Imaging Procedures

Question 1

Number 3 corresponds to which of the following? See Fig.

A. Nasopharynx

B. Sphenoid sinus

C. Ethmoid sinus

D. Trachea

Answer 1

A. Nasopharynx

Question 2

Which of the following numbers corresponds to the right lateral pterygoid plate? See Fig.

A. 4

B. 2

C. 3

D. 5

Answer 2

A

Number 4 corresponds to the right lateral pterygoid plate.

Question 3

Which of the following clinical findings best describes the abnormal anatomic condition labeled as number 6? See Fig.

A. Mucosal thickening

B. Deviated septum

C. Sinusitis

D. Retropharyngeal hematoma

Answer 3

B

The nasal septum is a cartilaginous process that vertically separates the nasal cavities. The nasal septum in the figure deviates, or abnormally curves, toward the left.

Question 4

Which of the following patient positions may have been used to produce this scout image of the head? See Fig.

A. Supine

B. Lateral

C. Prone

D. Both A and C

Answer 4

D

A coronal scout or pilot projection of the head may be obtained with the patient in either the supine or the prone position. In the supine position, the patient is instructed to hyperextend the neck by dropping the head back so that it rests on its vertex on a positioning support device. In the prone position, the patient is instructed to extend the neck with the head resting on the chin. Coronal CT images may be produced in either case with the imaging plane positioned parallel to the coronal plane of the patient’s head.

Question 5

Number 1 corresponds to which of the following? See Fig.

A. Lateral pterygoid plate

B. Styloid process

C. Rostrum

D. Posterior clinoid process

Answer 5

D

Number 1 corresponds to the posterior clinoid process.

Question 6

Number 3 corresponds to which of the following? See Fig.

A. External auditory meatus

B. Foramen rotundum

C. Foramen ovale

D. Mastoid air cells

Answer 6

A

Number 3 corresponds to the external auditory meatus.

Question 7

Number 4 corresponds to which of the following? See Fig.

A. Cochlea

B. Semicircular canal

C. Malleus

D. Incus

Answer 7

B

Number 4 corresponds to the semicircular canal.

Question 8

Number 5 corresponds to which of the following? See Fig.

A. Dorsum sella

B. Anterior clinoid process

C. Petrous bone

D. Posterior clinoid process

Answer 8

C

Number 5 corresponds to the petrous bone.

Question 9

Which of the following window level and width settings were used to display this image? See Fig.

A. Level= −700, width= 2000

B. Level= +50, width= 400

C. Level= +150, width= 1000

D. Level= +250, width= 4000

Answer 9

D

An extremely wide window should be used to display images containing tissues with varying density ranges. A width such as 4000 is sufficient to display the dense bone of the mastoid tip and internal auditory canals. The level is set at the approximate average value of the tissues displayed. A level of +250 is the approximate average of all tissues within this anatomic region.

Question 10

Number 1 corresponds to which of the following? See Fig.

A. Dorsum sella

B. Sphenoid sinus

C. Ethmoid sinus

D. Pituitary fossa

Answer 10

B

Number 1 corresponds to the sphenoid sinus.

Question 11

Which of the following areas of the head commonly becomes calcified?

1. Thalamus
2. Pineal gland
3. Choroid plexus

A. 2 only

B. 1 and 3 only

C. 2 and 3 only

D. 1, 2, and 3

Answer 11

C

The choroid plexus and pineal gland are common areas of calcification in the brain. These areas of increased attenuation and density are easily identified on the CT image.

Question 12

Following the injection of intravenous contrast media during a CT examination of the brain, which of the following anatomic areas does not enhance?

A. Anterior communicating artery

B. Choroid plexus

C. Posterior horn of lateral ventricle

D. Dura mater

Answer 12

C

The posterior horn of the lateral ventricle contains cerebrospinal fluid and does not enhance following the intravenous administration of contrast material. Areas with a good blood supply, such as the cranial blood vessels, choroid plexus, and dura mater, do enhance during a contrast study of the brain.

Question 13

Which of the following conditions or indications would not require the injection of iodinated contrast material for proper visualization during a CT examination of the brain?

A. S/P MVA 3 days ago; R/O subdural hematoma

B. Headaches; R/O meningioma

C. Loss of vision; R/O astrocytoma

D. Lung cancer; R/O metastases

Answer 13

A

Subdural hematomas caused by relatively recent trauma appear as hyperdense areas on CT images of the brain. Intravenous iodinated contrast media is not necessary for their visualization and may act to conceal them. Contrast media are extremely valuable for visualization of intracranial tumors.

Question 14

Which of the following statements regarding the pituitary gland is false?

A. It is sometimes referred to as the hypophysis cerebri.

B. It is seated within the sella turcica.

C. The infundibulum attaches it to the hypothalamus.

D. It is responsible for the production of epinephrine.

Answer 14

D

The pituitary gland is responsible for the production of several hormones, including somatotropin and prolactin. It is the adrenal glands that play a role in the production and secretion of epinephrine (adrenaline).

Question 15

Cerebrospinal fluid (CSF) is produced in the:

A. tentorium cerebelli.

B. pineal gland.

C. corpus callosum.

D. choroid plexuses.

Answer 15

D

The cerebrospinal fluid is secreted by the choroid plexuses that are located in each of the four ventricles of the brain.

Question 16

A stereotactic unit would be used for which of the following specialized CT examinations?

A. CT-guided fine-needle aspiration of an abdominal abscess

B. 3-D CT angiogram

C. CT-guided biopsy of the brain

D. Dual window scanning

Answer 16

C

Stereotactic biopsy units are specialized units designed specifically for CT-guided biopsies. They are most commonly used for intracranial lesions, for which precision and accuracy are extremely important.

Question 17

Which number corresponds to the lateral rectus muscle? See Fig.

A. 5

B. 2

C. 6

D. 4

Answer 17

B

Number 2 corresponds to the lateral rectus muscle.

Question 18

Number 4 corresponds to which of the following? See Fig.

A. Frontal sinus

B. Maxillary sinus

C. Sphenoid sinus

D. Ethmoid sinus

Answer 18

D

Number 4 corresponds to the ethmoid sinus.

Question 19

The image is part of a series that could be used to evaluate which of the following?

1. Posterior fossa
2. Orbits
3. Paranasal sinuses

See Fig.

A. 1 only

B. 1 and 3 only

C. 2 and 3 only

D. 1, 2, and 3

Answer 19

C

The image includes the anatomic areas of the paranasal sinuses and the orbits.

Question 20

Number 5 corresponds to which of the following? See Fig.

A. Superior rectus muscle

B. Levator palpebrae superioris muscle

C. Optic nerve

D. Inferior rectus muscle

Answer 20

C

Number 5 corresponds to the optic nerve.

Question 21

Number 1 corresponds to which of the following? See Fig.

A. Vomer

B. Nasal bone

C. Lacrimal bone

D. Clivus

Answer 21

B

Number 1 corresponds to the nasal bone.

Question 22

Which of the following most accurately describes the proper position of the patient for a CT examination of the brain? See Fig.

A. Prone with head extended

B. Supine with head extended

C. Prone with chin down

D. Supine with chin down

Answer 22

D

CT images of the brain should be acquired parallel to the skull base. Placing the patient in the supine position with the chin down facilitates the axial acquisition at an angle 15 degrees above the infraorbitomeatal line (IOML).

Question 23

Number 4 corresponds to which of the following? See Fig.

A. Fourth ventricle

B. Vein of Galen

C. Third ventricle

D. Thalamostriate vein

Answer 23

C

Number 4 corresponds to the third ventricle.

Question 24

Number 3 corresponds to which of the following? See Fig.

A. Cerebrum

B. Vermis of cerebellum

C. Tentorium cerebelli

D. Occipital lobe

Answer 24

B

Number 3 corresponds to the vermis of the cerebellum.

Question 25

Number 5 corresponds to which of the following? See Fig.

A. Caudate nucleus

B. Putamen

C. Thalamus

D. Globus pallidus

Answer 25

B

Number 5 corresponds to the putamen.

Question 26

Number 2 corresponds to which of the following? See Fig.

A. Caudate nucleus

B. Putamen

C. Thalamus

D. Globus pallidus

Answer 26

C

Number 2 corresponds to the thalamus.

Question 27

Which of the following corresponds to the genu of the corpus callosum? See Fig.

A. 6

B. 5

C. 2

D. 1

Answer 27

A

Number 6 corresponds to the genu of the corpus callosum.

Question 28

In which of the following cranial nerves would an acoustic neuroma be found?

A. Third

B. Eighth

C. Tenth

D. Twelfth

Answer 28

B

An acoustic neuroma (schwannoma) arises from Schwann cells of the eighth cranial nerve, or the vestibulocochlear nerve. This type of cranial mass may be imaged with CT examinations of the internal auditory canals.

Question 29

This type of image is referred to as a(n): See Fig.

A. three-dimensional (3-D) image.

B. retrospective image.

C. stereotactic image.

D. MPR image.

Answer 29

D

Multiplanar reformation (MPR) describes the process of displaying CT images in a different orientation from the one used in the original reconstruction process. MPR images may be constructed in the coronal, sagittal, or any other two-dimensional plane. MPR images are typically formed from a vertical stack of contiguous, helically acquired axial CT images.

Question 30

Number 2 corresponds to which of the following? See Fig.

A. Dental implants

B. Mandibular fractures

C. Surgical staples

D. Roots of teeth

Answer 30

D

Number 2 corresponds to the roots of teeth.

Question 31

Question 38 of 416

In an effort to reduce radiation exposure to the orbits during a CT examination of the brain, the gantry may be angled:

A. perpendicular to the hard palate.

B. parallel to the hard palate.

C. 15 degrees superior to the infraorbital-meatal line (IOML).

D. 15 degrees inferior to the infraorbital-meatal line (IOML).

Answer 31

C

Acquisition for a brain CT may be performed at an angle 15 degrees above the IOML, parallel to the skull base, to reduce orbital radiation dose and minimize beam-hardening artifact.

Question 32

Question 41 of 416

High-resolution CT examinations of the temporal bones and internal auditory canal should include which of the following technical parameters?

1. 5- to 7-mm section width
2. Small (less than 10 cm) targeted DFOV
3. Soft-tissue kernel

A. 1 only

B. 2 only

C. 1 and 3 only

D. 1, 2, and 3

Answer 32

B

CT studies of the temporal bones and internal auditory canal require a high-resolution imaging technique. The tenets of high-resolution CT include thin sections (1 to 2 mm), a small targeted DFOV, and the use of a high-resolution algorithm (kernel) for reconstruction.

Question 33

Question 43 of 416

Number 1 corresponds to which of the following? See Fig.

A. Coronoids

B. Coracoids

C. Mastoids

D. Adenoids

Answer 33

C

Number 1 corresponds to the mastoids (air cells).

Question 34

Question 44 of 416

Number 5 corresponds to which of the following? See Fig.

A. Internal auditory canal

B. External auditory canal

C. Middle auditory canal

D. Vestibule

Answer 34

A

Number 5 corresponds to the internal auditory canal.

Question 35

Question 45 of 416

Which number corresponds to the vestibule? See Fig.

A. 2

B. 3

C. 4

D. 5

Answer 35

C

Number 4 corresponds to the vestibule.

Question 36

Question 46 of 416

This image is displayed in which of the following anatomic planes? See Fig.

A. Axial

B. Oblique axial

C. Coronal

D. Sagittal

Answer 36

A

The image is displayed in the axial plane.

Question 37

Question 47 of 416

Number 2 corresponds to which of the following? See Fig.

A. Incus

B. Cochlea

C. Semicircular canal

D. Vestibule

Answer 37

C

Number 2 corresponds to the semicircular canal.

Question 38

Question 48 of 416

This image is displayed in which of the following anatomic planes? See Fig.

A. Axial

B. Oblique axial

C. Coronal

D. Sagittal

Answer 38

C

The image is displayed in the coronal plane.

Question 39

Question 49 of 416

Number 4 corresponds to which of the following? See Fig.

A. Internal auditory canal

B. Middle auditory canal

C. External auditory canal

D. Vestibule

Answer 39

A

Number 4 corresponds to the internal auditory canal (IAC).

Question 40

Question 50 of 416

Number 3 corresponds to which of the following? See Fig.

A. Right parietal lobe

B. Left parietal lobe

C. Right temporal lobe

D. Left temporal lobe

Answer 40

B

Number 3 corresponds to the left parietal lobe.

Question 41

Question 51 of 416

The areas indicated by number 2 correspond to which of the following? See Fig.

A. Corpus callosum

B. Thalamus

C. Pons

D. Internal capsule

Answer 41

A

Number 2 indicates the corpus callosum.

Question 42

Question 52 of 416

The areas indicated by number 4 correspond to which of the following? See Fig.

A. Subarachnoid hemorrhage

B. Calcified pineal gland

C. Contrast-enhanced meningioma

D. Calcified choroid plexus

Answer 42

D

Number 4 indicates the partially calcified choroid plexuses of the posterior horns of the lateral ventricles.

Question 43

Question 53 of 416

Number 1 corresponds to which of the following? See Fig.

A. Corpus callosum

B. Internal capsule

C. Septum pellucidum

D. Putamen

Answer 43

C

Number 1 corresponds to the septum pellucidum.

Question 44

Question 54 of 416

Number 2 corresponds to which of the following? See Fig.

A. Anterior cerebral artery

B. Third ventricle

C. Fourth ventricle

D. Optic tract

Answer 44

B

Number 2 corresponds to the third ventricle.

Question 45

Question 55 of 416

Number 4 corresponds to which of the following? See Fig.

A. Temporal lobe

B. Medulla oblongata

C. Pons

D. Cerebellum

Answer 45

D

Number 4 corresponds to the cerebellum.

Question 46

Question 56 of 416

Number 1 corresponds to which of the following? See Fig.

A. Third ventricle

B. Fourth ventricle

C. Ambient cistern

D. Sagittal sinus

Answer 46

C

Number 1 corresponds to the ambient, or quadrigeminal, cistern.

Question 47

Question 57 of 416

Number 3 corresponds to which of the following? See Fig.

A. Anterior horn of the lateral ventricle

B. Cingulate sulcus

C. Posterior horn of the lateral ventricle

D. Superior temporal sulcus

Answer 47

A

Number 3 corresponds to the anterior horn of the left lateral ventricle.

