What is the most common ultrasound appearance of the pancreas in mild acute pancreatitis?
Answer(s): A
In mild acute pancreatitis, the pancreas often appears diffusely enlarged and slightly hypoechoic due to edema and inflammation. However, in very early or mild cases, the pancreas may still appear normal. Heterogeneous echotexture may develop in more severe or necrotizing pancreatitis.According to Rumack's Diagnostic Ultrasound:"In mild pancreatitis, the pancreas is commonly enlarged and hypoechoic due to inflammatory edema."
Rumack CM, Wilson SR, Charboneau JW, Levine D. Diagnostic Ultrasound. 5th ed. Elsevier, 2017.AIUM Practice Parameter for the Performance of an Ultrasound Examination of the Abdomen, 2020.
Which adjustment would most likely improve visualization of a small superficial tubular structure such as a peripheral artery?
Answer(s): C
Reducing slice (section) width improves spatial resolution, particularly elevational resolution, which enhances visualization of small, superficial structures. Lower slice width reduces off-axis beam artifacts and blurring. Wavelength depends on transducer frequency, not adjustable directly during scanning.According to Zwiebel's Introduction to Vascular Ultrasound:"Reduction in slice thickness improves imaging of small superficial structures by minimizing volume averaging and improving elevational resolution."
Zwiebel WJ, Pellerito JS. Introduction to Vascular Ultrasound. 6th ed. Elsevier, 2019.AIUM Practice Parameter for Vascular Ultrasound, 2021.
During a renal artery Doppler study, which vessel should also be sampled to verify patency?
Answer(s): B
The main renal vein should be assessed in addition to the renal arteries during renal Doppler exams.Venous thrombosis may coexist with arterial abnormalities and can impact renal perfusion. Evaluation of both arterial inflow and venous outflow ensures a comprehensive assessment of renal vascular patency.According to Zwiebel's Introduction to Vascular Ultrasound:"Renal vein assessment should be performed during renal artery Doppler studies to exclude venous thrombosis or outflow obstruction."
Zwiebel WJ, Pellerito JS. Introduction to Vascular Ultrasound. 6th ed. Elsevier, 2019.AIUM Practice Parameter for Renal Artery Duplex Sonography, 2020.
Which condition presents sonographically as an anechoic mass between the umbilicus and the bladder?
Answer(s): D
A urachal cyst arises from incomplete closure of the urachus, a remnant of the fetal allantoic duct connecting the bladder to the umbilicus. It appears as a midline, anechoic, nonvascular mass located between the bladder dome and the umbilicus.According to Rumack's Diagnostic Ultrasound:"A urachal cyst is a midline, anechoic structure located between the bladder and umbilicus, resulting from incomplete obliteration of the urachus."
Rumack CM, Wilson SR, Charboneau JW, Levine D. Diagnostic Ultrasound. 5th ed. Elsevier, 2017.AIUM Practice Parameter for the Performance of Ultrasound of the Pelvis, 2020.
Which vessel lies anterior to the uncinate process?
The superior mesenteric vein (SMV) lies directly anterior to the uncinate process of the pancreas. The uncinate process wraps around the posterior aspect of the SMV and SMA. The portal vein and IVC lie more posteriorly in relation to the pancreatic head.According to Moore's Clinically Oriented Anatomy:"The superior mesenteric vein crosses anterior to the uncinate process of the pancreas."
Moore KL, Dalley AF, Agur AMR. Clinically Oriented Anatomy. 8th ed. Wolters Kluwer, 2018.Gray's Anatomy for Students, 4th ed., Elsevier, 2019.
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