MRAD 4218 Module 1-2 Pathology Radiographic Appearances

Esophageal Atresia w/ TEF

Esophageal Atresia w/ TEF

Esophageal Atresia w/ TEF

Esophageal Atresia w/ TEF

Esophageal Atresia w/ TEF

Acquired Tracheosophageal Fistula

Acquired Tracheosophageal Fistula

Acquired Tracheosophageal Fistula

Acquired Tracheosophageal Fistula

Zenker’s Diverticulum

Zenker’s Diverticulum

Zenker’s Diverticulum

Zenker’s Diverticulum

Esophageal Achalasia

Esophageal Achalasia

Esophageal Achalasia

Esophageal Achalasia

Esophageal Achalasia

Esophageal Achalasia

Esophageal Achalasia

GERD

GERD - Barrett’s Esophagus

GERD: Progression of GERD

• Erosion of the tissue and ulcerations may occur

  

GERD: Advanced GERD

• Narrowing of the lower esophagus

• Erosion evident by the hazy and serrated appearance of the esophageal borders

  

GERD: Advanced GERD

• Narrowed, eroded mucosa

• Narrowing comes from the inflammation at this stage

  

GERD: Area affected demonstrates a smooth tapered appearance

•  Barrett's esophagus will further alter the tissue to take on a "stomach like" appearance

  

Esophageal Varices: Rosary Beads

• Round and oval fillings defects

• Caused by the varices pressing on the outer esophagus

  

Esophageal Varices

Esophageal Varices: Rosary Beads

• Round and oval fillings defects

• Caused by the varices pressing on the outer esophagus

  

Esophageal Varices: Worm Tracings

• Long wavy impressions

• Made by the varices pressing on the outer esophagus

  

Esophageal Varices: Worm Tracings

• Long wavy impressions

• Made by the varices pressing on the outer esophagus

  

Esophageal Varices: CT Varices

• Varices surrounding the esophagus as indicated by the circle

• Gastric collateral veins dilation

  

Esophageal Varices: CT Varices

• Varices surrounding the esophagus as indicated by the circle

• Gastric collateral veins dilation

  

Hiatus Hernia: Roughened contours represent the stomach

Hiatus Hernia: Rugal folds seen above the diaphragm

Hiatus Hernia: Mass w/ an air-fluid level in the mediastinum

Hiatus Hernia:Majority of the stomach is in the thoracic cavity = diaphragmatic hiatus hernia

Hiatus Hernia: Diaphragmatic hiatus hernia

Ulcers

Ulcer - Pneumoperitoneum

Ulcer

Gastric Ulcer

• Gastric folds radiate out from the ulcer

• Due to inflammation, there is very little barium coating the tissue surrounding the ulcer

  

Gastric ulcer on the lesser curvature of the stomach

Duodena Ulcer

• Location in the pylorus

• PT had an ulcer in the past, higher up

• Healing sometimes causes scarring and rigidity of the stomach at the site

• No longer expands properly

  

"Clover Leaf" deformity

• Caused by fibrosis and scarring from a chronic duodenal ulcer

• Deformity lasts even after healing

  

Gastric Ulcer

• In the fundus

  

Gastric Ulcer

• Surrounding swelling associated with it (SW)

• ST is the inner lumen of the stomach

  

Duodenal perforation

• Contrast leaking out

  

Perforation of Gastric Ulcer

• Massive amount of free air anterior to the liver

  

CXR demonstrating the free air

Plyoric Stenosis: U/S

• Showing narrowing of the pyloric canal

  

Plyoric Stenosis: U/S

• Showing thickness of the gastric antral muscle in longitudinal (A) and transverse (B) plane

  

Plyoric Stenosis: Fluoroscopy

• Showing a complete blockage

  

Plyoric Stenosis: Fluoroscopy

• Showing a complete blockage

• Impression of antrum into the stomach on the top two images

  

