Radiology Spotters 7.0

8/18/2019 Radiology Spotters 7.0

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Spotters

Barium


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Spot 1


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Spot 2


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Spot 3


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Spot 4


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Spot 5


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Spot 6


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Spot 7


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Spot 8


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Spot 9


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Spot 10.


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• ANSWERS


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Spot 1


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Spot 1. Hiatus heria

• Spot ra!io"raph #rom the si"$e%&otrast phase o# a upper '(series) o*taie! +ith the patiet i a proe positio.

• ,he A ri") a$so -o+ as the mus&u$ar ri") is at thetrasitio *et+ee the tu*u$ar esopha"us a! the esopha"ea$esti*u$e. ,his is a trasiet$/ see) &otra&ti$e ri".

• ,he B ri" is a ri" &ompose! o# mu&osa a! su*mu&osa at the

• trasitio *et+ee esopha"us a! stoma&htheesopha"o"astri& u&tio. A S&hat-i ri" +ou$! o&&ur at thissite.

• ,he ri" is see i patiets +ith a hiata$ heria. ,his is a*roa!%*ase!) smooth etrisi& impressio */ the !iaphra"m othe stoma&h. ,he ri" i!eties the $o&atio o# the!iaphra"m


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Spot 2


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Spot 2. Esopha"ea$ +e*

• ( the upper &eri&a$ esopha"us) 12 mm she$# $i-e$$i" !e#e&ts are see o the aterior +a$$ or&ir&um#eretia$$/.

• artia$ o*stru&tio is su""este! &$ii&a$$/ */ so$i!

#oo! !/spha"ia or ra!io"raphi&a$$/ */ $umia$arro+i" o# 50) a et: o# *arium spurti"throu"h the +e*) or !i$atio o# the proima$ &eri&a$esopha"us.

•Re!u!at mu&osa is u!u$ati") is erti&a$$/oriete!) a! &ha"es sie +ith ar/i" !e"rees o#$umia$ !istetio */ the *o$us. We*s are she$;i-earro+i"s


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Spot 3


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Spot 3. Ba$$ooi" o#


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Spot 4


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Spot 4.S&hat-i ri"

• ,he esopha"o"astri& u&tio o#te has a ri"$i-e&o"uratio) terme! the mu&osa$ ri": or Bri".: ,he ri" is smooth) s/mmetri&) a! 24 mmi hei"ht) a! has a aria*$e $umia$ !iameter. ,he

term S&hat-i ri": is use! #or mu&osa$ ri"s o#arro+ eou"h &a$i*er to &ause !/spha"ia. ,hepatho"eesis o# S&hat-i ri"s is u&ertai) *ut ma/*e re$ate! to &hroi& "astroesopha"ea$ re;u a!re;u%re$ate! s&arri".

• epti& stri&tures at the esopha"o"astri& u&tio areri"$i-e) *ut are thi&-er tha 4 mm i hei"ht) haes$i"ht$/ tapere! e!"es a! #re=uet$/ are s$i"ht$/irre"u$ar i &otour a! as/mmetri&) +ith $o"er

tapere! e!"es i!i&ati" erti&a$$/ oriete!


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Spot 5


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.Heria• ( a true paraesopha"ea$ heria) the esopha"o"astri& u&tio is

*e$o+ the esopha"ea$ hiatus o# the !iaphra"m.

•

>ore &ommo$/) the esopha"ea$ hiatus o# the !iaphra"m isetreme$/ +i!e) a$$o+i" superior aia$ mi"ratio o# the "astri&&ar!ia ?a routie aia$ hiata$ heria@ a! a portio o# mi!stoma&h "oi" *a&- throu"h the esopha"ea$ hiatus o# the!iaphra"m a$o"si!e the "astri& &ar!ia. ,his situatio is o#te!es&ri*e! as a #orm o# "astri& o$u$us.

• ( our &ase presete! here) there is a ret i the $e#themi!iaphra"m ust $atera$ to the esopha"ea$ hiatus o# the!iaphra"m ,his !iaphra"mati& ret a$$o+s a sma$$ portio o#"astri& #u!us to heriate ito the &hest. Be&ause there +as ohistor/ o# ee remote trauma) this heria &ou$! ot *e

!es&ri*e! as a traumati& heria• Some sur"eos a! ra!io$o"ists +ou$! !es&ri*e this as a

paraesopha"ea$ heria. (t is *etter to !es&ri*e the aatomi&$o&atio o# the heriatio a! +hat portio o# stoma&h is a*oethe !iaphra"m.

S 6


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Spot 6


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Spot 6. orei" *o!/(mpa&tio

• A po$/poi! &ar&ioma is a e$/ $o*u$ate! tumor thatsuper&ia$$/ mimi&s a #orei" *o!/) *ut the sta$- o# thetumor is usua$$/ isi*$e. A meis&us is ot preset.

