Diagnostic Ultrasound - Abdomen and Pelvis

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PART II SECTION 4 Spleen Introduction and Overview Approach to Splenic Sonography 394 Splenic Lesions Splenomegaly 400 Splenic Cyst 404 Splenic Tumors 408 Splenic Infarct 414
Approach to Splenic Sonography 394 Diagnoses: Spleen Transducer Selection Similar to other intraabdominal organs, the spleen is best imaged using a 3-5 MHz curvilinear transducer. A curvilinear (or curved) transducer is preferred due to its larger area of coverage (suitable to include the entire span of the spleen), as compared to a sector (vector) transducer or linear array transducer. Finding an Acoustic Window The spleen is an intraperitoneal organ of variable size and morphology that occupies the left upper quadrant. The anatomy of the spleen and its relationships to adjacent organs are discussed in a separate chapter. Visualization of the spleen in the left upper quadrant is challenged by several anatomic factors, chiefly artifacts caused by the ribs, the left lung, the splenic flexure of the colon, and the stomach. The positioning of both the transducer and the patient will play a role in optimizing the acoustic window. An anterior subcostal approach may be attempted in the supine position, though such an approach is often limited due to bowel gas artifact from the colon &/or the stomach. When this view can be successfully achieved, it will often require an anterolateral oblique positioning of the transducer. Occasionally, patients may have variant liver anatomy in which the left hepatic lobe extends far across midline to the left upper quadrant. In this setting, the left hepatic lobe may serve as an acoustic window to visualize the spleen. A posterior approach is of little utility, limited by the anatomy of the lungs and diaphragm, which extend most caudally at this site. A lateral or posterolateral intercostal approach, with transducer parallel to the ribs and the patient in the supine or right lateral decubitus (i.e., left-side up) position, provides the best acoustic window for the spleen. The 10th to 11th rib intercostal space is an ideal place to start. The 9th to 10th rib intercostal space may also yield a satisfactory window. Several other techniques may aid in visualization of the spleen. Positioning the patient in the supine or right lateral decubitus positions has already been discussed. Note, however, the right lateral decubitus position may cause the spleen to fall away from the chest and abdominal wall, reducing visualization of the organ from an intercostal approach. Having the patient fast prior to the ultrasound examination may reduce gaseous distension of the stomach in the left upper quadrant. This may not be possible in the emergency setting, but can be feasible in the outpatient setting. During the ultrasound examination, asking the patient to perform deep inspiration (to bring the spleen down into the field of view) is a useful technique. Experimenting with different degrees of inspiration or expiration (partial or complete) with breath hold may improve visualization. Anatomic Orientation and Imaging Planes The posterolateral intercostal approach is the favored acoustic window of most sonographers and radiologists. Because of the orientation of the ribs, an intercostal approach effectively provides an oblique plane with respect to the standard x, y, and z anatomical planes of the body (i.e., the axial, coronal, and sagittal planes). Fortunately, because the anatomic orientation of the spleen is variable and may itself lie obliquely compared to the standard anatomical planes, this posterolateral oblique view is well-suited to identify the long axis of the spleen. By standard convention, this anatomically oblique plane is referred to as the "longitudinal" plane of the spleen (often abbreviated "long"). When the transducer orientation is flipped by 180°, this is, by convention, referred to as the "transverse" plane of the spleen (often abbreviated "trans"). Note that the conventional "longitudinal" and "transverse" planes of the spleen via the posterolateral intercostal approach are not perpendicular views; rather, they are mirror images of each other. The true transverse cross section of the spleen would be pie- or oval-shaped, rather than crescentshaped (as is seen in the longitudinal cross section). A true transverse image of the spleen could be obtained either by a 90° rotation of the transducer in the intercostal approach (a view that is limited by the orientation of the ribs) or from an oblique anterior subcostal approach (which is often limited by bowel gas artifact). Because of both the transducer orientation and the spleen's anatomic orientation, the conventional "longitudinal spleen" view (truly a longitudinal oblique) does not correspond directly to the traditional coronal or sagittal planes of CT or MR. Likewise, the conventional "transverse spleen" view does not correspond directly to the axial plane of CT or MR. In a similar regard, the "longitudinal spleen" view and the "longitudinal left kidney" view will not represent the same anatomic plane in the same patient, as these planes are "longitudinal" to the organs of interest, not the patient's body. Understanding the difference between imaging planes and anatomic planes also has important implications for the measurement of spleen size. By convention, the splenic length is measured as the greatest dimension in the "longitudinal" view. Splenic thickness is measured from the hilum to outer capsule on the "transverse" view (though it would be the same measurement on the "longitudinal" view). Splenic width is generally considered the greatest dimension on the "transverse" view, but because of the discrepancies in imaging and anatomic planes, the sonographic splenic width based on the conventional transverse view and the true splenic width (most accurately measured by CT or