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ix Preface Ultrasound continues to be one of the most important diagnostic tools at our disposal. It is used by a wide range of healthcare professionals across many applications. This book is intended as a practical, easily accessible guide to sonographers and those learning and developing in the field of abdominal ultrasound. The most obvious drawbacks of ultrasound diagnosis are the physical limitations of sound in tissue and its tremendous dependence upon the skill of the operator. This book seeks to enable the operator to maximize the diagnostic information and to recognize the limitations of the scan. Where possible it presents a wider, more holistic approach to the patient, including presenting symptoms, complementary imaging procedures and further management options. It is not a comprehensive account of all the pathological processes likely to be encountered, but is intended as a springboard from which practical skills and clinical knowledge can develop further. This book aims to increase the sonographer’s awareness of the contribution of ultrasound within the general clinical picture, and introduce the sonographer to its enormous potential. The author gratefully acknowledges the help and support of the staff of the Ultrasound Department at St James’s University Hospital, Leeds. Leeds 2004 Jane Bates
x Abbreviations ADPCDK AFP AI AIDS AIUM ALARA ALT AP APKD ARPCDK AST AT AV BCS CAPD CBD CD CF CT DIC DICOM DMSA autosomal dominant polycystic disease of the kidney alpha-fetoprotein acceleration index acquired immune deficiency syndrome American Institute for Ultrasound in Medicine as low as reasonably achievable alanine aminotransferase anteroposterior autosomal dominant (adult) polycystic kidney autosomal recessive polycystic disease of the kidney aspartate aminotransferase acceleration time arteriovenous Budd–Chiari syndrome continuous ambulatory peritoneal dialysis common bile duct common duct cystic fibrosis computed tomography disseminated intravascular coagulation Digital Imaging and Communications in Medicine dimercaptosuccinic acid DTPA EDF ERCP ESWL EUS FAST FDA FPS HA HCC HELLP HIDA HPS HV INR IOUS IVC IVU KUB LFT LPV LRV LS LUQ MCKD diethylene triaminepenta-acetic acid end-diastolic flow endoscopic retrograde cholangiopancreatography extracorporeal shock wave lithotripsy endoscopic ultrasound focused assessment with sonography for trauma Food and Drug Administration frames per second hepatic artery hepatocellular carcinoma haemolytic anaemia, elevated liver enzymes and low platelet count hepatic iminodiacetic acid hypertrophic pyloric stenosis hepatic vein international normalized ratio intraoperative ultrasound inferior vena cava intravenous urogram kidneys, ureters, bladder liver function test left portal vein left renal vein longitudinal section left upper quadrant multicystic dysplastic kidney
Page 2 and 3: Abdominal Ultrasound
Page 4 and 5: Abdominal Ultrasound How, Why and W
Page 6 and 7: v Contents Contributors Preface ix
Page 8 and 9: vii Contributors Rosemary Arthur FR
Page 12 and 13: ABBREVIATIONS xi MHA MHV MI MPV MRA
Page 14 and 15: Chapter 1 1 Optimizing the diagnost
Page 16 and 17: OPTIMIZING THE DIAGNOSTIC INFORMATI
Page 30 and 31: Chapter 2 17 The normal hepatobilia
Page 32 and 33: THE NORMAL HEPATOBILIARY SYSTEM 19
Page 54 and 55: Chapter 3 41 Pathology of the gallb
Page 56 and 57: PATHOLOGY OF THE GALLBLADDER AND BI
Page 58 and 59: PATHOLOGY OF THE GALLBLADDER AND BI
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PATHOLOGY OF THE GALLBLADDER AND BI
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Chapter 4 79 Pathology of the liver
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PATHOLOGY OF THE LIVER AND PORTAL V
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Chapter 5 121 The pancreas CHAPTER
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THE PANCREAS 123 the patient’s le
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THE PANCREAS 125 Acute pancreatitis
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THE PANCREAS 127 E F G Figure 5.3 c
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A C DISTANCE = 3.43 CM 5%. 13 Over
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THE PANCREAS 131 G H I Figure 5.5 c
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THE PANCREAS 133 head of pancreas.
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THE PANCREAS 135 pancreatic juice i
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Chapter 6 137 The spleen and lympha
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THE SPLEEN AND LYMPHATIC SYSTEM 139
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Chapter 7 153 The renal tract CHAPT
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THE RENAL TRACT 155 As with any oth
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THE RENAL TRACT 157 A B q 0 LRA AO
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THE RENAL TRACT 159 junctions of or
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THE RENAL TRACT 161 A B Figure 7.5
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THE RENAL TRACT 163 carcinomas, the
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THE RENAL TRACT 165 the vesicourete
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THE RENAL TRACT 167 Table 7.1 Sourc
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THE RENAL TRACT 169 A B Figure 7.13
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THE RENAL TRACT 171 Table 7.2 Diffe
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THE RENAL TRACT 173 Ultrasound stil
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THE RENAL TRACT 175 CT is useful fo
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THE RENAL TRACT 177 Xanthogranuloma
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THE RENAL TRACT 179 As with acute t
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THE RENAL TRACT 181 der with increa
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THE RENAL TRACT 183 ● ● Morphol
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THE RENAL TRACT 185 ● ● hydrone
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THE RENAL TRACT 187 A Figure 7.27 A
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THE RENAL TRACT 189 vascular reject
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THE RENAL TRACT 191 B A C Figure 7.
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THE RENAL TRACT 193 computerised ul
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Chapter 8 195 The retroperitoneum a
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THE RETROPERITONEUM AND GASTROINTES
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Chapter 9 215 The paediatric abdome
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THE PAEDIATRIC ABDOMEN 217 A B SPLE
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THE PAEDIATRIC ABDOMEN 219 B A B Fi
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THE PAEDIATRIC ABDOMEN 221 probe de
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THE PAEDIATRIC ABDOMEN 223 When the
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THE PAEDIATRIC ABDOMEN 225 + 78 A 2
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THE PAEDIATRIC ABDOMEN 227 A B C D
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THE PAEDIATRIC ABDOMEN 229 Table 9.
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THE PAEDIATRIC ABDOMEN 231 A LT B C
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THE PAEDIATRIC ABDOMEN 237 mesenter
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THE PAEDIATRIC ABDOMEN 239 E F G Fi
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THE PAEDIATRIC ABDOMEN 241 system i
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Chapter 10 The acute abdomen 243 CH
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THE ACUTE ABDOMEN 245 scan of the p
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THE ACUTE ABDOMEN 247 LIVER LS GB S
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THE ACUTE ABDOMEN 249 D A RT B C E
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THE ACUTE ABDOMEN 251 17. Patlas M,
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Chapter 11 253 Interventional and o
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INTERVENTIONAL AND OTHER TECHNIQUES
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275 Bibliography and further readin
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277 Index A Abdomen, acute gastroin
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INDEX 279 Continuous ambulatory per
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INDEX 281 Intravenous urography (IV
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INDEX 283 Phrygian cap, 29 Pneumobi
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