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Abdominal Ultrasound, An Issue of Ultrasound Clinics, E-Book

Abdominal Ultrasound, An Issue of Ultrasound Clinics, E-Book

Wui K. Chong

(2014)

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Book Details

Abstract

Abdominal Ultrasound is comprehensively reviewed by guest editor Wui K. Chong and authors. Articles will include: Ultrasound of the Liver and Spleen; Ultrasound of the Gallbladder and Biliary Tree; Doppler US of the Liver, Portal Hypertension, and TIPS; Contrast evaluation of liver masses; Elastography of the Abdomen; The Role of Sonography in Liver Transplantation; Renal Ultrasound; Ultrasound of the Renal Transplant; Sonography of the Retroperitoneum; Ultrasound Assessment of the Aorta and Mesenteric Arteries; Sonography of the Bowel; Ultrasound of the Abdominal Wall; Ultrasound-Guided Intervention in the Abdomen and Pelvis, and more!

Table of Contents

Section Title Page Action Price
Front Cover Cover
Abdominal Ultrasound i
Copyright\r ii
Contributors iii
Contents v
Ultrasound Clinics\r ix
Preface\r xiii
Ultrasound of the Liver and Spleen 545
Key points 545
Introduction 545
Liver 545
Anatomy 545
Diffuse Liver Disease 546
Fatty liver 546
Hepatitis 547
Cirrhosis 548
Hepatic Masses 549
HCC 549
Cavernous Hemangioma 550
Hepatic Cysts 551
FNH 552
Hepatic Adenoma 552
Metastatic Disease 553
Cholangiocarcinoma 554
Hepatic Abscess 555
Biliary Hamartoma 556
Lymphoma 556
Hepatic Trauma 557
Spleen 557
Anatomy 557
Technique 558
Splenic Trauma 558
Splenic Infarction 558
Splenic Cysts 560
Splenic Hamartoma 560
Splenic Abscess 560
Splenic Hemangioma 561
Splenic Lymphoma 561
Splenic Metastatic Disease 561
Splenic Sarcoidosis 561
References 562
Ultrasound of the Gallbladder and Biliary Tree 567
Key points 567
Introduction 567
Gallbladder anatomy 568
Biliary tree anatomy 568
Ultrasound technique 570
Gallstones 570
Biliary sludge 571
Cholecystitis 572
Interventional complications 575
Gallbladder wall thickening and porcelain gallbladder 575
Gallbladder polyps and adenomyomatosis 576
Biliary obstruction 577
Choledocholithiasis 577
Inflammatory and infectious biliary obstruction 579
Biliary tract malignancies 582
Choledochal cysts 583
Summary 585
Supplementary data 585
References 585
Doppler Ultrasound of the Liver, Portal Hypertension, and Transjugular Intrahepatic Portosystemic Shunts 587
Key points 587
Introduction 587
Doppler ultrasound technique 588
Hepatic arteries 588
Portal venous system 589
Portal Vein Gas 589
Portal vein stenosis 589
Congestive Cardiac Failure 589
Portal Hypertension 590
Portal vein thrombosis 594
Hepatic veins 595
Change with Respiration 596
Right heart failure 596
Hepatic vein obstruction 597
Transjugular intrahepatic portosystemic shunts 598
Complications of TIPS 600
What the referring physician needs to know 602
Summary 603
Supplementary data 603
References 603
Contrast Evaluation of Liver Masses 605
Key points 605
Introduction 605
Part 1: technical considerations 606
Ultrasound Contrast Agents 606
Physical properties 606
Microbubble interaction with ultrasound 606
Enhancement phases 606
Side effects and contraindications 607
Equipment 608
Low mechanical index imaging 608
Imaging mode 608
Analysis and quantification software 608
Examination Procedure 608
UCA administration 608
Bolus injection 608
Infusion injection 609
Imaging 609
Part 2: UCA evaluation of liver masses 609
Characterization of FLL 609
Common benign lesions 609
Hemangioma 609
Focal nodular hyperplasia 610
Hepatocellular adenoma 611
Cystic lesions 611
Infection/Inflammation 611
Focal fatty changes 611
Common malignant lesions 611
Cirrhotic liver 611
Regenerative nodule 612
Dysplastic nodule 612
Hepatocellular carcinoma 612
Cholangiocarcinoma 613
Metastases 613
Lymphoma 617
Lesion Detection 617