Question 48

Question 58 of 416

Multiplanar reformation (MPR) images along the long axis of the optic nerve would be best described by which of the following anatomic planes?

A. Sagittal

B. Coronal

C. Oblique sagittal

D. Oblique coronal

Answer 48

C

The optic nerve runs along a lateral-to-medial path from the orbit anteriorly and to the optic chiasma posteriorly. Oblique sagittal MPR images will demonstrate the optic nerve in a profile parallel to its long axis.

Question 49

Question 59 of 416

Which of the following may be used to reduce metal streak artifact on coronal-plane CT images of the orbits?

1. Retrospective reconstruction of targeted images with reduced display field of view (DFOV)
2. Metallic artifact reduction (MAR) software to improve image quality
3. Construction of coronal multiplanar reformation (MPR) images from the acquired axial-plane images

A. 1 only

B. 3 only

C. 2 and 3 only

D. 1, 2, and 3

Answer 49

C

Volumetric MDCT axial acquisition through the orbits, sinuses, and so on allows for high-quality coronal MPR images without metal streaking artifact. CT manufacturers may offer metallic artifact reduction (MAR) software in an effort to reduce streaking artifact from metal substances. Targeted reconstructions would eliminate only the streak artifact at the periphery of the field and would not remove unwanted streak artifact appearing through the area(s) of interest.

Question 50

Question 60 of 416

Number 3 corresponds to which of the following? See Fig.

A. Superior oblique muscle

B. Optic nerve

C. Medial rectus muscle

D. Medial ophthalmic vein

Answer 50

C

Number 3 corresponds to the medial rectus muscle

Question 51

Question 61 of 416

Number 8 corresponds to which of the following? See Fig.

A. Sphenoid sinus

B. Ethmoid sinus

C. Maxillary sinus

D. Frontal sinus

Answer 51

B

Number 8 corresponds to the ethmoid sinus.

Question 52

Question 63 of 416

Number 1 corresponds to which of the following? See Fig.

A. Optic nerve

B. Medial rectus muscle

C. Superior rectus muscle

D. Ophthalmic artery

Answer 52

A

Number 1 corresponds to the optic nerve.

Question 53

Question 64 of 416

Coronal imaging through the paranasal sinuses is typically performed with the plane of imaging:

A. parallel to the infraorbital-meatal line.

B. perpendicular to the glabellomeatal line.

C. parallel to Reid’s baseline.

D. perpendicular to the hard palate.

Answer 53

D

The imaging plane should be positioned perpendicular to the hard palate for coronal evaluation of the paranasal sinuses. This may be achieved by positioning the patient in either the supine, head extended-back position, or with the patient in the prone position. In either case, appropriate angulation of the gantry can help achieve an acquisition angle that is perpendicular to the hard palate. Alternatively, multiplanar reformation (MPR) images may be produced at an angle perpendicular to the axial acquisition, also resulting in coronal images through the paranasal sinuses.

Question 54

Question 65 of 416

Which of the following statements accurately describes the effects of administering an iodinated IV contrast agent during Imaging Procedures of the brain?

1. The contrast agent increases the attenuation values for normal gray matter.
2. The contrast agent improves the differentiation of subtle hemorrhage.
3. The contrast agent enhances neoplasms that have disrupted the blood–brain barrier.

A. 1 only

B. 1 and 2 only

C. 1 and 3 only

D. 1, 2, and 3

Answer 54

C

During CT imaging for suspected intracranial bleeding, contrast administration is initially contraindicated because the associated enhancement may mask subtle signs of hemorrhage.

Question 55

Question 66 of 416

Which of the following is NOT a component of the blood supply to the brain commonly referred to as the circle of Willis?

A. Right middle cerebral artery

B. Left posterior communicating artery

C. Anterior communicating artery

Answer 55

A

The circle of Willis is composed of the anterior cerebral, anterior communicating, internal carotid, posterior cerebral, and posterior communicating arteries. The basilar artery and middle cerebral arteries are important vessels supplying blood to the brain, but they do not form a part of the circle of Willis.

Question 56

Question 68 of 416

During a CTA of the brain’s circle of Willis, if an iodinated contrast agent is injected at a rate of 3 to 4 mL/sec, an adequate delay for optimal vessel opacification would be in the range of:

A. 4 to 10 seconds.

B. 12 to 20 seconds.

C. 45 to 60 seconds.

D. 60 to 90 seconds.

Answer 56

B

An empiric delay of 12 to 20 seconds would be adequate to ensure good vessel opacification of the circle of Willis.

Question 57

Question 69 of 416

Evaluation of the venous vascular structures of the brain is known as:

A. CT angiography.

B. CT perfusion.

C. CT runoff.

D. CT venography.

Answer 57

D

CT venography (CTV) of the brain is a variation of the CTA technique whereby the timing of data acquisition is optimized for the period of peak venous opacification.

Question 58

Question 71 of 416

During CT perfusion studies, the quantity of blood (in mL) contained within 100 g of brain tissue is termed the:

A. mean transit time (MTT).

B. cerebral blood flow (CBF).

C. cerebral blood volume (CBV).

D. percent-washout value (PWV).

Answer 58

C

Cerebral blood volume (CBV) describes the quantity of blood (in mL) contained within a 100-g volume of brain tissue. Normal range is 4 to 5 mL/100 g.

Question 59

Question 72 of 416

During CT perfusion studies, the measured time (in seconds) required for blood to pass through an area of brain tissue is termed the:

A. cerebral blood flow (CBF).

B. ejection fraction (EF).

C. mean transit time (MTT).

D. cerebral blood volume (CBV).

Answer 59

C

Mean transit time (MTT) describes the average time, in seconds, for blood to pass through a given region of brain tissue. MTT varies with the distance traveled between arterial inflow and venous outflow for a particular area.

Question 60

Question 73 of 416

Which of the following correctly illustrates the central volume principle of cerebral perfusion?

A. CBF = CBV/MTT

B. CBF = CBV × MTT

C. MTT = CBV × CBF

D. CBF = MTT/CBV

Answer 60

A

The central volume principle is described by the formula CBF = CBV/MTT. It illustrates the relationship of cerebral blood flow as a factor of the volume of blood within a given area of brain tissue and the time it takes for that blood to pass through the area. Reduced CBF may indicate ischemia resulting from stroke or other brain abnormalities.

Question 61

Question 75 of 416

The normal range of cerebral blood volume (CBV) contained within 100 g of brain tissue is:

A. 0.6 to 1.0 mL/100 g.

B. 4 to 5 mL/100 g.

C. 15 to 19 mL/100 g.

D. 30 to 40 mL/100 g.

Answer 61

B

The normal range of CBV in brain tissue is 4 to 5 mL/100 g.

Question 62

Question 76 of 416

Ischemic brain tissue is identified as an infarct core when cerebral blood volume (CBV) falls below:

A. 2.5 mL/100 g.

B. 5.0 mL/100 g.

C. 10.0 mL/100 g.

D. 50.0 mL/100 g.

Answer 62

A

Brain parenchyma with a CBV less than 2.5 mL/100 g is identified as the infarct core.

Question 63

Question 77 of 416

An injury to the brain at a location opposite to the site of traumatic impact is referred to as:

A. coup.

B. contrecoup.

C. subdural.

D. epidural.

Answer 63

B

The contrecoup type of acute brain injury occurs at a location on the opposite side of the head from the point of impact. As the moving skull rapidly decelerates prior to impact, the portion of brain opposite to the impact site temporarily pulls away from the skull before forcibly recoiling back into its original position, resulting in traumatic injury. In comparison, coup injuries to the brain occur at the actual site of traumatic impact.

Question 64

Question 78 of 416

The type of hemorrhage that occurs between the skull and outer layer of the dura in traumatic brain injury is referred to as a(n):

A. subdural hematoma.

B. epidural hematoma.

C. subarachnoid hematoma.

D. subcutaneous hematoma.

Answer 64

B

An epidural hematoma occurs between the skull and the outermost meningeal covering of the brain called the dura mater. Subdural hematomas occur between the dura mater and the next inner layer of the meninges, known as the arachnoid. The innermost layer of the meninges is called the pia mater.

Question 65

Question 79 of 416

Which number corresponds to the common carotid artery? See Fig.

A. 4

B. 3

C. 1

D. 5

Answer 65

B

Number 3 corresponds to the common carotid artery.

Question 66

Question 80 of 416

Number 4 corresponds to which of the following? See Fig.

A. Internal jugular vein

B. External carotid artery

C. Internal carotid artery

D. Retromandibular vein

Answer 66

A

Number 4 corresponds to the internal jugular vein.

Question 67

Question 81 of 416

Number 2 corresponds to which of the following? See Fig.

A. Trapezius muscle

B. Levator scapulae muscle

C. Sternocleidomastoid muscle

D. Parotid gland

Answer 67

C

Number 2 corresponds to the sternocleidomastoid muscle.

Question 68

Question 83 of 416

Number 2 corresponds to which of the following? See Fig.

A. Azygous vein

B. Esophagus

C. Internal jugular vein

D. Descending aorta

Answer 68

B

Number 2 corresponds to the esophagus.

Question 69

Question 84 of 416

Number 4 corresponds to which of the following? See Fig.

A. First rib

B. Second rib

C. Clavicle

D. Acromion

Answer 69

C

Number 4 corresponds to the clavicle.

Question 70

Number 1 corresponds to which of the following? See Fig.

A. Thyroid cartilage

B. Hyoid bone

C. Adam’s apple

D. Thyroid gland

Answer 70

D

Number 1 corresponds to the thyroid gland.

Question 71

Question 86 of 416

Which of the following pathologic processes best describes the abnormal finding in the figure? See Fig.

A. Primary lung cancer

B. Esophageal tumor

C. Enlarged thyroid

D. Tonsillitis

Answer 71

C

The thyroid gland is abnormally enlarged. This may be because of several processes, including thyroid carcinoma and various endocrine disorders.

Question 72

Question 87 of 416

Which number corresponds to the retromandibular vein? See Fig.

A. 3

B. 5

C. 4

D. 2

Answer 72

A

Number 3 corresponds to the left retromandibular vein.

Question 73

Question 88 of 416

Number 6 corresponds to which of the following? See Fig.

A. Nasopharynx

B. Oropharynx

C. Esophagus

D. Larynx

Answer 73

B

Number 6 corresponds to the oropharynx.

Question 74

Question 89 of 416

Number 2 corresponds to which of the following? See Fig.

A. Adenoids

B. Epiglottis

C. Pharyngeal constrictor muscle

D. Parotid gland

Answer 74

C

Number 2 corresponds to the pharyngeal constrictor muscle.

Question 75

Question 90 of 416

Number 2 corresponds to which of the following? See Fig.

A. Cricoid cartilage

B. Thyroid cartilage

C. Hyoid bone

D. Arytenoid cartilage

Answer 75

C

Number 2 corresponds to the hyoid bone.

Question 76

Question 91 of 416

Number 4 corresponds to which of the following? See Fig.

A. Parotid gland

B. Sternocleidomastoid muscle

C. Submandibular gland

D. Trapezius muscle

Answer 76

B

Number 4 corresponds to the sternocleidomastoid muscle.

Question 77

Question 92 of 416

Number 1 corresponds to which of the following? See Fig.

A. Right internal jugular vein

B. Right external carotid artery

C. Right internal carotid artery

D. Right external jugular vein

Answer 77

B

Number 1 corresponds to the right external carotid artery.

Question 78

Question 93 of 416

Number 3 corresponds to which of the following? See Fig.

A. Vertebral artery

B. Cervical ganglion

C. Vagus nerve

D. Posterior spinal artery

Answer 78

A

Number 3 corresponds to the vertebral artery.

Question 79

Question 94 of 416

Number 2 corresponds to which of the following? See Fig.

A. Azygous vein

B. Lymph node

C. Cricothyroid ligament

D. Esophagus

Answer 79

D

Number 2 corresponds to the esophagus.

Question 80

Question 95 of 416

Number 4 corresponds to which of the following? See Fig.

A. Left internal jugular vein

B. Left common carotid artery

C. Left vertebral artery

D. Left anterior jugular vein

Answer 80

B

Number 4 corresponds to the left common carotid artery.

Question 81

Question 96 of 416

Which of the following pathologic conditions could be exhibited by the structure labeled as number 3? See Fig.

A. Carotid artery disease (CAD)

B. Jugular vein distention

C. Vocal cord paralysis

D. Hypothyroidism

Answer 81

D

Number 3 is the thyroid gland. Hypothyroidism, or underactive thyroid, is a condition in which the thyroid does not produce a sufficient amount of thyroid hormone.

Question 82

Question 97 of 416

Number 1 corresponds to which of the following? See Fig.

A. Right internal jugular vein

B. Right external carotid artery

C. Right internal carotid artery

D. Right external jugular vein

Answer 82

A

Number 1 corresponds to the right internal jugular vein.

Question 83

Question 98 of 416

The tortuous S-shaped portion of the internal carotid artery as it enters the bony skull may be referred to as the carotid:

A. lordosis.

B. kyphosis.

C. siphon.

D. sinus.

Answer 83

C

Carotid siphon refers to the portion of the internal carotid artery as it enters the bony skull and bifurcates into the anterior cerebral and middle cerebral arteries.

Question 84

Question 100 of 416

Number 5 corresponds to which of the following? See Fig.

A. Left atrium

B. Right ventricle

C. Ascending aorta

D. Descending aorta

Answer 84

B

Number 5 corresponds to the right ventricle.

Question 85

Question 101 of 416

Which number corresponds to the left atrium? See Fig.

A. 1

B. 2

C. 3

D. 4

Answer 85

B

Number 2 corresponds to the left atrium.

Question 86

Question 102 of 416

Number 4 corresponds to which of the following? See Fig.

A. Azygous vein

B. Superior vena cava

C. Left ventricle

D. Right atrium

Answer 86

A

Number 4 corresponds to the azygous vein.

Question 87

Question 103 of 416

Which of the following algorithms was used in the reconstruction of this image? See Fig.

A. Bone

B. Edge

C. Soft tissue

D. Detail

Answer 87

C

The soft tissue or standard algorithm is selected for imaging of soft tissue structures such as those found in the mediastinum.

Question 88

Question 104 of 416

Number 2 corresponds to which of the following? See Fig.

A. Left primary bronchus

B. Descending aorta

C. Superior vena cava

D. Left pulmonary artery

Answer 88

D

Number 2 corresponds to the left pulmonary artery.

