This document discusses portal hypertension and portosystemic collateral pathways as evaluated by color doppler ultrasound and CT portography. It begins with an overview of normal portal circulation and the pathophysiology of portal hypertension. Color doppler is described as a method to evaluate portal hypertension and varices, while CT portography allows visualization of various collateral pathways that develop during portal hypertension. Common collateral pathways seen in cirrhosis include esophageal, paraesophageal, perigastric varices, and splenorenal shunts. CT portography provides detailed imaging of these tortuous collateral vessels and their anatomy.
This document discusses placental abnormalities that can be detected on prenatal sonography. It begins by covering embryology and normal placental development. It then discusses various placental abnormalities such as placental previa, accreta, infarction, and morphological abnormalities. It provides details on the sonographic findings, risk factors, and clinical implications of each abnormality. The conclusion emphasizes the importance of understanding placental anatomy and physiology to properly identify any abnormalities and optimize outcomes for the mother and baby.
Abdominal sonography is a non-invasive imaging technique that has several advantages over other modalities. It does not require contrast agents, radiation, or isotopes and can visualize organs and surrounding structures along with morphological abnormalities. While obesity, gas, or lack of patient cooperation can limit its effectiveness, sonography should be the first examination used to evaluate diseases of the liver, biliary system, pancreas, and urinary tract. It allows assessment of organ size, structure, lesions, and blood flow and can guide minimally invasive biopsies and procedures. Disadvantages include limited specificity requiring additional tests, but it provides real-time dynamic imaging without known health risks.
An intravenous pyelogram (IVP) is a radiographic examination of the urinary tract that involves injecting iodinated contrast medium intravenously. An IVP outlines the kidneys and urinary tract, showing their size, structure, and function. It is useful for evaluating conditions like kidney stones, tumors, infections, and anatomical abnormalities. The procedure involves preliminary imaging, injection of contrast, and multiple films over time to visualize different parts of the urinary system as the contrast flows through the kidneys and bladder. Potential risks include adverse reactions to the contrast medium and radiation exposure.
Doppler ultrasound of lower limb arteriesSamir Haffar
This document provides information on Doppler ultrasound of lower limb arteries. It begins with the anatomy of lower limb arteries including the abdominal aorta, iliac arteries, femoral arteries, and crural arteries. It then discusses normal Doppler ultrasound findings of lower limb arteries including normal arterial diameters, waveforms, and velocities. Finally, it covers duplex ultrasound criteria for arterial evaluation and various causes of lower limb arterial diseases such as atherosclerosis, thrombosis, aneurysms, and arterial occlusions.
This document discusses the anatomy and ultrasound evaluation of veins in the upper extremity. It describes the cephalic, basilic, brachial, axillary, subclavian, and internal jugular veins. The technical procedure for venous doppler ultrasound is outlined, including patient positioning, scanning techniques, and diagnostic criteria. Potential pitfalls like rouleaux and limited windows are noted. Chronic changes after deep vein thrombosis like valve changes and collateral veins are also described. Ultrasound is useful for evaluating suspected deep vein thrombosis and mapping veins for dialysis access planning.
radiological anatomy of retroperitoneum powerpointDactarAdhikari
brief and concise on radiological anatomy of retroperitoneum
includes topic like pararenal space,perirenal space,fascial plane,retroperitoneum hematoma and sign of mass origin
The document describes gradient echo pulse sequences. It discusses how gradients are used for spatial encoding by dephasing and rephasing magnetic moments. It explains slice selection, frequency encoding, and phase encoding. It describes how gradient echo sequences differ from spin echo by using variable flip angles and gradients instead of RF pulses to generate echoes. It discusses various gradient echo techniques including coherent, spoiled, and balanced sequences. It provides details on sequence parameters and how they control T1, T2, and PD weightings.
Presentation1, radiological imaging of hyperparathyroidism.Abdellah Nazeer
This document discusses radiological imaging features of hyperparathyroidism. It begins by explaining the pathology of the disease and its subtypes. Characteristic skeletal findings are described, including subperiosteal bone resorption of the phalanges and various sites of osteopenia, osteosclerosis, and brown tumors. Various imaging modalities are then discussed for localizing parathyroid adenomas and hyperplasia, including ultrasound, CT, nuclear medicine scans, and MRI. Characteristic appearances on imaging include subperiosteal bone changes, nephrocalcinosis, and enhancement patterns of parathyroid lesions.
This document discusses placental abnormalities that can be detected on prenatal sonography. It begins by covering embryology and normal placental development. It then discusses various placental abnormalities such as placental previa, accreta, infarction, and morphological abnormalities. It provides details on the sonographic findings, risk factors, and clinical implications of each abnormality. The conclusion emphasizes the importance of understanding placental anatomy and physiology to properly identify any abnormalities and optimize outcomes for the mother and baby.
Abdominal sonography is a non-invasive imaging technique that has several advantages over other modalities. It does not require contrast agents, radiation, or isotopes and can visualize organs and surrounding structures along with morphological abnormalities. While obesity, gas, or lack of patient cooperation can limit its effectiveness, sonography should be the first examination used to evaluate diseases of the liver, biliary system, pancreas, and urinary tract. It allows assessment of organ size, structure, lesions, and blood flow and can guide minimally invasive biopsies and procedures. Disadvantages include limited specificity requiring additional tests, but it provides real-time dynamic imaging without known health risks.
