Abdominal viscera: disease processes defined with radiology and ultrasound (Proceedings)


Abdominal viscera: disease processes defined with radiology and ultrasound (Proceedings)

     • For visualization of soft tissue structures, radiology and ultrasound are complimentary.
     • Analogy: Radiology is like standing on the outside of the building; it allows you to see the size, shape and contour of the building; ultrasound allows you to look into each room in the building i.e. the liver room, the gallbladder room, the pancreas room, the kidney room, the urinary bladder room etc.

Indications for radiographic examination

     • Overview
     • Size, shape, position, contour, opacity
     • Very good for bone and gas-skeletal system, lungs
     • Contrast studies-GI series, IVU, cystourethrogram, vaginogram enhance ability to define structures.
     • Can only see four opacities-gas, fat, bone and "soft tissues"
     • Need one opacity surrounding something of a different opacity to be able to define it radiographically

Indications for ultrasound examination

     • Individual soft tissue organ composition
     • Dynamic blood flow
     • Not so good for bone and gas

Abdominal cavity

Comparison – ultrasonic image to radiographic image
     A. Method of choice for detecting the etiology for peritoneal fluid.
          1. Fluid acts as "acoustic window/contrast medium"; THE FLUID ENHANCES THE ABILITY TO visualize intra-abdominal structures.
          2. Abdominal masses can be assessed despite the presence of hemorrhage.
          3. The liver can be evaluated, especially its architecture and contour.
          4. Focal Lesions-Metastasis, nodular hyperplasia CAN BE SEEN.
          5. Mass lesions-abscess, cysts, neoplasia can be seen.
          6. Hepatic congestion can be defined.
          7. Vascular abnormalities-shunts, av fistula can be defined
          8. Cirrhosis may be defined.

Echogenic Scale Of Organ Systems From Black To White
     B. Hepatobiliary system-indicated in presence of jaundice
          1. Cholelithiasis
          2. Extra-hepatic biliary obstruction, enlarged common bile duct
          3. Enlargement of intrahepatic bile ducts
          4. Neoplasia involving biliary system
          5. Obstruction due to pancreatic disease

     C. Spleen-indicated in presence of splenomegaly and blood dyscrasias
          1. Torsion
          2. Neoplasia
          3. Nodular hyperplasia
          4. Infection
          5. Infarction
          6. Hematoma

     D. Urogenital system
          1. Pregnancy diagnosis 18-25 days post-breeding
          2. Fetal viability-heart rate, gi motion, overall motion.
          3. Ovarian masses, cysts
          4. Infertility
          5. Pyometra/hematometra
          6. Ovarian pedicle and uterine stump pyogranuloma
          7. Scrotal enlargement-neoplasia, hydrocele
          8. Location of retained testicle
          9. Prostate gland-hyperplasia, cysts, abscesses, neoplasia
          10. Kidneys-neoplasia, cysts, abscesses, hydroureteronephrosis, glomerulonephrosis/ nephritis, mineral deposition/calculi, toxicosis, fibrosis, hypoplasia/dysplasia
          11. Urinary bladder-neoplasia, infection, neoplasia, wall thickness

     E. Other
          1. Pancreas-neoplasia, pancreatitis
          2. Adrenal glands-hyperplasia, neoplasia
          3. Gastrointestinal tract-neoplasia, intussusception, infiltrative diseases
          4. Lymph nodes-mesenteric, retroperitonel enlargement
          5. Peritoneum-carcinomatosis, mesenteric masses
          6. Retroperitoneum-effusion, hemorrhage, lymph node enlargement
          7. Hernia-diaphragmatic, pericardial-peritoneal, body wall
          8. General abdominal survey