MR) are not synonymous. The maximum splenic dimension on the conventional longitudinal and transverse views are, in actuality, the same measurement. Routine Evaluation of Spleen The standard evaluation of the spleen involves both grayscale and color Doppler interrogation. On grayscale ultrasound, the size, echotexture, and overall morphology of the spleen should be documented. As previously described, the size may be documented in terms of the length and thickness (and less accurately, the width, as described previously). The presence or absence of perisplenic fluid should also be noted. Routine evaluation of the splenic vein is an important component of a thorough sonographic exam of the spleen. The splenic vein can be assessed in two locations: at the splenic hilum and at midline, posterior to the pancreas. Proper interrogation of the splenic vein involves evaluating for vessel patency and ensuring flow is appropriately directed away from the spleen, toward the liver (hepatopetal flow). Splenic vein flow may be reversed, for example, in the setting of chronic portal hypertension. The splenic artery is often not part of routine splenic evaluation, but should be included when assessing for causes of splenic infarction or other vascular abnormalities of the spleen. Like the vein, the splenic artery can be assessed at the
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Diagnostic Ultrasound
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Diagnostic Ultrasound Aya Kamaya, M
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Dedications To my sweet and support
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Asef Khwaja, MD Assistant Professor
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Preface
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Acknowledgements Text Editors Nina
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Sections PART I - Anatomy SECTION 1
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TABLE OF CONTENTS VASCULAR CONDITIO
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TABLE OF CONTENTS 562 Perigraft Flu
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TABLE OF CONTENTS 906 Hyperechoic G
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Diagnostic Ultrasound
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PART I SECTION 1 Abdomen Liver 4 Bi
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Liver ○ Appear as echolucent defe
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Liver Coronary ligament HEPATIC ATT
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Liver Segment 8 HEPATIC SEGMENTS Se
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Liver Rectus abdominis muscle LEFT
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Liver Abdominal muscle LEFT LOBE OF
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Liver Anterior right portal vein RI
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Liver PORTA HEPATIS Anatomy: Abdome
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Liver Inferior liver margin OTHER V
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Biliary System • Harmonic imaging
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Biliary System Left hepatic duct Ri
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Biliary System Right rectus muscle
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Biliary System COMMON BILE DUCT Ana
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Biliary System LEFT INTRAHEPATIC DU
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Spleen SPLEEN ANATOMY AND HISTOLOGY
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Spleen Fat in splenic hilum Left he
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Spleen SPLENIC VESSELS Anatomy: Abd
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Spleen Splenosis ANATOMICAL VARIANT
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Pancreas PANCREAS IN SITU Anatomy:
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Pancreas PANCREAS, TRANSVERSE VIEW
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Pancreas Left lobe of liver PANCREA
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Kidneys - Normal peak systolic velo
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Kidneys KIDNEY ARTERIES AND INTERIO
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Kidneys RENAL FASCIA AND PERIRENAL
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Kidneys Right hemidiaphragm RIGHT K
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Kidneys RIGHT KIDNEY, CT CORRELATIO
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Kidneys Right erector spinae muscle
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Kidneys RIGHT INTRARENAL ARTERY AND
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Kidneys LEFT KIDNEY, CT CORRELATION
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Kidneys LEFT KIDNEY, CT CORRELATION
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Kidneys Subcutaneous fat Left latis
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Kidneys LEFT MAIN RENAL ARTERY AND
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Kidneys Right lobe of liver MULTIPL
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Bowel - Forms an incomplete ring in
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Bowel Falciform ligament STOMACH AN
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Bowel SMALL INTESTINE Anatomy: Abdo
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Bowel Abdominal wall STOMACH Anatom
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Bowel Rectus muscle SMALL BOWEL Ana
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Bowel Abdominal wall musculature Ce
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Bowel LARGE BOWEL Abdominal wall mu
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Bowel Urinary bladder RECTOSIGMOID