An intravenous pyelogram (IVP) is a radiographic examination of the urinary tract that involves injecting iodinated contrast medium intravenously. An IVP outlines the kidneys and urinary tract, showing their size, structure, and function. It is useful for evaluating conditions like kidney stones, tumors, infections, and anatomical abnormalities. The procedure involves preliminary imaging, injection of contrast, and multiple films over time to visualize different parts of the urinary system as the contrast flows through the kidneys and bladder. Potential risks include adverse reactions to the contrast medium and radiation exposure.
Doppler ultrasound of lower limb arteriesSamir Haffar
This document provides information on Doppler ultrasound of lower limb arteries. It begins with the anatomy of lower limb arteries including the abdominal aorta, iliac arteries, femoral arteries, and crural arteries. It then discusses normal Doppler ultrasound findings of lower limb arteries including normal arterial diameters, waveforms, and velocities. Finally, it covers duplex ultrasound criteria for arterial evaluation and various causes of lower limb arterial diseases such as atherosclerosis, thrombosis, aneurysms, and arterial occlusions.
This document discusses the anatomy and ultrasound evaluation of veins in the upper extremity. It describes the cephalic, basilic, brachial, axillary, subclavian, and internal jugular veins. The technical procedure for venous doppler ultrasound is outlined, including patient positioning, scanning techniques, and diagnostic criteria. Potential pitfalls like rouleaux and limited windows are noted. Chronic changes after deep vein thrombosis like valve changes and collateral veins are also described. Ultrasound is useful for evaluating suspected deep vein thrombosis and mapping veins for dialysis access planning.
radiological anatomy of retroperitoneum powerpointDactarAdhikari
brief and concise on radiological anatomy of retroperitoneum
includes topic like pararenal space,perirenal space,fascial plane,retroperitoneum hematoma and sign of mass origin
The document describes gradient echo pulse sequences. It discusses how gradients are used for spatial encoding by dephasing and rephasing magnetic moments. It explains slice selection, frequency encoding, and phase encoding. It describes how gradient echo sequences differ from spin echo by using variable flip angles and gradients instead of RF pulses to generate echoes. It discusses various gradient echo techniques including coherent, spoiled, and balanced sequences. It provides details on sequence parameters and how they control T1, T2, and PD weightings.
Presentation1, radiological imaging of hyperparathyroidism.Abdellah Nazeer
This document discusses radiological imaging features of hyperparathyroidism. It begins by explaining the pathology of the disease and its subtypes. Characteristic skeletal findings are described, including subperiosteal bone resorption of the phalanges and various sites of osteopenia, osteosclerosis, and brown tumors. Various imaging modalities are then discussed for localizing parathyroid adenomas and hyperplasia, including ultrasound, CT, nuclear medicine scans, and MRI. Characteristic appearances on imaging include subperiosteal bone changes, nephrocalcinosis, and enhancement patterns of parathyroid lesions.
A CT scan of the liver involves three phases - arterial, portal vein, and delayed phases - following injection of contrast. The arterial phase, 30 seconds after injection, highlights hypervascular lesions near arteries. The portal vein phase, 70-90 seconds after injection, shows hypovascular lesions as hypodense. The delayed phase, 5-10 minutes after injection, further characterizes lesions such as hemangiomas, HCC, and CCC. Each phase provides different information to identify and characterize liver lesions.
Presentation1.pptx, ultrasound examination of the liver and gall bladder.Abdellah Nazeer
This document provides an ultrasound protocol and guidelines for examining the liver and gallbladder. It begins with an overview of the role and technique of ultrasound for the liver, including scanning positions and images to capture. Common liver pathologies such as fatty liver, cirrhosis, cysts, hemangiomas, abscesses, and metastases are described. Guidelines are provided for gallbladder ultrasound including patient preparation, technique, and anatomy. Normal findings and pathologies like stones, acute cholecystitis, and emphysematous cholecystitis are outlined. The document concludes with potential vascular disorders of the liver involving blood flow.
CT and MRI urography are radiological techniques used to evaluate the kidneys, ureters, and bladder. CT urography involves acquiring images in three phases after intravenous contrast administration, while MRI urography uses heavily T2-weighted sequences without contrast or excretory T1-weighted sequences after gadolinium contrast. Both techniques provide anatomical details and can detect conditions like renal calculi, tumors, and congenital anomalies. CT urography has advantages of better spatial resolution and ability to depict calcifications but exposes patients to radiation, while MRI urography avoids radiation but has longer scan times and lower spatial resolution.
This document discusses various techniques for reducing radiation dose in computed tomography (CT) scans. It outlines strategies such as using automatic exposure control, adjusting scan parameters based on patient size, employing noise-tolerant images when possible, limiting scan lengths and phases, and utilizing newer reconstruction techniques. The goal is to lower radiation dose without compromising diagnostic image quality.
