Week 9 Flashcards

Question

Thermal Ablation: 1) What is it? 2) What can it be used for? 3) What is the procedure?

Answer 1

1) Umbrella term for tissue destruction via extreme heat or cold -Radiofrequency, microwave, cryo- ablations 2) Tumors (hepatic, renal, pulmonary) -Early stage, pts refusing surgery, surgery contraindicated 3) Ablation probes placed using US, CT, or MRI

Answer 2

1) GI bleeds 2) Arteriography is performed in branch arteries supplying area of concern Various methods of embolization depending on location, comorbidities, and operator preference Metallic coil, cyanoacrylate glue, Gelfoam Post embolization arteriogram is performed to confirm that bleeding has stopped

Answer 3

1) Indicated with thoracic or abdominal aortic aneurysms that are Asymptomatic and 5.5cm or larger Symptomatic regardless of size Known or impending rupture 2) Preprocedural CTA/MRA used to characterize aneurysm Femoral artery access is obtained Catheter is advanced then stent is deployed Post procedure aortogram used to ensure there is no leaking

Answer 4

1) Acute ischemic stroke 2) Controversial

Answer 5

1) Pre-procedure imaging is very important – CT, CTA, MRA perfusion imagining Identify offending thrombus 2) Arterial access obtained, then catheter advanced into internal carotid artery Thrombus is traversed and retriever is unsheathed over clot Pulled out through larger guiding catheter or aspiration system is used

Answer 6

1) Imaging modality using probe/transducer that transmits sound waves hundreds of times greater than what humans can hear 2) Coupling gel is applied to the body surface being imaged to eliminate any air gaps between body and transducer to produce the best images

Answer 7

The sound waves pulse from the transducer at different speeds depending on the density of the tissue. When the sound wave encounters a change in density, some waves continue forward, but some waves reflect back When the reflected waves return to the transducer, the waves are converted into electrical pulses and sent to the scanner

Answer 8

1) sound transmission 2) reflection

Answer 9

brightness or darkness depends on the amount of sound waves the tissue transmits or reflects

Answer 10

The frequency of the soundwaves plays a major role in the resolution of the image Higher frequency = higher resolution/more detail, but the shorter the penetration distance Therefore, higher frequency can get more detail but cannot image deep structures due to shorter penetration depth Transducers are labeled with their frequencies; so choosing the right transducer for the right study is critical to produce the most detailed image of the desired tissue

Answer 11

Uses the Doppler effect to assess blood flow; used for vascular U/S. Pulsed Doppler devices emit short bursts of energy that allow for an accurate localization of the target.

Answer 12

Used in vascular studies; refers to the simultaneous use of both gray-scale (+ color Doppler) to visualize the structure of and flow within a vessel

Answer 13

1) Generally well tolerated; can be done at bedside small, quick no patient discomfort No known long-term side effects 2) Inexperienced tech can get subpar images The FDA warns against the use of U/S during pregnancy to produce “keepsake photos or videos.”

Answer 14

occur in ~ 50% of women > 30 yo. They are heterogeneously hypoechoic, solid masses- they may display areas of varying areas of brightness/darkness) . Can also have cystic, calcified or fatty components as they degenerate.

Answer 15

Premenopausal the ovaries are approximately 2 × 3 × 4 cm often containing cystic follicles. (C ) Menopause atrophy Appearance also changes depending on the time within the menstrual cycle

Answer 16

Functional cysts are characteristically: well-defined thin-walled anechoic (dark) homogenous internal fluid echogenicity

Answer 17

internal heterogeneity = blood

Answer 18

endocrine abnormality with numerous ovarian follicles that develop in various stages of hormonal growth

Answer 19

Most ovarian tumors are cystic and benign, but can be malignant

Answer 20

thick/irregular walls, thick /irregular septations internal vascular flow solid papillary projections In the event of a malignant tumor, staging is best done with CT or MRI.