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Abdominal Lymph Nodes RETROPERITONE
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Abdominal Lymph Nodes LYMPHANGIOGRA
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Peritoneal Spaces and Structures PE
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Peritoneal Spaces and Structures PE
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Peritoneal Spaces and Structures Li
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Peritoneal Spaces and Structures IN
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Abdominal Wall ANTERIOR ABDOMINAL W
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Abdominal Wall MUSCLES OF BACK IN S
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Abdominal Wall Subcutaneous fat Rig
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Abdominal Wall Right lobe of liver
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Abdominal Wall Right rectus abdomin
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Abdominal Wall Subcutaneous fat Rig
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PART I SECTION 2 Pelvis Ureters and
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Ureters and Bladder - Distended bla
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Ureters and Bladder URINARY BLADDER
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Ureters and Bladder CT UROGRAM CORR
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Ureters and Bladder Liver URETER An
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Ureters and Bladder WEIGERT-MEYER L
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Prostate ○ Sac-like structures su
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Prostate ZONAL ANATOMY OF THE PROST
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Prostate SEMINAL VESICLES AND VAS D
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Prostate PROSTATE ANATOMY Anatomy:
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Testes ○ Internal oblique muscle
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Testes EPIDIDYMIS AND SCROTAL WALL
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Testes TESTIS, SAGITTAL VIEW Anatom
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Testes Scrotal wall EPIDIDYMIS, HEA
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Testes TESTICULAR AND EPIDIDYMAL AP
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Testes ARTERIAL AND VENOUS SUPPLY A
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Uterus ARTERIES OF UTERUS AND ADJAC
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Uterus NORMAL VARIATIONS, UTERINE P
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Uterus UTERINE VARIATIONS WITH AGE
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Uterus CYCLIC CHANGES OF ENDOMETRIU
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Uterus FALLOPIAN TUBE Anatomy: Pelv
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Cervix GRAPHICS OF CERVIX ANATOMY A
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Cervix TRANSVAGINAL ULTRASOUND OF C
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Cervix CHANGES OF CERVIX DURING PRE
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Vagina GRAPHICS OF NORMAL VAGINAL A
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Vagina Urinary bladder TRANSVERSE U
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Vagina SPECTRAL WAVEFORM OF VAGINAL
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Ovaries Mesosalpinx LIGAMENTOUS SUP
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Ovaries Transvaginal transducer NOR
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Ovaries Ovarian artery SPECTRAL WAV
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Ovaries CYCLIC CHANGES OF OVARY Ana
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Ovaries CYCLIC CHANGES OF INTRAOVAR
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Liver Transplant Hepatic Artery Ste
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Approach to Hepatic Sonography (Lef
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Approach to Hepatic Sonography (Lef
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Acute Hepatitis TERMINOLOGY Definit
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Acute Hepatitis (Left) Transverse g
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Hepatic Cirrhosis TERMINOLOGY Defin
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Hepatic Cirrhosis (Left) Longitudin
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Hepatic Steatosis TERMINOLOGY Synon
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Hepatic Steatosis (Left) Transverse
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Hepatic Schistosomiasis TERMINOLOGY
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Venoocclusive Disease TERMINOLOGY A
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Venoocclusive Disease (Left) Graysc
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Hepatic Cyst TERMINOLOGY Synonyms
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Hepatic Cyst (Left) Transverse and
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Biliary Hamartoma TERMINOLOGY Synon
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Biliary Hamartoma (Left) Ultrasound
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Caroli Disease TERMINOLOGY Synonyms
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Caroli Disease (Left) Oblique abdom
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Biloma TERMINOLOGY Definitions •
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Biliary Cystadenoma/Carcinoma TERMI
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Biliary Cystadenoma/Carcinoma (Left
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Pyogenic Hepatic Abscess TERMINOLOG
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Pyogenic Hepatic Abscess (Left) Obl