The voiding cystourethrogram is an x-ray exam used to evaluate the lower urinary tract. It involves inserting a catheter into the bladder and filling it with contrast dye before taking x-rays during urination. It can detect conditions like vesicoureteral reflux, bladder abnormalities, and issues with the bladder outlet. The document provides detailed information on how the exam is performed, what is evaluated, common findings, and examples of various normal and abnormal results.
1. Renal radionuclide imaging uses various radiotracers like DMSA, MAG3, and DTPA with technetium-99m or iodine-131 to evaluate renal perfusion and function, obstruction, renovascular hypertension, infection, and transplant and congenital kidney anomalies.
2. DMSA scintigraphy with technetium-99m is commonly used to assess renal morphology and detect infections, masses, and post-infection scarring by visualizing renal contours and detecting "cold" defects.
3. Diuretic renal scans with MAG3 or DTPA and Lasix are used to evaluate obstruction by assessing tracer washout from the renal pelvises,
Ultrasound of the urinary tract - Renal tumorsSamir Haffar
This document discusses ultrasound imaging of renal tumors. It begins by stating that ultrasound is often the first imaging modality used for the kidneys and plays an important role in diagnosing renal tumors. It then discusses technical advances in ultrasound imaging that have improved detection of renal tumors. The document goes on to describe normal kidney anatomy and various benign and malignant renal tumors that can be identified on ultrasound, including renal cell carcinoma, angiomyolipomas, cysts, and others. It provides ultrasound images and characteristics of different renal pathologies.
This document discusses Magnetic Resonance Cholangiopancreatography (MRCP), a non-invasive MRI technique used to investigate biliary and pancreatic pathologies. It works by exploiting the inherent differences in T2-weighted contrast between fluid-filled structures and soft tissue. Static or slow moving fluids within the biliary tree and pancreatic duct appear as high signal intensity on MRCP, while surrounding tissue has reduced signal intensity. The document outlines the MRCP technique, imaging parameters, indications including biliary and pancreatic diseases, advantages over ERCP, and some pitfalls.
This document discusses renal Doppler ultrasound techniques and findings. It describes three main approaches to imaging the renal arteries - anterior, oblique, and flank. Normal and abnormal Doppler waveforms are presented. Evaluation of renal artery stenosis can be done directly by imaging the renal arteries or indirectly by imaging intrarenal arteries. Findings suggestive of stenosis include increased velocities, renal/aortic ratios over 3.5, absence of the early systolic peak, and tardus parvus waveforms. Pathologies of renal transplants like rejection, infarction, and arterial or venous stenosis are also summarized.
This document discusses micturating cystourethrography (MCU) and retrograde urethrography (RGU). MCU involves introducing contrast into the bladder via catheter and imaging the bladder and urethra during micturition. It is used to assess for abnormalities like vesicoureteral reflux (VUR). The document then reviews normal bladder and urethral anatomy, indications for MCU including recurrent UTI and pre-/post-operative evaluation, the technique for MCU, and findings that can be identified like VUR grade. VUR involves abnormal flow of urine from bladder to kidneys and is a common cause of UTIs in children. MCU
This document discusses liver lesions and their appearance on various imaging modalities. It covers benign lesions like hemangioma, focal nodular hyperplasia and hepatic adenoma. Malignant primary lesions discussed are hepatocellular carcinoma and hepatoblastoma. Imaging features of hypervascular and hypovascular lesions on multiphasic CT are summarized. Hepatocellular carcinoma risk factors and clinical presentation are outlined. Imaging appearance of HCC on ultrasound, CT and MRI is described in detail. Hepatic metastases are also discussed along with hypervascular metastatic lesions.
The document provides information on performing and interpreting an ultrasound of the liver. It discusses normal liver anatomy and Doppler assessments of the hepatic vessels. Key findings of a normal liver ultrasound include evaluating the size, shape, echogenicity and echotexture of the liver. Doppler ultrasound can assess blood flow in the hepatic arteries, portal veins and hepatic veins which branch throughout the liver and should demonstrate continuous flow in the expected directions. Spectral analysis of waveforms can help identify abnormalities associated with conditions like portal hypertension.
A brief Introduction into the spleen (size, shape, location, function etc). Procedure for splenic ultrasound, Sonographic appearance of the normal spleen.
Pathologies of the Spleen (Splenic rupture , Splenic Hemangioma ,Sonographic appearance of)
This document provides information on renal artery anatomy and Doppler ultrasound evaluation of the renal arteries. It describes:
1. The typical origin and course of the right and left renal arteries. Approximately 30% of individuals have variant anatomy with more than one renal artery on each side.
2. How Doppler ultrasound is used to image the renal arteries from different approaches and measure parameters like peak systolic velocity to evaluate for renal artery stenosis.
3. The normal Doppler waveforms expected in the main renal artery and intrarenal arteries, as well as normal values for measured parameters.
