Color Doppler US initially: Highly accurate and cost effective CT or MR: Complete evaluation and to search for cause TOP DIFFERENTIAL DIAGNOSES • Streaming artifact • Extrinsic compression • Budd-Chiari syndrome PATHOLOGY • Most…
Enhancing (hyperemic) peripheral inner rim (increased vascularity) Nonenhancing peripheral outer rim or “halo” (avascular rim) Delayed or nonenhancing central part of tumor (myxoid and hyalinized stroma) • Imaging protocol: Multiphasic CT…
Splenic autoinfarction: Absent or small calcified spleen Massive splenic infarction: Rare complication defined as when > 50% of spleen is infarcted Splenic sequestration: Massive splenomegaly Splenic abscess: Usually due to…
Mucosal hyperenhancement accompanies active ulceration Reversal of jejunoileal fold patterns (atrophied jejunal, thickened ileal) Submucosal edema, fat, or gas Small bowel intussusception Eccentric soft tissue density mass in bowel wall…
Most common type of CCA Well circumscribed, large, with lobulated margins Multicentricity, especially around main tumor • Periductal-infiltrating CCA Grows along bile ducts and is elongated, spiculated, or branch-like • Progressive, gradual,…
Best modality for identifying intramural/intraluminal gallbladder (GB) gas (100% sensitive) Gas within pericholecystic abscess or free intraperitoneal air may be present with perforation Other CT findings similar to uncomplicated cholecystitis…
Sausage-like enlargement of pancreas (with smooth contour) and loss of normal pancreatic lobulations Hypoattenuating halo or capsule around pancreas Absence of retroperitoneal fluid, fluid collections/pseudocysts, or inflammation Less enhancement than…
Limited to bowel ± mesenteric nodes • Secondary lymphoma Involvement of spleen, liver, or thoracic nodes IMAGING • Intestinal metastases • Malignant melanoma is most common primary site Enhancing masses within SB mesentery…
Ascites may be slightly higher in attenuation (15-30 HU) on CT than simple ascites Internal complexity within ascites fluid (septations, debris) is common and easier to appreciate on MR or…
With periampullary tumors • Liver ± peritoneal metastases TOP DIFFERENTIAL DIAGNOSES • Pancreatic ductal carcinoma • Ampullary carcinoma • Intestinal metastases and lymphoma • GI stromal tumor (GIST) • Duodenal ulcer • Crohn disease • Tuberculosis • Annular pancreas…
