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Cystic lesions of the pancreas (differential)

The differential for cystic lesions of the pancreas includes: unilocular pancreatic pseudocyst intraductal papillary mucinous neoplasm (IPMN) serous cystadenoma uncommonly uni/macrolocular simple pancreatic cyst cystic neuroendocrine tumor of the pancreas diffuse pancreatic cysts pancrea...

Transient hepatic attenuation differences

Transient hepatic attenuation differences (THAD) lesions refer to areas of parenchymal enhancement visible during the hepatic artery phase on helical CT. They are thought to be a physiological phenomenon caused by the dual hepatic blood supply. Occasionally, they may be associated with hepatic t...

Splenic cyst

Splenic epithelial cysts, also known as splenic epidermoid cysts or primary splenic cysts, are unilocular fluid lesions with thin and smooth walls and no enhancement. They represent ~20% of cysts found in the spleen and are usually an innocuous incidental imaging finding. Note that most (~80%) ...

Medical devices in the abdomen and pelvis

Medical devices in the abdomen and pelvis are important to be recognized, just like medical devices of the chest. We often ignore these devices, considering them to be incidental and non-pathological, however it is essential to be aware of potential complications. Gastrointestinal devices tube...

Periportal hyperechogenicity

Periportal hyperechogenicity can result from many causes including: pneumobilia cholecystitis schistosomiasis of the portal region recurrent pyogenic cholangitis (oriental) inflammatory bowel disease: has been described to give "echo-rich" periportal cuffing 2 See also periportal hypoech...

Hepatic attenuation on CT

Hepatic attenuation on CT, reflected by Hounsfield values, depends on a combination of factors including the presence or absence, as well as the phase, of IV contrast administration. Allowing for all these factors, the mean unenhanced attenuation value is around 55 HU 4. Pathology Several int...

Pseudocirrhosis

Pseudocirrhosis is a radiological term used to convey the imaging findings of cirrhosis but emphasizes that it occurs in the setting of hepatic metastases. It is most commonly reported following chemotherapeutic treatment of breast cancer metastases, although it has also been reported before tre...

Inflammatory myofibroblastic tumors of the liver

Inflammatory myofibroblastic tumors (IMTs) of the liver are extremely rare and account for just 0.7% of all hepatic lesions 1. Refer to the article on inflammatory myofibroblastic tumors for a broad discussion. Epidemiology IMTs of the liver are usually frequent in young adults and Asian pe...

Hypervascular liver lesions

Hypervascular liver lesions are findings that enhance more or similarly to the background hepatic parenchyma in the late arterial phase, on contrast-enhanced CT or MRI. Differential diagnosis Non-neoplastic focal nodular hyperplasia (FNH) bright arterial phase enhancement except central scar...

Hemobilia

Hemobilia refers to the presence of blood in the biliary tree. Clinical presentation The classical Quincke triad, is seen with hemobilia in the context of hepatic arterial aneurysms, and consists of: melena (i.e. upper gastrointestinal bleeding) jaundice abdominal pain Pathology Etiology ...

Gallbladder folds

Gallbladder folds arise due to the gallbladder wall folding onto itself. They are thick, junctional in nature and incomplete or non-continuous in appearance. The posterior wall is usually involved, however, anterior wall folds may also occur 1. The folding may produce a bizarre or unusual shap...

Periportal lymphadenopathy (differential)

Periportal lymphadenopathy can be a common observation during imaging of the upper abdomen. What is considered the exact upper limit of normal has been variable 1,3 among different publications but with many authors suggesting a cut-off of around 10 mm in short axis diameter. Pathology Etiolog...

Congestive hepatopathy

Congestive hepatopathy includes a spectrum of hepatic derangements that can occur in the setting of right-sided heart failure (and its underlying causes). If there is subsequent hepatic fibrosis, the term cardiac cirrhosis may be used. The condition rarely occurs due to non-cardiac causes (e.g. ...

Diffuse gallbladder wall thickening (differential)

Diffuse thickening of the gallbladder wall can occur in a number of situations: cholecystitis acute cholecystitis chronic cholecystitis gallbladder empyema 7 xanthogranulomatous cholecystitis 11 acalculous cholecystitis 11 postprandial physiological state (pseudothickening) gallbladder o...

Coarsened hepatic echotexture

Coarsened hepatic echotexture is a sonographic descriptor used when the uniform smooth hepatic echotexture of the liver is lost. This can occur due to a number of reasons which include: conditions that cause hepatic fibrosis 1 cirrhosis hemochromatosis various types of hepatitis 3 particula...

Fetal intrahepatic calcification

Fetal intrahepatic calcification can be a relatively common finding. Calcifications in the liver can be single or multiple and in most cases in which isolated hepatic calcific deposits are detected, there is usually no underlying abnormality. The presence of isolated intrahepatic calcification ...

Splenomegaly

Splenomegaly refers to enlargement of the spleen. The upper limit of the normal adult splenic length is traditionally cited at 12 cm, but lengths upwards of 14 cm can be seen in normal, taller males 7. Terminology Massive splenomegaly is variably defined, including when the spleen is 5 standar...

Retained gallstone

Retained gallstones, also called dropped or slipped gallstones, are common during a laparoscopic cholecystectomy, with a reported incidence of 0.1–20%, and occur when gallstones are inadvertently spilled into the peritoneal cavity. Clinical presentation Many cases of dropped gallstones will be...

Bile duct dilatation

Bile duct dilatation refers to the dilatation of intrahepatic or extrahepatic bile ducts. Clinical presentation Variable, depending on the underlying cause, but usually: right upper quadrant pain jaundice Radiographic features Ultrasound Harmonic imaging is useful when assessing the bilia...

Ultrasound appearances of hepatic metastases

Ultrasound appearance of hepatic metastases can have bewildering variation, and the presence of hepatic steatosis can affect the sonographic appearance of liver lesions. Radiographic features Ultrasound Patterns do exist between ultrasound appearance of the hepatic metastases and the likely p...

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