4. How a bilateral renal Doppler examination is performed, including evaluating each kidney, the renal arteries and veins, and measuring parameters to identify
This document provides an overview of magnetic resonance cholangiopancreatography (MRCP). It discusses patient preparation, techniques, advantages, limitations, and clinical applications of MRCP. Key points include: MRCP uses heavily T2-weighted sequences to noninvasively visualize the biliary and pancreatic ducts. Patient preparation involves fasting and administering oral contrast. Thin-slab MRCP images provide high resolution of the ductal systems. MRCP is useful for evaluating biliary diseases, pancreatic diseases, and postoperative complications without radiation exposure. Limitations include inability to detect small stones and artifacts from gas or metal.
The liver is the largest solid organ located in the right upper quadrant of the abdomen. It is divided into eight segments based on vascular and biliary anatomy. The document describes the normal anatomy of the liver and common variations. It also discusses ultrasound techniques for imaging the liver and provides details on identifying different liver lesions including cysts, benign and malignant tumors, infections, and vascular anomalies on ultrasound scans.
This document discusses malignant liver lesions. It describes the different types of primary and secondary malignant tumors that can occur in the liver. The most common are metastatic deposits from other primary cancers, and hepatocellular carcinoma (HCC). HCC is described in detail, including risk factors, pathogenesis, imaging appearance on ultrasound, CT and MRI, staging systems, treatment surveillance, and diagnostic criteria. Other liver cancers such as cholangiocarcinoma are also briefly mentioned.
Starting with the Definition, Coverage of field, Seldinger technique, Instruments used in IR we move forward into the embolization Techniques and applications, IR procedures in hepatobiliary system, Portal hypertension, Varicose veins
and lastly RFA for bone tumors like ostoid osteoma
This presentation provides sufficient material for anyone who wants is interested in interventional radiology. Here we will discuss the available facilities, mechanisms and equipments.
In my opinion this presentation will prove a footstep in interventional radiology
Dr. Roshan Kumar Shah's document discusses portal hypertension, which is an increase in blood pressure within the portal vein system. It defines portal hypertension as a portal vein pressure above 40 mm Hg and describes its causes such as liver cirrhosis. It then covers the anatomy of the portal vein system, pathophysiology of increased resistance to blood flow, clinical signs including gastrointestinal bleeding, and approaches to diagnosis and management including medications, endoscopic therapy, surgery, and liver transplantation.
This document discusses portal hypertension and variceal bleeding. It begins by describing portal hemodynamics and defining clinically significant portal hypertension as a hepatic venous pressure gradient (HVPG) greater than 10-12 mm Hg.
The etiology of portal hypertension is categorized as prehepatic, hepatic, or posthepatic. Prehepatic causes include portal/splenic vein thrombosis. Hepatic causes include cirrhosis, which leads to fibrosis and increased production of vasoconstrictors. Posthepatic causes include Budd-Chiari syndrome.
Complications of portal hypertension include variceal bleeding, ascites, hepatic encephalopathy, and hepatorenal syndrome. Investigations for diagnosis include ultrasound Doppler,
A CT scan of the liver involves three phases - arterial, portal vein, and delayed phases - following injection of contrast. The arterial phase, 30 seconds after injection, highlights hypervascular lesions near arteries. The portal vein phase, 70-90 seconds after injection, shows hypovascular lesions as hypodense. The delayed phase, 5-10 minutes after injection, further characterizes lesions such as hemangiomas, HCC, and CCC. Each phase provides different information to identify and characterize liver lesions.
Presentation1.pptx, ultrasound examination of the liver and gall bladder.Abdellah Nazeer
This document provides an ultrasound protocol and guidelines for examining the liver and gallbladder. It begins with an overview of the role and technique of ultrasound for the liver, including scanning positions and images to capture. Common liver pathologies such as fatty liver, cirrhosis, cysts, hemangiomas, abscesses, and metastases are described. Guidelines are provided for gallbladder ultrasound including patient preparation, technique, and anatomy. Normal findings and pathologies like stones, acute cholecystitis, and emphysematous cholecystitis are outlined. The document concludes with potential vascular disorders of the liver involving blood flow.
CT and MRI urography are radiological techniques used to evaluate the kidneys, ureters, and bladder. CT urography involves acquiring images in three phases after intravenous contrast administration, while MRI urography uses heavily T2-weighted sequences without contrast or excretory T1-weighted sequences after gadolinium contrast. Both techniques provide anatomical details and can detect conditions like renal calculi, tumors, and congenital anomalies. CT urography has advantages of better spatial resolution and ability to depict calcifications but exposes patients to radiation, while MRI urography avoids radiation but has longer scan times and lower spatial resolution.
This document discusses various techniques for reducing radiation dose in computed tomography (CT) scans. It outlines strategies such as using automatic exposure control, adjusting scan parameters based on patient size, employing noise-tolerant images when possible, limiting scan lengths and phases, and utilizing newer reconstruction techniques. The goal is to lower radiation dose without compromising diagnostic image quality.
The voiding cystourethrogram is an x-ray exam used to evaluate the lower urinary tract. It involves inserting a catheter into the bladder and filling it with contrast dye before taking x-rays during urination. It can detect conditions like vesicoureteral reflux, bladder abnormalities, and issues with the bladder outlet. The document provides detailed information on how the exam is performed, what is evaluated, common findings, and examples of various normal and abnormal results.