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Amebic Hepatic Abscess TERMINOLOGY
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Amebic Hepatic Abscess (Left) Longi
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Hepatic Echinococcus Cyst TERMINOLO
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Hepatic Echinococcus Cyst (Left) Ob
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Hepatic Diffuse Microabscesses TERM
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Peribiliary Cyst TERMINOLOGY Synony
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Ciliated Hepatic Foregut Cyst TERMI
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Hepatic Cavernous Hemangioma TERMIN
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Hepatic Cavernous Hemangioma (Left)
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Hepatic Cavernous Hemangioma (Left)
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Focal Nodular Hyperplasia TERMINOLO
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Focal Nodular Hyperplasia (Left) Tr
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Hepatic Adenoma TERMINOLOGY Synonym
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Hepatic Adenoma (Left) Transverse t
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Hepatocellular Carcinoma TERMINOLOG
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Hepatocellular Carcinoma (Left) Tra
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Hepatocellular Carcinoma (Left) Tra
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Hepatic Metastases TERMINOLOGY Defi
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Hepatic Metastases (Left) Transvers
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Hepatic Lymphoma TERMINOLOGY Defini
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Hepatic Lymphoma (Left) Transverse
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Transjugular Intrahepatic Portosyst
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Transjugular Intrahepatic Portosyst
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Portal Vein Occlusion TERMINOLOGY A
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Portal Vein Occlusion (Left) Color
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Budd-Chiari Syndrome TERMINOLOGY Ab
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Budd-Chiari Syndrome (Left) Color D
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Portal Vein Gas TERMINOLOGY Abbrevi
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Liver Transplant Portal Vein Stenos
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Liver Transplant Biliary Stricture
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PART II SECTION 2 Biliary System In
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Approach to Biliary Sonography hosp
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Approach to Biliary Sonography (Lef
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Approach to Biliary Sonography (Lef
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Cholelithiasis TERMINOLOGY Synonyms
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Cholelithiasis (Left) Longitudinal
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Cholelithiasis (Left) Abdominal rad
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Echogenic Bile TERMINOLOGY Synonyms
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Echogenic Bile (Left) Transverse ul
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Gallbladder Cholesterol Polyp TERMI
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Gallbladder Cholesterol Polyp (Left
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Acute Calculous Cholecystitis TERMI
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Acute Calculous Cholecystitis (Left
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Acute Acalculous Cholecystitis TERM
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Acute Acalculous Cholecystitis (Lef
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Chronic Cholecystitis TERMINOLOGY D
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Xanthogranulomatous Cholecystitis T
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Porcelain Gallbladder TERMINOLOGY A
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Hyperplastic Cholecystosis (Adenomy
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Hyperplastic Cholecystosis (Adenomy
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Gallbladder Carcinoma TERMINOLOGY A
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Gallbladder Carcinoma (Left) Sagitt
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Biliary Ductal Dilatation IMAGING G
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Choledochal Cyst TERMINOLOGY Synony
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Choledochal Cyst (Left) Longitudina
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Choledocholithiasis TERMINOLOGY Abb
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Choledocholithiasis (Left) A single
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Biliary Ductal Gas TERMINOLOGY Syno
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Cholangiocarcinoma TERMINOLOGY Syno
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Cholangiocarcinoma (Left) Ultrasoun
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Ascending Cholangitis TERMINOLOGY S
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Ascending Cholangitis (Left) Longit
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Page 368 and 369: AIDS-Related Cholangiopathy TERMINO
Page 370 and 371: PART II SECTION 3 Pancreas Introduc
Page 372 and 373: Approach to Pancreatic Sonography C
Page 374 and 375: Approach to Pancreatic Sonography (
Page 376 and 377: Acute Pancreatitis TERMINOLOGY Abbr
Page 378 and 379: Acute Pancreatitis (Left) Transvers
Page 380 and 381: Pancreatic Pseudocyst TERMINOLOGY D
