This document summarizes gastrointestinal imaging techniques and examinations. It discusses: 1. The main imaging methods for examining the GI tract including fluoroscopy, radiography, CT, MRI, ultrasound, and nuclear medicine. 2. Special contrast techniques like double contrasting and pneumoparietography. 3. The anatomy, examination techniques, and common pathologies of the esophagus, stomach, small intestine, and large intestine. 4. Imaging findings of conditions like achalasia, cancer, ulcers, diverticula, obstructions, and perforations.

1. Gastrointestinal series
imaging

2. The main methods of
examination
- Fluoroscopy
- Radiography
- CT
- MRI
- Ultrasound
- Radionuclide methods (PET,
SPECT)

3. The special contrast methods
-
-
Double contrasting
Pneumoparietography of the stomach

4. The X-ray anatomy and
examination of esophagus
Width – 1,5 - 2,0 см;
Length – 25 - 26 см;
The parts of esophagus:
А) cervical;
Б) thoracic;
В) abdominal.

5. Three physiologic narrowings:
А) at the level of cricoid cartilage;
Б) at the level of aortic arc;
В) at the level of cardia.
The duration of the peristatic wave is
4 - 6 seconds.

6. peristalsis
narrowing (arc)
cardia

7. Folds of mucosa – parallel, longitudinal;
parallel
longitudinal

8. The X-ray anatomy and
examination of the stomach
1. The survey fluoroscopy.
2. The first stage of examination – the
patient drinks 1-2 swallows of contrast
barium sulfate (we can evaluate
the folds of mucosa of the stomach).
3. The second stage of examination –
tight filling. We can determine the
shape, size and position of stomach.

9. 4. The stomach peristalsis:
 Superficial;
 Medium depth;
 Deep;
 Segmental;
The duration of the peristatic wave is 21
seconds.

11. Double-contrast gastrography

12. 5. Parts of the stomach:
• Fundus;
• Cardiac part;
• Body;
• Sinus (or angle);
• Antrum;
• Pyloric part;
• Minor and major
curvature.

14. Ultrasound and MRI of the stomach is assigned
fairly rare, due to the fact that the procedure is
less effective for cavity organs than other methods
of investigation. Assign to detect metastases
gastric cancer to other organs

15. Computed tomography of the stomach is used
mainly for the detection of neoplastic diseases of
the stomach. .

16. . normal Stomach wall thickening . Endoscopy was suggested
for biopsy. Biopsy - Carcinoma

17. The x-ray anatomy and examination
of duodenum and small intestine
1. The duodenum comes after stomach
and it has three parts:
• Superior (bulb of triangular
shape);
• Descending (covers the head of
pancreas);
• Inferior.

18. 2. Small intestine:
• duodenum;
• jejunum;
• ileum;
Kerckring's folds of the mucosal layer.

19. N

20. The X-ray anatomy and
examination of large intestine
1. The methods of
examination:
• Per os;
• Irrigoscopy – contrast
enema.

21. 2. X-ray anatomy and parts of the large
-
-
-
-
-
-
intestine: Caecum;
C. ascendens;
C. transversum;
C. descendens;
C. sygmoideum;
Rectum.

22. 3. Irrigoscopy:
The first stage of examination – tight filling
of the bowel.
А) shape;
Б) size;
В) localiation.
The second stage of examination– the evaluation
of the mucosa folds (after depletion of patient);
The third stage of examination– double contrasting
(inflation of large intestine with barium sulfate by
Bobrov device).
The elasticity of the walls is determined.

23. Double-Contrast Barium Enema

24. N

27. MRI of the internal organs - a method of
medical research , which is to apply a
magnetic field to produce images and three-
dimensional images of the examined organ
and tissue . The patient is placed in a
magnetic field such that its abdomen was at
the center of radiation. Then, the doctor
performs a complete scan of the selected
region receives digital images and three-
dimensional model on a computer screen.
One advantage of MRI bowel that does not
require long preparation. Thus , the
preparation for bowel MRI includes a
conversation with the patient to identify the
information about the presence of iron-bearing
elements in the body ( body piercing ,
implants , pins , tattoos of special materials) ,
which is a contraindication for the procedure .

28. MRI of the intestine , usually assigned in the
following cases:
 To detect tumors
 Body checking
 Hydro- MRI
 Effective and informative

29. The pathology of the
gastrointestinal tract
1.Esophagus:
Esophageal diverticuli:
А) pulsational; Б) tractional; В)
functional.
Achalasia of esophagus

33. Radiographs of the esophagus with
achalasia cardia: visible sharply
narrowed terminal esophagus, supra-
stenotic extension of the esophagus,
stomach gas bubble is not defined.

36. Balon dilatation
Achalasia before
after

37. Radiographs of esophageal
perforation: taken by mouth
radiopaque substance is
distributed in the posterior
mediastinum in the form of a
large streaks.
ма пищевода при перфорации: принятое через рот рентгеноконтрастное вещество распространяется в заднем средостении в в

38. - Cancer of
esophagus:
А) scirrhous;
Б) bowl-shaped ;
В) medullar shape.

39. The symptoms of cancer:
-
-
-
-
-
-
Stenosis of esophagus; Filling defect;
Irregular borders;
The delay of contrast media above the
level of stenosis;
Deformation and absence of the folds;
The absence of peristalsis at the level of
defect.

40. filling defect
cancer
filling defect
cancer

41. filling defect

42. Computed tomography (CT)
of the esophagus to determine the
boundaries of lesions of the
esophagus, to identify the affected
organs and metastatic lymph nodes,
as well as the suspected growing into
adjacent organs.
At a cancer, esophageal
ultrasound is used to detect
metastases in abdominal organs and
remote lymph nodes.

