Abdomen ultrasound

Created by Tarzannaa 

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right hepatic vein

divides the right lobe into anterior and posterior segments

middle hepatic vein

vessel that runs in the main lobar fissure; vein that divides right and left lobes

left hepatic vein

divides left lobe into medial and lateral segments

right portal vein

supplies the right lobe of the liver; branches into anterior and posterior segments

left portal vein (horizontal segment)

vein that separates caudate lobe from medial segment of left lobe

left portal vein (ascending segment)

vein divides medial from lateral segment of left lobe

gallbladder fossa

located in main lobar fissure

ligamentum teres

along with falciform ligament, it divides medial and lateral segments of the left lobe of liver; recanalizes in cirrhosis

ligamentum venosum

separates the lt lobe from the caudate lobe; , Continuos with the teres/round ligament; a fibrous remnant of the fetal ductus venosus

riedel's lobe

inferior projection of right lobe

sonography of acute hepatitis

sonographic features: hypoechoic liver parenchyma, liver enlargement, hyperechoic portal vein walls

sonography of chronic hepatitis

sonographic features: hyperechoic liver parenchyma, small liver, decreased echogenicity of portal vein walls

granulomas

appear as small calcifications on ultrasound

pyogenic abcess (bacterial)

sonographic features: complex mass, echogenic Gas, reverberation artifact

Candidiasis (fungal abscess)

fungal infection, appearance "wheel within a wheel", "bullseye"

Echinococcal cyst (hydatid disease)

simple cyst to complex massappearance, may have water lily sign, daughter cysts are common; sheep; casoni skin test to diagnose

schistosomiasis

parasitic infection; intrahepatic portal veins occlude resulting in portal hypertension (cuz of eggs)

Cushing's syndrome

excess cortisol secretion associated with adrenal adenomas

Cushing's disease

excess cortisol secretion due to increased ACTH from a pituitary adenoma

Conn's disease

excess aldosterone secretion associated with adrenal adenoma

Hirsutism

may be caused by androgen secreting adrenocortical and ovarian disorders

right renal vein

short, drains directly into IVC

left renal vein

longer vein passes between SMA and Ao to IVC

adrenal neuroblastoma

most common childhood adrenal mass

adrenal hemorrhage

most common adrenal mass in newborn

multicystic dysplastic kidneys

most common neonatal abdominal/ renal mass

wilm's tumor

most common childhood renal mass

renal artery stenosis diagnostic criteria

renal artery/ aorta ratio (RAR) > 3.5;
>3.5 means there is at least 60% narrowing

resistive index formula

(peak systolic freq - end diastolic freq) / peak systolic freq

spermatoceles or epididymal cysts

occurs in epididymal head, anechoic, well defined; both can result from prior episodes of epididymitis

two common causes of acute scrotal pain

torsion of spermatic cord or epididymitis / orchitis

SMA doppler in fasting state

doppler waveform in this artery is high resistance in fasting state

SMA doppler in postprandial state

doppler waveform is low resistance, increased velocity after eating

TSH

thyroid stimulating hormone; produced by pituitary

Hypothyroidism

increase in TSH, T4/T3 decreases

Hyperthyroidism

decrease in TSH, T4/T3 increased

serum thyroid hormones

T4-Throxine, T3-Triodothyronine

papillary carcinoma

most common primary thyroid cancer

follicular adenoma

true thyroid neoplasm char by well defined mass, halo usually hypoechoic

follicular carcinoma

indistinguishable from follicular adenoma, encapsulated

medullary carcinoma

tumor associated with MEN syndrome

Graves disease

disorder of the thyroid gland characterized by the presence of hyperthyroidism, goiter, and exophthalmos

thyroid artery supply

superior (branch from ECA) and inferior (branch from thyrocervical trunk) thyroid arteries

thyroid venous supply

superior, middle drain into IVC, inferior thryoid vein drains into inominate vein

pseudoaneurysm

results from a defect in hte main artery wall, eg post catheter insertion. Must be a channel communication from main artery to pulsatile structure outside vessel walls.

true aneurysm

involve all three layers of the arterial wall and are best described as the weakening of the vessel wall. Can be fusiform and circumferential (most are) or saccular

normal intestinal wall measures

3-5mm thick in measurement depending on distention of bowel

pseudokidney sign

sonographic pattern of intestinal pathology, aka target sign, hyperechoic center

inflammatory appendix

sonographic criteria includes non compressible appendix, >6mm diameter, appendicolith (fecalith)

hypertrohic pyloric stenosis

neonatal patients(3-6wks) vomiting; criteria for diagnosis all will increase: pyloric muscle thickness, py channel length, py diameter

diverticulitis

colonic outpouchings (common involves sigmoid)

intussusception

teleschoping of intestinal lumen, causes bowel obstruction

portal hypertension

increase in blood pressure in the veins of the portal system caused by obstruction in the liver (often associated with alcoholic cirrhosis, now leading cause is hepatitis C), causing enlargement of the spleen and (portosystemic) collateral veins, ascites; portal vein size >13mm, pressure gradient normal is slightly higher than ivc; TIPS to lower portal pressure

cholangitis

Inflammation of the cystic &/or common bile duct

cholecystitis

an inflammation of the gallbladder that may occur as an acute or chronic process. Acute inflammation is associated with gallstones. Chronic condition of this results when inefficient bile emptying and gallbladder muscle wall disease causes a fibrotic and contracted gallbladder.

cirrhosis

sonographic findings include: hepatomegaly (acute), liver atropy ( chronic), caudate lobe enlargement, surface nodularity, fatty infiltration

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