Answer 21

infections affecting the uterus, fallopian tubes, and ovaries

Answer 22

1) first trimester goals are to: exclude an ectopic pregnancy estimate the age of the pregnancy to determine viability and the number of embryos 2) second and third trimesters goals include: estimates of amniotic fluid volume detection of fetal anomalies determination of placental and fetal positioning

Answer 23

1) Benign tumor that can result from a nonviable pregnancy 2) Grape-like degeneration of chorionic villi uterine size that is disproportionately large for the gestational age

Answer 24

anencephaly & complete ectopia cordis

Answer 25

therefore U/S plays a major role in the management of pregnancy as it is widely available, safe, cheap and results are available quickly

Answer 26

1) a protuberance of tissue, usually bowel, through a defect or hole in the abdominal wall 2) Inguinal hernia most common Can be imaged with U/S in real time can be induced by Valsalva

Answer 27

1) The normal appendix will compress when pressure is applied with the transducer. -The inflamed appendix is noncompressible 2) Acute appendicitis is obstruction of the appendiceal lumen with progressive distension of the obstructed appendix until perforation occurs and a periappendiceal abscess forms.

Answer 28

1) Appears anechoic on U/S 2) Common site of fluid collections: RUQ near the liver and diaphragm the most dependent locations of the peritoneal cavity.

Answer 29

Paracentesis

Answer 30

U/S has the advantages of real-time imaging lower cost lack of contraindications associated with the strong magnetic field used in MRI.

Answer 31

Tendinopathy can be diagnosed by U/S when the tendon appears thickened or when there is fluid around the tendon. A tendon tear appears as fluid in the tendon or discontinuity of the tendon fibers.

Answer 32

Detect foreign bodies (Left, part of an earring in the ear lobe) evaluate joint effusions, and superficial ligaments/ musculature small joints in the hands and feet can also be used to guide therapeutic and diagnostic injections and fluid removal

Answer 33

Increasingly being used in the U/S contrast agent with specialized U/S imaging software to demonstrate vascular flow and soft-tissue perfusion. Particularly good at identifying soft tissue tumors. contrast agent is safe with no nephrotoxicity or risk of nephrogenic systemic fibrosis as with other imaging modalities

Answer 34

Curved arrow shows fluid around the tendon = tenosynovitis Also used to identify foreign bodies in the superficial soft tissues Ex/ wooden splinters, glass, metal and plastic

Answer 35

gray-scale ultrasound Doppler ultrasonography =a combination called duplex sonography

Answer 36

which displays the appearance of vessels as well as the flow direction/velocity of moving blood in those vessels. red indicates movement toward the transducer and blue indicates movement away from transducer

Answer 37

an increase in blood velocity through the area of narrowing

Answer 38

1) Evaluate bruits 2) Preoperative screening prior to other major vascular surgery 3) Assess the patency of the vessel after endarterectomy.

Answer 39

> 50% stenosis of the carotid artery lumen = velocity of flow becomes elevated also used to assess thickness of the vessel wall (it gets thicker with atherosclerosis) and the presence of plaque.

Answer 40

1) Forms when there is a rupture/ injury to the arterial wall, but the blood leaking through the defect remains confined -Can develop after an invasive vascular procedure such as cardiac cath-most often at the catheter entrance site, (usually in the groin at the common femoral artery) 2) But unlike a true aneurysm, the artery is not dilated

Answer 41

1) U/S can be used for the treatment of pseudoaneurysms by applying direct compression with the ultrasound probe to occlude the aneurysm sac, especially if the sac is small 2) Or by guiding injection of thrombin into aneurysm to create thrombosis and occlude it

Answer 42

No radiation Small body habitus of child allows for easy penetration of sound waves and produce a high-resolution image

Answer 43

Used at bedside to quickly determine pathologic conditions, but does not replace detailed, routine sonographic evaluation

Week 9 Flashcards

(68 cards)