SERPENTINE FILLING DEFECT IN STOMACH

Q.Numerous serpentine filling defect in stomach in the barium study of upper GI may be due to

a.lymphoma

b.carcinoma

c.portal hypertension

d.hypertrophic gastropathy

e.gastric ulcer

Gastrointestinal Radiology591 × 350

7ANS--c

Gastric varices due to portal hypertension cause serpentine filling defect in the stomach. 

HEMOCHROMATOSIS---SQUID

Q.All are true regarding imaging of hepatic hemochromatosis except

a.Dual energy CT ia an accurate noninvasive means of measuring the liver iron concentration

b.Ferric iron causes extreme shortening  of T1 relaxation time

c.MRI can indicate cause of iron overload 

d.SQUID provides a quantitative estimate of liver iron

e.Amount of fibrosis can be reduced by iron depletion

ANS.---b

Ferric iron causes  shortening  of both T1 and T2 relaxation time.Although the effect on T1 is moderate ,there is extreme shortening of the T1 rate.

MRI can indicate cause of iron overload.In patients with genetic hemochromatosis,there is proportionately less deposition of iron in the reticuloendothelial system and more deposition in the parenchymal cells of organs than there is parenteral iron overload.Thus spleen usually exhibits a low signal intensity in parenteral iron overload and more signal intensity in genetic hemochromatosis.Pancreas and myocardium show a low signal in genetic hemochromatosis while theyshow normal signal in iron overload.

WHEN LIVER BE CALLED FATTY?

Q.Fat content in fatty liver exceeds ----% of the liver weight

a.1%

b. 5%

c.10%

d.15%

e.20%.

ANS.---b

Fat content(largely triglycerides) in fatty liver exceeds 5% of the liver weight

DOTTED LINE SIGN OF LIVER

Q.Ultrasonographic findings suggestive of cirrhosis of liver are all except

a.the caudate lobe/right lobe ratio greater than or equal to 0.55

b.hypoechoic nodules

c.dotted-line sign

d.coarseness

e.meshwork pattern/cobblestone appearance

ANS.—a

Harbin et al first proposed the ratio of the width of transverse caudate lobe to the width of the right lobe as a means to diagnose cirrhosis using CT.The liver cirrhosis could be separated from normal lives with a sensitivity of 84% ,a specificity of 100% and an accuracy of 94% based ona criterion of the caudate lobe/right lobe ratio greater than or equal to 0.65.

However three –dimensional  caudate lobe index to the right lobe diameter ratio on USG  has greater sensitivity than caudate lobe/right lobe ratio.

In micronodular cirrhosis the hepatic surface appears normal or subtly undulated .The hyperechoic line of the hepatic surface may be interrupted (dotted line sign ) in some cases of micronodular cirrhosis.

Tc

q.All are true regarding Technetium 99m  except

a. an  energy 140 ke V

b.optimal for gamma imaging

c.physical half life of 6 hrs

d. beta particle radiation

e.suitable for SPECT

ans.—d

Technetium 99m  has no beta particle radiation .