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94 Cards in this Set
- Front
- Back
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Cystic lesions of liver
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common – simple cysts; uncommon – abscess, hematoma, cystic mets (ovarian, lung, sarcomas), biloma; rare – aneurysm, AVF, adenoma, echinococcus, biliary cystadenoma
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Calcified hepatic masses
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large with or without mass – mets (colon most common, mucinous ovarian, breast, stomach), fibrolamellar HCC, old hematoma, old abscess; small without mass – granulomas, PCP, biliary stones
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Hepatic target lesions
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common – mets, HCC; uncommon – lymphoma, adenoma, FNH, fungal microabscesses
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Diffuse hepatic inhomogeneity
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common – cirrhosis, mets (breast), fatty infiltration; uncommon – HCC, hepatic fibrosis, lymphoma
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Homogeneous hyperechoic lesions
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common – hemangioma; uncommon – mets, fatty infiltration, HCC; rare – adenoma, FNH
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GB masses
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common – polyps, adenomyomatosis, GB CA, tumefactive sludge; uncommon – mets (melanoma), chronic cholecystitis
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GB wall thickening
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biliary – cholecystitis, adenomyomatosis, CA, AIDS cholangiopathy, sclerosing cholangitis; nonbiliary – hepatitis, pancreatitis, CHF, hypoproteinemia, cirrhosis, portal HTN, lymphatic obstruction
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GB fossa shadowing
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stone-filled GB, porcelain GB, emphysematous cholecystitis
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Intrahepatic biliary ductal echogenic foci
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pneumobilia, stones, calcified HA, PV gas
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Bile duct wall thickening
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CBD stones, cholangioCA, sclerosing cholangitis, ascending cholangitis, pancreatitis, AIDS cholangiopathy, oriental cholangiohepatitis
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Porta hepatis cystic lesion
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choledochal cyst, liver cyst, duodenal duplication cyst, omental or mesenteric cyst, pancreatic pseudocyst, R renal cyst, HA aneurysm
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DDx simple renal cyst
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caliceal diverticula, aneurysm, pseudoaneurysm, AVM, papillary necrosis, obstructed upper pole duplication, lymphoma
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Renal cystic disease
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ADPKD, acquired cystic disease, VHL, TS, MCDK
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Solid renal mass
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RCC, AML, TCC, oncocytoma, lymphoma, mets
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Intraluminal mass in collecting system
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TCC, blood clot, fungus ball, fibroepithelial polyp, malacoplakia, stone, sloughed papilla
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Complex cystic renal masses
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hemorrhagic cyst, infected cyst, multiseptated cyst, abscess, hematoma, cystic RCC, multilocular cystic nephroma, cystic Wilm’s
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Urothelial thickening
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pyelonephritis, ureteral calculi, relieved obstruction, transplant rejection, transplant ischemia, TCC
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Nephrocalcinosis
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medullary sponge kidney, RTA, HPT, Lasix therapy in kids
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Renal parenchymal disease
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GN, AIDS, amyloid, drugs, HTN, DM
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Solid hypoechoic pancreatic mass
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CA, focal pancreatitis, lymphoma, mets, islet cell tumor, thrombosed aneurysm, peripancreatic lymph node
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Cystic pancreatic lesions
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pseudocyst, microcystic or macrocystic tumor, IPMT, solid and papillary epithelial tumor, ADPKD, VHL, CF, tortuous splenic artery, splenic artery aneurysm/pseudoaneurysm
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Splenic cyst
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trauma, epidermoid, parasitic
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Splenic solid lesion
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hemangioma, lymphoma, infarct, abscess, granulomatous, sarcoid, extramedullary hematopoeisis, mets
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Splenomegaly
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common – CHF, portal HTN, lymphoma, leukemia, hepatitis, mononucleosis, hemoytic anemias; uncommon – glycogen storage disease, malaria, myelofibrosis
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Cystic scrotal lesions
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spermatocele, epididymal cyst, intratesticular cyst, tubular ectasia of rete testis, tunica albuginea cyst, hydrocele, varicocele
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Solid testicular lesions
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seminoma, mixed germ cell tumor, epidermoid cyst, mets, lymphoma, microlithiasis; mimics of tumor – focal orchitis, atrophy, infarct, abscess, hematoma, adrenal rests
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Solid extratesticular lesions
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adenomatoid tumor of epididymis, chronic inflammatory mass, sperm cell granuloma, scrotal pearl
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Enlarged hypoechoic testis
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orchitis, torsion, lymphoma, diffuse seminoma
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Hypoechoic prostate nodule
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CA, prostatitis, atrophy, fibrosis, infarct, BPH
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Bladder wall thickening
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BOO, tumor, infection, radiation, neurogenic
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Bladder wall calcification
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Schistosomiasis, cytoxan, radiation, interstitial cystitis, TB, TCC
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Thickened hyperechoic endometrial stripe
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pregnancy related – normal early IUP, ectopic, incomplete abortion, RPOC,, endometritis, molar pregnancy; postmenopausal – hyperplasia, polyps, CA, tamoxifen, HRT
