Diagnostic Ultrasound - Abdomen and Pelvis

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PART II SECTION 9 Bowel Approach to Bowel Sonography 642 Appendicitis 646 652 Intussusception 656 Epiploic Appendagitis 660 Diverticulitis 664 Crohn Disease 668 674
Approach to Bowel Sonography 642 Diagnoses: Bowel Introduction Assessment of the bowel with ultrasound has been undervalued due to the commonly held perception that artifact (notably from gas in the lumen of the bowel) will limit visibility. The lack of awareness of normal and diseased bowel, limited technical expertise, and prolonged time of study are some compounding factors that have lead to a significant inconsistency in radiology departments for the application of ultrasound in the assessment of the bowel. US is safe, noninvasive, inexpensive, and does not use ionizing radiation. Real-time images can be obtained to provide a dynamic assessment. With the appropriate skills and knowledge, ultrasound has a valuable role in the assessment of patients with suspected and known bowel diseases. US remains the first-line imaging modality in acute abdominal conditions, particularly in Europe, hence a systematic approach and familiarity of the sonographic appearances of the spectrum of diseases affecting the bowel is crucial. Anatomy-Based Imaging Issues The gut is a long, tortuous, confluent hollow viscus that has a reproducible stratified layered pattern on ultrasound referred to as the gut signature. This alternating layered pattern corresponds to distinct histological layers of the normal bowel wall. Five sonographic layers are identified as alternating hyperechoic and hypoechoic layers. These consecutive layers from innermost (layer 1) to outermost (layer 5) are listed below. • Layer 1: Interface of lumen and mucosa • Layer 2: Muscularis mucosa • Layer 3: Submucosa • Layer 4: Muscularis propria • Layer 5: Serosa There are typically three hyperechoic layers (layer 1, 3, and 5). These three hyperechoic layers are the interface of the lumen and mucosa, submucosa and serosa. The hypoechoic layers (layers 2 and 4) represent the two respective muscular layers; the muscularis mucosa (inner) and muscularis propria (outer), respectively. The number of visible layers depends on: • Frequency of transducer • Proximity of transducer to gut wall The trade off between the improved resolution with a highfrequency probe is the depth of penetration of the sound beam. It is ideal to maximize the frequency to obtain the best permissible resolution; however, this is reliant on the body habitus of the patient. On a routine 5 MHz curvilinear probe, the transverse section of the bowel demonstrates a stratified target-like appearance with an inner hyperechoic layer representing the submucosa and a hypoechoic outer rim of the muscularis propria. Using high-resolution linear transducer (12-18 MHz), the five distinct layers can be readily appreciated. On axial imaging, a pattern of concentric rings of alternating bands of hyper and hypoechoic rings can be seen. The technological advances in transducers, combined with endoscopy, have lead to the evolution of endoscopic ultrasound technique. This represents the combined endoscopic and ultrasound assessment of the gut wall. The direct contact of the ultrasound transducer with the gut wall and high-frequency transducer allows for a focused assessment of a lesion, depiction of the depth of penetration in relation to the gut wall layers and lumen. In addition, histological assessment with needle biopsy is now also possible using this minimally invasive technique. Normal bowel has an average maximal single wall thickness of 3-5 mm dependent on the degree of distension. Fixed points of the bowel are easier to assess with transabdominal ultrasound: C loop of the duodenum, ileocecal junction, rectum, and recto sigmoid. Features of small bowel loops are the central location, presence of valvulae conniventes, and active bowel peristalsis. In contrast, the colon has a heterogenous haustral pattern associated with a prominent linear arc of gas and posterior reverberation artefact. Clinical Implications US of the bowel: • Can be part of routine abdominal scan for nonspecific broad range of abdominal symptoms • Has an established focused role in suspected acute GI conditions, such as acute appendicitis, pyloric