• A *roas&u$ar po$/p is a smooth) e$o"ate!) po$/poi!

mass) usua$$/ arisi" #rom the aterior +a$$ o# the&eri&a$ esopha"us.

• Spi!$e &e$$ &ar&ioma is a $ar"e) $o*u$ate!) mai$/itra$umia$ po$/poi! mass) t/pi&a$$/ see i themi!esopha"us.


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Spot 7


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Spot 7. A&h$asia• rimar/ perista$sis is a*set. Some patiets ehi*it

sha$$o+ operista$ti& &otra&tios a #e+ patiets haere$atie$/ hi"her amp$itu!e operista$ti& &otra&tiosso%&a$$e! i"orous a&ha$asia.

• ,he !ista$ esopha"us has a short) smooth) *ea-$i-etapere! arro+i" that eetua$$/ opes to a aria*$e

!e"ree this re;e&ts the $o+er esopha"ea$ sphi&ter!/s#u&tio. ,he esopha"us is aria*$/ !i$ate!.

• ( ear$/ a&ha$asia) esopha"ea$ !i$atio ma/ *e su*t$e. (these patiets) !ia"osis !epe!s o ea$uatio o#perista$sis a! $o+er esopha"ea$ sphi&ter opei".

• With $o"er !uratio o# !isease) the esopha"us !i$ates.With e!%sta"e !isease) the esopha"us is massie$/!i$ate! a! tortuous) assumi" a si"moi!: shape isome patiets.

S 8


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Spot 8


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Spot 8. seu!o%A&h$asia

• seu!oa&ha$asia t/pi&a$$/ resu$ts #romsu*mu&osa$ i$tratio o# the !ista$esopha"us a! &ar!ia */ &a&er.

• seu!oa&ha$asia &a *e !iCeretiate!#rom a&ha$asia */ &$ii&a$ !i"s a!*/ as/mmetr/) a*rupt trasitios)

mu&osa$ o!u$arit/) a! asso&iate!mass a! u$&eratio i the #ormer.


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Spot 9


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Spot 9. Dari&es• Dari&es are mai#este! o *arium stu!ies as smooth) thi&-)

u!u$ati") s&a$$ope! #o$!s that &ha"e sie +ith arious

!e"rees o# esopha"ea$ !istetio) perista$sis) or respiratio.• E$ar"e! #o$!s i Re;u esopha"itis are ot smooth) *ut hae

a s$i"ht$/ irre"u$ar &otour.

• Su*mu&osa$ sprea! o# s=uamous &e$$ &ar&ioma ma/ pro!u&ethi&- u!u$ati" #o$!s ho+eer) the sur#a&e o# the #o$!s is

o#te o!u$ar)ma! the tumorous #o$!s !o ot &ha"e sie orshape +ith arious !e"rees o# $umia$ !istetio.

•


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Spot 10.


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Spot 10. Re;u esopha"itis• Re;u esopha"itis is t/pie! */ ti/) i$$%!ee! e$eatios o# the

mu&osa$ sur#a&e ) terme! mu&osa$ "rau$arit/: or "rau$armu&osa.: ,he o!u$es or "rau$es o# re;u esopha"itis are

&o;uet) $o&ate! i the !ista$ esopha"us.• ,he o!u$es i re;u esopha"itis are poor$/ !ee! a! $o&ate! i

the $o+er esopha"us.

• ,he o!u$es o# "$/&o"ei& a&athosis) a a"i" ariat) are more!is&rete) o# aria*$e sie up to 3%4 mm) a! are $o&ate! i the

upper a! mi! thora&i& esopha"us. ,hese o!u$es are usua$$/separate! */ orma$ smooth mu&osa.

• ,he mu&osa ma/ *e e$/ u$&erate! or o!u$ar i patiets +itha&ute ra!iatio esopha"itis. ,he esopha"itis is &oe! to thera!iatio porta$

• BarrettFs esopha"us has ar/i" #orms o# &o$umar metap$asia

arra"e! ito tu#ts. ,here#ore) the reti&u$ar patter: o# BarrettFsesopha"us mimi&s the reti&u$ar &o"uratio o# the areae"astri&ae o# the stoma&h) thou"h the tu#ts are sma$$er) a*out 1mm i sie. A*out 10 o# patiets +ith BarrettFs esopha"us!emostrate a reti&u$ar patter): o#te a!a&et to the !ista$aspe&t o# a re;u%i!u&e! stri&ture.

• Super&ia$ sprea!i" &ar&ioma is a &o;uet pat&h or $o"er


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Documents

Radiology Spotters 7.0