense to liver. Arterial phase, early homogeneous enhancement. Few Kupffer cells, no sulfur colloid uptake

Front 179

FNH CT features?

Back 179

Mini liver central stellate scar and fibrous bands. Unenhanced, isodense to liver. Arterial phase, immediate intense homogeneous enhancement. May have delayed enhancement of scar. Positive sulfur colloid uptake

Front 180

Cavernous Hemangioma CT features?

Back 180

Unenhanced, hypodense mass. Arterial phase, peripheral nodules of contrast. Venous phase, progressive filling-in from periphery. Delayed, prolonged enhancement. Small hemangiomas, immediate homogeneous enhancement.

Front 181

Cystic liver masses?

Back 181

Hepatic cysts Pyogenic abscess Amebic abscess Hydatid cyst

Front 182

Normal bile duct measurements?

Back 182

Intrahepatic ducts 2 mm in central liver. Common duct < 6 mm. Give 1 mm per decade in elderly

Front 183

CT findings of biliary obstruction?

Back 183

Dilated intrahepatic biliary ducts, Dilatation of common duct > 7 mm, Gallbladder diameter > 5 cm

Front 184

Precursors of choriocarcinoma?

Back 184

Choledochal cyst Primary sclerosing cholangitis Caroli's disease intrahepatic stone disease Clonorchiasis

Front 185

cholangiocarcinoma CT features?

Back 185

Intrahepatic mass-forming, homogeneous tumor with irregular borders. Periductal infiltrating lesions grow along bile ducts. Intraductal tumors, polypoid or sessile. Extrahepatic cholangiocarcinoma, duct obstructing tumor

Front 186

CT features of primary sclerosing cholangitis?

Back 186

Multiple segmental strictures (beaded appearance) with thickening of bile duct. Complications: obstruction, cholestasis, biliary cirrhosis, cholangiocarcinoma.

Front 187

Choledochal cyst types?

Back 187

Type I, cystic dilation of CBD. Type II, CBD diverticulum. Type III, choledochocele, protrudes into duodenal lumen. Type IVa, intrahepatic saccular dilatations. IVb, extrahepatic multiple cystic dilatations. Type V, Caroli's disease.

Front 188

CT findings of acute cholecystitis?

Back 188

Gallstones in gallbladder 75%, GB distension > 5 cm, GB wall thickening > 3 mm, Early-phase enhanced GB fossa, Pericholecystic stranding, Air in GB wall (emphysematous)

Front 189

Gallbladder carcinoma CT features?

Back 189

Polypoid soft-tissue mass, Focal or diffuse wall thickening, Mass containing stones replaces GB and invades liver.

Front 190

CT features of lymphoma in abdomen

Back 190

Multiple enlarged nodes, Coalescence of enlarged nodes to form multinodular masses which may encase vessels, Conglomerate nodal masses

Front 191

CT features of AIDS in abdomen?

Back 191

Lymphadenopathy (MAI, lymphoma, Kaposi's), Focal, small low-density liver lesions (TB, Histo, lymphoma, Kaposi) Focal, small low density spleen lesions (MAI,Cocci, candida, PCP, lymphoma) Splenic or LN calcifications (PCP) Nephromegaly with striated nephrogram (HIV nephropathy) Kaposi's sarcoma (adenopathy, hepatosplenomegaly) AIDS-related lymphoma (any solid mass)

Front 192

Surgical indications for splenic trauma?

Back 192

Active bleeding, Large nonperfused portions Pseudoaneurysm formation

Front 193

Cortical rim sign?

Back 193

Delayed finding. Faint enhancement of kidney periphery in renal infarction. Renal capsule supplied by separate arteries

Front 194

Complications of pancreatic trauma?

Back 194

Pseudocyst formation hemorrhagic pancreatitis Abscess Fistula

Front 195

Shock bowel?

Back 195

Severe hypotension and hypoperfusion of bowel. Diffuse dilation of small bowel with wall thickening and increased wall enhancement

Front 196

Extraperitoneal bladder rupture?

Back 196

Contrast leakage into retropubic space, along abdominal wall, scrotum, thigh, and retroperitoneum.

Front 197

Intraperitoneal bladder rupture?

Back 197

Contrast in paracolic gutters and surrounding bowel

Front 198

Which adrenal gland more susceptible to traumatic injury?

Back 198

Right adrenal gland. compression of gland between liver and spine.

Front 199

Liver segment I?

Back 199

Caudate lobe, Ligamentum venosum and IVC separate it from liver

Front 200

Liver segments II and III?

Back 200

Lateral division of left lobe. II-superior. III-inferior.

Front 201

Liver segments IV?

Back 201

Medial division of left lobe. IVa-superior. IVb-inferior.

Front 202

Liver segments V and VIII?

Back 202

Anterior segments of right lobe. VIII-superior. V-inferior.

Front 203

Liver segments VI and VIII?

Back 203

Posterior segments of right lobe. VII-superior. VI-inferior.

Front 204

Third inflow?

Back 204

Areas of liver supplied by aberrant systemic veins. Porta hepatis, adjacent to gallbladder, adjacent to fissure of ligamentum teres.