Question 89

Question 105 of 416

Which number corresponds to the right primary bronchus? See Fig.

A. 6

B. 3

C. 5

D. 1

Answer 89

C

Number 5 corresponds to the right primary bronchus.

Question 90

Question 106 of 416

Number 3 corresponds to which of the following? See Fig.

A. Descending aorta

B. Inferior vena cava

C. Left pulmonary artery

D. Esophagus

Answer 90

A

Number 3 corresponds to the descending aorta.

Question 91

Question 107 of 416

Which of the following types of CT scanners is best suited for the evaluation of coronary artery disease?

A. PET-CT

B. Fourth-generation

C. Electron beam CT (EBCT)

D. Second-generation

Answer 91

C

Electron beam CT (EBCT) scanners are designed to acquire information at an extremely rapid rate. With the use of electron beam technology, these ultrafast CT systems can greatly reduce cardiac and pulmonary motion, allowing detailed evaluation of anatomic areas such as the coronary arteries.

Question 92

Question 108 of 416

High-resolution computed tomography (HRCT) of the chest incorporates which of the following protocols?

A. 10-mm sections, standard algorithm

B. 10-mm sections, bone algorithm

C. 3-mm sections, standard algorithm

D. 1-mm sections, bone algorithm

Answer 92

D

High-resolution computed tomography (HRCT) of the chest is used to examine diffuse pulmonary disease. This technique offers excellent visualization of the lungs, airways, and pulmonary hilum. HRCT involves the use of narrow sections (1 to 3 mm) and a high-resolution algorithm.

Question 93

Question 109 of 416

A solitary pulmonary nodule can be assumed benign when its average density is within which of the following ranges?

A. 10 to 30 HU

B. 45 to 80 HU

C. 100 to 140 HU

D. 165 to 200 HU

Answer 93

D

Pulmonary nodules appearing on CT examinations of the lungs may be determined as benign if their average density is more than +164 Hounsfield units. Although there have been conflicting studies in this area, researchers tend to agree that density values approaching +200 HU make the benign diagnosis more certain.

Question 94

Question 110 of 416

Which of the following contrast media may be used during a CT examination of the chest?

1. Diatrizoate meglumine
2. Barium sulfate
3. Iopamidol

A. 1 only

B. 1 and 2 only

C. 2 and 3 only

D. 1, 2, and 3

Answer 94

D

Diatrizoate meglumine is an ionic intravenous contrast material, and iopamidol is a nonionic one. Both may be used for soft-tissue enhancement during CT of the chest. A barium sulfate contrast agent, usually in the form of a paste, may also be used to outline the esophagus, when necessary.

Question 95

Question 111 of 416

This localizer (scout) image was performed for a general CT survey of the chest. What technical error(s) was/were made with this image?

1. Image proceeds too far superiorly and inferiorly.
2. Incorrect azimuth is used.
3. Patient’s hands were not positioned overhead. See Fig.

A. 1 only

B. 1 and 2 only

C. 1 and 3 only

D. 1, 2, and 3

Answer 95

C

A scout image or scanogram for a CT examination of the chest should be a frontal projection including from above the apices to just below the costophrenic angles. The patient’s arms should be positioned overhead whenever possible to avoid streaking artifacts on the axial images.

Question 96

Question 115 of 416

The __________ gland is located in the anterosuperior portion of the mediastinum and is often identified with CT during scanning of younger patients.

A. thyroid

B. Luschka

C. thymus

D. parathyroid

Answer 96

C

The thymus gland may be found in the anterosuperior portion of the mediastinum. It is most easily visible prior to puberty. After puberty it becomes increasingly infiltrated with fat, so it is more difficult to image with computed tomography.

Question 97

Question 116 of 416

Number 6 corresponds to which of the following? See Fig.

A. Right brachiocephalic vein

B. Left subclavian artery

C. Brachiocephalic artery

D. Left common carotid artery

Answer 97

A

Number 6 corresponds to the right brachiocephalic vein.

Question 98

Question 117 of 416

Number 2 corresponds to which of the following? See Fig.

A. Right brachiocephalic vein

B. Left subclavian artery

C. Brachiocephalic artery

D. Left common carotid artery

Answer 98

D

Number 2 corresponds to the left common carotid artery.

Question 99

Question 118 of 416

Number 7 corresponds to which of the following? See Fig.

A. Right brachiocephalic vein

B. Left subclavian artery

C. Brachiocephalic artery

D. Left common carotid artery

Answer 99

C

Number 7 corresponds to the brachiocephalic artery.

Question 100

Question 119 of 416

Which number corresponds to the left brachiocephalic vein? See Fig.

A. 2

B. 4

C. 5

D. 1

Answer 100

D

Number 1 corresponds to the left brachiocephalic vein.

Question 101

Question 120 of 416

Which of the following does not branch off from the aortic arch? See Fig.

A. 6

B. 3

C. 7

D. 2

Answer 101

A

The subclavian (3), brachiocephalic (7), and common carotid (2) arteries all branch off the superior portion of the aortic arch. The left (1) and right (6) brachiocephalic veins originate from the superior vena cava.

Question 102

Question 121 of 416

Number 2 corresponds to which of the following? See Fig.

A. Right ventricle

B. Right atrium

C. Left ventricle

D. Left atrium

Answer 102

C

Number 2 corresponds to the left ventricle.

Question 103

Question 122 of 416

Which of the following algorithm type, matrix size, and section thickness parameters were used for the image? See Fig.

A. Soft tissue, 320, 5.0 mm

B. Bone, 512, 10.0 mm

C. Standard, 512, 5.0 mm

D. Standard, 512, 10.0 mm

Answer 103

D

The matrix size, algorithm type, and section thickness can all be found on the peripheral portion of the image. Each of these factors is variable and greatly affects the image quality.

Question 104

Question 123 of 416

Number 4 corresponds to which of the following? See Fig.

A. Descending aorta

B. Esophagus

C. Azygous vein

D. Trachea

Answer 104

C

Number 4 corresponds to the azygous vein.

Question 105

Question 124 of 416

Which of the following technical changes would serve to improve the quality of the image? See Fig.

A. Change matrix size to 256.

B. Decrease DFOV size.

C. Change matrix size to 320.

D. Increase DFOV size.

Answer 105

B

The image was reconstructed in a DFOV larger than necessary. The image appears minified because of this error. The DFOV chosen for an image should be slightly larger than the diameter of the area of interest. The DFOV used here was 48 cm. This image would appear significantly larger with a DFOV of 36 to 40 cm.

Question 106

Question 125 of 416

Which number corresponds to the right atrium? See Fig.

A. 2

B. 5

C. 1

D. 3

Answer 106

B

Number 5 corresponds to the right atrium.

Question 107

Question 126 of 416

Which of the following improvements in CT chest imaging is a direct result of the advent of multidetector CT (MDCT)?

1. Reduction in misregistration artifacts
2. Increased examination speed
3. Reduction in patient dose

A. 1 only

B. 1 and 2 only

C. 1 and 3 only

D. 1, 2, and 3

Answer 107

B

Speed is one of the key attributes of helical MDCT. The ability to volumetrically acquire images of the entire chest in a single breath-hold has greatly reduced the occurrence of misregistration artifacts. For many applications, MDCT may result in greater patient radiation dose than single-slice CT (SSCT).

Question 108

Question 127 of 416

Which of the following is NOT an improvement in CT chest imaging because of the development of multidetector technology?

A. An overall reduction in patient radiation dose

B. Reduction in partial volume artifact

C. Elimination of misregistration artifacts

D. Improved contrast enhancement

Answer 108

A

The speed of MDCT systems allow for images of the entire chest to be volumetrically acquired in just a few seconds. Fast, single-breath-hold acquisitions greatly reduce artifacts from breathing motion and allow for more efficient utilization of iodinated contrast agents. The ability to retrospectively reconstruct thin-section images can effectively eliminate the partial volume artifact on small areas of pathology. The drawback to MDCT is the potential for an increase in overall patient radiation dose. However, careful protocol optimization and continued technologic advancements work to limit any increases in patient radiation dose from MDCT examinations.

Question 109

Question 129 of 416

Number 3 corresponds to which of the following muscles? See Fig.

A. Pectoralis major

B. Pectoralis minor

C. Intercostals

D. Serratus posterior superior

Answer 109

A

Number 3 corresponds to the pectoralis major muscle.

Question 110

Question 131 of 416

Number 2 corresponds to which of the following? See Fig.

A. Left pulmonary artery

B. Thymus

C. Left brachiocephalic vein

D. Aortic arch

Answer 110

D

Number 2 corresponds to the aortic arch.

Question 111

Question 132 of 416

During HRCT of the lungs, image acquisition upon full expiration may be performed to improve demonstration of:

A. pulmonary nodules.

B. metastatic lesions.

C. air trapping from COPD.

D. dilated pulmonary arteries.

Answer 111

C.

Suspension of breathing at the end of forced expiration (static expiratory HRCT) may be utilized to demonstrate air trapping in patients with suspected small airway disease, such as chronic obstructive pulmonary disease (COPD), and emphysema.

Question 112

Question 134 of 416

Primary technical considerations for a CTA of the chest to rule out pulmonary embolism include:

1. Short acquisition in a single breath-hold from diaphragm to lung apex
2. Bolus injection of iodinated contrast agent at 4 to 5 mL/sec
3. Portal-phase acquisition at 60 to 70 seconds

A. 1 only.

B. 1 and 2 only.

C. 2 and 3 only.

D. 1, 2, and 3.

Answer 112

B.

CTA acquisition for pulmonary embolism must occur during peak contrast enhancement of the pulmonary arteries. Test bolus and automated bolus tracking methods are available to ensure appropriate scan delay for acquisition during the arterial phase of vessel opacification. Additional technical parameters include thin-section (0.5 to 1.25), caudocephalad acquisition with the use of a saline flush immediately following the administration of 80 to 150 mL of low-osmolar or iso-osmolar contrast media.

Question 113

Question 135 of 416

Why is it recommended that data acquisition for a CTA of the pulmonary arteries be performed in the caudocephalad direction?

A. To reduce overall patient radiation dose

B. To reduce required contrast volume

C. Pulmonary emboli are more prevalent superiorly

D. Less streaking artifact from dense contrast in the superior vena cava

Answer 113

D. Less streaking artifact from dense contrast in the superior vena cava

Scanning is best performed in the caudocephalad direction because there is reduced streaking artifact from dense contrast in the superior vena cava as the scan progresses. Also, if the patient is unable to hold the breath for the entire scan, motion artifacts are reduced higher in the chest.

Question 114

Question 136 of 416

Following a CTA of the chest for pulmonary embolism, an additional acquisition may be performed through the lower extremities to evaluate for:

A. swelling.

B. contrast retention.

C. deep vein thrombosis (DVT).

D. femoral aneurysm.

Answer 114

C. deep vein thrombosis (DVT).

During a CT pulmonary angiogram (CTPA) study, CT venography (CTV) of the lower extremities for the identification of deep vein thrombosis (DVT) may also be performed. DVT, the formation of blood clots within distal blood vessels, is common in the popliteal and femoral veins of the lower extremities. Pulmonary emboli occur when clots formed in the distal extremities dislodge and travel into the pulmonary arteries.

Question 115

Question 137 of 416

For a given CTA examination of the pulmonary arteries, 100 mL of a low-osmolar iodinated contrast agent is administered at a rate of 4 mL/sec. Peak pulmonary artery opacification should occur at approximately:

A. 5 to 10 seconds.

B. 20 to 25 seconds.

C. 50 to 60 seconds.

D. 80 to 90 seconds.

Answer 115

B.

Empiric scan delays for CTA of the pulmonary arteries vary between 20 and 25 seconds. Peak contrast opacification of the pulmonary arteries depends heavily on the rate of injection and the cardiac output of the patient. Performing a test bolus sequence and utilizing bolus-tracking software are valuable methods of ensuring that acquisition occurs during the period of maximum vessel opacification.

Question 116

Question 138 of 416

The primary indication for a noncontrast cardiac MDCT examination is:

A. coronary artery stenosis.

B. aortic aneurysm.

C. coronary artery calcium quantification.

D. pulmonary embolism.

Answer 116

C.

The primary clinical indication for noncontrast cardiac MDCT is coronary artery calcium (CAC) quantification for the assessment of atherosclerotic disease.

Question 117

Question 139 of 416

Prospectively gated cardiac CT data acquisition occurs only during the portion of the ECG termed the:

A. P wave.

B. QRS complex.

C. ST segment.

D. T wave.

Answer 117

D. T wave.

With prospective electrocardiography (ECG) monitoring, scanning only occurs during diastole, when the heart demonstrates the least motion. A user-defined percentage of the R-R interval is set as the trigger for data acquisition to occur during the T wave of the ECG.

Question 118

Question 140 of 416

For MDCT, identified areas of calcium must demonstrate relative attenuation values greater than:

A. +20 HU.

B. +130 HU.

C. +450 HU.

D. +1000 HU.

Answer 118

B.

On MDCT cardiac examinations for coronary artery calcification (CAC) quantification, areas of calcium are identified as those greater than 1 mm2 in area with Hounsfield values above 130.

Question 119

Question 141 of 416

An Agatston score of 250 on an MDCT cardiac examination for coronary artery calcification is rated as:

A. minimal.

B. mild.

C. moderate.

D. extensive.

Answer 119

C. moderate.

The Agatston scoring system quantifies coronary artery calcium as minimal (1 to 10), mild (11 to 100), moderate (101 to 400), and extensive (>400).

Question 120

Question 142 of 416

An Agatston score of 5 on an MDCT cardiac examination for coronary artery calcification is rated as:

A. minimal.

B. mild.

C. moderate.

D. extensive.

Answer 120

A.

The Agatston scoring system quantifies the volume and density of calcium within the coronary arteries. A score of 1-10 is minimal. A score between 11-100 is mild. A score between 101-400 is moderate. A score greater than 400 is extensive.

Question 121

Question 143 of 416

The major controlling factor of examination quality for coronary CTA is the:

A. contrast injection rate.

B. patient heart rate.

C. signal-to-noise ratio (SNR).

D. pitch.

Answer 121

B.

The major controlling factor of coronary CTA is the patient’s heart rate. Stable, steady heart rates below 65 to 70 beats per minute (bpm) yield the best results.

Question 122

Question 144 of 416

In patients who are right dominant, the posterior descending artery branches from the:

A. ramus intermedius.

B. conus artery.

C. right coronary artery.

D. right ventricular branch.

Answer 122

C.

