Diagnostic Ultrasound - Abdomen and Pelvis

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Spleen Splenosis ANATOMICAL VARIANTS Intercostal muscle Anatomy: Abdomen Left kidney Pancreatic tail Superior pole of left kidney Splenosis Splenic cyst Ascites Left-sided liver Right-sided spleen (Top) Longitudinal oblique intercostal grayscale ultrasound through the left upper quadrant shows a round hypoechoic structure adjacent to the upper pole of the left kidney; this represents splenosis. (Middle) Correlative axial CECT through the left upper quadrant in a patient with prior splenic trauma and splenectomy shows residual splenosis. (Bottom) Transverse anterior ultrasound in the setting of heterotaxy with polysplenia demonstrates the relationship between the right-sided spleen and the left-sided liver. 37
Pancreas 38 Anatomy: Abdomen GROSS ANATOMY Overview • Pancreas: Accessory digestive gland lying in retroperitoneum behind stomach ○ Exocrine function: Pancreatic acinar cells secrete pancreatic juice → pancreatic duct → duodenum ○ Endocrine: Pancreatic islet cells (of Langerhans) secrete insulin, glucagon, and other polypeptides → portal venous system Divisions • Head: Thickest part; lies to right of superior mesenteric artery and vein (SMA, SMV) ○ Attached to "C" loop of duodenum (2nd & 3rd parts) ○ Uncinate process: Head extension, posterior to SMV ○ Bile duct lies along posterior surface of head, joins with pancreatic duct (of Wirsung) to form hepatopancreatic ampulla (of Vater) ○ Main pancreatic and bile ducts empty into major papilla in 2nd portion of duodenum • Neck: Thinnest part; lies anterior to SMA, SMV ○ SMV joins splenic vein behind pancreatic neck to form portal vein • Body: Main part; lies to left of SMA, SMV ○ Splenic vein lies in groove on posterior surface of body ○ Anterior surface is covered with peritoneum forming back surface of omental bursa (lesser sac) • Tail: Lies between layers of splenorenal ligament in splenic hilum Internal Structures • Pancreatic duct (of Wirsung) runs length of pancreas, turning inferiorly through head to join bile duct • Accessory pancreatic duct (of Santorini) opens into duodenum at minor duodenal papilla ○ Usually communicates with main pancreatic duct ○ Variations are common, including a dominant accessory duct draining most pancreatic juice • Vessels, nerves, and lymphatics ○ Arteries to head mainly from gastroduodenal artery – Pancreaticoduodenal arcade of vessels around head also supplied by SMA branches ○ Arteries to body & tail from splenic artery ○ Veins are tributaries of SMV and splenic vein → portal vein ○ Autonomic nerves from celiac and superior mesenteric plexus – Parasympathetic stimulation of pancreatic secretion, but pancreatic juice secretion is mostly under hormonal control (secretin, from duodenum) ○ Lymphatics follow blood vessels – Collect in splenic, celiac, superior mesenteric and hepatic nodes IMAGING ANATOMY Overview • Pancreas can be localized on ultrasound by ○ Typical parenchymal architecture: Homogeneously isoechoic/hyperechoic echo pattern when compared with overlying liver ○ Surrounding anatomical landmarks: Body anterior to splenic vein; neck anterior to SMA/SMV • Variations in reflectivity related to degree of fatty infiltration; uncinate process and posterior pancreatic head are relatively echo-poor in 25% of subjects (lack of intraparenchymal fat) ANATOMY IMAGING ISSUES Imaging Recommendations • Use 2-5 MHz transducers, or up to 9 MHz for smaller patients • Techniques to combat overlying stomach and bowel gas include ○ Displacement of intervening bowel gas by gentle firm graded compression with transducer ○ Overnight fasting or fasting > 6-8 hours ○ Non-effervescent fluid can be given orally to fill gastric fundus – Scanning delayed for a few minutes to allow fluid to settle – Patient can lie on left side to allow imaging of body and tail of pancreas – Patient can then be turned right to allow gastric fluid to flow to stomach antrum and duodenum, allowing imaging of head and uncinate process • CT is preferred imaging modality for imaging of pancreas • MRCP or ERCP useful for defining pancreatic duct Imaging Pitfalls • Ultrasound examination of pancreas is often limited by overlying bowel gas Key Concepts • Shape, size, and texture of pancreas are quite variable ○ Largest in young adults ○ Atrophy and fatty