Front 205

Increased liver attenuation?

Back 205

Amiodarone Hemochromatosis (secondary form-hemosiderosis, blood transfusions)

Front 206

Liver nodules in cirrhosis?

Back 206

Regenerative nodules Dysplastic nodules Small HCC nodules Metastatic disease Hemangiomas

Front 207

CT features of portal hypertension?

Back 207

Portosystemic collateral vessels Enlarged portal vein, > 13 mm. Splenomegaly Ascites

Front 208

CT features of Budd-Chiari syndrome?

Back 208

Enlarged caudate lobe. Central liver enhances early and peripheral liver enhances late.

Front 209

Clinically significant liver lesions?

Back 209

Metastases Hepatoma Hepatic adenoma

Front 210

Metastases to liver features on CT?

Back 210

Most common liver malignancy. Most commonly from colon. Target appearance. Hypervascular (carcinoid, choriocarcinoma, pheochromocytoma, RCC, thyroid cancer). Some cystic/nectrotic, calcification

Front 211

HCC CT features?

Back 211

50% solitary tumor 30% infiltrative 20% multinodular Small tumors, < 3cm bright homogeneous enhancement Necrosis and calcification common Invasion of hepatic and portal veins

Front 212

How much must a renal mass enhance in Hounsfield units before it is considered enhanced?

Back 212

10 - 15 H

Front 213

Metastatic lymph node size in RCC?

Back 213

> 2 cm nearly alwasy metastatic 1 - 2 cm indeterminate

Front 214

Most common sites for RCC metastases?

Back 214

lungs mediastinum bone liver contralateral kidney adrenal gland brain

Front 215

Bosniak cystic renal mass categories?

Back 215

Category I Benign simple cyst Category 2 Benign Complicated Category 3 Indeterminate cystic lesions Category 4 Malignant cystic tumors (enhancing soft tissue)

Front 216

VHL and TS CNS involvement differences?

Back 216

VHL--cerebellar, spinal cord, and retinal hemangioblastomas. TS--retinal and cerebral hamartomas

Front 217

Emphysematous pyelonephritis versus emphysematous pyelitis?

Back 217

Emphysematous pyelonephritis: diabetes, urinary obstruction, gas in renal parynchema, nephrectomy. Emphysematous pyelitis: gas in pelvis and calyces (trauma, iatragenic, infection), not a surgical urgency.

Front 218

Renal stone not seen at CT?

Back 218

Crystallin stones related to indinavir (protease inhbitor HIV Rx)

Front 219

What size renal stones can pass on their own?

Back 219

< 4 mm nearly always pass. > 8 mm rarely pass.

Front 220

Tissue rim sign?

Back 220

Halo of soft tissue that surrounds ureter stone.

Front 221

Absence of white pyramids?

Back 221

Subtle sign of urinary obstruction on affected side.

Front 222

Phlebolith distinguishers?

Back 222

tail sign (vein), central lucency, round

Front 223

Adrenocortical carcinoma features?

Back 223

large > 5 cm Necrosis and calcification Delayed contrast washout

Front 224

Adrenal calcification causes?

Back 224

Children (neuroblastoma, gnaglioneuroma) Adult (adrenal carcinoma, pheochromocytoma, glanglioneuroma, metastases) Wolman's disease (autosomal recessive, enlarged calcified adrenal glands, hepatosplenomegaly)

Front 225

In adrenal hyperplasia, adrenal limb thickness exceeds?

Back 225

10 mm

Front 226

Organ of Zuckerkandl?

Back 226

Common location for extra-adrenal pheochromoctyoma. Near origin of IMA

Front 227

Common metastases to adrenal glands?

Back 227

Lung Breast Melanoma

Front 228

Lipid-rich adrenal adenoma Hounsfield units?

Back 228

< 10 H

Front 229

Lipid-poor adrenal adenoma features?

Back 229

Non-contrast H > 10 Enhancement washout > 50% 15 minute post-contrast H < 35

Front 230

Serous ascites attenuation value in H?

Back 230

-10 to +15

Front 231

Hemoperitoneum attenuation value in H?

Back 231

>35, averaging 45 H

Front 232

With absence of intrahepatic segment of IVC, how does lower body venous blood reach the heart?

Back 232

Drainage to SVC via azygos system?

Front 233

Aneurysmal diameters of abdominal aorta and iliac arteries?

Back 233

AAA > 3 cm Iliac aneurysm > 1.5 cm

Front 234

Hyperattenuating crescent sign?

Back 234

Crescent area of high attenuation (dissecting contrast) within wall or intraluminal thrombus of AAA, impending rupture

Front 235

Beak sign in distinguishing true lumen from false lumen in aortic dissection?

Back 235

Intimal flap and false lumen wall create an acute angle: beak sign

Front 236

Dilatation of vein at site of DVT means acute or chronic?

Back 236

Acute

Front 237

Abdominal and retrocrural lymph node pathologic size cutoff?

Back 237

Abdominal LN > 10 mm. Retrocrural LN > 6 mm