85% of the population is said to be right dominant, meaning that the posterior descending artery (PDA) branches from the right coronary artery (RCA).

Question 123

Question 145 of 416

In patients who are left dominant, the posterior descending artery branches from the:

A. left circumflex artery.

B. left ventricular branch.

C. conus artery.

D. sinus node artery.

Answer 123

A.

8% of the population is said to be left dominant, meaning that the posterior descending artery (PDA) branches from the left circumflex artery (LCX).

Question 124

Question 146 of 416

Patients whose posterior descending artery branches from the right coronary artery and whose left posterior ventricular branches arise from the left circumflex artery, are said to be:

A. right dominant.

B. left dominant.

C. codominant.

D. posteriorly dominant.

Answer 124

C.

7% of the population is said to be codominant, meaning that the posterior descending artery (PDA) is supplied by the right coronary artery (RCA), and the left posterior ventricular branches arise from the left circumflex artery (LCX).

Question 125

Question 148 of 416

The branches of the left coronary artery include the:

1. Sinus node artery
2. Left anterior descending artery
3. Left circumflex artery

A. 2 only.

B. 1 and 2 only.

C. 2 and 3 only.

D. 1, 2, and 3.

Answer 125

C.

Refer to figure 4-40 in the textbook.

Question 126

Question 149 of 416

During a coronary artery CTA, single-segment reconstruction of a 400-msec rotation scan results in a temporal resolution of:

A. 100 msec

B. 200 msec.

C. 400 msec.

D. 800 msec.

Answer 126

B.

During single-segment, or half-scan reconstruction, data from only half a gantry rotation is used, resulting in a temporal resolution equal to one half the gantry rotation time.

Question 127

Question 150 of 416

The ability of an MDCT system to freeze heart motion during a cardiac CT is described by its:

A. detector resolution.

B. spatial resolution.

C. temporal resolution.

D. contrast resolution.

Answer 127

C.

The temporal resolution of an MDCT system describes its ability to freeze the motion of the heart as well as the arterial motion velocity within the coronary vasculature.

Question 128

Question 151 of 416

Which of the following technical attributes enables MDCT systems to acquire motion-free images of the heart and surrounding vasculature?

A. Excellent contrast resolution

B. Superior temporal resolution

C. Consistent linearity

D. High SNR

Answer 128

B.

The temporal resolution of an MDCT system describes its ability to freeze the motion of the heart as well as the arterial motion velocity within the coronary vasculature.

Question 129

Question 152 of 416

The primary advantage of prospective ECG gating for cardiac CT over retrospective ECG gating is:

A. the ability to scan patients with severe arrhythmia.

B. the ability to evaluate cardiac function.

C. a reduction in required contrast dose.

D. a reduction in patient radiation dose.

Answer 129

D.

The main benefit of prospective ECG gating is the potential for up to a 70% reduction in patient radiation dose. Prospective ECG gating requires a steady heartbeat to limit motion artifact, and the evaluation of cardiac function is not possible because data is acquired only during diastole.

Question 130

Question 153 of 416

The Stanford type B dissecting aneurysm affects which portion of the aorta?

A. Ascending thoracic

B. Descending thoracic

C. Abdominal

D. Bifurcation

Answer 130

B.

Stanford type B dissecting aneurysms affect the descending aorta. Stanford type A dissecting aneurysms affect the ascending aorta.

Question 131

Question 154 of 416

During prospectively ECG-gated cardiac CTA studies, the scanning acquisition mode may be best described as:

A. axial “step-and-shoot.”

B. helical volumetric.

C. axial cine.

D. multiplanar reconstruction.

Answer 131

A.

During prospective ECG-gated cardiac CTA, data are acquired in an axial “step-and-shoot” mode. The x-ray and data acquisition systems are activated only during the diastolic portion of the R-R interval. Retrospective ECG gating involves a volumetric helical acquisition with only the diastolic portion of the data used for image reconstruction. Cine CT involves a series of acquisitions of a limited area over time. Routinely used in perfusion CT studies, cine acquisitions may have certain cardiac applications, such as the evaluation of valves, specific vessels, and cardiac perfusion.

Question 132

Question 155 of 416

The quantity of blood pumped out of a ventricle every heartbeat is termed the:

A. end-diastolic volume.

B. ejection fraction.

C. end-systolic volume.

D. injection fraction.

Answer 132

B.

Ejection fraction describes the percentage of blood pumped out of a cardiac ventricle during each contraction. It is a measure of cardiac function and can be accurately determined during a cardiac CT examination. With system software, the ejection fraction can be calculated from a comparison between the volume of blood within a ventricle at the end of filling (end-diastolic volume) and the volume at end of contraction (end-systolic volume).

Question 133

Question 156 of 416

On axial CT images of the chest, the region between the ascending aorta and descending aorta just below the aortic arch is commonly referred to as the:

A. carina.

B. costophrenic angle.

C. retrocrural space.

D. aortic-pulmonary (AP) window.

Answer 133

D. aortic-pulmonary (AP) window.

The aortic-pulmonary (AP) window is located between the ascending and descending aorta on axial CT cross section, just below the aortic arch. Containing mostly fat, the AP window is a common location for the visualization of abnormally enlarged lymph nodes (lymphadenopathy).

Question 134

Question 157 of 416

By CT criteria, a solitary pulmonary nodule may be defined as a focal area of increased density in the lung that is smaller than:

A. 1 cm.

B. 3 cm.

C. 5 cm.

D. 10 cm.

Answer 134

B.

Solitary pulmonary nodules are typically ovoid focal areas of increased density that are less than 3 cm in diameter. Any lesion larger than 3 cm is referred to as a focal mass, with an increased propensity for malignancy.

Question 135

Question 158 of 416

The exaggeration of displayed calcification within the coronary arteries during a cardiac MDCT study is referred to as:

A. aliasing.

B. blooming.

C. star artifact.

D. penumbra.

Answer 135

B.

Blooming refers to the potential overestimation of vessel calcification because of partial volume artifact. During cardiac MDCT studies, blooming may be somewhat mitigated by improving the spatial resolution of a given acquisition or choosing an appropriately wide window setting (1500 HU) to reduce the appearance of the artifact.

Question 136

Question 159 of 416

Number 5 corresponds to which of the following? See Fig.

A. Gallbladder

B. Inferior vena cava

C. Descending aorta

D. Right adrenal gland

Answer 136

B.

Number 5 corresponds to the inferior vena cava.

Question 137

Question 160 of 416

Number 3 corresponds to which of the following? See Fig.

A. Spleen

B. Small bowel

C. Descending colon

D. Left kidney

Answer 137

A.

Number 3 corresponds to the spleen.

Question 138

Question 161 of 416

The portion of the nephron responsible for filtration of unwanted materials from the blood plasma is called the:

A. afferent arteriole.

B. proximal tubule.

C. efferent arteriole.

D. glomerulus.

Answer 138

D.

The glomerulus is the portion of the nephron responsible for filtering unwanted substances from blood plasma. The blood enters into the glomerulus through the afferent arteriole and exits through the efferent arteriole. The waste fluid leaves the glomerulus through the proximal tubule.

Question 139

Question 163 of 416

Differentiation between the duodenum and head of the pancreas is best accomplished with:

1. An oral contrast agent administered 30 to 45 minutes prior to scanning
2. Pre- and post-contrast images of the abdomen
3. Placement of the patient in the right lateral decubitus position prior to scanning

A. 1 only.

B. 1 and 3 only.

C. 2 and 3 only.

D. 1, 2, and 3.

Answer 139

B.

The duodenum and pancreatic head are often difficult to distinguish. This is one important reason why the small bowel must be properly opacified. To accomplish adequate opacification, an oral contrast agent should be administered at least 30 minutes prior to scanning. Positioning the patient in a right lateral decubitus position is also helpful in ensuring opacification of the duodenum, which surrounds the pancreatic head.

Question 140

Question 164 of 416

__________ is a term that refers to an excessive amount of nitrogenous materials in the blood and is a symptom of renal failure.

A. Hydronephrosis

B. Azotemia

C. Oliguria

D. Diuresis

Answer 140

B.

Azotemia describes the condition of excessive nitrogenous materials in the blood. This condition is also commonly called uremia. Azotemia is a symptom of renal insufficiency and may occur during chronic renal failure.

Question 141

Question 165 of 416

CT images of the abdomen should be acquired with the patient:

A. at full inspiration.

B. breathing quietly.

C. at full expiration.

D. breathing normally.

Answer 141

C.

Suspended respiration at the end of full expiration is the most reproducible point in the respiratory cycle. It results in less misregistration artifact during CT examinations of the abdomen.

Question 142

Question 167 of 416

Following the intravenous administration of iodinated contrast media, a hepatic hemangioma may become __________ and may no longer appear on the CT image.

A. hypodense

B. radiolucent

C. isodense

D. hyperdense

Answer 142

C.

The diagnosis of hemangioma is confirmed on CT by evaluation of its pattern of enhancement. Hemangiomas enhance from the periphery inward, until they become isodense with the surrounding hepatic tissue. Once isodense, the hemangioma attenuates the beam in the same way as the hepatic tissue. The CT numbers of the hemangioma and hepatic tissue become equal and the structures may become impossible to differentiate.

Question 143

Question 168 of 416

Which of the following would most likely require the intravenous injection of an iodinated contrast agent for accurate differentiation during a CT study of the abdomen?

A. Angiomyolipoma

B. Renal stone

C. Diverticulitis

D. Renal cyst

Answer 143

D.

The diagnosis of simple cyst is accurately made with proper CT examination. Pre- and post-contrast images must be obtained to measure enhancement. The attenuation values for the cystic area should be at or near zero. The diagnoses of angiomyolipoma, renal stone, and diverticulitis can be made without the intravenous injection of contrast material.

Question 144

Question 169 of 416

Number 2 corresponds to which of the following? See Fig.

A. Splenic vein

B. Left renal artery

C. Pancreas

D. Duodenum

Answer 144

C.

Number 2 corresponds to the pancreas.

Question 145

Question 170 of 416

Which of the following methods of oral contrast agent administration would be suitable for the CT scan of the abdomen depicted in this figure? See Fig.

A. 1500 mL 90 to 120 minutes prior to scanning

B. 1200-mL enema immediately prior to scanning

C. 100 mL 3 hours prior to scanning with an additional 50 mL given just before the study

D. 450 mL 30 minutes prior to scanning with an additional 250 mL given just before the study

Answer 145

D. 450 mL 30 minutes prior to scanning with an additional 250 mL given just before the study

For a CT examination of the abdomen, an oral contrast agent should be administered in a volume of approximately 450 mL 15 to 30 minutes prior to the examination. An additional 250 mL should be given just prior to the study. This method of administration should provide adequate opacification of the stomach and small bowel.

Question 146

Question 171 of 416

Number 3 corresponds to which of the following? See Fig.

A. Inferior mesenteric artery

B. Adrenal gland

C. Tail of pancreas

D. Renal vein

Answer 146

B. Adrenal gland

Number 3 corresponds to the adrenal gland.

Question 147

Question 172 of 416

Which number corresponds to the left lobe of the liver? See Fig.

A. 5

B. 1

C. 4

D. 6

Answer 147

B. 1

Number 1 corresponds to the left lobe of the liver.

Question 148

Question 173 of 416

The presence of outpocketings in the wall of the colon is referred to as:

A. intussusception.

B. diverticulitis.

C. polyps.

D. diverticulosis.

Answer 148

D. diverticulosis

Diverticulosis is the presence of small pouch-like openings in the wall of the colon. Diverticulitis is used when the diverticula become inflamed.

Question 149

Question 174 of 416

Often seen in pediatric patients, a specific type of renal mass arising from immature kidney cells is referred to as:

A. Krukenberg tumor.

B. Wilms tumor.

C. von Hippel-Lindau syndrome.

D. Ewing sarcoma.

Answer 149

B. Wilms tumor.

Wilms tumor is a specific type of renal mass that develops from immature renal parenchyma. It may also be referred to as nephroblastoma and occurs in pediatric patients, usually between ages 1 and 5 years.

Question 150

Question 175 of 416

During a CT examination of the abdomen including intravenous administration of an iodinated contrast agent, which of the following abnormal findings could appear hyperdense in comparison with surrounding tissue?

A. Angiomyolipoma of the kidney

B. Simple hepatic cyst

C. Dilated common bile duct

D. Gallstone

Answer 150

D. Gallstone

Owing to their relatively high CT numbers, gallstones usually appear hyperdense in comparison with the bile-filled gallbladder. Some gallstones having lower attenuation values can appear isodense on a CT scan of the abdomen.

Question 151

Question 176 of 416

CT-guided needle biopsies are most commonly performed on which of the following anatomic areas?

A. Brain

B. Pancreas

C. Cervix

D. Stomach

Answer 151

B. Pancreas

The pancreas is a common area for CT-guided needle biopsy. The location of a pathologic process and the type of tissue involved govern the use of percutaneous biopsy under CT guidance.

Question 152

Question 177 of 416

Which of the following sets of reconstructed section widths and intervals would be best suited for a general survey CT study of the abdomen and pelvis in a patient with a history of lymphoma?

A. 0.625 mm × 0.625 mm

B. 1.25 mm × 2.5 mm

C. 5.0 mm × 5.0 mm

D. 10 mm × 15 mm

Answer 152

C. 5.0 mm × 5.0 mm

General survey CT studies for lymphoma are typically performed contiguously with section widths ranging from 3.0 to 5.0 mm for routine review. Data acquisition with an MDCT system may involve the use of a thinner detector configuration, such as 0.625 mm. Thicker section widths are reconstructed for review, with thinner images used for multiplanar reformation (MPR) or for areas of specific concern.

Question 153

Question 179 of 416

What procedure is being performed in this figure? See Fig.

A. Quantitative CT

B. Percutaneous abscess drainage

C. Percutaneous needle biopsy

D. Radiation therapy planning

Answer 153

C. Percutaneous needle biopsy

The high-density object leading from the skin surface into the pancreatic head indicates that this image is part of a CT-guided percutaneous needle biopsy.

Question 154

Question 180 of 416

Number 4 corresponds to which of the following? See Fig.

A. Streaking artifact

B. Hernia

C. Gunshot

D. Biopsy needle

Answer 154

D. Biopsy needle

Number 4 corresponds to a biopsy needle.

