ExpertDDx: Abdomen and Pelvis

Dr. Atif Zaheer has a specialty focus on CT, MR, and US of the abdomen and pelvis. He is Professor of Radiology, Oncology and Medicine at The Johns Hopkins University School of Medicine in Baltimore, Maryland. Dr. Siva Raman is a board-certified radiologist who gained his subspecialty expertise in thoracoabdominal imaging during a fellowship at Stanford University, and intern residency at UC Davis Medical Center. He attended Johns Hopkins University Medical School. Dr. Raman is a radiologist at Bay Imaging Consultants in Walnut Creek, California, with a subspecialty focus on thoracoabdominal imaging Dr. Bryan Foster is a body imaging radiologist with a subspecialty focus on oncologic, hepatobiliary, pancreatic, prostate, and small bowel imaging. Dr. Foster is the Professor of Radiology at Oregon Health & Science University in Portland, Oregon, and performs complex image-guided biopsies; he also performs CEUS imaging and US elastography. Dr. Foster is skilled in all facets of imaging including radiography, fluoroscopy, ultrasound, CT, and MRI. His interests include oncologic, hepatobiliary, pancreatic, prostate, and small bowel imaging. Dr. Foster has recently started performing contrast-enhanced ultrasound imaging (as the only site in Oregon) and US elastography. He is one of two radiologists that perform MRI-guided prostate biopsies (also only site in Oregon). Recently he was selected as an Honored Educator for the Radiological Society of North America. Dr. Ghaneh Fananapazir is a radiologist with specialization in abdominal radiology. He is Professor of Radiology at the University of California - Davis, in Sacramento, California. Fananapazir's clinical focus includes nonvascular interventional procedures, advanced US, CT and MR techniques, vascular imaging, and abdominal organ transplantation (kidney, liver, pancreas). In addition to his clinical duties, Dr. Fananapazir is passionate about medical education and research, particularly relating to kidney transplantation, and has authored textbooks and peer-reviewed research in highly impactful medical journals.

• SECTION 1: PERITONEUM ANDMESENTERYGENERIC IMAGING PATTERNS4 Mesenteric or Omental Mass (Solid)Siva P. Raman, MD10 Mesenteric or Omental Mass (Cystic)Siva P. Raman, MD14 Fat-Containing Lesion, Peritoneal CavitySiva P. Raman, MD18 Mesenteric LymphadenopathySiva P. Raman, MD22 Abdominal CalcificationsSiva P. Raman, MD28 PneumoperitoneumSiva P. Raman, MD32 HemoperitoneumSiva P. Raman, MD36 Misty (Infiltrated) MesenterySiva P. Raman, MDMODALITY-SPECIFIC IMAGING FINDINGSCOMPUTED TOMOGRAPHY42 High-Attenuation (Hyperdense) AscitesSiva P. Raman, MDSECTION 2: ABDOMINAL WALLANATOMICALLY BASED DIFFERENTIALS48 Abdominal Wall MassSiva P. Raman, MD52 Mass in Iliopsoas CompartmentSiva P. Raman, MD54 Groin MassSiva P. Raman, MD58 Elevated or Deformed HemidiaphragmSiva P. Raman, MD60 Defect in Abdominal Wall (Hernia)Siva P. Raman, MDSECTION 3: ESOPHAGUSGENERIC IMAGING PATTERNS66 Intraluminal Mass, EsophagusAtif Zaheer, MD and Michael