Page 382 and 383: Pancreatic Pseudocyst (Left) Transv
Page 384 and 385: Chronic Pancreatitis TERMINOLOGY Ab
Page 386 and 387: Chronic Pancreatitis (Left) Transve
Page 388 and 389: Mucinous Cystic Pancreatic Tumor TE
Page 390 and 391: Mucinous Cystic Pancreatic Tumor (L
Page 392 and 393: Serous Cystadenoma of Pancreas TERM
Page 394 and 395: Serous Cystadenoma of Pancreas (Lef
Page 396 and 397: Intraductal Papillary Mucinous Neop
Page 402 and 403: Pancreatic Ductal Carcinoma TERMINO
Page 404 and 405: Pancreatic Ductal Carcinoma (Left)
Page 406 and 407: Pancreatic Neuroendocrine Tumor TER
Page 408 and 409: Pancreatic Neuroendocrine Tumor (Le
Page 410 and 411: Solid Pseudopapillary Neoplasm TERM
Page 412 and 413: Solid Pseudopapillary Neoplasm (Lef
Page 416 and 417: Approach to Splenic Sonography sple
Page 418 and 419: Approach to Splenic Sonography (Lef
Page 420 and 421: Approach to Splenic Sonography (Lef
Page 422 and 423: Splenomegaly TERMINOLOGY Abbreviati
Page 424 and 425: Splenomegaly (Left) US in a 92-year
Page 426 and 427: Splenic Cyst TERMINOLOGY Definition
Page 428 and 429: Splenic Cyst (Left) Grayscale US of
Page 430 and 431: Splenic Tumors TERMINOLOGY Definiti
Page 432 and 433: Splenic Tumors (Left) Longitudinal
Page 434 and 435: Splenic Tumors (Left) A solid, hypo
Page 436 and 437: Splenic Infarct TERMINOLOGY Abbrevi
Page 438 and 439: Splenic Infarct (Left) Power Dopple
Page 440 and 441: Vascular Conditions Renal Artery St
Page 442 and 443: Approach to Urinary Tract Sonograph
Page 444 and 445: Approach to Urinary Tract Sonograph
Page 446 and 447: Column of Bertin, Kidney TERMINOLOG
Page 448 and 449: Renal Junction Line TERMINOLOGY Syn
Page 450 and 451: Renal Ectopia TERMINOLOGY Abbreviat
Page 452 and 453: Renal Ectopia (Left) Grayscale ultr
Page 454 and 455: Horseshoe Kidney TERMINOLOGY Defini
Page 456 and 457: Horseshoe Kidney (Left) Longitudina
Page 458 and 459: Ureteral Duplication TERMINOLOGY Sy
Page 460 and 461: Ureteral Duplication (Left) Longitu
Page 462 and 463: Ureteral Ectopia TERMINOLOGY Abbrev
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Ureteral Ectopia (Left) Coronal T2
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Ureteropelvic Junction Obstruction
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Ureteropelvic Junction Obstruction
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Urolithiasis TERMINOLOGY Abbreviati
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Urolithiasis (Left) Longitudinal US
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Urolithiasis (Left) Intravenous pye
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Nephrocalcinosis TERMINOLOGY Abbrev
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Nephrocalcinosis (Left) Coronal MIP
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Hydronephrosis TERMINOLOGY Synonyms
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Hydronephrosis (Left) Longitudinal
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Simple Renal Cyst TERMINOLOGY Defin
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Simple Renal Cyst (Left) Longitudin
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Complex Renal Cyst TERMINOLOGY Defi
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Complex Renal Cyst (Left) Transvers
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Cystic Disease of Dialysis TERMINOL
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Cystic Disease of Dialysis (Left) L
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Multilocular Cystic Nephroma TERMIN
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Acute Pyelonephritis TERMINOLOGY Ab
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Acute Pyelonephritis (Left) Longitu
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Renal Abscess TERMINOLOGY Definitio
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Emphysematous Pyelonephritis TERMIN
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Emphysematous Pyelonephritis (Left)
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Pyonephrosis TERMINOLOGY Definition
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Xanthogranulomatous Pyelonephritis
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Tuberculosis, Urinary Tract TERMINO
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Tuberculosis, Urinary Tract (Left)
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Renal Cell Carcinoma TERMINOLOGY Ab
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Renal Cell Carcinoma (Left) Longitu
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Renal Metastases IMAGING General Fe
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Renal Angiomyolipoma TERMINOLOGY Ab
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Renal Angiomyolipoma (Left) Longitu
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Upper Tract Urothelial Carcinoma TE
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Upper Tract Urothelial Carcinoma (L
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Renal Lymphoma TERMINOLOGY Abbrevia
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Renal Lymphoma (Left) Longitudinal
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Renal Artery Stenosis TERMINOLOGY A
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Renal Artery Stenosis (Left) Obliqu
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Renal Vein Thrombosis TERMINOLOGY A
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Renal Vein Thrombosis (Left) Longit
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Renal Infarct TERMINOLOGY Definitio
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Perinephric Hematoma TERMINOLOGY De
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Prostatic Hyperplasia TERMINOLOGY A
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Prostatic Hyperplasia (Left) Axial
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Prostatic Carcinoma TERMINOLOGY Abb