Question 155

Question 181 of 416

Number 3 corresponds to which of the following? See Fig.

A. Abscess

B. Hepatic tumor

C. Ascending colon

D. Gallbladder

Answer 155

D. Gallbladder

Number 3 corresponds to the gallbladder.

Question 156

Question 182 of 416

Number 1 corresponds to which of the following? See Fig.

A. Transverse colon

B. Splenic flexure

C. Stomach

D. Diverticular abscess

Answer 156

C. Stomach

Number 1 corresponds to the stomach.

Question 157

Question 183 of 416

Number 2 corresponds to which of the following? See Fig.

A. Erector spinae muscle

B. Gluteus medius muscle

C. Psoas major muscle

D. Sacrospinalis muscle

Answer 157

C. Psoas major muscle

Number 2 corresponds to the psoas major muscle.

Question 158

Question 184 of 416

The circle labeled as number 1 is used here for what purpose? See Fig.

A. To outline an area of pathology

B. To make an ROI (region of interest) measurement

C. To target an area for needle biopsy

D. To change the display field of view

Answer 158

B. To make an ROI (region of interest) measurement

Region of interest (ROI) or attenuation measurements may be made on the CT image through numerous software applications. The image in this figure has a circular cursor positioned over an area of the kidney. The computer is capable of calculating the average attenuation value (CT number) for the pixels included within the circle. This information is valuable in identifying the type of tissue present and can aid in the determination of a diagnosis for selected pathologies.

Question 159

Question 185 of 416

The measured density of the area labeled as number 4 is approximately +5 HU. This area most likely represents: See Fig.

A. kidney stone.

B. angiomyolipoma.

C. renal tumor.

D. renal cyst.

Answer 159

D. renal cyst

The diagnosis of renal cyst from a CT scan depends on several factors. The area must be of relatively homogeneous density with explicit demarcations from the surrounding renal tissue. It must also present no remarkable enhancement after intravenous contrast agent administration, maintaining an average Hounsfield value of zero (±20 HU).

Question 160

Question 186 of 416

Which of the following statements is true concerning CT scans of the abdomen for the differentiation of renal cysts? See Fig.

1. Acquisitions through the kidneys should be performed before and after administration of an IV contrast agent.
2. ROI measurements of the cyst should be made to help determine its composition.
3. The patient should refrain from urination for 2 hours prior to the examination.

A. 1 only

B. 1 and 2 only

C. 2 and 3 only

D. 1, 2, and 3

Answer 160

B. 1 and 2 only

CT examinations for the evaluation of renal cysts should be performed pre- and post-contrast agent administration to determine whether the area in question enhances. A renal cyst should also have an average density near or equal to that of water: −20 to +20 HU.

Question 161

Question 187 of 416

Number 3 corresponds to which of the following? See Fig.

A. Adrenal gland

B. Spleen

C. Liver

D. Duodenum

Answer 161

C. Liver

Number 3 corresponds to the liver.

Question 162

Question 188 of 416

Which of the following abnormal findings will reduce the density of the liver?

A. Hyperdense cyst

B. Contrast-enhancing tumor

C. Fatty infiltrate

D. Calcified granuloma

Answer 162

C. Fatty infiltrate

The density of the liver decreases with the presence of fatty infiltrates. The minimal attenuation of fat and its low CT number cause an overall decrease in the attenuation and CT number of the hepatic parenchyma.

Question 163

Question 189 of 416

CT scanning of the liver for tumor evaluation should NOT be performed during which of the following phases of contrast enhancement?

A. Arterial phase

B. Equilibrium phase

C. Portal venous phase

D. Bolus phase

Answer 163

B. Equilibrium phase

Contrast enhancement is at its lowest point during the equilibrium phase. This phase is apparent when the aorta and inferior vena cava differ by less than 10 HU. It is during this phase that hepatic lesions may become isodense with the surrounding hepatic parenchyma. Noncontrast scanning of the liver is actually preferred to scanning during the equilibrium phase.

Question 164

Question 190 of 416

The kidneys are usually located anatomically between which vertebrae?

A. T6 and L2

B. T12 and L3

C. L2 and L4

D. L3 and S1

Answer 164

B. T12 and L3

The CT technologist is often called upon to localize the exact area of the kidneys. Although there may be some fluctuation from patient to patient, the kidneys can usually be found between the 12th thoracic vertebrae and 3rd lumbar vertebrae.

Question 165

Question 191 of 416

The majority of pancreatic tumors occur in the pancreatic:

A. head.

B. body.

C. tail.

D. uncinate process.

Answer 165

A. head.

The majority of pancreatic tumors occur in the head of the pancreas. The majority of these masses are adenocarcinomas.

Question 166

Question 192 of 416

Which of the following organs is/are characterized as retroperitoneal in location?

1. Pancreas
2. Liver
3. Kidneys

A. 1 only

B. 1 and 3 only

C. 2 and 3 only

D. 1, 2, and 3

Answer 166

B. 1 and 3 only

Retroperitoneal structures are those contained within the retroperitoneum. The retroperitoneum is the space located between the peritoneum and the posterior abdominal wall. It includes the duodenum, pancreas, adrenal glands, kidneys, ureters, and bladder.

Question 167

Question 193 of 416

Normal unenhanced hepatic parenchyma exhibits CT densities within the range of:

A. −20 to 0 HU.

B. +15 to +30 HU.

C. +45 to +65 HU.

D. +80 to +105 HU.

Answer 167

C. +45 to +65 HU

Normal unenhanced hepatic parenchyma is homogenous in appearance with CT densities between +45 and +65 Hounsfield units (HU). The CT density of the unenhanced liver is normally slightly greater than the densities of blood vessels and the splenic parenchyma.

Question 168

Question 194 of 416

Which of the following is an example of a hypovascular hepatic mass?

A. Hemangioma

B. Hepatic cyst

C. Hepatocellular carcinoma (HCC)

D. Focal nodular hyperplasia (FNH)

Answer 168

B. Hepatic cyst

The hallmark CT finding for a cyst is lack of enhancement with IV contrast agent administration. Cysts are therefore characterized as hypovascular. Hemangiomas, hepatocellular carcinomas (HCC), focal nodular hyperplasia (FNH), and certain metastatic lesions are all examples of hypervascular tumors of the liver.

Question 169

Question 195 of 416

Malignant neoplasms of the liver include which of the following?

1. Focal nodular hyperplasia (FNH)
2. Cavernous hemangioma
3. Hepatocellular carcinoma (HCC)

A. 3 only

B. 1 and 3 only

C. 2 and 3 only

D. 1, 2, and 3

Answer 169

A. 3 only

Hepatocellular carcinoma (HCC) and metastases are the most common malignant neoplasms of the liver. Hemangiomas and focal nodular hyperplasia (FNH) are both examples of benign hepatic tumor.

Question 170

Question 196 of 416

The liver has a dual blood supply and receives 25% of its blood from the:

A. hepatic artery.

B. superior mesenteric artery.

C. portal vein.

D. superior mesenteric vein.

Answer 170

A. hepatic artery.

The liver has a dual blood supply, receiving 75% of its supply from the portal vein, and the remaining 25% of blood from the hepatic artery.

Question 171

Question 197 of 416

Contrast enhancement phases of the liver include which of the following?

1. Corticomedullary
2. Arterial
3. Portal venous

A. 2 only

B. 1 and 2 only

C. 2 and 3 only

D. 1, 2, and 3

Answer 171

C. 2 and 3 only

The primary hepatic phases of contrast enhancement are the arterial, portal venous, and equilibrium phases. The early arterial and delayed phases of hepatic enhancement are also noted.

Question 172

Question 198 of 416

After initiation of rapid bolus administration of an iodinated contrast agent, the hepatic venous phase of contrast enhancement occurs at approximately:

A. 15 to 20 seconds.

B. 25 to 35 seconds.

C. 60 to 70 seconds.

D. 120 to 180 seconds.

Answer 172

C. 60 to 70 seconds.

The hepatic (or portal) venous phase is the period of peak hepatic parenchymal enhancement during which contrast material redistributes from the blood into the extravascular spaces. It occurs at approximately 60 to 70 seconds after the initiation of rapid bolus administration of a contrast agent.

Question 173

Question 199 of 416

After initiation of rapid bolus administration of an iodinated contrast agent, the equilibrium phase of hepatic contrast enhancement occurs at approximately:

A. 15 to 20 seconds.

B. 25 to 35 seconds.

C. 60 to 70 seconds.

D. 120 to 180 seconds.

Answer 173

D. 120 to 180 seconds.

The equilibrium phase of hepatic contrast enhancement usually occurs 2 to 3 minutes after the initiation of contrast agent administration. During this phase, hepatic parenchymal enhancement dissipates and there is minimal difference in contrast enhancement between the intravascular and extravascular spaces.

Question 174

Question 200 of 416

After initiation of rapid bolus administration of an iodinated contrast agent, the early arterial phase of hepatic contrast enhancement occurs at approximately:

A. 15 to 20 seconds.

B. 25 to 35 seconds.

C. 60 to 70 seconds.

D. 120 to 180 seconds.

Answer 174

A. 15 to 20 seconds.

Occurring at 15 to 20 seconds after the initiation of contrast administration, the early arterial phase of contrast enhancement is the optimal phase for angiographic applications of liver CT. During this phase, the hepatic arterial supply is well opacified with little or no parenchymal enhancement.

Question 175

Question 201 of 416

The period of peak hepatic parenchymal enhancement following rapid bolus injection of iodinated contrast is termed the:

A. equilibrium phase.

B. portal venous phase.

C. arterial phase.

D. nephrographic phase.

Answer 175

B. portal venous phase.

The portal (or hepatic) venous phase is the period of peak hepatic parenchymal enhancement during which contrast material redistributes from the blood into the extravascular spaces. It occurs at approximately 60 to 70 seconds after the initiation of rapid bolus contrast administration.

Question 176

Question 202 of 416

The presence of stones within the gallbladder is termed:

A. nephrolithiasis.

B. cholelithiasis.

C. choledocholithiasis.

D. sialolithiasis.

Answer 176

B. cholelithiasis

The condition of stones within the gallbladder is referred to as cholelithiasis. Choledocholithiasis is the presence of gallstones within the bile ducts. Nephrolithiasis refers to renal stones. Sialolithiasisrefers to the presence of stones in the salivary glands.

Question 177

Question 203 of 416

The hallmark CT finding for focal nodular hyperplasia (FNH) of the liver is:

A. lack of enhancement with IV contrast agent administration.

B. CT density approximately 10 HU less than that of the spleen.

C. peripheral globular enhancement during initial contrast agent administration.

D. central scar that remains hypodense after initial contrast agent administration.

Answer 177

D. central scar that remains hypodense after initial contrast agent administration.

Focal nodular hyperplasia (FNH) is a common vascular lesion often identified along the surface of the liver. It is characterized by intense homogeneous enhancement with contrast agent administration. There is usually a central scar that remains hypodense until delayed imaging, when it may also enhance.

Question 178

Question 204 of 416

Portal venous phase imaging of the liver is used to optimally demonstrate which of the following?

A. Hepatocellular carcinoma (HCC)

B. Hypovascular hepatic metastases

C. Hepatic artery aneurysm

D. Focal nodular hyperplasia (FNH)

Answer 178

B. Hypovascular hepatic metastases

Portal venous phase imaging is the phase during which hypovascular lesions are most conspicuous because of their density difference in comparison with the enhancing hepatic parenchyma. Hepatocellular carcinoma (HCC), hepatic artery aneurysm, and focal nodular hyperplasia are all hypervascular in nature and would be best demonstrated on arterial phase imaging.

Question 179

Question 205 of 416

During post-contrast CT imaging of the abdomen, the degree of hepatic parenchymal enhancement depends on:

1. The iodine concentration of the contrast agent
2. The rate if contrast agent injection
3. The osmolality of the contrast medium

A. 1 only.

B. 1 and 2 only.

C. 2 and 3 only.

D. 1, 2, and 3.

Answer 179

B. 1 and 2 only.

The extent of hepatic parenchymal enhancement depends on the overall dose of iodine delivered. The iodine dose may be increased directly by utilizing a contrast agent with a higher concentration, or indirectly by increasing the injection rate.

Question 180

Question 206 of 416

The approximate CT density of the unenhanced spleen is:

A. less than 0 HU.

B. between +40 and +60 HU.

C. between +75 and +90 HU.

D. greater than +100 HU.

Answer 180

B. between +40 and +60 HU

The CT density of the unenhanced spleen is between +40 and +60 HU. The unenhanced spleen CT density is approximately 10 HU less than that of the unenhanced liver.

Question 181

Question 207 of 416

Which of the following phases of contrast enhancement optimally demonstrates the relationship between pancreatic neoplasm and the surrounding vasculature?

A. Pre-contrast

B. Arterial phase

C. Pancreatic phase

D. Portal venous phase

Answer 181

B. Arterial phase

During arterial phase acquisition through the pancreas, there is maximum opacification of the surrounding vasculature, including the aorta and superior mesenteric artery. An important goal of pancreatic CT is to evaluate the involvement of surrounding vessels by pancreatic neoplasm.

Question 182

Question 208 of 416

Which of the following technical considerations is necessary to differentiate hydronephrosis from parapelvic cysts on CT examination?

A. Administration of an iodinated IV contrast agent

B. Prone acquisition

C. Administration of an oral contrast agent

D. Valsalva maneuver

Answer 182

A. Administration of an iodinated IV contrast agent

Parapelvic cysts are simple cysts arising within the renal pelvis. They are similar in appearance to the distention of the pelvis and calyces known as hydronephrosis. Delayed imaging after IV contrast agent administration opacifies the renal pelvis, clearly differentiating hydronephrosis from parapelvic cysts.

Question 183

Question 209 of 416

After initiation of rapid bolus administration of an iodinated contrast agent, the corticomedullary phase of renal contrast enhancement occurs at approximately:

A. 20 to 25 seconds.

B. 30 to 40 seconds.

C. 70 to 90 seconds.

D. 3 to 5 minutes.

Answer 183

B. 30 to 40 seconds.

The corticomedullary phase is a late arterial phase beginning 30 to 40 seconds after the initiation of contrast agent administration. Optimal enhancement of the renal cortex and renal veins occurs during this period.

