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94 Cards in this Set

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