11  Abdomen Template

11.1 Abdo Normal

11.1.1 Normal U/S WA

FINDINGS:

Liver: Normal size and parenchymal echogenicity. No focal lesion.

Biliary system: CBD size ___ mm. No intrahepatic ductal dilatation.

Gallbladder: ([Well | Partially])-distended gallbladder. No stone or mass.

Spleen: Normal in size.

Pancreas: Visualized portions are unremarkable.

Kidneys: Normal size and parenchymal echogenicity of both kidneys. No stone, hydronephrosis or solid mass.

Urinary bladder: No stone or mass.

Aorta: Normal caliber.

Peritoneum: No free fluid.

(Choose one)

Prostate gland: Normal size, measuring ___ ml in volume.

Uterus: Unremarkable.

Ovaries: [Normal size of | Non-visualized] both ovaries. No gross adnexal mass.

IMPRESSION: [TODO]

11.1.2 Normal U/S KUB

FINDING:

Right kidney: Normal size and parenchymal echogenicity, measuring about _ x _ x _ cm. No stone or hydronephrosis.

Left kidney: Normal size and parenchymal echogenicity, measuring about _ x _ x _ cm. No stone or hydronephrosis.

Bladder: Well-distended urinary bladder without stone or mass.

Uterus: Endometrial thickness measures about ___ mm.

Ovaries and adnexae: Normal size of both ovaries.

Others: No free fluid.

11.1.3 Limited study

  • Bowel gas: Limited evaluation due to overlying bowel gas.

  • High liver: Limited evaluation due to high liver position.

11.2 Liver Findings

11.2.1 History

  • NAFLD; surveillance.
  • Chronic HBV infection; HCC surveillance.

11.2.2 Parenchymatous Dz

Increase Echo or Coarse

  • Liver: Normal size and (mildly/slightly) [increased | coarse] parenchymal echogenicity. No focal sesion.

IMPRESSION:

  • (Mild) Parenchymatous disease of the liver without focal lesion.

11.2.3 Fatty Liver

  • Mild: Normal size with mildly increased parenchymal echogenicity of the liver,

  • Moderate: Normal size with (diffusely) increased parenchymal echogenicity of the liver, causing imparied visualization of intrahepatic vasculature,

  • Severe: Normal size with (diffusely) increased parenchymal echogenicity of the liver, causing imparied visualization of intrahepatic vasculature and right hemidiaphragm,

… compatible with [mild | moderate | severe] fatty liver.

(Focal fat sparing): + Geographic hypoechoic areas [at | adjacent to]…

  • periportal
  • peri-gallbladder (gallbladder fossa)
  • …

region, likely a focal fat sparing. (ref: rID-6852)

IMPRESSION:

  • [Mild | Moderate | Severe] fatty liver without focal lesion.
  • [Mild | Moderate | Severe] fatty liver with focal fat sparing adjacent to ___. No gross mass.

11.2.4 Cirrhosis

  • Liver: [Normal size | Enlarged caudate lobe] with diffusely coarsen parenchymal echogenicity and surface nodularity. No focal lesion. Portal vein enlarged, measuring ___ cm.

  • Spleen: Spleenomegaly ?. No focal lesion.

IMPRESSION:

  • Liver cirrhosis without focal lesion.

11.3 Biliary Findings

11.3.1 GB Adenomyomatosis

Gallbladder: Distended gallbladder with …

(Choose one)

  • focal (localised)
  • segmental (annular)
  • generalised (diffuse)

adenomyomatosis at ___ of the gallbladder. No stone.

IMPRESSION:

  • [Focal | Segmental | Generalised] adenomyomatosis of the gallbladder at ___.

(Ref: radiopedia)

11.3.2 Gallstone

Gallbladder: A ???-cm gallstone. No gallbladder wall thickening or pericholecystic fluid.

IMPRESSION:

  • A ???-cm gallstone without evidence of cholecystitis

11.3.3 Bile sludge

Gallbladder: Distended gallbladder containing bile sludge. No gallbladder wall thickening or pericholecystic fluid. No stone or mass.

IMPRESSION:

  • Bile sludge in gallbladder without evidence of cholecystitis

11.3.4 Post-cholecystectomy

  • Gallbladder: Surgically absent gallbladder.

11.3.5 Cholecystostomy

Gallbladder: Collapsed gallbladder with retained cholecystostomy tube. No stone.

IMPRESSION:

  • Proper position of cholecystosmy tube within collapsed gallbladder.

11.3.6 Dilate CBD

Biliary system: Dilated CBD measures about ___ mm

  • (Not seen cause): + without demonstrable cause of obstruction. No intrahepatic ductal dilatation.

11.4 Pancreas Findings

11.4.1 No Acute Pancreatitis

Pancreas: Normal size of the visualized portion without detectable pancreatic ductal dilatation or peripancreatic fluid collection. No focal lesion.

IMPRESSION:

  • No sonographic evidence of acute pancreatitis or peripancreatic fluid collection.

11.5 Renal Findings

11.5.1 Parenchymatous Dz

Increased echo only => parenchymatous dz.

  • Kidneys: [Normal | Small] size and (mildly) increased parenchymal echogenicity of ___ kidney.

IMPRESSION:

  • Parenchymatous disease of ___ kidney.

