Gallbladder Polyps
Large polyps may show internal color flow vascularity “Comet tail” artifacts suggest cholesterol polyp • CT: Useful for staging in larger polyps where ↑ risk of malignancy Difficult to visualize many polyps…
Portal Hypertension and Varices
Ascites: Fluid in dependent recesses of peritoneal cavity Splenomegaly: Spleen is enlarged > 500 cc Varices: Well-defined, tubular or serpentine collateral vessels with same enhancement as adjacent veins – Usually opacify on venous…
HELLP Syndrome
Intrahepatic or subcapsular fluid collection (hematoma) on US or CT • CT not ideal due to radiation dose, but may be necessary in severe cases • US: Irregular or wedge-shaped liver hemorrhage…
Passive Hepatic Congestion
Early retrograde enhancement of dilated inferior vena cava (IVC) and hepatic veins (HVs) Heterogeneous, mottled, reticulated, mosaic hepatic parenchymal pattern Periportal low attenuation (perivascular lymphedema) Hepatomegaly and ascites • US: Loss…
Asplenia and Polysplenia
Absent spleen in virtually all patients Congenital heart disease in ∼ 100% of patients Bilateral trilobed lungs Malrotation in most patients Aorta and inferior vena cava (IVC) are frequently ipsilateral…
Splenomegaly and Hypersplenism
Congestive – Right heart failure, portal hypertension, sickle cell disease (in acute setting), and splenic vein thrombosis Hematologic – Polycythemia vera, myelofibrosis, and hemoglobinopathies Inflammatory/infectious – Mononucleosis and HIV/AIDS most common infections to…
Ischemic Enteritis
Clot or narrowing of superior mesenteric artery or superior mesenteric vein with bowel wall thickening • Best imaging tool MDCT with CT angiography; multiplanar reformations Catheter angiography for diagnostic confirmation and…
Vasculitis
Large vessel: Takayasu arteritis Medium vessel: Polyarteritis nodosa Small vessel: Henoch-Schönlein purpura, lupus vasculitis, Behçet disease, Wegener granulomatosis IMAGING • Takayasu arteritis Classically involves aortic arch Wall thickening of vascular segment in acute phase…
Hepatic Trauma
Intraparenchymal &/or subcapsular hematoma Injury to bare area of liver may result in retroperitoneal, not intraperitoneal, bleeding • Best imaging tool: MDCT in hemodynamically stable patients • CT protocol advice: Rapid bolus…
Esophageal Scleroderma
GI tract, lungs, heart, kidneys, and nervous system • GI: 3rd most common manifestation after skin changes and Raynaud phenomenon Seen in up to 90% of patients Most common sites – Esophagus…