1. Renal radionuclide imaging uses various radiotracers like DMSA, MAG3, and DTPA with technetium-99m or iodine-131 to evaluate renal perfusion and function, obstruction, renovascular hypertension, infection, and transplant and congenital kidney anomalies.
2. DMSA scintigraphy with technetium-99m is commonly used to assess renal morphology and detect infections, masses, and post-infection scarring by visualizing renal contours and detecting "cold" defects.
3. Diuretic renal scans with MAG3 or DTPA and Lasix are used to evaluate obstruction by assessing tracer washout from the renal pelvises,
Ultrasound of the urinary tract - Renal tumorsSamir Haffar
This document discusses ultrasound imaging of renal tumors. It begins by stating that ultrasound is often the first imaging modality used for the kidneys and plays an important role in diagnosing renal tumors. It then discusses technical advances in ultrasound imaging that have improved detection of renal tumors. The document goes on to describe normal kidney anatomy and various benign and malignant renal tumors that can be identified on ultrasound, including renal cell carcinoma, angiomyolipomas, cysts, and others. It provides ultrasound images and characteristics of different renal pathologies.
This document discusses Magnetic Resonance Cholangiopancreatography (MRCP), a non-invasive MRI technique used to investigate biliary and pancreatic pathologies. It works by exploiting the inherent differences in T2-weighted contrast between fluid-filled structures and soft tissue. Static or slow moving fluids within the biliary tree and pancreatic duct appear as high signal intensity on MRCP, while surrounding tissue has reduced signal intensity. The document outlines the MRCP technique, imaging parameters, indications including biliary and pancreatic diseases, advantages over ERCP, and some pitfalls.
This document discusses renal Doppler ultrasound techniques and findings. It describes three main approaches to imaging the renal arteries - anterior, oblique, and flank. Normal and abnormal Doppler waveforms are presented. Evaluation of renal artery stenosis can be done directly by imaging the renal arteries or indirectly by imaging intrarenal arteries. Findings suggestive of stenosis include increased velocities, renal/aortic ratios over 3.5, absence of the early systolic peak, and tardus parvus waveforms. Pathologies of renal transplants like rejection, infarction, and arterial or venous stenosis are also summarized.
This document discusses micturating cystourethrography (MCU) and retrograde urethrography (RGU). MCU involves introducing contrast into the bladder via catheter and imaging the bladder and urethra during micturition. It is used to assess for abnormalities like vesicoureteral reflux (VUR). The document then reviews normal bladder and urethral anatomy, indications for MCU including recurrent UTI and pre-/post-operative evaluation, the technique for MCU, and findings that can be identified like VUR grade. VUR involves abnormal flow of urine from bladder to kidneys and is a common cause of UTIs in children. MCU
This document discusses liver lesions and their appearance on various imaging modalities. It covers benign lesions like hemangioma, focal nodular hyperplasia and hepatic adenoma. Malignant primary lesions discussed are hepatocellular carcinoma and hepatoblastoma. Imaging features of hypervascular and hypovascular lesions on multiphasic CT are summarized. Hepatocellular carcinoma risk factors and clinical presentation are outlined. Imaging appearance of HCC on ultrasound, CT and MRI is described in detail. Hepatic metastases are also discussed along with hypervascular metastatic lesions.
The document provides information on performing and interpreting an ultrasound of the liver. It discusses normal liver anatomy and Doppler assessments of the hepatic vessels. Key findings of a normal liver ultrasound include evaluating the size, shape, echogenicity and echotexture of the liver. Doppler ultrasound can assess blood flow in the hepatic arteries, portal veins and hepatic veins which branch throughout the liver and should demonstrate continuous flow in the expected directions. Spectral analysis of waveforms can help identify abnormalities associated with conditions like portal hypertension.
A brief Introduction into the spleen (size, shape, location, function etc). Procedure for splenic ultrasound, Sonographic appearance of the normal spleen.
Pathologies of the Spleen (Splenic rupture , Splenic Hemangioma ,Sonographic appearance of)
This document provides information on renal artery anatomy and Doppler ultrasound evaluation of the renal arteries. It describes:
1. The typical origin and course of the right and left renal arteries. Approximately 30% of individuals have variant anatomy with more than one renal artery on each side.
2. How Doppler ultrasound is used to image the renal arteries from different approaches and measure parameters like peak systolic velocity to evaluate for renal artery stenosis.
3. The normal Doppler waveforms expected in the main renal artery and intrarenal arteries, as well as normal values for measured parameters.
4. How a bilateral renal Doppler examination is performed, including evaluating each kidney, the renal arteries and veins, and measuring parameters to identify
This document provides an overview of magnetic resonance cholangiopancreatography (MRCP). It discusses patient preparation, techniques, advantages, limitations, and clinical applications of MRCP. Key points include: MRCP uses heavily T2-weighted sequences to noninvasively visualize the biliary and pancreatic ducts. Patient preparation involves fasting and administering oral contrast. Thin-slab MRCP images provide high resolution of the ductal systems. MRCP is useful for evaluating biliary diseases, pancreatic diseases, and postoperative complications without radiation exposure. Limitations include inability to detect small stones and artifacts from gas or metal.