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Hypoechoic structures in hyperechoic endometrium
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premenopausal – molar pregnancy, RPOC, degenerated fibroid, degenerated placenta; postmenopausal – hyperplasia, polyps, CA
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Fluid in endometrial cavity
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acquired (cervical stenosis) – cervical CA, endometrial CA, endometritis, PID, radiation; pregnancy related – early IUP, pseudogestational sac, blighted ovum; congenital – imperforate hymen, vaginal septum, vaginal atresia, rudimentary uterine horn
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Uterine enlargement or distortion
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fibroids (#1), adenomyosis, pregnancy
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Uterine bleeding
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endometrial atrophy, hyperplasia, polyps, CA, adenomyosis, submucosal fibroid
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Uterine and vaginal cystic masses
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nabothian cyst, Gartner’s duct cyst, Bartholin cyst, hydrometrocolpos
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Shadowing in endometrial cavity
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IUD, calcifications from fibroids or TB, gas
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Congenital uterine anomalies
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septate, bicornuate, didelphys, arcuate, unicornuate, hypoplastic, in-utero DES exposure
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Cystic adnexal masses
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follicle, CLC, PCO, OHS, theca lutein cyst (multiple gestation, mole, OHS), hemorrhagic cyst, endometrioma, dermoid, TOA, ectopic, CA, hydrosalpinx, paraovarian cyst
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Complex pelvic masses
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ovarian – ectopic, TOA, endometrioma, hemorrhagic cyst, torsion, dermoid, CA; tubal – pyosalpinx; uterine – pedunculated fibroid, extruded IUD, CA; other – pelvic abscess, appendicitis, diverticulitis, hematoma, pelvic kidneys, iliac aneurysm
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Masses with homogeneous low-level echoes
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TOA, endometrioma, hemorrhagic cyst
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Solid ovarian masses
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fibroma, thecoma, endometrioma, germ cell tumor, CA, mets; mimics - pedunculated fibroid, lymphadenopathy
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Endometrial filling defect by HSG
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submucosal fibroid, air bubble, endometrial polyp, blood clot, retained POC, IUP, synechiae
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Tubal filling defects by HSG
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polyp, CA, tubal pregnancy, air bubble
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Tubal irregularity by HSG
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SIN, tubal diverticula, endometriosis, post-op changes, TB
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Diverticula by HSG
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uterus – adenomyosis; isthmus – SIN, TB
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Pseudokidney sign on US
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IBD, tumor, intussusception, always exclude pelvic kidney
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1st trimester bleeding
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normal IUP, abortion, ectopic, GTD, subchorionic hemorrhage
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SAB
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TV 18mm MGSD without embryo, 13 mm MGSD without YS, 5 mm CRL without heart motion
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Empty GS
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normal early IUP, blighted ovum, pseudogestational sac from ectopic
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Echogenic central cavity
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decidual reaction, hemorrhage, RPOC
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Complex intrauterine mass
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missed abortion, fetal demise, molar pregnancy, degenerated fibroid, endometrial CA
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High MSAFP
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incorrect dates, multiple gestation, NTD, abd wall defect, GI obstruction, renal anomalies, fetal hepatitis, placental hemorrhage
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Low MSAFP
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Downs, trisomy 18, incorrect dates, fetal death, not pregnant, hydatidiform mole
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Hydrops
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immune; most nonimmune – cardiac tacharrhythmias or defect, idiopathic, chromosomal anomalies, twin-twin transfusion, anemias, infections
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Polyhydramnios
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idiopathic; maternal – DM, HTN; fetal – NTD, proximal GI obstruction, chest masses, twin-twin transfusion, nonimmune hydrops, chromosomal anomalies, infection
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Oligohydramnios
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DRIPPC – demise, renal anomalies, IUGR, PROM, post-dates, chromosomal anomalies
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Placentomegaly
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>4cm thick; hydrops, maternal DM, maternal anemia, TORCH, intraplacental hematoma
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Small placenta
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maternal HTN, toxemia, severe DM, IUGR
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Abnormal placental echotexture
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partial mole, hydropic placenta, hemorrhage or abruption, common but insignificant findings (venous lakes, infarcts), chorioangioma
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Umbilical cord abnormalities
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solitary umbilical artery - trisomy 13, 18, structural anomalies; enlarged umbilical cord – edema, hematoma, cysts, mucoid degeneration of Wharton’s jelly; other – knots, varices, straight cord, nuchal cord, vasa previa
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Abnormal LUS
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cord prolapse (Trendelenburg and call OB), incompetent cervix, placenta previa, cerclage, low fibroid
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3rd trimester bleeding
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placenta previa, abruption, cervical lesions, idiopathic
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Masses during pregnancy
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uterus – fibroid, focal contraction, GTD, hemorrhage; adnexal – CLC, dermoid, theca lutein cysts, other ovarian neoplasms; other – PID, appendiceal abscess