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Prostatic Carcinoma (Left) Transver
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Prostatic Carcinoma (Left) Transver
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Bladder Carcinoma TERMINOLOGY Defin
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Bladder Carcinoma (Left) Transverse
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Ureterocele TERMINOLOGY Definitions
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Ureterocele (Left) Transabdominal l
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Bladder Diverticulum TERMINOLOGY Ab
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Bladder Diverticulum (Left) Transab
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Bladder Calculi TERMINOLOGY Synonym
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Schistosomiasis, Bladder TERMINOLOG
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PART II SECTION 6 Kidney Transplant
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Approach to Sonography of Renal All
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Allograft Hydronephrosis TERMINOLOG
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Allograft Hydronephrosis (Left) Lon
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Perigraft Fluid Collections TERMINO
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Perigraft Fluid Collections (Left)
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Transplant Renal Artery Stenosis TE
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Transplant Renal Artery Stenosis (L
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Transplant Renal Artery Thrombosis
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Transplant Renal Vein Thrombosis TE
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Renal Transplant Arteriovenous (AV)
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Renal Transplant Pseudoaneurysm TER
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Renal Transplant Rejection IMAGING
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Delayed Renal Graft Function TERMIN
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PART II SECTION 7 Adrenal Gland Adr
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Adrenal Hemorrhage TERMINOLOGY Abbr
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Adrenal Hemorrhage (Left) Longitudi
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Myelolipoma TERMINOLOGY Definitions
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Myelolipoma (Left) Longitudinal US
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Adrenal Adenoma TERMINOLOGY Synonym
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Adrenal Adenoma (Left) Longitudinal
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Adrenal Cyst TERMINOLOGY Definition
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Pheochromocytoma TERMINOLOGY Defini
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Pheochromocytoma (Left) Longitudina
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Adrenal Carcinoma TERMINOLOGY Synon
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Adrenal Carcinoma (Left) Transverse
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PART II SECTION 8 Abdominal Wall/Pe
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Approach to Sonography of Abdominal
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Approach to Sonography of Abdominal
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Abdominal Wall Hernia TERMINOLOGY D
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Abdominal Wall Hernia (Left) Transv
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Abdominal Wall Hernia (Left) Transv
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Groin Hernia TERMINOLOGY Definition
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Groin Hernia (Left) Graphic shows a
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Groin Hernia (Left) Longitudinal ul
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Ascites TERMINOLOGY Definitions •
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Ascites (Left) Transverse ultrasoun
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Peritoneal Carcinomatosis TERMINOLO
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Peritoneal Carcinomatosis (Left) Lo
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Peritoneal Carcinomatosis (Left) Tr
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Peritoneal Space Abscess TERMINOLOG
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Peritoneal Space Abscess (Left) Tra
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Segmental Omental Infarction TERMIN
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PART II SECTION 9 Bowel Approach to
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Approach to Bowel Sonography Given
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Approach to Bowel Sonography (Left)
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Appendicitis TERMINOLOGY Definition
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Appendicitis (Left) Axial ultrasoun
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Appendicitis (Left) Axial ultrasoun
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Appendiceal Mucocele TERMINOLOGY De
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Appendiceal Mucocele (Left) Sagitta
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Intussusception TERMINOLOGY Definit
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Intussusception (Left) Transverse t
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Epiploic Appendagitis TERMINOLOGY A
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Epiploic Appendagitis (Left) Graysc
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Diverticulitis TERMINOLOGY Definiti
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Diverticulitis (Left) Acute diverti