Esophageal Carcinoma: Infiltrative

Esophageal Carcinoma: Infiltrative

Esophageal Carcinoma: Proliferating

Gastric Carcinoma: Infiltrative Total involvement of the stomach

• Lack of any rugae

  

Gastric Carcinoma: Infiltrative Elongation of the stomach (rigid stomach)

• Yellow dotted lines = areas of the diseased tissues

  

Gastric Carcinoma: Infiltrative Hourglass appearance

• Obstruction has occurred as very little barium is passing through the narrowing

  

Gastric Carcinoma: Infiltrative In the pylorus area

• Overall narrowing of the lumen

• Irregular appearance at the rugal folds

• Gives impression the tumor is extending proximally

 

Gastric Carcinoma: Infiltrative Total involvement of the stomach

• Lack of any rugae

  

Gastric Carcinoma: Proliferating

Gastric Carcinoma: Proliferating Polypoid mass

• Almost occluding the pyloric sphincter

• Very little contrast getting through

  

Gastric Carcinoma: Proliferating Yellow arrow showing 2polypoid mass

Red arrow showing tumor growth surrounding the entire stomach

Chron’s: Narrowing of the terminal ileum

Chron’s: Narrowing of the terminal ileum

Chron’s: Large section of the terminal portion of the ileum w/ narrowing

Chron’s: Large section of the ileum affected

Chron’s: Skip lesions (white arrows)

Common in Chron's Disease, inflamed area of the bowel will be interspersed w/ normal non-affected areas of bowel

Chron’s: Narrowed area of bowel w/ a cobblestone appearance

Cobblestone look represents areas of ulceration within the bowel wall

Chron’s: Areas of ulceration of the wall of the small bowel

Chron’s: Arrows indicating a massive fistula within the transverse colon wall

Chron’s: Demonstrating thicken small bowel walls

Chron’s: Demonstrating multiple areas of inflammation of the bowel wall

Ulcerative Colitis:Stove Pipe appearance of descending and sigmoid regions of the large bowel

Ulcerative Colitis: Stove Pipe appearance in this double contrast decub

Ulcerative Colitis: Involvement of the entire large bowel is demonstrated (Pancolitis)

Ulcerative Colitis: White arrow shows the irregular appearance of an area of UC as compared w/ normal bowel wall (black arrow)

Ulcerative Colitis: "Collar button" appearance of damaged mucosa

Ulcerative Colitis: Ulcerated mucosal lining at the splenic flexure

Ulcerative Colitis: Disease has progressed into the transverse colon 

Toxic Megacolon: CT image of an UC PT w/ Toxic Megacolon who tested positive for C-dif infection

Toxic Megacolon: Grossly distended transverse colon of an Ulcerative Colitis PT w/ Toxic Megacolon

Toxic Megacolon: Dilation of the transverse colon measures 9 cm

Toxic Megacolon: Toxic Megacolon - pseudo polyps as indicated by the arrows

Toxic Megacolon: CT image of Toxic Megacolon w/ dilation measured at 8.4 cm in the large bowel

Diverticular Disease: "Saw-tooth" appearance

Diverticular Disease: "Saw tooth" appearance of the bowel in the distal portion of the descending colon

Diverticular Disease: Splenic flexure shown demonstrating diverticula in descending and transverse colon

Diverticular Disease: Multiple areas of diverticula

Diverticular Disease: Remnants of contrast within the diverticula

Diverticular Disease: Active diverticulitis

Diverticular Disease: CT AXIAL SLICE "saw tooth" appearance

Diverticular Disease:

Diverticular Disease: Demonstrates a colovesical fistula b/w the sigmoid colon and the bladder due to diverticulitis

Diverticular Disease:Inflamed bleeding diverticulum

Diverticular Disease: Blue represents diverticulum which in turn has caused a pneumoperitoneum (yellow arrows)

Diverticular Disease:

Volvulus: Cecal volvulus

Volvulus: Sigmoid volvulus