1 What is a urogram? A urogram is an imaging study that is used to evaluate both the anatomy and physiology of the urinary tract. The major indications for urography are to evaluate patients with gross or microscopic hematuria, history of urothelial carcinoma, urinary tract stones, and suspected post-surgical or post-traumatic ureteral leaks. 2 What are the different ways a urogram can be performed? There are…
1 Why is computed tomography (CT) commonly used initially for diagnostic purposes in patients with an acute abdomen or pelvis? Accurate and timely diagnosis of life-threatening disease involving the abdomen and pelvis is essential to decrease potential morbidity and mortality. Clinical evaluation is sometimes difficult, and laboratory analysis and radiographic findings are not always useful in diagnosing the condition at hand. CT imaging of the abdomen…
1 What is the peritoneum? The peritoneum is the largest and most complexly arranged serous membrane in the body. It is closed in men and open to the ends of the fallopian tubes in women. The parietal layer lines the abdominal wall, whereas the visceral layer lines the visceral organs. It contains a potential space, the peritoneal space, which normally contains a small amount of fluid.…
1 What are the general indications for computed tomography (CT) and magnetic resonance imaging (MRI) of the pancreas? CT and MRI are commonly used to assess the extent and severity of disease in patients suspected of having pancreatitis, to evaluate for associated complications of pancreatitis, and to provide guidance for percutaneous drainage of peripancreatic fluid collections or percutaneous biopsy of pancreatic lesions. They are also useful…
1 What is the normal CT and MRI appearance of the spleen? The normal spleen has homogeneous soft tissue attenuation on unenhanced CT, usually 5 to 10 HU less than liver, and appears slightly hypointense on T1-weighted images and hyperintense on T2-weighted images relative to liver ( Figure 29-1 ). It is typically less than 13 cm in craniocaudal dimension and has an average volume of ≈225 ml in…
1 What are the common indications for computed tomography (CT) and magnetic resonance imaging (MRI) of the liver, gallbladder, and biliary tree? The most common clinical indications include: Characterization of indeterminate hepatic lesions detected on prior cross-sectional imaging. Surveillance of cirrhotic patients for hepatocellular carcinoma (HCC). Surveillance of patients with primary sclerosing cholangitis (PSC) for cholangiocarcinoma. Staging and response assessment of patients with hepatobiliary malignancies. Pretreatment…
1 What is shown in Figure 27-1 ? A topogram from a computed tomographic colonography (CTC), an examination tailored to evaluate for colorectal polyps and masses. 2 What is the adenoma-carcinoma sequence? The adenoma-carcinoma sequence refers to a series of genetic mutations whereby small adenomatous colon polyps (<5 mm) transform into large adenomatous polyps (>1 cm), noninvasive carcinomas, and then invasive carcinomas. This entire process takes, on average,…
1 Identify the parts of the colon (numbers 1 through 8) labeled in Figure 26-1 . For the answer, see the figure legend. 2 What are haustra? The longitudinal muscle layer of the colon is divided into three thick bands, termed the taeniae coli . There is a paucity of longitudinal muscle between the three tenial bands. Haustra are sacculations of colon protruding between the three…
1 What are the general indications for routine computed tomography (CT) and magnetic resonance imaging (MRI) of the upper gastrointestinal (GI) tract? General indications for routine abdominopelvic CT or MRI evaluation of the upper GI tract include: Assessment of patients with clinical symptoms or signs potentially related to GI tract pathology for detection and characterization of the underlying etiologies. Staging, pretreatment planning, response assessment, and restaging…
1 What organs are studied during an upper gastrointestinal (GI) series? The esophagus, stomach, and duodenum are studied. The radiologist evaluates the morphology and motility of these organs. 2 What organs are studied during a pharyngoesophagogram? The radiologist evaluates the motility of the oral cavity, pharynx, and esophagus, and the morphology of the pharynx, esophagus, and gastric cardia. The radiologist records the fluoroscopic images of oral,…
1 What is a “flat plate” of the abdomen? Flat plate is a historical term that refers to a past method of radiography when radiographs were recorded on flat plates of glass coated with an emulsion sensitive to x-rays. This examination also has been termed a plain abdominal radiograph, plain film of the abdomen, abdominal plain film, and KUB. KUB refers to the kidney, ureters, and…
1 What is the radiographic appearance of an endotracheal tube (ETT), and where is it optimally placed? An ETT usually appears as a faintly radiopaque tube with a thin, densely radiopaque line along its length, and its position should be determined relative to the carina, which if not seen on a chest radiograph can be approximated by following the course of the mainstem bronchi medially at…
1 Describe the normal pleural anatomy and physiologic features. The pleural space is a potential space that contains 2 to 10 mL of pleural fluid between the visceral and parietal pleural layers that essentially represents interstitial fluid from the parietal pleura (an ultrafiltrate of plasma). The pleural space is contiguous with the interlobar fissures of the lungs. The pleura is a thin, serous layer that covers the…
1 Describe the anatomy of the mediastinum. The mediastinum is located centrally within the thorax between the pleural cavities laterally, the sternum anteriorly, the spine posteriorly, the thoracic inlet superiorly, and the diaphragm inferiorly. It is usually divided into anterior, middle, and posterior compartments to help categorize tumors and diseases by their site of origin and location. Processes that arise in these different compartments are generally…
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24.1 Introduction Special procedures are defined by the following characteristics: ▪ Unique beam configuration, accessories, or radiation delivery device settings compared to other treatments such as 3D conformal radiation therapy (3D CRT) or intensity-modulated radiation therapy (IMRT) ▪ Relative number of patients treated is small ▪ Not widely offered in all clinics because of the relative effort to implement a special procedure compared to the number…
23.1 Introduction The goal of intraoperative radiotherapy (IORT) is to deliver a single high dose of radiation at the time of surgery to enhance tumor control. IORT is typically useful in cases where a complete surgical resection will be difficult. For example, a locally invasive tumor might surround a nerve or blood vessel that cannot be resected, or a tumor may invade into a bone that…
22.1 Introduction Prostate brachytherapy is one of several treatment techniques available for patients with localized disease. Prostate brachytherapy is currently practiced using two different techniques: (1) prostate seed implant (PSI) using low dose rate (LDR) sources and (2) high dose rate (HDR) brachytherapy. Because prostate HDR is one variation of interstitial implants, it is grouped with other interstitial implants in Chapter 20 . Like other technologies…
21.1 Introduction Interstitial brachytherapy has a long tradition, starting with radium needles being implanted in superficial tumors in the 1930s. The implant systems developed at the time, Manchester and Quimby, still guide the needle placement patterns used in implants today. Though radium needles where initially used for interstitial implants, other radioactive nuclei were developed over time. Table 8.1 in Chapter 8 contains a list of the…