infiltration with age (> 70), obesity, diabetes, corticosteroids, Cushing disease ○ Pancreatic duct also becomes more prominent with age (normal < 3 mm diameter) ○ Focal bulge or mass effect is abnormal • Location behind lesser sac ○ Acute pancreatitis often results in lesser sac fluid (may mimic pseudocyst) • Pancreas lies in anterior pararenal space (APS) ○ Inflammation (from pancreatitis) easily spreads to duodenum and descending colon; also lie in APS ○ Inflammation easily spreads into mesentery and mesocolon; roots of these lie just ventral to pancreas • Obstruction of pancreatic duct ○ Relatively common result of chronic pancreatitis (fibrosis &/or stone occluding pancreatic duct), or pancreatic ductal carcinoma • Acute pancreatitis ○ Relatively common result of gallstone (lodged in hepatopancreatic ampulla causing bile to reflux into pancreas) or damage from alcohol abuse
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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
Page 8 and 9: Asef Khwaja, MD Assistant Professor
Page 10 and 11: Preface
Page 12 and 13: Acknowledgements Text Editors Nina
Page 14 and 15: Sections PART I - Anatomy SECTION 1
Page 16 and 17: TABLE OF CONTENTS VASCULAR CONDITIO
Page 18 and 19: TABLE OF CONTENTS 562 Perigraft Flu
Page 20 and 21: TABLE OF CONTENTS 906 Hyperechoic G
Page 22 and 23: Diagnostic Ultrasound
Page 24 and 25: PART I SECTION 1 Abdomen Liver 4 Bi
Page 26 and 27: Liver ○ Appear as echolucent defe
Page 28 and 29: Liver Coronary ligament HEPATIC ATT
Page 30 and 31: Liver Segment 8 HEPATIC SEGMENTS Se
Page 32 and 33: Liver Rectus abdominis muscle LEFT
Page 34 and 35: Liver Abdominal muscle LEFT LOBE OF
Page 36 and 37: Liver Anterior right portal vein RI
Page 38 and 39: Liver PORTA HEPATIS Anatomy: Abdome
Page 40 and 41: Liver Inferior liver margin OTHER V
Page 42 and 43: Biliary System • Harmonic imaging
Page 44 and 45: Biliary System Left hepatic duct Ri
Page 46 and 47: Biliary System Right rectus muscle
Page 48 and 49: Biliary System COMMON BILE DUCT Ana
Page 50 and 51: Biliary System LEFT INTRAHEPATIC DU
Page 52 and 53: Spleen SPLEEN ANATOMY AND HISTOLOGY
Page 54 and 55: Spleen Fat in splenic hilum Left he
Page 56 and 57: Spleen SPLENIC VESSELS Anatomy: Abd
Page 60 and 61: Pancreas PANCREAS IN SITU Anatomy:
Page 62 and 63: Pancreas PANCREAS, TRANSVERSE VIEW
Page 64 and 65: Pancreas Left lobe of liver PANCREA
Page 66 and 67: Kidneys - Normal peak systolic velo
Page 68 and 69: Kidneys KIDNEY ARTERIES AND INTERIO
Page 70 and 71: Kidneys RENAL FASCIA AND PERIRENAL
Page 72 and 73: Kidneys Right hemidiaphragm RIGHT K
Page 74 and 75: Kidneys RIGHT KIDNEY, CT CORRELATIO
Page 76 and 77: Kidneys Right erector spinae muscle
Page 78 and 79: Kidneys RIGHT INTRARENAL ARTERY AND
Page 80 and 81: Kidneys LEFT KIDNEY, CT CORRELATION
Page 82 and 83: Kidneys LEFT KIDNEY, CT CORRELATION
Page 84 and 85: Kidneys Subcutaneous fat Left latis
Page 86 and 87: Kidneys LEFT MAIN RENAL ARTERY AND
Page 88 and 89: Kidneys Right lobe of liver MULTIPL
Page 90 and 91: Bowel - Forms an incomplete ring in
Page 92 and 93: Bowel Falciform ligament STOMACH AN
Page 94 and 95: Bowel SMALL INTESTINE Anatomy: Abdo
Page 96 and 97: Bowel Abdominal wall STOMACH Anatom
Page 98 and 99: Bowel Rectus muscle SMALL BOWEL Ana
Page 100 and 101: Bowel Abdominal wall musculature Ce
Page 102 and 103: Bowel LARGE BOWEL Abdominal wall mu
Page 104 and 105: Bowel Urinary bladder RECTOSIGMOID
Page 106 and 107: 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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Recurrent Pyogenic Cholangitis TERM
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Recurrent Pyogenic Cholangitis (Lef
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AIDS-Related Cholangiopathy TERMINO
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PART II SECTION 3 Pancreas Introduc
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Approach to Pancreatic Sonography C
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Approach to Pancreatic Sonography (
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Acute Pancreatitis TERMINOLOGY Abbr
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Acute Pancreatitis (Left) Transvers
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Pancreatic Pseudocyst TERMINOLOGY D
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Pancreatic Pseudocyst (Left) Transv