stenosis, and intussusception, especially in children and young adults • Can be used for dedicated assessment of chronic gutrelated disorders In patients with Crohn disease, ultrasound has a role in: • Detection of disease • Evaluation of disease extent • Detection of complication such as formation of abscess, fistula, or obstruction • Assessment of activity and follow-up of disease Given the increasing use of ultrasound as the first-line modality, in addition to the standard assessment of the solid abdominal viscera, it is crucial for the operator to have an understanding of the principles of bowel ultrasound to avoid overlooking a GI tract-related diagnosis. The value is significantly felt in the younger population where ultrasound is much better tolerated and can significantly reduce the radiation burden of unjustified CT scans. One of the inherent strengths of performing ultrasound is the instant clinical history and specific detail that is directly available from the patient. Ultrasound becomes an extension of the clinical examination and facilitates the diagnostic process. With accurate history and clinical signs, the operator can formulate a tailored approach to the ultrasound examination. Note that sonographic findings often overlap, hence the clinical history is crucial to determine the accurate diagnosis. Imaging Technique Routine transabdominal assessment of the bowel is typically performed after assessment of the solid abdominal viscera. The assessment of the bowel starts by using a standard 5 MHz curvilinear transducer. While scanning, it is important to optimize the settings, in particular the focal point and dynamic contrast, to enhance image quality. Recognizing useful landmarks such as the interface of the peritoneum with the abdominal wall and the psoas muscle provides an indicator of the depth of assessment and is helpful to avoid any confusion at the outset.
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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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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
Page 612 and 613: Myelolipoma (Left) Longitudinal US
Page 614 and 615: Adrenal Adenoma TERMINOLOGY Synonym
Page 616 and 617: Adrenal Adenoma (Left) Longitudinal
Page 618 and 619: Adrenal Cyst TERMINOLOGY Definition
Page 620 and 621: Pheochromocytoma TERMINOLOGY Defini
Page 622 and 623: Pheochromocytoma (Left) Longitudina
Page 624 and 625: Adrenal Carcinoma TERMINOLOGY Synon
Page 626 and 627: Adrenal Carcinoma (Left) Transverse
Page 628 and 629: PART II SECTION 8 Abdominal Wall/Pe
Page 630 and 631: Approach to Sonography of Abdominal
Page 632 and 633: Approach to Sonography of Abdominal
Page 634 and 635: Abdominal Wall Hernia TERMINOLOGY D
Page 636 and 637: Abdominal Wall Hernia (Left) Transv
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Page 640 and 641: Groin Hernia TERMINOLOGY Definition
Page 642 and 643: Groin Hernia (Left) Graphic shows a
Page 644 and 645: Groin Hernia (Left) Longitudinal ul
Page 646 and 647: Ascites TERMINOLOGY Definitions •
Page 648 and 649: Ascites (Left) Transverse ultrasoun
Page 650 and 651: Peritoneal Carcinomatosis TERMINOLO
Page 652 and 653: Peritoneal Carcinomatosis (Left) Lo
Page 654 and 655: Peritoneal Carcinomatosis (Left) Tr
Page 656 and 657: Peritoneal Space Abscess TERMINOLOG
Page 658 and 659: Peritoneal Space Abscess (Left) Tra
Page 660 and 661: Segmental Omental Infarction TERMIN
Page 664 and 665: Approach to Bowel Sonography Given
Page 666 and 667: Approach to Bowel Sonography (Left)
Page 668 and 669: Appendicitis TERMINOLOGY Definition
Page 670 and 671: Appendicitis (Left) Axial ultrasoun
Page 672 and 673: Appendicitis (Left) Axial ultrasoun
Page 674 and 675: Appendiceal Mucocele TERMINOLOGY De
Page 676 and 677: Appendiceal Mucocele (Left) Sagitta
Page 678 and 679: Intussusception TERMINOLOGY Definit
Page 680 and 681: Intussusception (Left) Transverse t
Page 682 and 683: Epiploic Appendagitis TERMINOLOGY A
Page 684 and 685: Epiploic Appendagitis (Left) Graysc
Page 686 and 687: Diverticulitis TERMINOLOGY Definiti
Page 688 and 689: Diverticulitis (Left) Acute diverti
Page 690 and 691: Crohn Disease TERMINOLOGY Synonyms
Page 692 and 693: 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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