P. Federle, MD, FACR68 Extrinsic Mass, EsophagusAtif Zaheer, MD and Michael P. Federle, MD, FACR72 Lesion at Pharyngoesophageal JunctionAtif Zaheer, MD and Michael P. Federle, MD, FACR74 Esophageal UlcerationAtif Zaheer, MD and Michael P. Federle, MD, FACR76 Mucosal Nodularity, EsophagusAtif Zaheer, MD and Michael P. Federle, MD, FACR78 Esophageal StricturesAtif Zaheer, MD and Michael P. Federle, MD, FACR80 Dilated EsophagusAtif Zaheer, MD and Michael P. Federle, MD, FACR82 Esophageal Outpouchings (Diverticula)Atif Zaheer, MD and Michael P. Federle, MD, FACR84 Esophageal DysmotilityAtif Zaheer, MD and Michael P. Federle, MD, FACRCLINICALLY BASED DIFFERENTIALS86 OdynophagiaAtif Zaheer, MD and Michael P. Federle, MD, FACRSECTION 4: STOMACHGENERIC IMAGING PATTERNS90 Gastric Mass LesionsAtif Zaheer, MD and Michael P. Federle, MD, FACR96 Intramural Mass, StomachAtif Zaheer, MD and Michael P. Federle, MD, FACR98 Target or Bull's-Eye Lesions, StomachAtif Zaheer, MD and Michael P. Federle, MD, FACR100 Gastric Ulceration (Without Mass)Atif Zaheer, MD and Michael P. Federle, MD, FACR102 Intrathoracic StomachAtif Zaheer, MD and Michael P. Federle, MD, FACR104 Thickened Gastric FoldsAtif Zaheer, MD and Michael P. Federle, MD, FACR110 Gastric Dilation or Outlet ObstructionAtif Zaheer, MD and Michael P. Federle, MD, FACR114 Linitis Plastica, Limited DistensibilityAtif Zaheer, MD and Michael P. Federle, MD, FACRCLINICALLY BASED DIFFERENTIALS118 Epigastric PainAtif Zaheer, MD and Michael P. Federle, MD, FACR124 Left Upper Quadrant MassAtif Zaheer, MD and Michael P. Federle, MD, FACRSECTION 5: DUODENUMGENERIC IMAGING PATTERNS130 Duodenal MassAtif Zaheer, MD and Michael P. Federle, MD, FACR136 Dilated DuodenumAtif Zaheer, MD and Michael P. Federle, MD, FACR138 Thickened Duodenal FoldsAtif Zaheer, MD and Michael P. Federle, MD, FACRSECTION 6: SMALL INTESTINEGENERIC IMAGING PATTERNS142 Multiple Masses or Filling Defects, Small BowelAtif Zaheer, MD and Michael P. Federle, MD, FACR144 Cluster of Dilated Small BowelAtif Zaheer, MD and Michael P. Federle, MD, FACR146 Aneurysmal Dilation of Small Bowel LumenAtif Zaheer, MD and Michael P. Federle, MD, FACR148 Stenosis, Terminal IleumAtif Zaheer, MD and Michael P. Federle, MD, FACR150 Segmental or Diffuse Small Bowel Wall ThickeningAtif Zaheer, MD and Michael P. Federle, MD, FACR156 Pneumatosis of Small Intestine or ColonAtif Zaheer, MD and Michael P. Federle, MD, FACRCLINICALLY BASED DIFFERENTIALS160 Occult GI BleedingAtif Zaheer, MD and Michael P. Federle, MD, FACR164 Small Bowel ObstructionAtif Zaheer, MD and Michael P. Federle, MD, FACRSECTION 7: COLONGENERIC IMAGING PATTERNS172 Solitary Colonic Filling DefectAtif Zaheer, MD and Michael P. Federle, MD, FACR174 Multiple Colonic Filling DefectsAtif Zaheer, MD and Michael P. Federle, MD, FACR176 Mass or Inflammation of Ileocecal AreaAtif Zaheer, MD and Michael P. Federle, MD, FACR182 Colonic Ileus or DilationAtif Zaheer, MD and Michael P. Federle, MD, FACR186 Toxic MegacolonAtif Zaheer, MD and Michael P. Federle, MD, FACR188 Rectal or