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Chronic Pancreatitis TERMINOLOGY Ab
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Chronic Pancreatitis (Left) Transve
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Mucinous Cystic Pancreatic Tumor TE
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Mucinous Cystic Pancreatic Tumor (L
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Serous Cystadenoma of Pancreas TERM
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Serous Cystadenoma of Pancreas (Lef
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Intraductal Papillary Mucinous Neop
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Pancreatic Ductal Carcinoma TERMINO
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Pancreatic Ductal Carcinoma (Left)
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Pancreatic Neuroendocrine Tumor TER
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Pancreatic Neuroendocrine Tumor (Le
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Solid Pseudopapillary Neoplasm TERM
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Solid Pseudopapillary Neoplasm (Lef
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PART II SECTION 4 Spleen Introducti
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Approach to Splenic Sonography sple
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Approach to Splenic Sonography (Lef
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Approach to Splenic Sonography (Lef
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Splenomegaly TERMINOLOGY Abbreviati
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Splenomegaly (Left) US in a 92-year
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Splenic Cyst TERMINOLOGY Definition
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Splenic Cyst (Left) Grayscale US of
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Splenic Tumors TERMINOLOGY Definiti
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Splenic Tumors (Left) Longitudinal
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Splenic Tumors (Left) A solid, hypo
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Splenic Infarct TERMINOLOGY Abbrevi
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Splenic Infarct (Left) Power Dopple
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Vascular Conditions Renal Artery St
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Approach to Urinary Tract Sonograph
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Approach to Urinary Tract Sonograph
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Column of Bertin, Kidney TERMINOLOG
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Renal Junction Line TERMINOLOGY Syn
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Renal Ectopia TERMINOLOGY Abbreviat
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Renal Ectopia (Left) Grayscale ultr
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Horseshoe Kidney TERMINOLOGY Defini
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Horseshoe Kidney (Left) Longitudina
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Ureteral Duplication TERMINOLOGY Sy
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Ureteral Duplication (Left) Longitu
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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
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Crohn Disease (Left) Long-axis ultr
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Large Bowel Malignancy TERMINOLOGY
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Large Bowel Malignancy (Left) Hepat
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PART II SECTION 10 Scrotum Introduc
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Approach to Scrotal Sonography (Lef
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Testicular Germ Cell Tumors TERMINO
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Testicular Germ Cell Tumors (Left)
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Gonadal Stromal Tumors, Testis TERM
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Gonadal Stromal Tumors, Testis (Lef
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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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