The liver is the largest solid organ located in the right upper quadrant of the abdomen. It is divided into eight segments based on vascular and biliary anatomy. The document describes the normal anatomy of the liver and common variations. It also discusses ultrasound techniques for imaging the liver and provides details on identifying different liver lesions including cysts, benign and malignant tumors, infections, and vascular anomalies on ultrasound scans.
This document discusses malignant liver lesions. It describes the different types of primary and secondary malignant tumors that can occur in the liver. The most common are metastatic deposits from other primary cancers, and hepatocellular carcinoma (HCC). HCC is described in detail, including risk factors, pathogenesis, imaging appearance on ultrasound, CT and MRI, staging systems, treatment surveillance, and diagnostic criteria. Other liver cancers such as cholangiocarcinoma are also briefly mentioned.
Starting with the Definition, Coverage of field, Seldinger technique, Instruments used in IR we move forward into the embolization Techniques and applications, IR procedures in hepatobiliary system, Portal hypertension, Varicose veins
and lastly RFA for bone tumors like ostoid osteoma
This presentation provides sufficient material for anyone who wants is interested in interventional radiology. Here we will discuss the available facilities, mechanisms and equipments.
In my opinion this presentation will prove a footstep in interventional radiology
Dr. Roshan Kumar Shah's document discusses portal hypertension, which is an increase in blood pressure within the portal vein system. It defines portal hypertension as a portal vein pressure above 40 mm Hg and describes its causes such as liver cirrhosis. It then covers the anatomy of the portal vein system, pathophysiology of increased resistance to blood flow, clinical signs including gastrointestinal bleeding, and approaches to diagnosis and management including medications, endoscopic therapy, surgery, and liver transplantation.
This document discusses portal hypertension and variceal bleeding. It begins by describing portal hemodynamics and defining clinically significant portal hypertension as a hepatic venous pressure gradient (HVPG) greater than 10-12 mm Hg.
The etiology of portal hypertension is categorized as prehepatic, hepatic, or posthepatic. Prehepatic causes include portal/splenic vein thrombosis. Hepatic causes include cirrhosis, which leads to fibrosis and increased production of vasoconstrictors. Posthepatic causes include Budd-Chiari syndrome.
Complications of portal hypertension include variceal bleeding, ascites, hepatic encephalopathy, and hepatorenal syndrome. Investigations for diagnosis include ultrasound Doppler,
This document provides information on portal hypertension, including:
1. It defines portal hypertension and describes types such as cirrhotic and non-cirrhotic portal hypertension.
2. It outlines the portal venous system and portosystemic circulation.
3. It discusses causes, clinical features, investigations, and management of portal hypertension including pharmacotherapy, endoscopic therapy, TIPS procedure, and surgeries.
4. Prevention of recurrent variceal hemorrhage is highlighted through long-term pharmacotherapy, endoscopic therapy, interventional procedures like TIPS, or surgical shunts if other options fail.
PORTAL HYPERTENSION by Dr.Abhijeet Majhi.pptxAbhijeet Majhi
The portal vein drains blood from the intestines and organs into the liver. Portal hypertension is defined as increased pressure in the portal vein above normal levels. It can be caused by obstruction anywhere along the portal vein system or within the liver. Complications include gastrointestinal bleeding, ascites, and liver dysfunction. Treatment involves medication to reduce pressure, endoscopic procedures to treat varices, surgical shunts, and liver transplantation in severe cases.
The document discusses portal hypertension in children. It covers the anatomy of the portal system, causes/classifications of portal hypertension, clinical manifestations, diagnosis, and treatment. Regarding diagnosis, it describes using endoscopy to identify varices, ultrasound to detect portal vein thrombosis, and CT/MRI/venography to further evaluate vascular anatomy. Treatment of acute variceal bleeding involves stabilizing the patient and reducing portal pressure to stop bleeding.
Cirrhosis is a diffuse process characterized by liver necrosis and fibrosis that converts the normal liver architecture into abnormal nodules lacking normal structure. It has many causes including viral hepatitis, alcohol, autoimmune conditions, and genetic disorders. Complications of cirrhosis arise from portal hypertension and liver insufficiency, leading to variceal bleeding, ascites, encephalopathy, and jaundice. Cirrhosis is diagnosed based on clinical signs, lab tests, imaging, and may involve liver biopsy. Management focuses on treating complications and screening for hepatocellular carcinoma.
This document discusses portal hypertension, its causes, signs, symptoms, diagnosis, and management. It provides an overview of normal portal circulation and defines portal hypertension as a portal pressure greater than 12 mmHg. It describes various etiologies of portal hypertension including presinusoidal, sinusoidal, postsinusoidal, and posthepatic causes. Complications of portal hypertension like variceal bleeding, ascites, and hepatic encephalopathy are discussed. The management of portal hypertension and its complications is also summarized.