Colonic FistulaAtif Zaheer, MD and Michael P. Federle, MD, FACR194 Segmental Colonic NarrowingAtif Zaheer, MD and Michael P. Federle, MD, FACR198 Colonic ThumbprintingAtif Zaheer, MD and Michael P. Federle, MD, FACR200 Colonic Wall ThickeningAtif Zaheer, MD and Michael P. Federle, MD, FACR206 Smooth Ahaustral ColonAtif Zaheer, MD and Michael P. Federle, MD, FACRCLINICALLY BASED DIFFERENTIALS208 Acute Right Lower Quadrant PainAtif Zaheer, MD and Michael P. Federle, MD, FACR214 Acute Left Lower Quadrant PainAtif Zaheer, MD and Michael P. Federle, MD, FACRSECTION 8: SPLEENGENERIC IMAGING PATTERNS222 SplenomegalySiva P. Raman, MD226 Multiple Splenic CalcificationsSiva P. Raman, MD228 Solid Splenic Mass or MassesSiva P. Raman, MD230 Cystic Splenic MassSiva P. Raman, MDMODALITY-SPECIFIC IMAGING FINDINGSCOMPUTED TOMOGRAPHY232 Diffuse Increased Attenuation, SpleenSiva P. Raman, MDSECTION 9: LIVERGENERIC IMAGING PATTERNS236 Liver Mass With Central or Eccentric ScarAtif Zaheer, MD and Michael P. Federle, MD, FACR240 Focal Liver Lesion With HemorrhageAtif Zaheer, MD and Michael P. Federle, MD, FACR244 Liver "Mass" With Capsular RetractionAtif Zaheer, MD and Michael P. Federle, MD, FACR246 Fat-Containing Liver MassAtif Zaheer, MD and Michael P. Federle, MD, FACR248 Cystic Hepatic MassAtif Zaheer, MD and Michael P. Federle, MD, FACR252 Focal Hypervascular Liver LesionAtif Zaheer, MD and Michael P. Federle, MD, FACR258 Liver Mass With Mosaic EnhancementAtif Zaheer, MD262 Mosaic or Patchy HepatogramAtif Zaheer, MD and Michael P. Federle, MD, FACR266 Hepatic CalcificationsAtif Zaheer, MD and Michael P. Federle, MD, FACR270 Liver Lesion Containing GasAtif Zaheer, MD and Michael P. Federle, MD, FACR274 Portal Venous GasAtif Zaheer, MD and Michael P. Federle, MD, FACR276 Widened Hepatic FissuresAtif Zaheer, MD and Michael P. Federle, MD, FACR278 Dysmorphic Liver With Abnormal Bile DuctsAtif Zaheer, MD and Michael P. Federle, MD, FACR282 Focal Hyperperfusion Abnormality (THAD or THID)Atif Zaheer, MD and Michael P. Federle, MD, FACRMODALITY-SPECIFIC IMAGING FINDINGSMAGNETIC RESONANCE IMAGING288 Multiple Hypodense Liver LesionsAtif Zaheer, MD and Michael P. Federle, MD, FACR294 Multiple Hypointense Liver Lesions (T2WI)Atif Zaheer, MD and Michael P. Federle, MD, FACR298 Hyperintense Liver Lesions (T1WI)Atif Zaheer, MD and Michael P. Federle, MD, FACR304 Liver Lesion With Capsule or Halo on MRAtif Zaheer, MD and Michael P. Federle, MD, FACRCOMPUTED TOMOGRAPHY308 Focal Hyperdense Hepatic Mass on Nonenhanced CTAtif Zaheer, MD and Michael P. Federle, MD, FACR312 Periportal Lucency or EdemaAtif Zaheer, MD and Michael P. Federle, MD, FACR318 Widespread Low Attenuation Within LiverAtif Zaheer, MD and Michael P. Federle, MD, FACRULTRASOUND322 Focal Hepatic Echogenic Lesion ± AcousticShadowingAtif Zaheer, MD, Gregory E. Antonio, MD, DRANZCR,FHKCR, and Eric K. H. Liu, PhD, RDMS328 Hyperechoic Liver, DiffuseAtif Zaheer, MD, Gregory E. Antonio, MD, DRANZCR,FHKCR, and Eric K. H. Liu, PhD, RDMS330 HepatomegalyHee Sun Park, MD, PhD and Aya