Intraoperative Contrast Ultrasound 617
CEUS in Ablation Therapy 618
Limitations 618
Pitfalls 619
Part 3: future prospects 619
Tumor Perfusion Quantification 619
3-D and 4-D Imaging with Microbubbles 619
Targeted Imaging 620
Summary 620
Acknowledgments 620
Supplementary data 620
References 620
Elastography of the Abdomen 625
Key points 625
Introduction 625
Principles of elastography 626
SE 626
Elastography Using an ARFI Pulse 627
SWE 627
Elastography of the liver 628
Focal Liver Lesions 628
Diffuse Liver Disease 628
Transient Elastography 629
Shear Wave Speed Measurement 631
SE 632
Elastography of the pancreas 633
Elastography of the GI tract 636
Summary 636
References 636
Update on the Role of Sonography in Liver Transplantation 641
Key points 641
Introduction 641
Use of ultrasonography for preoperative assessment 642
US in the immediate postoperative period 642
Complications of liver transplantation 643
Vascular Complications 643
Hepatic artery complications 643
Hepatic artery thrombosis 643
Hepatic artery stenosis 643
Hepatic artery pseudoaneurysm 644
Portal Vein Complications 644
IVC Complications 645
Hepatic Veins 645
Liver Infarction 645
Splenic Artery Steal Syndrome 646
Biliary Complications 647
Biliary Obstruction 647
Bile Leak 647
Postoperative Fluid Collections 648
Infections 648
Malignancy in liver transplantation 649
De novo nonlymphoid malignancies 649
PTLD 650
Recurrent HCC 650
Rejection in transplantation 650
Acute rejection 651
Chronic rejection 651
Summary 651
References 651
Renal Ultrasound 653
Key points 653
Introduction 653
Renal anatomy 653
Sonographic technique 654
Congenital normal variants 654
Infection and inflammation 656
HIV-Related Renal Disease 660
Hydronephrosis 660
Obstructive Hydronephrosis 661
Nonobstructive Hydronephrosis 665
Renal cystic disease 666
Renal neoplasms 670
Perirenal pathology 674
Vascular pathology 676
Summary 680
References 680
Ultrasonography of the Renal Transplant 683
Key points 683
Ultrasound examination of the renal transplant 683
Vascular abnormalities 684
Anatomy 684
Renal artery stenosis 685
Renal artery thrombosis/infarct 686
Renal vein thrombosis 686
Vascular abnormalities after interventional procedures 687
AVF 687
PSA 688
Compartment syndrome 688
Graft dysfunction 688
Contrast-enhanced ultrasonography 690
Elastography 690
Peritransplant fluid collections 690
Urologic complications 691
Urine leak and urinomas 691
Obstruction 691
Stones 691
Neoplastic complications 692
Summary 693
References 693
Sonography of the Retroperitoneum 697
Key points 697
Anatomy of the retroperitoneum 697
Scanning technique 697
Normal structures visible with ultrasonography 698
Adrenal glands 700
Anatomy and Imaging Techniques 700
Hemorrhage 700
Cysts 701
Adrenal tumors 701
Adrenal tumors: benign 702
Adenoma 702
Myelolipoma 702
Pheochromocytoma 702
Uncommon adrenal tumors 703
Adrenal tumors: malignant 704
Metastases 704
Adrenal cortical carcinoma 704
Neuroblastoma and ganglioneuroblastoma 704
Pancreas 704
Anatomy and Imaging Techniques 704
Acute Pancreatitis 705
Chronic Pancreatitis 705
Pseudocyst 706
Autoimmune Pancreatitis 707
Pancreatic tumors 707
Adenocarcinoma 707
Cystic Neoplasms 708
Neuroendocrine Tumors 708
Retroperitoneal Tumors (Extraorgan) 709
Primary neoplasms; malignant 710
Liposarcoma 711
Leiomyosarcoma 713
Undifferentiated Pleomorphic Sarcoma 713
Primary neoplasms: benign 713
Lipoma/Lipomatosis 713
Retroperitoneal Fibrosis 714
Angiomyolipoma 715
Teratoma 715
Paraganglioma (Extra-Adrenal Pheochromocytoma) 715
Other Neoplasms 716
Neurogenic tumors 716
Lymphadenopathy 716
Fluid collections 717
Hematoma 717
Pseudocyst 717
Abscess 718
Urinoma 718
Lymphocele 718
Lymphangioma/Lymphangiomatosis 719
Pseudolesions 719
Summary 719
References 719
Ultrasonography Assessment of the Aorta and Mesenteric Arteries 723
Key points 723