Question 184

Question 210 of 416

After initiation of rapid bolus administration of an iodinated contrast agent, the excretory phase of renal contrast enhancement occurs at approximately:

A. 20 to 25 seconds.

B. 30 to 40 seconds.

C. 70 to 90 seconds.

D. 3 to 5 minutes.

Answer 184

D. 3 to 5 minutes.

The excretory phase is a delayed-imaging phase that begins approximately 3 minutes after the initiation of contrast agent administration. During this phase, contrast material has been excreted into the renal calyces, opacifying the renal pelvis and the remainder of the urinary collecting system (ureters, bladder). The excretory phase best demonstrates the filling defects and potential lesions involving the urothelium, such as those from transitional cell carcinoma (TCC).

Question 185

Question 211 of 416

The period of peak enhancement of the renal cortex following rapid bolus injection of an iodinated contrast agent is termed the:

A. early arterial phase.

B. portal venous phase.

C. corticomedullary phase.

D. nephrographic phase.

Answer 185

C. corticomedullary phase

The corticomedullary phase is a late arterial phase beginning 30 to 40 seconds after the initiation of contrast agent administration. Optimal enhancement of the renal cortex and renal veins occurs during this period.

Question 186

Question 212 of 416

Which of the following phases of renal contrast enhancement provides maximum sensitivity for parenchymal lesions?

A. Early arterial

B. Corticomedullary

C. Nephrographic

D. Excretory

Answer 186

C. Nephrographic

During the nephrographic phase, enhancement between renal cortex and medulla reaches equilibrium, providing optimal sensitivity for parenchymal lesions. The nephrographic phase occurs between 70 and 90 seconds after the start of injection.

Question 187

Question 213 of 416

An abnormal connection between the intestine and an adjacent anatomic structure is called a(n):

A. perforation.

B. abscess.

C. sinus tract.

D. fistula.

Answer 187

D. fistula

A fistula is an abnormal connection between the intestine and an adjacent structure. Fistulas are commonly associated with inflammatory bowel disease.

Question 188

Question 214 of 416

Which of the following phases of IV contrast agent administration provides the best gastric and intestinal wall enhancement?

A. Early arterial

B. Corticomedullary

C. Portal venous

D. Excretory

Answer 188

C. Portal venous

For indications involving the GI tract, acquisition is typically obtained during the portal venous phase for optimal gastric and intestinal wall enhancement.

Question 189

Question 215 of 416

The duodenum is suspended from the diaphragm by the:

A. ligamentum teres.

B. diaphragmatic crus.

C. falciform ligament.

D. ligament of Treitz.

Answer 189

D. ligament of Treitz

The suspensory ligament of the diaphragm is commonly referred to as the ligament of Treitz.

Question 190

Question 216 of 416

Which of the following oral contrast agents offers the best visualization of the enhancing GI wall on post-IV contrast CT examination?

A. Low-osmolar water-soluble iodinated solution

B. High-osmolar water-soluble iodinated solution

C. Water

D. Barium sulfate suspension

Answer 190

C. Water

Water as a negative oral contrast agent improves visualization of the enhancing enteral wall when an IV contrast agent is administered. Other agents, such as VoLumen and milk, may also be effective as agents capable of distending the bowel while allowing for wall visualization.

Question 191

Question 217 of 416

The condition whereby a portion of the small intestine collapses or telescopes into itself is termed:

A. ileus.

B. diverticulosis.

C. adhesion.

D. intussusception.

Answer 191

D. intussusception

Intussusception describes the condition whereby a portion of the small intestine collapses or telescopes into itself. It is a rare occurrence that may result in obstruction.

Question 192

Question 218 of 416

The term appendicolith is applied to which of the following pathologic conditions of the appendix?

A. Perforation

B. Inflammation

C. Calcification

D. Fistula

Answer 192

C. Calcification

An appendicolith is a calcification or stone within the appendix and is often associated with appendicitis.

Question 193

Number 1 corresponds to which of the following? See Fig.

A. Ligament of Treitz

B. Portal vein

C. Ligamentum teres

D. Gallbladder

Answer 193

D. Gallbladder

Number 1 corresponds to the gallbladder.

Question 194

Question 220 of 416

This image of the abdomen was most likely acquired in which of the following renal enhancement phases? See Fig.

A. Pre-contrast

B. Corticomedullary

C. Nephrographic

D. Excretory

Answer 194

B. Corticomedullary

Beginning 30 to 40 seconds after the initiation of contrast agent administration, the corticomedullary phase demonstrates optimal enhancement of the renal cortex with maximum differentiation from the renal medulla.

Question 195

Question 221 of 416

Number 5 corresponds to which of the following? See Fig.

A. Portal vein

B. Superior mesenteric vein

C. Left renal vein

D. Left ureter

Answer 195

C. Left renal vein

Number 5 corresponds to the left renal vein.

Question 196

Question 222 of 416

Number 8 corresponds to which of the following? See Fig.

A. Inferior vena cava

B. Common bile duct

C. Portal vein

D. Superior mesenteric vein

Answer 196

A. Inferior vena cava

Number 8 corresponds to the inferior vena cava.

Question 197

Question 223 of 416

Number 4 corresponds to which of the following? See Fig.

A. Large colon

B. Jejunum

C. Spleen

D. Pancreas

Answer 197

C. Spleen

Number 4 corresponds to the spleen.

Question 198

Question 224 of 416

Number 7 corresponds to which of the following? See Fig.

A. Renal pyramid

B. Renal pelvis

C. Renal cortex

D. Renal calyx

Answer 198

B. Renal pelvis

Number 7 corresponds to the renal pelvis.

Question 199

Question 225 of 416

Which of the following reformation techniques best describes the image? See Fig.

A. Volume-rendered (VR) 3-D

B. Multiplanar reformation (MPR)

C. Maximum intensity projection (MIP)

D. Minimum intensity projection (minIP)

Answer 199

B. Multiplanar reformation (MPR)

This coronal representation is a standard multiplanar reformation (MPR) image. It demonstrates the same density and contrast as a conventional helically acquired axial image. Multiplanar reformation (MPR) describes the process of displaying CT images in a different orientation from the one used in the original reconstruction process. The reformatted image is one voxel thick, with the pixels facing the viewer and each representing the average attenuation occurring within the represented voxels.

Question 200

Question 226 of 416

Which of the following corresponds to the high-attenuation area indicated by number 1? See Fig.

A. Renal cortex

B. Renal pelvis

C. Renal calyx

D. Renal pyramid

Answer 200

A. Renal cortex

Number 1 corresponds to the renal cortex.

Question 201

Question 227 of 416

Number 2 corresponds to which of the following? See Fig.

A. Renal cortex

B. Right adrenal gland

C. Renal calyx

D. Renal pyramid

Answer 201

B. Right adrenal gland

Question 202

Question 228 of 416

The areas indicated by number 3 most likely correspond to which of the following? See Fig.

A. Appendicolithiasis

B. Urolithiasis

C. Phleboliths

D. Cholelithiasis

Answer 202

C. Phleboliths

Phleboliths are calcifications within pelvic veins. On this post-contrast CT urogram, the calcifications are demonstrated outside of the urinary tract.

Question 203

Question 229 of 416

Number 4 corresponds to which of the following? See Fig.

A. Ureteropelvic junction

B. Ureterovesical junction

C. Ureterocalyceal junction

D. Ureteropyramidal junction

Answer 203

B. Ureterovesical junction

Number 4 corresponds to the ureterovesical junction (UVJ).

Question 204

Question 230 of 416

Number 5 corresponds to which of the following? See Fig.

A. Duodenum

B. Descending colon

C. Jejunum

D. Ascending colon

Answer 204

B. Descending colon

Number 5 corresponds to the descending colon.

Question 205

Question 231 of 416

This image of the abdomen was most likely acquired in which of the following renal enhancement phases? See Fig.

A. Pre-contrast

B. Corticomedullary

C. Nephrographic

D. Excretory

Answer 205

C. Nephrographic

The nephrographic phase occurs between 70 and 90 seconds after the start of injection. Enhancement between renal cortex and medulla reaches equilibrium, providing optimal sensitivity for parenchymal lesions.

Question 206

Question 232 of 416

Number 1 corresponds to which of the following? See Fig.

A. Transverse colon

B. Duodenum

C. Jejunum

D. Cecum

Answer 206

C. Jejunum

Number 1 corresponds to the duodenum.

Question 207

Question 233 of 416

Number 6 corresponds to which of the following? See Fig.

A. Erector spinae muscle

B. Psoas muscle

C. Gluteus minimus muscle

D. External oblique muscle

Answer 207

A. Erector spinae muscle

Number 6 corresponds to the erector spinae muscle.

Question 208

Question 234 of 416

Number 8 corresponds to which of the following? See Fig.

A. Internal iliac vein

B. Common iliac artery

C. Femoral artery

D. Femoral vein

Answer 208

B. Common iliac artery

Number 8 corresponds to the common iliac artery.

Question 209

Question 235 of 416

Number 2 corresponds to which of the following? See Fig.

A. Splenic flexure

B. Transverse colon

C. Stomach

D. Duodenum

Answer 209

C. Stomach

Number 2 corresponds to the stomach.

Question 210

Question 236 of 416

Number 1 corresponds to which of the following? See Fig.

A. Portal vein

B. Hepatic artery

C. Inferior vena cava

D. Common bile duct

Answer 210

A

Number 1 corresponds to the portal vein.

Question 211

Question 237 of 416

Number 4 corresponds to which of the following? See Fig.

A. Ischium

B. Ilium

C. Pubis

D. Obturator

Answer 211

B. Ilium

Question 212

Question 238 of 416

Number 5 corresponds to which of the following? See Fig.

A. Ileum

B. Cecum

C. Appendix

D. Jejunum

Answer 212

C

Number 5 corresponds to the appendix.

Question 213

Number 2 corresponds to which of the following? See Fig.

A. Jejunum

B. Ileum

C. Descending colon

D. Sigmoid colon

Answer 213

A. Jejunum

Number 2 corresponds to the jejunum.

Question 214

Question 242 of 416

The abdominal aorta divides into the left and right common iliac arteries at approximately the level of:

A. L2.

B. L4.

C. sacrum.

D. pubic symphysis.

Answer 214

B. L4.

The abdominal aorta divides into the right and left common iliac arteries at approximately the level of L4.

Question 215

Question 247 of 416

Assuming a bolus injection of iodinated contrast agent at a rate of at least 4 mL/sec, an appropriate scan delay for a CTA examination of the mesenteric vasculature would be in the range of:

A. 5 to 8 seconds.

B. 20 to 30 seconds.

C. 45 to 60 seconds.

D. 70 to 90 seconds.

Answer 215

B. 20 to 30 seconds.

Dual-phase imaging including the arterial phase (20 to 30 seconds) and portal venous phase (60 to 70 seconds) is typically performed for complete evaluation of the mesenteric vasculature. The use of bolus-tracking software or test bolus technique is recommended to ensure appropriate scan timing.

Question 216

Question 248 of 416

An IV contrast enhanced specialized CT evaluation of the small bowel after the oral administration of a low-density (0.1%) barium sulfate solution is termed:

A. CT enteroclysis.

B. CT colonography.

C. CT enterography.

D. CT colonoscopy.

Answer 216

C. CT enterography.

CT enterography does not involve contrast agent administration through a nasogastric tube and is therefore less invasive than CT enteroclysis.

Question 217

Question 249 of 416

During CT colonography examinations, tagged fecal matter appears __________ on the image.

A. black

B. gray

C. white

D. noisy

Answer 217

C. white

Dual-agent tagging involves the oral administration of both barium and water-soluble iodinated contrast agent. The barium tags residual stool and coats the surface of polyps. The iodine contrast tags residual fluid. Tagged fluid and fecal matter exhibit high CT density and appear white on the CTC image. Tagging allows for differentiation of polyp from fecal matter and improves the visualization of polyps that may be surrounded by residual fluid.

Question 218

Question 250 of 416

The oral administration of barium and iodinated contrast media prior to CT colonography serves the primary purpose of:

A. lesion enhancement.

B. insufflation.

C. catharsis.

D. polyp tagging.

Answer 218

D. polyp tagging.

Dual-agent tagging involves the oral administration of both barium and water-soluble iodinated contrast. The barium tags residual stool and coats the surface of polyps. The iodine contrast tags residual fluid. Tagged fluid and fecal matter exhibit high CT density and appear “white” on the CTC image. Tagging allows for differentiation of polyp from fecal matter and improves the visualization of polyps that may be surrounded by residual fluid.

Question 219

Question 251 of 416

Which of the following contrast agents may be used for the purpose of colon insufflation during a CT colonography examination?

1. Room air
2. CO2
3. Normal (0.9%) saline

A. 1 only

B. 1 and 2 only

C. 2 and 3 only

D. 1, 2, and 3

Answer 219

B. 1 and 2 only

Colon insufflation involves the introduction of room air or carbon dioxide into the colon for the purpose of bowel wall distention.

Question 220

Question 252 of 416

Which of the following is an advantage of automatic CO2 insufflation for CT colonography?

1. Cheaper cost
2. Lower risk of anaphylaxis
3. Lower risk of perforation

A. 1 only

B. 3 only

C. 1 and 2 only

D. 2 and 3 only

Answer 220

B. 3 only

Advantages of automatic CO2 insufflation include better overall distention and lower risk of perforation. Also, owing to the faster absorption rate of CO2, there is a reduction in post-procedural discomfort in the patient.

Question 221

Question 253 of 416

Advantages of automatic CO2 insufflation for CT colonography include:

1. Better distention
2. Lower risk of perforation
3. Improved patient comfort

A. 1 only

B. 1 and 2 only

C. 1 and 3 only

D. 1, 2, and 3

Answer 221

D. 1, 2, and 3

Advantages of automatic CO2 insufflation include better overall distention and lower risk of perforation. Also, owing to the faster absorption rate of CO2, there is a reduction in post-procedural discomfort in the patient.

Question 222

Question 254 of 416

During CT colonography, acquisitions are performed with the patient in at least two positions for the purpose of:

A. reducing gonadal dose.

B. differentiating polyps from feces/fluid.

C. allowing digital subtraction techniques.

D. measuring lesion dimensions.

Answer 222

B. differentiating polyps from feces/fluid.

During CT colonography, two positions are a necessity to ensure maximal distention of the various segments of the colon and to differentiate between fixed polyps and mobile feces and fluid.

Question 223

Question 255 of 416

Which of the following window settings would optimally display CT colonography images?

