277 Index A Abdomen, acute gastrointestinal tract, 245–6 hepatobiliary emergencies, 246–8 other retroperitoneal emergencies, 248–50 pancreas, acute, 248 renal tract emergencies, 248 trauma, 244–5 use of ultrasound, 243–4 Abdominal aorta, 195–9, 196 Abdominal aortic aneurysms, 248 Abscesses appendicitis, 246, 246 drainage of, 262 hepatic, 82–4, 84, 95, 96, 116, 247 psoas, 250 renal, 175, 176, 187 splenic, 145 Acalculous cholecystitis, 59 Acquired cystic disease, 162, 162 Acquired immunodeficiency syndrome (AIDS), 111, 139 Acute abdomen see Abdomen, acute Acute appendicitis, 209 Acute cholecystitis, 59, 246 Acute diverticulitis, 246 Acute fatty liver, 109 Acute hepatitis, 106, 107 Acute pancreas, 248 Acute tubular necrosis (ATN), 177–8, 189, 260 Acute ureteric obstruction, 248 Adenocarcinomas, 130, 132 Adenomas, 86, 86–7, 95, 162–3, 203, 205 Adenomyomatosis, 51–3, 52 Adrenal glands, 201–6, 204, 232, 233 Adrenal haemorrhage, 232, 233 Agenesis, renal, 224 Air in the biliary tree, 72–3, 73 Alagille’s syndrome, 218 Alcoholic cirrhosis, 98, 129 Alcoholic-induced liver disease, 96, 97, 125, 126, 248 Alcoholism, 125 American Institute for Ultrasound in Medicine (AIUM), 10 Amoebic abscess, 83 Amyloid, 179 Anaemia, 82–3, 109–10, 139, 146 Analgesia, 254 Aneurysms aortic, 196–9, 198, 199, 248 renal artery, 191 splenic artery, 147–8 Angiomyolipoma, 162, 163 Aorta, 38, 213 Aortic aneurysms, 196–9, 199, 248 Appearances, ultrasound adrenal glands, 201 Budd–Chiari syndrome, 107–9 cirrhosis, 97–9 hepatic metastases, 90–2 hepatitis, 106–7 hepatocellular carcinoma, 94 kidneys, 155 normal spleen, 137–9, 138 normal transplanted kidney, 182–5 pancreas, 123 pancreatic carcinoma, 132 pancreatic transplant, 135 pancreatitis, 125 renal artery stenosis (RAS), 179–80 renal calculi, 172–3 renal cell carcinoma (RCC), 163–4 renal cysts, 160–1 splenic lymphoma, 141 Appendicitis, 209, 238, 238–9, 239, 245–6, 246 Appendix, 206–7, 209 Arrays, 7 Artefacts, 30 Arteriovenous fistulae, 181, 189, 191 Artery aneurysm, splenic, 147–8 Artery stenosis, renal (RAS), 179–80, 180, 187–9, 188 Ascaris worm, 70, 71 Ascites, 103, 212, 213 Atresia, biliary, 112, 216–18 Atrial systole, 29 Autosomal dominant polycystic kidney disease (APKD), 161–2 Autosomal recessive disease (PCKD), 162 Autosomal recessive polycystic disease of the kidneys (ARPCDK), 224–5 B Beckwith–Wiedemann syndrome, 218, 229 Benign focal liver lesions, 79–89 Benign focal pancreatic lesions, 133–4 Benign focal renal tumours, 162–3 Benign splenic conditions, 143–8 Bile, 49, 71
278 INDEX Bile ducts, 31–3 see also Common bile duct (CBD) Biliary atresia, 112, 216–18, 219 biliary tree, 17 calculi, 125 colic, 52, 70 crystals, 72, 72 dilatation, 248 dilation without jaundice, 66–7 obstruction, 246 reflux, 47 sludge, 56 stasis, 71–2 see also Bile ducts; Gallbladder Bilirubin, 34–5 Biochemical analysis, pancreas, 123 Biological effects of ultrasound, 10–11 Biopsy attachments, 7 Biopsy, renal, 179, 259–61 Biopsy, ultrasound-guided see Ultrasound-guided biopsy Bladder diverticulum, 175, 176 paediatric, 221 tumour, 4 Blind biopsy, 255 Blood clot, renal, 167, 168–9 Blood in the gallbladder, 72 Blood tests for renal function, 157 Bone-at-focus index (TIB), 11 Bone-at-surface index (TIC), 11 Bowels carcinoma, 91 gas in, 29, 63, 223 malignant tumours in the, 210–11 perforation of the, 245 problems in the, 36 rupture of the, 244 Breast carcinoma, 143, 213 Budd–Chiari syndrome (BCS) free intraperitoneal fluid, 111 indications for liver transplantation, 112 liver metastasis, 203 management of, 108–9 risk of thrombosis, 115 ultrasound appearances of, 107–8, 108 with suspected liver lesion, 94 C Caecal carcinoma, 212, 212 Calcification adrenal, 232, 233 hepatic, 88–9, 90 pancreatic, 128, 129, 132 renal tract, 170–4 splenic, 