Introduction 723
Anatomy of the abdominal aorta and its major branches 723
Abdominal Aorta 723
Anatomy of the Mesenteric Arteries and Collateral Pathways 724
Hemodynamics of the abdominal aorta and mesenteric arteries 724
Hemodynamics of the Aorta 724
Hemodynamics of the Mesenteric Vessels 725
Technique 726
Protocol 726
Abdominal Aorta 726
Mesenteric Arteries 726
Atherosclerosis and occlusive arterial disease 726
Aortic Wall Structure 726
Plaque Formation 727
Ultrasonography Assessment of the Plaque and Associated Luminal Stenosis 727
Occlusion of the Aorta 729
Normal sizes of the abdominal aorta 729
AAA 731
Natural History of AAAs 731
Pathophysiology of AAA and AAA Rupture 731
Growth Rate of Aneurysms 732
AAA Screening and Surveillance 732
Types of AAA 732
Diagnostic Criteria 732
Ultrasonography Assessment of AAA 733
Ultrasonography Findings of Aortic Rupture 734
AAA repair and its complications 734
Dissection of the aorta and the mesenteric arteries 737
Atherosclerotic disease of the mesenteric arteries and bowel ischemia 740
Natural History of Bowel Ischemia 740
Diagnostic Criteria of Mesenteric Artery Stenosis 741
Pitfalls in Diagnosis 742
Mesenteric Arterial Occlusion 743
Mesenteric Arterial Dissection 743
Median Arcuate Ligament Syndrome 743
Aneurysms and pseudoaneurysms of the mesenteric arteries 745
References 747
Sonography of the Bowel 751
Key points 751
Introduction 751
The Gut Signature 751
Gut Wall Pathology 752
Technique 752
Blood Flow Evaluation of the Gut Wall 753
Gastrointestinal Neoplasms 753
Inflammatory bowel disease 755
The Clinical Story 755
Diagnosis and Monitoring of IBD 756
Sonography of IBD 756
Classic features of IBD 757
Gut Wall Thickening 757
Inflammatory Fat 757
Lymphadenopathy 757
Hyperemia 758
Doppler 758
CEUS 758
Complications of CD 758
Strictures 758
Mechanical Bowel Obstruction 759
Inflammatory Masses 760
Localized Perforation 761
Fistula Formation 762
Perianal Inflammatory Disease 762
Complicating Neoplasia 762
Acute abdomen 763
Right Lower Quadrant Pain 763
Acute appendicitis 763
Crohn appendicitis 766
Right-sided diverticulitis 767
Acute typhlitis 767
Mesenteric adenitis and acute terminal ileitis 767
Right-sided segmental omental infarction 768
Left Lower-Quadrant Pain 768
Acute diverticulitis 768
Summary 770
Acknowledgments 770
Supplementary data 770
References 770
Ultrasound of the Abdominal Wall 775
Key points 775
Introduction 775
Anatomy 775
Sonographic technique 777
Hernias 777
Fluid collections 780
Mass lesions 781
Vascular abnormalities 784
Miscellaneous conditions 786
Summary 789
Supplementary data 789
References 789
Ultrasound-Guided Intervention in the Abdomen and Pelvis 793
Key points 793
Introduction 793
Imaging review 794
Sonographer 794
Room setup 795
Imaging nurse 795
Pathology support 795
Needle selection 795
Catheter selection 796
Transducer selection 796
Coagulation and bleeding risk 797
Anticoagulants 797
Hemostatic Agents 797
Platelets 797
Fresh frozen plasma 797
Contraindications 798
Interventional techniques 799
Biopsy techniques 800
Drain placement techniques 801
Patient positioning 802
Hepatic interventions 802
Indications 802
Potential Contraindications 802
Procedure 802
Postprocedure Management 806
Complications 806
Adrenal gland 807
Contraindications 807
Procedure 807
Postprocedure Management 807
Complications 808
Renal interventions 808
Indications 808
Contraindications 808
Procedure 808
Postprocedure Management 809
Complications 809
Splenic interventions 810
Indications 810
Procedure 810
Complications 810
Pelvic interventions 811
Indications 811
Procedure 811
Postprocedure Management 812
Complications 813
Paracentesis 814
Indications 814
Procedure 814
Complications 814
Miscellaneous 814
Fusion guidance—CT, MR, PET 817
Summary 817
Supplementary data 817
References 817
Index 821