11.5.2 CKD

Increased echo + small size => chronic parenchymatous dz.

  • Kidneys: Small size ___ kidney, measuring ?x?x? cm, with thinning of cortex, measuring 0.? cm, and increased parenchymal echogenicity.

IMPRESSION:

  • Chronic parenchymatous disease of ___ kidney.

11.5.3 Renal Stone

Calcified vessel: Hyperechoic foci at ___, probably calcified vessels or non-obstructive calyceal stone.

Non-obs, caliceal stone: Normal size and parenchymal echogenicity of both kidneys. Non-obstructing caliceal stones at ?? pole of ?? kidney, measuring ___. No solid mass.

Staghorn stone: Multiple ___ caliceal stones, up to ?? cm, probably staghorn stones.

11.5.4 Renal Hydronephrosis

11.5.4.1 Hydronephrosis (no cause)

  • Kidneys: Dilatation of pelvicalyceal system (extending to proximal part of ureter) without demonstrable cause of obstruction. (± Limited evaluation of mid to distal ureter due to overlying bowel gas.)

IMPRESSION:

  • [Mild | Moderate | Severe] … hydronephrosis without demonstrable cause.

11.5.4.2 Distended bladder

  • Kidneys: Mildly dilated pelvicalyceal system of ___ kidney without demonstrable cause of obstruction.

IMPRESSION:

  • Mild dilatation of the ___ pelvocaleceal system, probably reflux from fully-distended urinary bladder.

11.5.5 Renal Cyst

A ??-cm (simple) cortical cyst…

  • (±) with calcified wall
  • (±) with internal septation
  • (±) with internal dependent hyperechogenic foci

Bosniak classification

See nice illustrations.

  • Class I, II: No need F/U

  • Class IIF: F/U

  • Class III, IV: further CT or MRI

11.5.5.1 ADPKD

Kidneys: Enlarged size with increased parenchymal echogenicity and innumerable cysts of vary in size, measuring up to ___ cm. (Some cysts have hyperechoic content, thin septation and/or calcified walls.) No hydronephrosis or suspicious solid mass.

IMPRESSION:

  • Parenchymatous kidney disease and innumerable cysts in both kidneys, some cysts have hyperechoic content, thin septation and/or calcified walls.

11.5.6 Nephrectomy

  • Partial nephrectomy: Evidence of partial nephrectomy at ___ of … kidney.

11.5.7 Extrarenal pelvis

  • [Left | Right] extrarenal pelvis was seen.

  • hypoechoic mass just outside the renal sinus without calyceal system dilatation, consistent with extrarenal pelvis.

(Adapted from this case report)

11.5.8 Renal Scar

  • Renal cortical defect: Focal cortical scar at ___ pole of the ___ kidney. (ref)

11.5.9 Renal AML

  • Kidneys: A ?-cm hyperechoic lesion at ___.

IMPRESSION:

  • A ?-cm hyperechoic lesion at ___, possibly angiomyolipoma.

11.6 Bladder Findings

11.6.1 Foley

Bladder: [Collapsed | Partially distended] urinary bladder with retained Foley catheter. No stone or mass.

11.6.2 Residual Urine

Bladder: [small | moderate | large] amount of post-voided residual urine.

11.6.3 Neobladder

Bladder: Surgically absent. The neobladder appears unremarkable. No mass.

11.6.4 Wall thickening (Collapsed)

Bladder: [Collapsed | Partially distended] urinary bladder. Mild wall thickening. No stone or mass.

IMPRESSION:

  • Bladder wall thickening; probably due to partial distension or cystitis. Please correlate with UA and clinical context.

11.6.5 Hyperechoic Lesion

Bladder: An __ hyperechoic lesion at ___ aspect of urinary bladder wall.

IMPRESSION:

  • An __ hyperechoic lesion at ___ aspect of urinary bladder wall. Please correlate with cystoscope.

11.7 Repro Findings

11.7.1 Myoma & Cyst

Uterus:

  • __ of a ? x ? x ?-cm [intramural | submucosal | subserous] myoma.

  • Endometrial thickness is measured about __ mm.

Ovaries and adnexae: Normal size of ___ ovaries. A ???-cm cystic lesion at right adnexa, probably functional cyst or endometriotic cyst.

11.7.2 Prostate

11.7.2.1 Prominent prostate (25 - 40 ml)

  • Prostate gland: [Prominent size | Mild enlargement], measuring ___ ml in volume.

IMPRESSION:

  • [Prominent size | Mild enlargement] of prostate gland.

11.7.2.2 Enlarged prostate

  • Prostate gland: (Markedly) enlarged prostate gland with intravesical indentation, measuring 100 ml in volume.

IMPRESSION:

  • (Marked) enlarge prostate gland with intravesical indentation.

11.8 Free Fluid

11.8.1 Ascites

Peritoneum: [Small | Moderate | Large] amount of free fluid at

  • (+) subhepatic
  • (+) perihepatic
  • (+) perisplenic
  • (+) bilateral paracolic gutters
  • (+) pelvic cavity

regions

IMPRESSION:

  • [Small | Moderate | Large] amount of ascites.

11.8.2 Pleural effusion

Others: Partially seen bilateral pleural effusions.

IMPRESSION:

  • Presence of bilateral pleural effusion.