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Crohn Disease TERMINOLOGY Synonyms
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Crohn Disease (Left) Long-axis ultr
Page 694 and 695:
Crohn Disease (Left) Long-axis ultr
Page 696 and 697:
Large Bowel Malignancy TERMINOLOGY
Page 698 and 699:
Large Bowel Malignancy (Left) Hepat
Page 700 and 701:
PART II SECTION 10 Scrotum Introduc
Page 702 and 703:
Approach to Scrotal Sonography (Lef
Page 704 and 705:
Testicular Germ Cell Tumors TERMINO
Page 706 and 707:
Testicular Germ Cell Tumors (Left)
Page 708 and 709:
Gonadal Stromal Tumors, Testis TERM
Page 710 and 711:
Gonadal Stromal Tumors, Testis (Lef
Page 712 and 713:
Testicular Lymphoma/Leukemia TERMIN
Page 714 and 715:
Epidermoid Cyst TERMINOLOGY Synonym
Page 716 and 717:
Tubular Ectasia of Rete Testis TERM
Page 718 and 719:
Testicular Microlithiasis TERMINOLO
Page 720 and 721:
Testicular Microlithiasis (Left) Tr
Page 722 and 723:
Testicular Torsion/Infarction TERMI
Page 724 and 725:
Testicular Torsion/Infarction (Left
Page 726 and 727:
Undescended Testis TERMINOLOGY Syno
Page 728 and 729:
Epididymitis/Orchitis TERMINOLOGY S
Page 730 and 731:
Epididymitis/Orchitis (Left) Sagitt
Page 732 and 733:
Scrotal Trauma TERMINOLOGY Definiti
Page 734 and 735:
Scrotal Trauma (Left) Transverse gr
Page 736 and 737:
Hydrocele TERMINOLOGY Definitions
Page 738 and 739:
Spermatocele/Epididymal Cyst TERMIN
Page 740 and 741:
Adenomatoid Tumor TERMINOLOGY Defin
Page 742 and 743:
Varicocele TERMINOLOGY Definitions
Page 744 and 745:
Non-Ovarian Cystic Masses Hydrosalp
Page 746 and 747:
Approach to Sonography of the Femal
Page 748 and 749:
Nabothian Cyst TERMINOLOGY Synonyms
Page 750 and 751:
Nabothian Cyst (Left) Longitudinal
Page 752 and 753:
Cervical Carcinoma IMAGING General
Page 754 and 755:
Cervical Carcinoma (Left) Longitudi
Page 756 and 757:
Cervical Carcinoma (Left) Longitudi
Page 758 and 759:
Adenomyosis TERMINOLOGY Synonyms
Page 760 and 761:
Adenomyosis (Left) Longitudinal tra
Page 762 and 763:
Leiomyoma TERMINOLOGY Abbreviations
Page 764 and 765:
Leiomyoma (Left) Transvaginal ultra
Page 766 and 767:
Leiomyoma (Left) Transverse transab
Page 768 and 769:
Uterine Anomalies TERMINOLOGY Abbre
Page 770 and 771:
Uterine Anomalies (Left) 3D ultraso
Page 772 and 773:
Uterine Anomalies (Left) Graphic of
Page 774 and 775:
Hematometrocolpos TERMINOLOGY Abbre
Page 776 and 777:
Hematometrocolpos (Left) Transverse
Page 778 and 779:
Endometrial Polyp TERMINOLOGY Abbre
Page 780 and 781:
Endometrial Polyp (Left) Longitudin
Page 782 and 783:
Endometrial Polyp (Left) Transabdom
Page 784 and 785:
Endometrial Carcinoma TERMINOLOGY A
Page 786 and 787:
Endometrial Carcinoma (Left) Longit
Page 788 and 789:
Endometritis TERMINOLOGY Synonyms
Page 790 and 791:
Endometritis (Left) Longitudinal tr
Page 792 and 793:
Intrauterine Device TERMINOLOGY Abb
Page 794 and 795:
Intrauterine Device (Left) Longitud
Page 796 and 797:
Tubal Ectopic Pregnancy TERMINOLOGY
Page 798 and 799:
Tubal Ectopic Pregnancy (Left) Tran
Page 800 and 801:
Tubal Ectopic Pregnancy (Left) Sagi
Page 802 and 803:
Unusual Ectopic Pregnancies TERMINO
Page 804 and 805:
Unusual Ectopic Pregnancies (Left)
Page 806 and 807:
Unusual Ectopic Pregnancies (Left)
Page 808 and 809:
Failed First Trimester Pregnancy TE
Page 810 and 811:
Failed First Trimester Pregnancy (L
Page 812 and 813:
Failed First Trimester Pregnancy (L
Page 814 and 815:
Retained Products of Conception TER
Page 816 and 817:
Retained Products of Conception (Le
Page 818 and 819:
Gestational Trophoblastic Disease T
Page 820 and 821:
Gestational Trophoblastic Disease (
Page 822 and 823:
Functional Ovarian Cyst TERMINOLOGY
Page 824 and 825:
Functional Ovarian Cyst (Left) Typi
Page 826 and 827:
Hemorrhagic Cyst TERMINOLOGY Abbrev
Page 828 and 829:
Hemorrhagic Cyst (Left) Using color
Page 830 and 831:
Ovarian Hyperstimulation Syndrome T
Page 832 and 833:
Ovarian Hyperstimulation Syndrome (
Page 834 and 835:
Serous Ovarian Cystadenoma/Carcinom
Page 836 and 837:
Serous Ovarian Cystadenoma/Carcinom
Page 838 and 839:
Mucinous Ovarian Cystadenoma/Carcin
Page 840 and 841:
Mucinous Ovarian Cystadenoma/Carcin
Page 842 and 843:
Ovarian Teratoma TERMINOLOGY Synony
Page 844 and 845:
Ovarian Teratoma (Left) Ultrasound
Page 846 and 847:
Polycystic Ovarian Syndrome TERMINO
Page 848 and 849:
Endometrioma TERMINOLOGY Synonyms
Page 850 and 851:
Endometrioma (Left) Longitudinal en
Page 852 and 853:
Hydrosalpinx TERMINOLOGY Definition
Page 854 and 855:
Hydrosalpinx (Left) Longitudinal tr
Page 856 and 857:
Tubo-Ovarian Abscess TERMINOLOGY De
Page 858 and 859:
Tubo-Ovarian Abscess (Left) Longitu
Page 860 and 861:
Parovarian Cyst TERMINOLOGY Abbrevi
Page 862 and 863:
Peritoneal Inclusion Cyst TERMINOLO
Page 864 and 865:
Peritoneal Inclusion Cyst (Left) Sa
Page 866 and 867:
Bartholin Cyst TERMINOLOGY Definiti
Page 868 and 869:
Gartner Duct Cyst TERMINOLOGY Abbre
Page 870 and 871:
Gartner Duct Cyst (Left) Longitudin
Page 872 and 873:
Sex Cord-Stromal Tumor TERMINOLOGY
Page 874 and 875:
Sex Cord-Stromal Tumor (Left) Trans
Page 876 and 877:
Sex Cord-Stromal Tumor (Left) Sagit
Page 878 and 879:
Adnexal/Ovarian Torsion TERMINOLOGY
Page 880 and 881:
Adnexal/Ovarian Torsion (Left) Long
Page 882 and 883:
Ovarian Metastases Including Kruken
Page 884 and 885:
Ovarian Metastases Including Kruken
Page 886 and 887:
PART III SECTION 1 Liver Hepatomega
Page 888 and 889:
Hepatomegaly - Firm consistency (du
Page 890 and 891:
Hepatomegaly Lymphoma Lymphoma (Lef
Page 892 and 893:
Diffuse Liver Disease Acute/Chronic
Page 894 and 895:
Cystic Liver Lesion ○ May be soli
Page 896 and 897:
Cystic Liver Lesion Peribiliary Cys
Page 898 and 899:
Hypoechoic Liver Mass - Adjacent he
Page 900 and 901:
Hypoechoic Liver Mass Infected Bilo
Page 902 and 903:
Echogenic Liver Mass • Fibrolamel
Page 904 and 905:
Echogenic Liver Mass Hepatic Ligame
Page 906 and 907:
Target Lesions in Liver Hepatic Met