The document discusses the proximal splenorenal shunt procedure for patients with liver cirrhosis and portal hypertension combined with hypersplenism. The procedure involves creating a shunt from the splenic vein to the left renal vein to decompress the portal system. It is indicated for select patients as an alternative to other procedures to prevent variceal bleeding while removing the spleen. However, it carries risks of hepatic encephalopathy, worsening liver function, and is not suitable for future transplantation. The authors' experience with 17 patients who underwent this procedure is presented, along with postoperative outcomes.
A presentation on the pathology and current management (with Especial emphasis on surgical management) of Portal Hypertension; a common complication of liver cirrhosis among other liver diseases. Being a copy of seminar presentation I for the HepatoPancreaticoBiliary Unit of the Division of General Surgery, Ahmadu Belllo University Teaching Hospital, Zaria.
The document discusses portal hypertension, including:
- Anatomy of the portal vein and causes of increased portal pressure.
- Cirrhosis of the liver is a leading cause of portal hypertension due to obstruction of blood flow through the liver.
- Consequences of portal hypertension include splenomegaly, variceal bleeding, and ascites.
- Investigations involve assessing liver function and imaging tests to identify varices.
- Treatment depends on severity but may include band ligation, sclerotherapy, drugs, or shunt surgery to reduce portal pressure.
The document discusses portal hypertension, which occurs when portal venous blood pressure is greater than 12 mmHg. It outlines the causes of portal hypertension as pre-hepatic, hepatic, or post-hepatic. Cirrhosis is the most common hepatic cause. Complications of portal hypertension include esophageal and gastric varices, which can bleed severely. Treatment involves beta-blockers, sclerotherapy or banding of varices, and sometimes transjugular intrahepatic portosystemic shunt placement or liver transplant. Management of acute variceal bleeding requires fluid resuscitation and blood transfusion, with potential use of balloon tamponade or vasoactive drugs.
The document discusses portal hypertension, which occurs when portal venous blood pressure is greater than 12 mmHg. It can be caused by conditions that affect blood flow pre-hepatically, hepatically, or post-hepatically. Complications include esophageal and gastric variceal bleeding. Management involves treating the underlying cause, reducing portal pressure with medications, banding or sclerotherapy of varices, and shunt procedures or transplant for severe cases.
Portal hypertension occurs when there is increased resistance to blood flow through the portal vein, causing elevated pressure. It is usually caused by cirrhosis which damages the liver and increases vascular resistance. Common clinical signs include gastrointestinal bleeding, ascites, and an enlarged spleen. Treatment depends on the severity and includes pharmacotherapy, endoscopic procedures, transjugular intrahepatic portosystemic shunt placement, and liver transplantation for advanced disease. The goal is to reduce portal pressure and prevent complications.
Portosystemic shunts and its management in dogsMAGESHWARSINGH
This document summarizes portosystemic shunts and their management in dogs. Portosystemic shunts are abnormal blood vessel connections that allow blood to bypass the liver. They can be congenital or acquired. Clinical signs include neurological, gastrointestinal and urinary issues. Diagnosis involves imaging like ultrasound, scintigraphy and portography. Treatment options are medical management to improve health for surgery or surgical attenuation of the shunt vessel. The goal of surgery is to redirect blood flow to the liver without causing excessive portal hypertension. Post-operative care focuses on a low-protein diet and medications to prevent hepatic encephalopathy.
Role of Doppler in Liver Cirrhosis & Portal Hypertensionnishit viradia
Doppler ultrasound is useful for assessing portal hypertension and liver cirrhosis. Key findings include increased portal vein diameter (>13mm), decreased increase in splenic or portal vein diameter with respiration, reversed or biphasic portal flow, increased hepatic artery flow and resistive index, altered hepatic vein waveforms, splenomegaly (>13cm), and presence of portosystemic collateral veins. Together these Doppler ultrasound metrics can diagnose and characterize portal hypertension noninvasively.
NCPF is a condition characterized by portal fibrosis and involvement of small and medium portal veins, leading to portal hypertension and splenomegaly despite normal liver function and structure. It commonly affects individuals in the Indian subcontinent aged 25-35 years from low socioeconomic backgrounds. Diagnosis involves evidence of portal hypertension and varices with normal liver function tests and histology showing obliteration of small portal veins without cirrhosis or injury. Management focuses on treatment and prevention of variceal bleeding through endoscopic therapies and beta blockers, with an otherwise excellent prognosis.
This document discusses portal hypertension and anesthetic concerns for lienorenal shunt surgery. It begins by defining portal hypertension as an increase in pressure gradient between the portal vein and hepatic veins/inferior vena cava. Common causes include increased resistance to hepatic blood flow from cirrhosis and increased splanchnic blood flow from splanchnic vasodilation. Major consequences include ascites, portosystemic shunts/varices, splenomegaly, and hepatic encephalopathy. Management of acute variceal bleeding and procedures like TIPS and surgery are discussed. Anesthetic considerations include aspiration prophylaxis, hemodynamic monitoring, and managing complications of variceal bleeding and procedures.
This document discusses portal hypertension, including its causes, clinical presentation, investigations, and treatments. Key points:
- Portal hypertension occurs when portal vein pressure exceeds 12 mmHg. It can be caused by increased resistance (e.g. cirrhosis) or increased blood flow (e.g. arterio-portal fistula).
