Radiology of the GIT

1. The radiological
methods of the
gastrointestinal system
examination

2. The main methods of
examination
- Roentgenoscopy (fluoroscopy)
- Roentgenography
- Fluorography

3. The additional methods
- Roentgen polygraphy
- Roentgen kymography
- Tomography
- Roentgenoscopy with primary
magnification

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

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

6. - Three physiologic narrowings:
А) at the level of cricoid cartilage;
Б) at the level of aortic arc;
В) at the level of cardia.
- The folds of mucosa – 2-3 см, parallel,
longitudinal;
- The velocity of contrast movement
is 4-6 sec.

7. folds

8. peristalsis
narrowing (arc)
cardia

9. The roentgen anatomy and
examination of the stomach
1. The survey roentgenoscopy.
2. The first stage of examination – the
patient drinks 1-2 swallows of contrast
(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.

10. 4. The stomach peristalsis:
- Superficial;
- Medium depth;
- Deep;
- Segmental;
- The velocity of peristaltic wave is 21 sec.

11. trendelenburg

12. Double contrasting

13. parietography

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

16. The roentgen 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.

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

18. N

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

21. 2. Roentgen 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) localization.
- 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. N

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

32. Balon dilatation
Achalasia before
after

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

34. 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.

35. cr
cr

36. - 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-Podobed.

37. burn

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

40. - 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).

41. Acute ulcer

42. Chronic ulcer

43. ulcus

45. ulcus

46. ulcus

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

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

49. cr

50. cr

51. polyposis

52. Malignant polyps of stomach

53. 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.

54. colitis
artefact

55. n

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

57. Cr sygm

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

59. B. obstruction

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