Page 908 and 909:
Multiple Hepatic Masses ○ Cluster
Page 910 and 911:
Multiple Hepatic Masses Cirrhosis W
Page 912 and 913:
Hepatic Mass With Central Scar Foca
Page 914 and 915:
Periportal Lesion Helpful Clues for
Page 916 and 917:
Periportal Lesion Peribiliary Cyst
Page 918 and 919:
Irregular Hepatic Surface Subcapsul
Page 920 and 921:
Portal Vein Abnormality Bland Porta
Page 922 and 923:
PART III SECTION 2 Biliary System
Page 924 and 925:
Diffuse Gallbladder Wall Thickening
Page 926 and 927:
Diffuse Gallbladder Wall Thickening
Page 928 and 929:
Hyperechoic Gallbladder Wall Porcel
Page 930 and 931:
Focal Gallbladder Wall Thickening/M
Page 932 and 933:
Echogenic Material in Gallbladder S
Page 934 and 935:
Dilated Gallbladder ○ Distended n
Page 936 and 937:
Dilated Gallbladder Mucocele/Hydrop
Page 938 and 939:
Intrahepatic and Extrahepatic Duct
Page 940 and 941:
PART III SECTION 3 Pancreas Cystic
Page 942 and 943:
Cystic Pancreatic Lesion Helpful Cl
Page 944 and 945:
Cystic Pancreatic Lesion Mucinous C
Page 946 and 947:
Solid Pancreatic Lesion ○ Usually
Page 948 and 949:
Solid Pancreatic Lesion Serous Cyst
Page 950 and 951:
Pancreatic Duct Dilatation Chronic
Page 952 and 953:
PART III SECTION 4 Spleen Focal Spl
Page 954 and 955:
Focal Splenic Lesion - Typically mu
Page 956 and 957:
Focal Splenic Lesion Pyogenic Absce
Page 958 and 959:
Focal Splenic Lesion Splenic Infarc
Page 960 and 961:
PART III SECTION 5 Urinary Tract 9
Page 962 and 963:
Intraluminal Bladder Mass Bladder C
Page 964 and 965:
Abnormal Bladder Wall □ Uterine c
Page 966 and 967:
Abnormal Bladder Wall Invasion by P
Page 968 and 969:
PART III SECTION 6 Kidney Enlarged
Page 970 and 971:
Enlarged Kidney - Nonneoplastic cau
Page 972 and 973:
Enlarged Kidney Perinephric Fluid C
Page 974 and 975:
Small Kidney ○ Pseudotumors from
Page 976 and 977:
Small Kidney Postobstructive Atroph
Page 978 and 979:
Hypoechoic Kidney • Multiple Myel
Page 980 and 981:
Hypoechoic Kidney Acute Renal Arter
Page 982 and 983:
Hyperechoic Kidney ○ Echogenic co
Page 984 and 985:
Hyperechoic Kidney Chronic Glomerul
Page 986 and 987:
Cystic Renal Mass ○ Associated wi
Page 988 and 989:
Cystic Renal Mass Multicystic Dyspl
Page 990 and 991:
Solid Renal Mass • Horseshoe Kidn
Page 992 and 993:
Solid Renal Mass Renal Lymphoma Ren
Page 994 and 995:
Renal Pseudotumor Column of Bertin
Page 996 and 997:
Dilated Renal Pelvis • Intrarenal
Page 998 and 999:
Dilated Renal Pelvis Pyonephrosis P
Page 1000 and 1001:
PART III SECTION 7 Abdominal Wall/P
Page 1002 and 1003:
Diffuse Peritoneal Fluid Hemoperito
Page 1004 and 1005:
Solid Peritoneal Mass - Higher dens
Page 1006 and 1007:
Solid Peritoneal Mass Mimics Benign
Page 1008 and 1009:
Cystic Peritoneal Mass ○ Women of
Page 1010 and 1011:
Cystic Peritoneal Mass Pseudomyxoma
Page 1012 and 1013:
PART III SECTION 8 Prostate Enlarge
Page 1014 and 1015:
Enlarged Prostate Benign Prostatic
Page 1016 and 1017:
Focal Lesion in Prostate ○ Variab
Page 1018 and 1019:
Focal Lesion in Prostate Müllerian
Page 1020 and 1021:
PART III SECTION 9 Bowel Bowel Wall
Page 1022 and 1023:
Bowel Wall Thickening - Distal ileu
Page 1024 and 1025:
Bowel Wall Thickening Crohn Disease
Page 1026 and 1027:
Bowel Wall Thickening Clostridium D
Page 1028 and 1029:
PART III SECTION 10 Scrotum 1008
Page 1030 and 1031:
Diffuse Testicular Enlargement Test
Page 1032 and 1033:
Decreased Testicular Size Testicula
Page 1034 and 1035:
Testicular Calcifications Sertoli C
Page 1036 and 1037:
Focal Testicular Mass - Most common
Page 1038 and 1039:
Focal Testicular Mass Testicular Ly
Page 1040 and 1041:
Focal Extratesticular Mass - 3-50 m
Page 1042 and 1043:
Focal Extratesticular Mass Inguinal
Page 1044 and 1045:
Focal Extratesticular Mass Liposarc
Page 1046 and 1047:
Extratesticular Cystic Mass Varicoc
Page 1048 and 1049:
PART III SECTION 11 Female Pelvis
Page 1050 and 1051:
Cystic Adnexal Mass □ Hemorrhagic
Page 1052 and 1053:
Cystic Adnexal Mass Dermoid (Mature
Page 1054 and 1055:
Solid Adnexal Mass - May masquerade
Page 1056 and 1057:
Solid Adnexal Mass Fibrothecoma Hem
Page 1058 and 1059:
Extraovarian Adnexal Mass Helpful C
Page 1060 and 1061:
Extraovarian Adnexal Mass Paraovari
Page 1062 and 1063:
Extraovarian Adnexal Mass Lymph Nod
Page 1064 and 1065:
Enlarged Ovary - Often bilateral (5
Page 1066 and 1067:
Enlarged Ovary Theca Lutein Cysts T
Page 1068 and 1069:
Enlarged Uterus Leiomyoma Adenomyos
Page 1070 and 1071:
Abnormal Endometrium ○ Multiple e
Page 1072 and 1073:
Abnormal Endometrium Pregnancy and
Page 1074 and 1075:
Abnormal Endometrium Tamoxifen-Indu
Page 1076 and 1077:
INDEX A Abdominal aorta, 34, 40, 42
Page 1078 and 1079:
INDEX - myelolipoma vs., 590 - stag
Page 1080 and 1081:
INDEX Biliary cyst. See Choledochal
Page 1082 and 1083:
INDEX Caroli disease, 204-207 - bil
Page 1084 and 1085:
INDEX - solid renal mass vs., 968 -
Page 1086 and 1087:
INDEX diagnostic checklist, 839 dif
Page 1088 and 1089:
INDEX Efferent ductules, 130 Ejacul
Page 1090 and 1091:
INDEX Focal myometrial contraction
Page 1092 and 1093:
INDEX - hydrocele vs., 715 - sperma
Page 1094 and 1095:
INDEX Hepatocellular carcinoma (HCC
Page 1096 and 1097:
INDEX Inflammatory pseudotumor, sol
Page 1098 and 1099:
INDEX - focal extratesticular mass
Page 1100 and 1101:
INDEX irregular hepatic surface vs.
Page 1102 and 1103:
INDEX Normal postpartum, enlarged u
Page 1104 and 1105:
INDEX Pararenal fat, posterior, 64
Page 1106 and 1107:
INDEX - inflammatory, gallbladder c
Page 1108 and 1109:
INDEX Pyelogenic cyst - dilated ren
Page 1110 and 1111:
INDEX Renal infection - renal lymph
Page 1112 and 1113:
INDEX - macrocystic variant, mucino
Page 1114 and 1115:
INDEX - right, 92 lesser sac, 93 Su
Page 1116 and 1117:
INDEX Tunica albuginea cyst - calci
Page 1118:
INDEX X Xanthogranulomatous cholecy
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Diagnostic Ultrasound - Abdomen and Pelvis

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