- Clinical sequelae include portosystemic collaterals, splenomegaly, gastrointestinal congestion, variceal bleeding, and ascites.
- Investigations include liver function tests, endoscopy to detect varices, and tests to identify the underlying cause such as hepatitis markers or biopsy.
- Treatment depends on severity but may include endoscopic var
Cirrhosis is a diffuse process characterized by liver necrosis and fibrosis that converts the normal liver architecture into abnormal nodules. It has many causes including viral hepatitis, alcohol, autoimmune conditions, and genetic disorders. Cirrhosis can lead to complications from portal hypertension such as variceal bleeding and ascites. It is diagnosed based on clinical findings, lab tests, imaging, and may require liver biopsy. Treatment focuses on managing complications and potentially liver transplantation.
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This presentation includes basic of PCOS their pathology and treatment and also Ayurveda correlation of PCOS and Ayurvedic line of treatment mentioned in classics.
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it describes the bony anatomy including the femoral head , acetabulum, labrum . also discusses the capsule , ligaments . muscle that act on the hip joint and the range of motion are outlined. factors affecting hip joint stability and weight transmission through the joint are summarized.
This slide is special for master students (MIBS & MIFB) in UUM. Also useful for readers who are interested in the topic of contemporary Islamic banking.
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7. • CLINICAL SIGNIFICANCE
• (i) Diagnostic signiAicance: portosystemic collateral pathways
constitutes the direct sign of portal hypertension on imaging.
• (ii) Prognostic signiAicance: The more severe and more
prolonged the portal hypertension, the higher are the number
of portosystemic pathways.
• (iii) Therapeutic signiAicance: Detailed information about
collateral pathways is especially relevant when therapeutic
interventional procedures or surgery is being contemplated as
inadvertent collateral vessel injury can be potentially lethal As
these vessels can easily torn and are difNicult to repair
• There have been many reported cases of intraoperative
mortality and morbidity due to unintentional disruption of
unexpected portosystemic collaterals.
23. Recanalised paraumblical vein :
• Ligamentum teres in the left lobe of liver
• Recanalized visible as a channel greater than 3 mm in diameter
• Hepatofugal Nlow
• Recanalization of umbilical vein is a highly speciNic sign of portal
hypertension
• From the umbilicus, the blood may pass to the superior or
inferior epigastric veins, or through subcutaneous veins in the
anterior abdominal wall, known as the ‘Caput Medusa’, to reach
the systemic circulation.
• Patients with known portal hypertension, who present with an
umbilical hernia, should undergo imaging evaluation prior to
surgery as the hernia may contain a dilated varix, rather than
bowel. This pathway has less risk of life-threatening variceal
bleeding
30. • ESOPHAGEAL & PARA-ESOPHAGEAL COLLATERALS
• Typical CT appearance is nodular thickening of the esophageal wall
and enhancing nodular intraluminal protrusions with scalloped
borders
• Esophageal varices are enlarged, tortuous veins situated in the wall of
the lower esophagus formed by dilated subepithebial, submucosal
and perforating veins. While, the paraesophageal varices are situated
outside the esophagus in the posterior mediastinum
• Esophageal varices are usually supplied by the anterior branch of the
left gastric vein, whereas the posterior branch of this vein supplies
paraesophageal collateral vessels.
• Blood from the esophageal and paraesophageal varices usually drains
into the azygos vein (78%). Uncommonly, it drains into the IVC
(12%), or pulmonary or brachiocephalic veins
• Clinical signiAicance: Esophageal varices are common collateral
pathways observed in portal hypertension which may increase up to
six-fold in size and can carry up to a half litre of blood per minute.
Unfortunately, they are the commonest to bleed in cirrhotic patients
owing to the high-volume of blood Nlow and account for the high
mortality associated with spontaneous variceal bleeding.
43. SPLENO-RENAL & GASTRO-SPLENORENAL
COLLATERALS:
• Collaterals along the spleen, primarily supplied by the short
gastric vein, usually shunt the blood into the left renal vein
(systemic circulation) via a spleno-renal shunt
• The splenic collaterals may also drain into left suprarenal vein
and then into the left renal vein (i.e. splenoadrenorenal
shunt).
• Varices in this location may communicate with gastric,
perigastric or retrogastric varices and drain through a common
shunt into the left renal vein (spleno-gastrorenal shunt)
• Among patients with large spontaneous shunts, there is a high
frequency of hepatic encephabopathy and their closure has
shown good results in improving the patient's neurological
status.
51. • ATYPICAL COLLATERAL PATHWAYS
• MESENTERICO-GONADAL & MESENTERICO-CAVAL VARICES:
• Mesenterico-gonadal or mesenterico-caval varices are
uncommon collateral pathways communicating between
intestinal or retroperitoneal tributaries of the superior and
inferior mesenteric veins and systemic veins
• The mesenteric varices are more commonly supplied by
branches SMV and usually drain into the IVC through the dilated
right gonadal vein, right renal vein, or sometimes directly join
the IVC.
• In rare instances IMV provides a conduit for portosystemic
shunting.