Imaging Approach to the Esophagus
(Left) Graphic shows the nasopharynx (A, purple, base of skull to palate), oropharynx (B, blue, palate to base of epiglottis), hypopharynx, (C, green, epiglottis to cricopharyngeus), and esophagus (D, below…
Biliary Metastases and Lymphoma
CT: Usually polyploid enhancing nodule or mass within GB lumen, but may appear as focal mural thickening MR: Melanoma classically hyperintense on T1WI and hypointense on T2WI US: Immobile polypoid mass…
Venoocclusive Disease
Hematopoietic cell transplantation (HCT) Graft vs. host disease (GVHD) IMAGING • Sensitivity and specificity of imaging findings are low (overlap those of GVHD) • Ultrasound provides suggestive evidence of VOD; helps exclude…
Traumatic Abdominal Wall Hernia
High-energy injuries: Motor vehicle accidents constitute ∼ 50% of cases, with seat belts increasing risk – “High-riding” seat belt incorrectly placed over abdomen increases risk (muscle avulsion from iliac crest) – Other…
Brunner Gland Hyperplasia
Upper GI barium study and endoscopic US • Diffuse type (Brunner gland hyperplasia) Multiple, small, submucosal nodules < 5 mm in proximal duodenum “Cobblestone” or “strawberry” appearance • Solitary type (Brunner gland…
SMA Syndrome
Reformat in sagittal plane to see aorta and SMA • Antiperistaltic flow of barium proximal to obstruction • Relief of obstruction in prone, knee-chest, or left lateral decubitus positions TOP DIFFERENTIAL DIAGNOSES…
Undifferentiated Sarcoma
Undifferentiated embryonal sarcoma • Definition Primary malignant tumor of liver composed of primitive mesenchymal cells with partial, divergent differentiation IMAGING • Large, encapsulated, spherical mass • May have peripheral rim of viable, hypervascular…
Mesenteric Adenitis and Enteritis
Mesenteric adenopathy is often much more evident on coronal-reformatted CT • Ileal ± cecal wall thickening, sometimes with regional ileus Mucosal hyperenhancement, submucosal edema • Normal-appearing appendix TOP DIFFERENTIAL DIAGNOSES • Appendicitis • Crohn…
Malabsorption Conditions
Chronic pancreatitis, cholestasis, ileal resection • Malabsorption at mucosal level Celiac disease, Crohn, tropical sprue Short bowel, cystic fibrosis Eosinophilic gastroenteritis, Whipple disease Amyloidosis, hypogammaglobulinemia, mastocytosis • Malassimilation Primary and secondary lymphangiectasia…
Esophageal Webs
Lacks muscle layer (unlike distal esophageal A and B rings) IMAGING • Full column barium esophagram with rapid-sequence filming or have patient swallow small marshmallow followed by barium • Appearance: 1-2 mm…