A. Level= −400, width= 1600

B. Level= +50, width= 400

C. Level= +150, width= 1000

D. Level= +250, width= 4000

Answer 223

A. Level= −400, width= 1600

CT colonography images are best displayed in a wide “lung-type” window setting.

Question 224

Question 256 of 416

The act of the CT patient straining the abdominal muscles or “bearing down” to improve demonstration of an abdominal wall hernia is referred to as:

A. Valsalva maneuver.

B. catharsis.

C. insufflation.

D. Spurling maneuver.

Answer 224

A. Valsalva maneuver.

Valsalva maneuver refers to the physical act of straining the abdominal muscles or “bearing down.” A CT acquisition while the patient performs this maneuver may be utilized to improve visualization of abdominal wall hernias.

Question 225

Question 257 of 416

The portion of the male reproductive system responsible for storage of the majority of mature sperm is the:

A. seminal vesicles.

B. vas deferens.

C. testes.

D. prostate gland.

Answer 225

B. vas deferens.

The majority of mature sperm is stored in the vas deferens. Sperm is produced in the seminiferous tubules and passes through the epididymis, where a small amount may be stored.

Question 226

Question 258 of 416

Which of the following scan parameters is commonly used during a radiation therapy planning CT study of the prostate gland?

1. Patient placed on a flat tabletop
2. Small DFOV used to include only the prostate gland
3. CT scan performed with patient in exact position used for radiation treatment

A. 1 only

B. 1 and 3 only

C. 2 and 3 only

D. 1, 2, and 3

Answer 226

B. 1 and 3 only

CT scans are commonly performed for radiation therapy planning. The purpose of the examination is to precisely locate the area of interest for therapeutic treatment with irradiation. It is important that the patient position during the CT examination is exactly the same as that used during radiation therapy. This includes using a flat tabletop, via a board or foam insert. Equally important is the DVOV chosen by the technologist. It must be large enough to include the entire surface of the anatomic part.

Question 227

Question 263 of 416

Which of the following types of contrast material may be used during CT evaluation of the pelvis?

1. An intravenous iodinated contrast agent
2. Low dense barium sulfate solutions
3. Oil-soluble contrast material

A. 1 only

B. 2 only

C. 1 and 2 only

D. 1, 2, and 3

Answer 227

C. 1 and 2 only

During CT examination of the pelvis, both intravenous and oral contrast agents are commonly administered. An intravenous contrast agent is important in differentiating pelvic blood vessels from lymph nodes. An oral contrast agent serves to opacify the small and large colon and greatly improves their visualization. Oil-based contrast media are not commonly used for CT Imaging Procedures.

Question 228

Question 264 of 416

A common, nonmalignant enlargement of the prostate gland is typically referred to as:

A. prostatic carcinoma.

B. prostatic abscess.

C. prostatic hypertrophy.

D. extraprostatic extension.

Answer 228

C. prostatic hypertrophy.

Benign prostatic hypertrophy (BPH) is a nonmalignant enlargement of the prostate commonly seen in men over the age of 50.

Question 229

Question 274 of 416

Which of the following techniques assists in visualizing the vagina during a CT study of the pelvis?

A. Tampon insertion

B. Pre- and post-contrast scanning

C. Oral administration of a contrast agent

D. Administration of a contrast by enema

Answer 229

A. Tampon insertion

Insertion of a tampon during the CT examination of the pelvis dilates the vagina and fills it with negative contrast (air). This makes for easier visualization of the vagina and its relationship with surrounding structures.

Question 230

Question 275 of 416

Which of the following are reasons why intravenous contrast is administered during CT evaluation of the pelvis?

1. Distention and contrast enhancement of the bladder
2. Visualization of the rectosigmoid junction
3. Differentiation of blood vessels and pelvic lymph nodes

A. 1 only

B. 1 and 2 only

C. 1 and 3 only

D. 1, 2, and 3

Answer 230

C. 1 and 3 only

Intravenous contrast agent administration during a CT examination of the pelvis is valuable for several reasons. The bladder is easily visualized when filled with contrast material, and differentiation between blood vessels and enlarged pelvic lymph nodes is improved. The rectosigmoid junction may be better visualized once opacification has been attained through the use of oral or enema administration of a contrast agent.

Question 231

Question 276 of 416

Which of the following algorithm types would provide the greatest soft tissue detail during a CT study of the pelvis?

A. High spatial frequency

B. Detail

C. Edge

D. Low spatial frequency

Answer 231

D. Low spatial frequency

Low spatial frequency algorithms are usually referred to as standard or soft tissue algorithms. They filter out high spatial frequency information, such as that pertaining to bone, and provide maximum details of soft tissue structures.

Question 232

Question 277 of 416

Which of the following correctly describes the position of the seminal vesicles in the male pelvis?

A. Posterior to the bladder and anterior to the rectum

B. Superior to the rectum and inferior to the prostate

C. Anterior to the bladder and superior to the prostate

D. Inferior to the bladder and posterior to the rectum

Answer 232

A. Posterior to the bladder and anterior to the rectum

The seminal vesicles are located posterior to the bladder and anterior to the rectum on a cross section of the male pelvis.

Question 233

Question 282 of 416

An abnormal accumulation of fluid around a testicle is termed as:

A. hernia.

B. hypergonad.

C. hydrocele.

D. hypogonad.

Answer 233

C. hydrocele.

A hydrocele of the testes is an abnormal accumulation of fluid around a testicle.

Question 234

Question 283 of 416

Components of the uterine wall include which of the following?

1. Perimetrium
2. Myometrium
3. Endometrium

A. 3 only

B. 1 and 3 only

C. 2 and 3 only

D. 1, 2, and 3

Answer 234

D. 1, 2, and 3

The perimetrium is the outer layer of the uterine wall. The myometrium is the middle layer, and the endometrium the innermost layer.

Question 235

Question 284 of 416

Which layer of the uterine wall brightly enhances after IV administration of an iodinated contrast agent?

A. Mesometrium

B. Perimetrium

C. Myometrium

D. Endometrium

Answer 235

C. Myometrium

The myometrium enhances brightly after IV contrast agent administration owing to its highly vascular composition.

Question 236

Question 285 of 416

A dermoid tumor of the ovary may also be referred to as a:

A. leiomyoma.

B. cystic teratoma.

C. germ cell tumor.

D. hemorrhagic cyst.

Answer 236

B. cystic teratoma.

A dermoid cyst is a mature cystic teratoma that is characterized on CT imaging by areas of widely varying densities including fat, fluid, and calcifications.

Question 237

Question 307 of 416

Axial CT sections of the lumbar spine for intervertebral disk evaluation should be reconstructed with the plane of imaging:

A. perpendicular to the transverse plane of the patient.

B. parallel to the plane of the intervertebral disk spaces.

C. parallel to the transverse plane of the patient.

D. perpendicular to the coronal plane of the patient.

Answer 237

B. parallel to the plane of the intervertebral disk spaces.

For best demonstration of lumbar vertebral disk spaces, the plane of imaging should be parallel to the plane of the disk spaces. This may be accomplished with individual axial acquisitions through each disk space with the gantry angled parallel to the plane of the intervertebral disk. With the volumetric acquisition capabilities of MDCT, multiplanar reformation (MPR) images may be reconstructed from a single complete data set acquired with a perpendicular gantry position.

Question 238

Question 308 of 416

Which of the following sets of section widths and intervals is best suited for a CT examination of the cervical spine to rule out intervertebral disk herniation?

A. 5 mm × 5 mm

B. 1.25 mm × 1.25 mm

C. 5 mm × 7 mm

D. 10 mm × 10 mm

Answer 238

B. 1.25 mm × 1.25 mm

Contiguous acquisition with narrow slice thickness is preferred during CT examination of the cervical spine. Section widths of 1.25 mm or less should be used with no gap or even an overlap, thus ensuring thorough evaluation of the relatively small intervertebral disk spaces.

Question 239

Question 309 of 416

Quantitative computed tomography (QCT) is a specialized technique used most often for the diagnosis of:

A. lymphoma.

B. osteoporosis.

C. renal cyst.

D. hemangioma.

Answer 239

B. osteoporosis.

Quantitative computed tomography (QCT) is used to measure the mineral content of bone. Density measurements of the patient’s bone are compared with density measurements of a reference phantom. The bone mineral density (BMD) values are compared with normal values to assess osteoporosis.

Question 240

Question 310 of 416

Which of the following would be a suitable range for contrast agent volume for an intrathecal injection during a postmyelogram CT examination of the lumbar spine in an adult patient?

A. 1 to 3 mL

B. 5 to 9 mL

C. 12 to 14 mL

D. 18 to 22 mL

Answer 240

C. 12 to 14 mL

A common range of contrast agent volume for an intrathecal injection during post-myelographic CT is 12 to 14 mL in an adult patient. The total volume should not exceed approximately 17 mL, so as to keep the iodine dose below 3 g.

Question 241

Question 317 of 416

Which of the following display fields of view (DFOV) should be chosen for a CT examination of the thoracic spine on a patient whose thorax measures 40 cm?

A. 15 cm

B. 25 cm

C. 32 cm

D. 42 cm

Answer 241

A. 15 cm

During a CT examination of the spine, the display field of view should be one that displays the spine enlarged on the monitor. Commonly referred to as targeting, this technique provides the viewer with an enlarged image of the spine without the loss of detail that accompanies magnification of the CT image. Although in this example the patient measures 40 cm, the DFOV of 15 cm will be sufficient to target the spine and enlarge its image on the viewing monitor.

Question 242

Question 337 of 416

Of the bones of the foot, which are tarsals?

1. Third proximal phalanx
2. Lateral cuneiform
3. First metatarsal

A. 1 only

B. 2 only

C. 2 and 3 only

D. 1, 2, and 3

Answer 242

B. 2 only

The tarsals include the calcaneus, talus, navicular, and cuboid and the medial, intermediate, and lateral cuneiforms.

Question 243

Question 338 of 416

The articulation between the inferior articular processes of one vertebra with the superior articular processes of the next is called a:

A. spondylolisthesis joint.

B. spondylolysis joint.

C. pars interarticularis joint.

D. zygapophyseal joint.

Answer 243

D. zygapophyseal joint.

A zygapophyseal joint is the articulation between the inferior articular processes of one vertebra with the superior articular processes of the next. Zygapophyseal joints may also be referred to as facet joints.

Question 244

Question 339 of 416

The soft center of each intervertebral disk is called the:

A. nucleus pulposus.

B. nucleus prepositus.

C. annulus fibrosus.

D. annulus stapedius.

Answer 244

A. nucleus pulposus.

The nucleus pulposus is the soft center of an intervertebral disk.

Question 245

Question 340 of 416

At its distal end, the spinal cord tapers into the:

A. bulbus cordis.

B. caudate nucleus.

C. conus elasticus.

D. conus medullaris.

Answer 245

D. conus medullaris.

The distal spinal cord tapers into the conus medullaris.

Question 246

Question 341 of 416

A portion of a herniated intervertebral disk that has migrated from its normal position is called a(n):

A. bulging disk.

B. sequestered disk.

C. osteophyte.

D. protrusion.

Answer 246

B. sequestered disk.

Sequestered disk or free fragment is used when a portion of the disk nucleus completely breaks free and migrates from its normal position.

Question 247

Question 342 of 416

Compression of the spinal cord or nerve roots from a herniated intervertebral disk may result in the referred limb pain commonly referred to as:

A. ischemia.

B. sciatica.

C. spondylolisthesis.

D. spondylolysis.

Answer 247

B. sciatica.

Compression of the spinal cord and/or nerve roots may result in the referred limb pain commonly referred to as sciatica. Additional causes include disk herniation, tumor, and the formation of osteophytes (abnormal bone growths).

Question 248

Question 343 of 416

The degenerative pathologic process of the spine known as spondylolysis involves a defect in the:

A. spinous process.

B. transverse process.

C. pars interarticularis.

D. intervertebral disk.

Answer 248

C. pars interarticularis.

Spondylolysis involves a defect in the pars interarticularis commonly caused by osteophyte formation. The pars interarticularis is the area of the vertebrae between the inferior and superior articular processes (neck of the “scotty dog”).

Question 249

Question 344 of 416

Which of the following imaging planes best demonstrates spondylolisthesis of the spine?

A. Axial

B. Coronal

C. Sagittal

D. Oblique axial

Answer 249

C. Sagittal

Spondylolisthesis refers to the forward “slipping” of an upper vertebral body over the lower because of degenerative changes of the facet joints. It is best demonstrated on sagittal MPR images of the spine.

Question 250

Question 345 of 416

Which of the following is a malignant tumor of the skeletal system?

A. Chondroblastoma

B. Osteochondroma

C. Enchondroma

D. Osteosarcoma

Answer 250

D. Osteosarcoma

Malignant tumors of the skeletal system include osteosarcoma, chondrosarcoma, and multiple myeloma.

Question 251

Question 346 of 416

Which of the following bones is found within the hindfoot?

A. Talus

B. Metatarsals

C. Navicular

D. Cuboid

Answer 251

A. Talus

The talus and calcaneus constitute the hindfoot. The navicular, cuboid, and cuneiforms make up the midfoot, and the forefoot consists of the metatarsals and phalanges.

Question 252

Question 347 of 416

The CT imaging plane that is parallel to the metatarsals, approximately 20 to 30 degrees caudal from the direct axial plane, is called the:

A. mortise plane.

B. oblique axial plane.

C. sagittal plane.

D. coronal plane.

Answer 252

B. oblique axial plane.

The oblique axial plane is located parallel to the metatarsals, approximately 20 to 30 degrees caudal from the direct axial plane. MPR images along this plane are used to assess the tarsal–metatarsal joint.

Question 253

Question 348 of 416

The articulation between the distal tibia and fibula is called the:

A. synarthrosis.

B. amphiarthrosis.

C. synostoses.

D. syndesmosis.

Answer 253

D. syndesmosis.

The syndesmosis is the articulation between the distal tibia and fibula.

Question 254

Question 377 of 416

Each iliac artery bifurcates into the internal and external iliac arteries at about the level of:

A. L4.

B. L5-S1.

C. the pubic symphysis.

D. the patella.

Answer 254

B. L5-S1.

The iliac artery bifurcates into internal and external branches at L5-S1.