Kamaya, MD, FSRU, FSAR334 Diffuse Liver DiseaseHee Sun Park, MD, PhD and Aya Kamaya, MD, FSRU, FSAR336 Cystic Liver LesionHee Sun Park, MD, PhD and Aya Kamaya, MD, FSRU, FSAR340 Hypoechoic Liver MassHee Sun Park, MD, PhD and Aya Kamaya, MD, FSRU, FSAR344 Echogenic Liver MassHee Sun Park, MD, PhD and Aya Kamaya, MD, FSRU, FSAR348 Target Lesions in LiverHee Sun Park, MD, PhD and Aya Kamaya, MD, FSRU, FSAR350 Multiple Hepatic MassesHee Sun Park, MD, PhD and Aya Kamaya, MD, FSRU, FSAR354 Hepatic Mass With Central ScarHee Sun Park, MD, PhD and Aya Kamaya, MD, FSRU, FSAR356 Periportal LesionHee Sun Park, MD, PhD and Aya Kamaya, MD, FSRU, FSAR360 Irregular Hepatic SurfaceAya Kamaya, MD, FSRU, FSAR362 Portal Vein AbnormalityHee Sun Park, MD, PhD and Aya Kamaya, MD, FSRU, FSARSECTION 10: GALLBLADDERGENERIC IMAGING PATTERNS366 Distended GallbladderSiva P. Raman, MD368 Gas in Bile Ducts or GallbladderSiva P. Raman, MD372 Focal Gallbladder Wall ThickeningSiva P. Raman, MD374 Diffuse Gallbladder Wall ThickeningJade Wong-You-Cheong, MBChB, MRCP, FRCR, FSRU,FSARMODALITY-SPECIFIC IMAGING FINDINGSCOMPUTED TOMOGRAPHY378 High-Attenuation (Hyperdense) Bile in GallbladderSiva P. Raman, MDULTRASOUND380 Hyperechoic Gallbladder WallJade Wong-You-Cheong, MBChB, MRCP, FRCR, FSRU,FSAR382 Echogenic Material in GallbladderJade Wong-You-Cheong, MBChB, MRCP, FRCR, FSRU,FSAR384 Dilated GallbladderJade Wong-You-Cheong, MBChB, MRCP, FRCR, FSRU,FSAR388 Intrahepatic and Extrahepatic Duct DilatationL. Nayeli Morimoto, MD and Aya Kamaya, MD, FSRU,FSARCLINICALLY BASED DIFFERENTIALS390 Right Upper Quadrant PainSiva P. Raman, MDSECTION 11: BILIARY TRACTGENERIC IMAGING PATTERNS398 Dilated Common Bile DuctSiva P. Raman, MD404 Asymmetric Dilation of Intrahepatic Bile DuctsSiva P. Raman, MD408 Biliary Strictures, MultipleSiva P. Raman, MDMODALITY-SPECIFIC IMAGING FINDINGSMAGNETIC RESONANCE IMAGING412 Hypointense Lesion in Biliary Tree (MRCP)Siva P. Raman, MDSECTION 12: PANCREASGENERIC IMAGING PATTERNS416 Hypovascular Pancreatic MassSiva P. Raman, MD422 Hypervascular Pancreatic MassSiva P. Raman, MD426 Cystic Pancreatic MassSiva P. Raman, MD432 Atrophy or Fatty Replacement of PancreasSiva P. Raman, MD434 Dilated Pancreatic DuctSiva P. Raman, MD438 Infiltration of Peripancreatic Fat PlanesSiva P. Raman, MD444 Pancreatic CalcificationsSiva P. Raman, MDMODALITY-SPECIFIC IMAGING FINDINGSULTRASOUND448 Cystic Pancreatic LesionFauzia Vandermeer, MD452 Solid Pancreatic LesionFauzia Vandermeer, MD456 Pancreatic Duct DilatationFauzia Vandermeer, MDSECTION 13: RETROPERITONEUMGENERIC IMAGING PATTERNS460 Retroperitoneal Mass, CysticMatthew T. Heller, MD, FSAR466 Retroperitoneal Mass, Soft Tissue DensityMatthew T. Heller, MD, FSAR472 Retroperitoneal Mass, Fat ContainingMatthew T. Heller, MD, FSAR474 Retroperitoneal HemorrhageMatthew T. Heller, MD, FSARSECTION 14: ADRENALGENERIC IMAGING PATTERNS478 Adrenal MassMitchell Tublin, MDSECTION 15: KIDNEYGENERIC IMAGING PATTERNS486 Solid Renal MassMitchell Tublin, MD490 Cystic Renal MassMitchell Tublin, MD494 Bilateral Renal Cysts