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l Radiology
Contrast media
Type of contrast media
–Barium sulfate
–Water soluble
Questions
• 1. The case in aspiration is
suspected, which contrast
medium is preferred?
A B C
extrinsic mass
mucosal mass submucosal or
intramural mass
Extrinsic lesion
MASS
ี่ ดจากพยาธิสภาพนอกทางเดิน
ความผิดปกติทเกิ
อาหาร
Protruded lesion
A B mucosal mass
Polyp
A B
Diagram
submucosal or
intramural mass
Depressed lesion
A Double
contrast
B upright
C Single
contrast
E n-face Profile
CARCINOMA
CARCINOMA (2)
CARCINOMA (3)
CARCINOMA (4)
CARCINOMA (5)
E SOP HAGUS
ACHALASIA CARDIA
THORACIC DIVERTICULUM
- Traction diverticulum
(arrow) that develops
in response to the
pull of fibrous
adhesion after
mediastinal lymph
node infection
or inflammation (star)
EPIPHRENIC DIVERTICULUM
Esophagogram
Answer : CORROSIVE ESOPHAGITIS
EARLY STAGE
- Flat plaque-like
lesion or small
polypoid
lesion) on one
wall of the
esophagus
: Major radiographic appearances (2) :
ADVANCED STAGE
•
Advanced stage
• 2.1 Hampton’s
line:
an approximately 1-2 mm
thin straight line (green
arrow)traversing the
orifice of the ulcer crater
(white arrow)
• On profile view represent
overhanging normal
gastric mucosa of
undermined ulcer
Radiographic appearances of benign gastric ulcer (3)
• : represent
thickened rim of
edematousgastric
wall
Radiographic appearances of benign gastric ulcer (4)
Radiographic appearances of benign gastric ulcer
• 2.3 Ulcer mound:
smooth, sharply
delineated, gradually
sloping extensive
tissue mass (arrow)
surrounding the ulcer
(arrowhead)
• : represent severe
edematous gastric
wall
Radiographic appearances of benign gastric ulcer (5)
Radiographic appearances of benign gastric ulcer
4. Chronic duodenal ulcer : Deformity of the duodenal bulb from fibrotic healing
- Cloverleaf deformity (A) : symmetric narrowing of the midportion of the bulb
with dilatation of the inferior and superior recesses at the base of the bulb (arrow)
- Pseudodiverticulum (B) : asymmetric narrowing of the bulb
Answer : Duodenal Diverticulum
- Incidental finding in 5%of barium examination
• Most common
bulb found along the
medial border of
the descending
duodenum at
stom periampullary
ach region
• Smooth rounded
shape with narrow
neck projecting
beyond the bowel
lumen (arrow)
Gastric Diverticulum
Note : Pseudodiverticulum
from chronic duodenal
ulcer at duodenal bulb
(arrowhead)
Radiographic appearances : Gastric cancer
Polypoid mass
- S mall polypoid
mass in early
stage (arrow) may
be
indistinguishable
from benign polyp
- Large polypoid
carcinoma appear
as lobulated or
fungating masses
Radiographic appearances : Gastric cancer (1)
• Ulcerated
carcinoma
tumor mass
(arrowhead)
has been
replaced by
ulceration
(arrow)
Malignant ulcer from gastric leiomyosarcoma
• Tumor of smooth muscle of
GI tract
• Intramural in origin
• Radiographic appearances:
1. Intramural or submucosal
mass
(green arrow) : obtuse angle
with
the normal bowel wall (white
arrow)
2. Variable appearances:
intraluminal, exogastric
(extrinsic mass) or mixed form
3. Frequently ulceration
(black arrow)
COLON
R adiographic findings :
Colonic Diverticulosis
• 1. Multiple round
or oval
outpouchings of
barium projecting
beyond the lumen
on profile view
(white arrow),
barium collection
Radiographic findings : Colonic
Diverticulosis
• 2. Criss-crossing
ridges of
thickened
circular muscle
(sawtooth
configuration)
(arrow)
Polyp: focal, protruded lesion within the
bowel including neoplastic and non-
neoplastic lesion
Morphologic Classification :
1. Sessile plaque : flat plaque and base
wider than height
2. Sessile hemisphere : semilunar shape
Colonic Carcinoma
• Annular Carcinoma
(green arrow) with
shelf-like margin
(black arrow)
Colonic Carcinoma
Polypoid Carcinoma
(arrow)
Tuberculous enterocolitis
• Ileocecal area (80-90%)
• Radiographic findings :
– 1. Irregular thickened bowel wall
C (white arrow) resulting in narrowing of
the lumen (coned cecum)(C)
– 2. Thickened ileocecal valve
– 3. Wide gap of patulous ileocecal valve
(green arrow)
I – 4. Thickened wall of terminal ileum (I)
– 5. Deep ulcer with/without sinus tract
or fistula