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Fetal death
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no fetal heartbeat, absent fetal movement, overlapping skull bones (Spalding’s sign), gross distortion of fetal anatomy (maceration), soft tissue edema
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Cystic CNS structures
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supratentorial – CPC, hydrocephalus, hydranencephaly, porencephaly, holoprosencephaly, arachnoid cyst, teratoma; posterior fossa – DW malformation, arachnoid cyst, mega cisterna magna; midline cysts – cavum septum pellucidum, dorsal cyst in ACC, vein of Galen AVM
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Hydrocephalus
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obstructive - NTD (Chiari II), DW complex, aqueductal stenosis, ACC (colpocephaly); nonobstructive – hemorrhage, infection
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Cystic head and/or neck masses
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cystic hygroma, encephalocele, hemangioma, teratoma, branchial cleft cyst, thyroglossal duct cyst, nuchal cord
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Cystic back masses
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NTD, cystic teratoma
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Hyperechoic brain mass
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hemorrhage, teratoma, callosal lipoma
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Incomplete skull mineralization
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OI, hypophosphatasia, achondrogenesis
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Skull deformities
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lemon sign – normal, myelomeningocele, encephalocele; cloverleaf skull – craniosynostosis, thanatophoric dwarf
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Kyphoscoliosis
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isolated – hemivertebra, butterfly vertebra; complex – VACTERL, limb-body wall complex, any skeletal dysplasia
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Cystic thoracic masses
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CDH, CCAM (types 1,2), cysts (bronchogenic, duplication, pericardial), cystic hygroma
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Solid echogenic thoracic masses
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CDH, CCAM (type 3), sequestration, tumors (teratoma, neurogenic tumors, cardiac rhabdomyoma)
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Pleural effusion
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unilateral usu due to lung masses – CDH, CCAM, sequestration; bilateral – hydrops, lymphangiectasia; unilateral or bilateral – idiopathic, infection, chromosomal anomalies
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Absent stomach bubble
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oligohydramnios, swallowing abnormality from CNS defect, EA, CDH, situs abnormality, trisomy 18
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Double bubble
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assoc with polyhydramnios; duodenal atresia, annular pancreas, proximal jejunal atresia, gut duplication
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Dilated bowel
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atresia, stenosis, volvulus, meconium ileus, enteric duplication, Hirschsprung’s; proximal obstructions usu assoc with polyhydramnios; distal obstructions usu assoc with normal amniotic fluid
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Echogenic bowel
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as bright as bone; normal variant in 2nd trimester, CF (common), Downs, IUGR, CMV, small bowel atresia or volvulus, swallowed blood in amniotic fluid
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Abdominal calcification
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meconium peritonitis (most common), meconium ileus, atresias, volvulus, renal, liver TORCH, neuroblastoma, teratoma, fetal gallstones
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Hydronephrosis
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UPJ (#1), UVJ, duplex collecting system, BOO (PUV, prune belly)
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Common renal anomalies
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agenesis, ectopic kidney, hydronephrosis, ARKD, MCDK
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Cystic abdominal structures
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hydronephrosis, fluid-filled dilated bowel, ascites, meconium pseudocyst, cysts (mesenteric, urachal, duplication, ovarian, choledochal)
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Liver
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calcification – TORCH; cysts – simple, polycystic dz, choledochal cyst, Caroli’s, hamartoma; masses – teratoma, hepatoblastoma, hemangioma, hemangioendothelioma, hamartoma
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Splenomegaly
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immune hydrops, PROM, TORCH
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Ascites
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hydrops, meconium peritonitis, urine ascites, infection, pseudoascites
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Anterior wall defects
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midline – omphalocele; lateral – gastroschisis, amniotic band syndrome; infraumbilical – bladder or cloacal exstrophy
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Sacral region anomalies
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teratoma, meningocele, duplication cyst, caudal regression syndrome
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Fractures
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OI, hypophosphatasia
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Polydactyly
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familial, trisomy 18, 13, Meckel-Gruber syndrome, chondroectodermal dysplasia
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Clubfoot
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idiopathic, trisomy 18, amniotic band syndrome, meningocele
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Chromosomal anomalies
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trisomy 21 – nuchal tranlucency/thickening, short humerus and femur, pyelectasis, echogenic bowel, cystic hygroma, duodenal atresia, hydrocephalus, ECD, echogenic cardiac focus, widened iliac angle; trisomy 18 – IUGR, cardiac anomalies, cystic hygroma, omphalocele, strawberry shaped calvarium, CPC, enlarged cisterna magna, myelomeningocele, clenched fists, rocker-bottom and clubfoot, placentomegaly; trisomy 13 – IUGR, holoprosencephaly, microcephaly, enlarged cisterna magna, hydrocephalus, cleft lip and palate, cyclopia, hypotelorism, nuchal thickening, cystic hygroma, lymphangiectasia, hydrops, enlarged echogenic kidneys, omphalocele, echogenic bowel, polydactyly, rocker bottom and clubfoot, clenched and overlapping digits, cardiac anomalies; Turner’s – nuchal thickening, cystic hygroma, coarctation, bicuspid aortic valve
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