In the stepwise approach, which imaging procedure may be used to evaluate abnormal structures?

In the stepwise approach, which imaging procedure may be used to evaluate abnormal structures?

• A. Abdominal ultrasound +/- FNA of abnormal structures
• B. CT scan only
• C. MRI only
• D. Plain X-ray

Answer: (A)

When evaluating abnormal abdominal structures in a stepwise imaging approach, start with abdominal ultrasound because it is quick, noninvasive, and widely available, with no radiation. It effectively characterizes lesions as solid or cystic, assesses size and relationships to nearby vessels, and can be repeated easily to monitor changes. Importantly, if a suspicious structure is identified, ultrasound can guide a fine-needle aspiration to obtain tissue or cells for diagnosis without needing a more invasive procedure. While CT or MRI can provide more detail when needed, they involve higher cost, longer exam times, and, in the case of CT, radiation. Plain X-ray has limited ability to evaluate soft-tissue abdominal structures. Thus, ultrasound with potential FNA of abnormal structures fits the stepwise approach as the initial, best-fitting imaging choice.

When evaluating abnormal abdominal structures in a stepwise imaging approach, start with abdominal ultrasound because it is quick, noninvasive, and widely available, with no radiation. It effectively characterizes lesions as solid or cystic, assesses size and relationships to nearby vessels, and can be repeated easily to monitor changes. Importantly, if a suspicious structure is identified, ultrasound can guide a fine-needle aspiration to obtain tissue or cells for diagnosis without needing a more invasive procedure. While CT or MRI can provide more detail when needed, they involve higher cost, longer exam times, and, in the case of CT, radiation. Plain X-ray has limited ability to evaluate soft-tissue abdominal structures. Thus, ultrasound with potential FNA of abnormal structures fits the stepwise approach as the initial, best-fitting imaging choice.