145, 145–6 Calcium stones, 171 Candidiasis, 229, 230 Candidiasis abscess, 83–4 CAPD fluid, 111 Capillary haemangiomas, 257 Carcinomas adenocarcinoma, 130, 132 adrenal, 206 bowel, 36, 91, 212, 212 breast, 143, 213 cervical, 167 cholangiocarcinoma, 64, 67, 68, 74, 75, 95 colorectal, 268–9, 271 cystadenocarcinoma, 130, 132 gallbladder, 50, 73, 73 gastric, 208 hepatocellular carcinoma (HCC) (see Main entry) lung, 205 oesophagus, 207 ovarian, 75, 80, 81, 90, 111 pancreatic, 128–33, 131, 247, 266, 271 renal, 134, 163–5, 164, 202 transitional cell carcinoma, 164–5, 165, 166 Cardiac failure, 111 Caroli’s diesease, 68–70, 70 Cervical carcinoma, 167 Chemotherapy, 91 Children see Paediatric abdomen Cholangiocarcinomas, 64, 67, 68, 74, 75, 95 Cholangitis, 66, 66, 70, 247, 247 Cholecystectomy acalculous cholecystitis, treatment for, 247 bile duct measurements, 33, 33 choledocholithiasis, 45 gallstones, management of, 47, 52 laparoscopic, 56, 67 scar, 29 Cholecystitis acalculous, 56–7, 59, 247 acute, 54–6, 55, 59, 111, 246 chronic, 56, 59 complications of, 47, 57–8 emphysematous, 60 Cholecystokinin-stimulated hepatic iminodiacetic acid (HIDA) scan, 57 Choledochal cysts, 64–6, 66, 68–70, 218, 219 Choledocholithiasis, 45–7 Cholelithiasis see Gallstones Cholestasis, 110, 112, 216–18, 218 Cholesterolosis, 53–4, 54 Choosing a machine, 6–9 Chronic cholecystitis, 59 Chronic liver disease, 257 see also specific disease Ciclosporin nephrotoxicity, 191 Cirrhosis alcoholic, 98, 129 and chronic hepatitis, 107 and hepatocellular carcinoma (HCC), 94 causes of non-obstructive jaundice, 96 increased echogenicity, 111 liver biopsy in patients with, 257, 261 liver transplants, 110, 112 micronodular, 97 ultrasound appearances, 97–9 Coarse texture of the liver, 111 Colic, acute renal, 249 Colitis, ulcerative, 209 Colonic carcinoma, 36 Colonic mass, 210 Colorectal carcinoma, 268–9, 271 Colour Doppler diagnosing cholecystitis, 54 dilated bile duct, 61 hepatic vein, 5 pancreatic duct, 131 pancreatic transplant, 135 portal venous system, 26, 101 renal tract, 155–6, 157 thermal effects of, 11 use of, 2–4 Common bile duct (CBD) cysts, 64–6, 66, 68–70, 218, 219 dilated, 58–67, 59, 62, 65, 66–7 normal, 25, 27, 31–3, 32 obstructed, 130 postoperative ultrasound appearances, 116 stones in, 45–7, 46, 218 see also Gallbladder Complex cysts, 80–1, 81 Complications, post operative renal transplant, 185 Computed tomography (CT) scan, 167, 212, 229, 232, 244, 246, 259 Congenital anomalies of the pancreas, 123–4 Congenital intrahepatic biliary dilation, 68–70 Congenital megacalyces, 170 Congestive cardiac disease, 109
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Abdominal Ultrasound
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Abdominal Ultrasound How, Why and W
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v Contents Contributors Preface ix
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vii Contributors Rosemary Arthur FR
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ix Preface Ultrasound continues to
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ABBREVIATIONS xi MHA MHV MI MPV MRA
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Chapter 1 1 Optimizing the diagnost
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OPTIMIZING THE DIAGNOSTIC INFORMATI
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Chapter 2 17 The normal hepatobilia
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Chapter 3 41 Pathology of the gallb
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PATHOLOGY OF THE GALLBLADDER AND BI
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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 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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