43. Positron Emission Tomography (PET ) study, which allows you to
simultaneously identify all the malignant tumor in the body lesions larger
than 5 -10mm .
Before examining a patient is injected into the vein of a small amount of
radioactive glucose ( sugar). After that rotates around the body scanner that
detects areas of increased accumulation of radioactive glucose in the body.
Malignant tumor cells rapidly accumulate glucose they need for active growth
Therefore , the images obtained from a scanner , malignant tumor foci
appear much brighter than the surrounding tissue. PET value in treating
cancer of the esophagus , now constantly increases

44. PET CT (esophageal cancer)

45. - Burn of esophagus:
The first examination is possible after 2-3
weeks.
Symptoms:
 Circular stenosis;
 Flat contours;
 Deformation – cone-, funnel-, ampullar.
-Foreign substances
Method by Ivanova : after 1-2 sips of
barium sulfate patient takes one sip of
water, balances contrast are above the
foreign body.

47. burn

50. 2. Stomach:
- Gastritis:
А) acute; Б) chronic;
В) chronic hyperthrophic gastritis;
Г) rigid antral gastritis.

51. - The ulcer of stomach and
duodenum:
Symptoms:
 “niche”;
 inflammative elevation of mucosa;
 folds convergention;
 the symptom of “pointing finger”.
Complications:
 hemorrhage;
 perforation;
 penetration;
 malignisation (transformation into
cancer).

52. Chronic ulcer
niche

53. niche

54. ulcer
niche

55. ulcer
niche

56. niche
ulcer
ulcer
niche

57. - Cancer of
stomach:
 polypous;
 bowl-shape;
 ulcerative cancer;
 diffuse;
 cancerous ulcer;
 cancer from polyp.

58. Symptoms:
 filling defect;
 the absence of the folds of mucosa;
 the absence of peristalsis at the defect
localization;
 stenosis of the lumen.

59. Cancer of stomach:
filling defect

60. Cancer of stomach:
filling defect

61. Cancer of stomach:
filling defect

62. cancer

63.  filling defect

64. polyposis
filling defect

65. Malignant polyps of stomach
filling defect

66. Computed tomography
tumor formation

67. Leiomyoma
Computed tomography before intravenous
contrast: between the small curvature of the
stomach and the left lobe of the liver detected
tumor formation
Computed tomography after intravenous
contrast: a significant increase in the radiopacity
of the tumor with clear smooth contours

68. 3. Large intestine:
- Inflammations:
А) colitis;
Б) chronic colitis;
В) chronic spastic colitis;
Г) unspecific ulcerative colitis.
Symptoms:
 spasm of intestine;
 smoothness of haustrum;
 smoothness of the folds of mucosa.

69. colitis
smoothness of haustrum

70. Colorectal polyp
Clinical presentation: Usually colon polyps are
asymptomatic and constitute an accidental finding.
They can bleed, thus a positive fecal blood test
can draw attention to their existence. They are
also considered precancerous lesions. Polyps
larger than 2 cm are potentially malignant.
A round lesion with sharp edges protrudes
into the intestinal lumen.

71. Diverticula of the colon
protrusion wall filled with contrast

72. foreign
bodie

73. Plain abdominal x-ray showing multiple foreign
bodies.

74. - Cancer of the large intestine
Symptoms:
 filling defect;
 irregular contours;
 circular stenosis;
 the absence of the folds of mucosa;
 evacuation disorders.

75. Cancer of the large intestine
filling defect

76. Cancer of the large intestine
filling defect

77. Cancer of the large intestine
filling defect

78. Transvaginal ultrasound
In the pelvic cavity , posterior to the stump of the
uterus, is determined the area of the intestine
( the size 6.8 x2, 9x7,4 cm, thick up to 0.5-0.6 cm
wall decreased echogenicity . Peristalsis in this
projection is absent, the inner lumen is
differentiated clearly. The contents of the intestine
practically defined .
In Doppler mode with ultrasonic
angiography
in the wall is determined by the presence of
pronounced vascularisation vessels with blood type
spectrum (Vmax 14,4 cm / s , RI 0 , 74) .
Conclusion. Condition after supravaginal
hysterectomy . . Ultrasonic signs of tumors
of the rectum, pelvic formation

79. Пр ри биопсии био ииПри биопси
иП пс и
Conclusion MRI. Suspected mass lesion distal sigmoid colon (the spread
on the proximal colon; manifestations of moderate lymphadenopathy).
Suspected secondary changes in bone structure at the studied levels.
Condition after supravaginal amputation. Uterine cysts . Suspected
cervical polyp. Cystiform formation of the right ovary
Histological report - Rectosigmoid tumor .

80. The x-ray picture of the acute
abdomen
1. Bowel obstruction.
-
-
high;
low.
Symptoms:
- Kloyberg cups(at the background of
swallen bowel there is the presence of
horisontal level of fluid).

81. Symptoms obstruction the small
intestine:
Kloyberg cups located in the central
parts of the image;
-Height is greater than their width;
-Not see haustres.

82. Symptoms obstruction in the large
intestine:
Kloyberg cups located in peripheral parts
of the image;
Their width is greater than height;
Haustres - see.

83. Kloyberg cups

84. Kloyberg cups

85. Bowel obstruction Kloyerg cups

86. 2. Perforate ulcer.
- Symptom of sickle (the presence of air
under the right cupola of the diaphragm).
Symptom of sickle