Question 255

Question 378 of 416

During IV contrast agent administration for peripheral CTA examinations, the bolus duration should be equal to the scan time minus:

A. 0 seconds.

B. 5 seconds.

C. 15 seconds.

D. 30 seconds.

Answer 255

B. 5 seconds.

The duration of scan acquisition for peripheral CTA will be based on the anatomic length of the study and the capabilities of the particular CT system in use. Faster scanners run the risk of “outrunning” the bolus by completing the acquisition before the entire contrast volume has been administered. Bolus duration, or the time required to inject a specific volume of contrast, may be calculated as the product of injection flow rate and total contrast agent volume. The subtraction of 5 seconds allows the scanner to maintain pace with the contrast agent as it moves down the aorta and results in the cessation of contrast agent administration just prior (5 seconds) to the end of data acquisition.

Question 256

Question 379 of 416

The most common indication for CT-guided radiofrequency ablation (RFA) is in treatment of neoplasms involving the:

A. internal auditory canal (IAC).

B. uterus.

C. lungs.

D. liver.

Answer 256

D. liver.

The most common indication for CT-guided RFA is in treatment of hepatic neoplasm.

Question 257

Question 380 of 416

The detectors of a PET system absorb and measure what type of radiation?

A. x-ray photons

B. Annihilation photons

C. Light photons

D. Ultraviolet photons

Answer 257

B. Annihilation photons

Annihilation photons are emitted from the radionuclide F-18-fluorodeoxyglucose (FDG) that has been taken up by the tumor cells. PET detectors absorb the emitted photons, measuring the activity of a given area of potential malignancy.

Question 258

Question 382 of 416

What is the maximum allowable blood glucose measurement for patients scheduled to undergo PET-CT examination?

A. 25 mg/dL.

B. 75 mg/dL.

C. 150 mg/dL.

D. 500 mg/dL.

Answer 258

C. 150 mg/dL.

The patient’s blood glucose may be measured prior to the injection of F-18-fluorodeoxyglucose (FDG). It should be below 150 mg/dL to prevent FDG uptake inhibition by glucose circulating in the bloodstream.

Question 259

Question 383 of 416

The typical dose of the radiopharmaceutical F-18-fluorodeoxyglucose (FDG) for combined PET-CT examination is within the range of:

A. 0.3 to 0.8 millicuries (mCi).

B. 1.5 to 3.0 mCi.

C. 5.0 to 7.0 mCi.

D. 10.0 to 15.0 mCi.

Answer 259

D. 10.0 to 15.0 mCi.

Typical dose consists of 10 to 15 millicuries (mCi) of FDG administered intravenously.

Question 260

Question 384 of 416

During combined PET-CT imaging, abnormal physiologic uptake of radiopharmaceutical can occur in patient muscle because of:

A. low blood glucose.

B. pre-examination fasting.

C. strenuous activity.

D. high blood pressure.

Answer 260

C. strenuous activity.

Strenuous physical activity can cause abnormal physiologic uptake of FDG in muscle. Therefore, the patient is instructed to avoid such activity prior to the injection and during the delay for imaging. In addition, all patient activity and speech are limited for up to 60 minutes after the injection of FDG.

Question 261

Question 385 of 416

The purpose of intravenous contrast agent administration during a CT study is to:

1. Increase the contrast between adjacent structures
2. Increase the overall image density
3. Increase beam attenuation of enhanced structures

A. 1 only.

B. 1 and 3 only.

C. 2 and 3 only.

D. 3 only.

Answer 261

B. 1 and 3 only.

Iodinated intravenous contrast agents alter the CT image by increasing the density of enhanced structures. Organs, blood vessels, and so on containing iodine attenuate a greater portion of the primary beam, thereby increasing their attenuation value. This permits greater differentiation of anatomic structures and pathologic processes. Any “enhanced” structure has an increased attenuation value (and subsequent image density) than its normal, unenhanced state.

Question 262

Question 386 of 416

The excretion half-time of intravenous iodinated contrast media in a patient with normal renal function is between:

A. 1 and 2 hours.

B. 18 and 24 hours.

C. 1 and 2 days.

D. 5 and 7 days.

Answer 262

A. 1 and 2 hours.

Excretion half-time is a value describing the amount of time necessary for 50% of the contrast agent administered to be filtered by the renal system. In patients with normal renal function, the half-time is usually between 1 and 2 hours.

Question 263

Question 387 of 416

The plane that passes vertically through the midline of the body, dividing it into equal anterior and posterior portions, is referred to as the:

A. orthogonal.

B. axial.

C. midsagittal.

D. midcoronal.

Answer 263

D. midcoronal.

The midcoronal plane passes through the body vertically, dividing it into equal anterior and posterior portions. The midsagittal plane divides the body into equal right and left portions. Any axial (transverse, horizontal) plane is one occurring at right angles to the coronal and sagittal planes and divides the body into superior and inferior portions.

Question 264

Question 388 of 416

A common formula used to calculate dosage of intravenous iodinated contrast material in the pediatric patient is:

A. 3 mg per kg body weight.

B. 5 mL per lb body weight.

C. 1 mL per lb body weight.

D. 100 mL over 10 lb.

Answer 264

C. 1 mL per lb body weight.

Dosage calculations for intravenous contrast agent administration in the pediatric patient are usually made following the general rule of 1 mL per pound of body weight.

Question 265

Question 389 of 416

Which of the following may be considered as advantages of spiral/helical CT over conventional CT scanning?

1. Reduced scan time
2. Reduction of misregistration artifacts
3. Decreased patient radiation dose

A. 1 only

B. 1 and 2 only

C. 1 and 3 only

D. 1, 2, and 3

Answer 265

B. 1 and 2 only

Spiral/helical CT offers many advantages over conventional computed tomography. Complete anatomic areas are scanned in very short times owing to continuous acquisition and no interscan delay (ISD). Because no delays are needed, entire volumes of information may be obtained, often during only one breath-hold. This reduces misregistration artifacts associated with inconsistent patient breathing. There is no reduction in patient radiation dose with the use of spiral CT.

Question 266

Question 390 of 416

The plane that passes vertically through the body, dividing it into left and right portions, is referred to as the:

A. orthogonal plane.

B. axial plane.

C. sagittal plane.

D. coronal plane.

Answer 266

C. sagittal plane.

The sagittal plane divides the body into right and left portions. The coronal plane divides the body into anterior and posterior portions. The axial (transverse, horizontal) plane occurs at right angles to the sagittal and coronal planes and divides the body into superior and inferior portions.

Question 267

Question 391 of 416

During a CT-guided needle biopsy, the insertion site is usually anesthetized with:

A. diazepam.

B. lidocaine.

C. lithium.

D. Percodan.

Answer 267

B. lidocaine.

Lidocaine is a local anesthetic commonly used for preparation of the needle insertion site during a percutaneous biopsy.

Question 268

Question 392 of 416

An axial CT image of the trunk should be viewed in which of the following orientations?

A. From the feet toward the head with the patient’s left on the viewer’s left

B. From the feet toward the head with the patient’s left on the viewer’s right

C. From the head toward the feet with the patient’s right on the viewer’s right

D. From the head toward the feet with the patient’s right on the viewer’s left

Answer 268

B. From the feet toward the head with the patient’s left on the viewer’s right

When one is viewing transverse cross-sectional anatomy, the image should be oriented with the left side of the patient on one’s right side with a perspective up from the feet toward the head.

Question 269

Question 393 of 416

Which of the following technical factor(s) play(s) a role in the production of an isotropic data set?

1. Section width
2. Scan field of view (SFOV)
3. Display field of view (DFOV)

A. 1 only

B. 1 and 2 only

C. 1 and 3 only

D. 2 and 3 only

Answer 269

C. 1 and 3 only

Isotropic resolution is approached by choosing the thinnest detector collimation available to produce the thinnest slices available and by reconstructing the acquired data with the smallest DFOV allowed according to the part of interest. Minimizing these two factors results in voxels approaching equal lengths in all directions.

Question 270

Question 394 of 416

The retroperitoneum contains which of the following anatomic structures?

A. Spleen

B. Ovaries

C. Kidneys

D. Stomach

Answer 270

C. Kidneys

The retroperitoneum is the space located between the peritoneum and the posterior abdominal wall. It contains the duodenum, pancreas, adrenal glands, kidneys, ureters, and bladder.

Question 271

Question 395 of 416

CTA of the renal arteries should be performed using a section width of:

A. 1.25 mm or less.

B. 2 to 3 mm.

C. 3 to 5 mm.

D. 5 to 7 mm.

Answer 271

A. 1.25 mm or less.

The renal arteries are small structures that are optimally visualized with MDCT section widths of 1.25 mm or less.

Question 272

Question 396 of 416

The most common indication for CT-guided percutaneous biopsy is the:

A. identification of foreign bodies.

B. quantification of bone mineral density.

C. confirmation of a malignancy.

D. measurement of tissue perfusion.

Answer 272

C. confirmation of a malignancy.

The most common indication for CT-guided percutaneous biopsy is to confirm the malignancy of a mass.

Question 273

Question 397 of 416

Axial CT images of the knee may be acquired in four separate series with gantry angulations of 0, 30, 45, and 60 degrees in order to demonstrate the:

A. tibial plateau.

B. patellofemoral joint.

C. medial and lateral menisci.

D. anterior cruciate ligament.

Answer 273

B. patellofemoral joint.

This technique allows for visualization of the relationship between the patella and the femur as the knee is increasingly flexed. The patellofemoral congruence, or the position of the patella within the patellar surface of the femur, may be measured at each point of flexion. Any medial or lateral displacement of the patella may indicate an abnormality of the patellofemoral joint.

Question 274

Question 398 of 416

Which of the following paranasal sinuses is usually the last to fully develop?

A. Frontal

B. Ethmoidal

C. Sphenoidal

D. Maxillary

Answer 274

A. Frontal

The frontal sinuses are absent at birth and do not usually fully develop until after puberty. The ethmoidal, maxillary, and sphenoidal sinuses begin to develop during gestation.

Question 275

Question 399 of 416

Which of the following pelvic bones combine(s) to form the acetabulum?

1. Ilium
2. Ischium
3. Pubis

A. 2 only

B. 1 and 2 only

C. 2 and 3 only

D. 1, 2 and 3

Answer 275

D. 1, 2 and 3

The acetabulum is a cup-shaped cavity that holds the head of the femur, forming the hip joint. It is composed of portions of the ilium, ischium, and pubis.

Question 276

Question 400 of 416

A CT angiogram of the neck is performed primarily for the evaluation of the:

A. carotid veins.

B. jugular veins.

C. carotid arteries.

D. coronary arteries.

Answer 276

C. carotid arteries.

CTA of the neck is used primarily to evaluate the carotid arteries.

Question 277

Question 401 of 416

On an ECG of the complete cardiac cycle, at which portion of the R-R interval is the heart muscle in diastole?

A. 10% to 20%

B. 35% to 50%

C. 55% to 75%

D. 85% to 95%

Answer 277

C. 55% to 75%

The least heart motion occurs at approximately 55% to 75% of the R-R interval, typically corresponding to the point of mid-diastole.

Question 278

Question 402 of 416

During a spiral or helical CT examination, the scanner acquires data:

1. Continuously as the patient travels through the gantry
2. One section at a time
3. In the form of a complete volumetric data set

A. 1 only.

B. 2 only.

C. 1 and 3 only.

D. 2 and 3 only.

Answer 278

C. 1 and 3 only.

Spiral/helical CT examinations are obtained with the scanner continuously acquiring data as the patient travels through the gantry. The data acquired are volumetric, containing all of the attenuation information for a given area of anatomy.

Question 279

Question 403 of 416

Prior to a CT colonography, the patient may undergo a process of bowel cleansing termed:

A. purgation.

B. hydration.

C. catharsis.

D. fasting.

Answer 279

C. catharsis.

Catharsis describes the process of bowel cleansing that is required to improve the examination quality of CT colonography. A combination of restricted diet and bowel cleansing with polyethylene glycol (PEG) or magnesium citrate is used to achieve catharsis.

Question 280

Question 404 of 416

Which of the following protocols would provide the best image quality for a 3-D disarticulation study of the hip?

A. Noncontiguous 10-mm-thick sections, standard algorithm

B. Contiguous 10-mm-thick sections, bone algorithm

C. Overlapping 1.5-mm-thick sections, bone algorithm

D. Noncontiguous 5-mm-thick sections, standard algorithm

Answer 280

C. Overlapping 1.5-mm-thick sections, bone algorithm

Three-dimensional studies are best performed with the use of narrow sections acquired with no spacing (contiguous) or, preferably, with a reconstruction an overlap (e.g., 1.5-mm-thick section reconstructed every 1.0 mm). A detail (bone) algorithm is used for optimal demonstration of bony structures.

Question 281

Question 405 of 416

Which of the following sets of section width and spacing would be most suitable for a general survey CT of the neck?

A. 0.75-mm-thick every 0.75 mm

B. 3-mm-thick every 5 mm

C. 3-mm-thick every 3 mm

D. 10-mm-thick every 10 mm

Answer 281

C. 3-mm-thick every 3 mm

A contiguous study with section widths ranging from 3 to 6 mm is sufficient for a general survey CT study of the neck.

Question 282

Question 406 of 416

Which of the following technical maneuvers may be used to remove unwanted pulsation artifacts from cardiac motion during a CTA of the chest for pulmonary embolism?

A. Automated bolus tracking

B. Automatic tube current modulation

C. Retrospective ECG gating

D. Saline flush

Answer 282

C. Retrospective ECG gating

Electrocardiographic (ECG) gating can be utilized to eliminate pulsation artifacts because of cardiac motion during the study. Retrospective gating involves scanning throughout the entire cardiac cycle. Only data from specific user-determined portions of the ECG waveform are reconstructed into images.

Question 283

Question 407 of 416

The ideal scan field of view (SFOV) for a CT examination of the cervical spine would be:

A. 9.6 cm.

B. 15.0 cm.

C. 25.0 cm.

D. 50.0 cm.

Answer 283

D. 50.0 cm.

Acquisition of the cervical spine is performed with a large SFOV, 48 to 50 cm. Targeted reconstructions are made using a display field of view (DFOV) between 10 and 15 cm. Larger DFOV reconstructions may be used to retrospectively display a greater anatomic area as clinical indication dictates. Utilizing a SFOV that is too small for the lower cervical spine region (shoulder girdle) would result in an out-of-field artifact.

Question 284

Question 408 of 416

Which of the following is used as the IV-administered radiopharmaceutical during a PET-CT hybrid examination?

A. Technetium Tc 99m

B. Iodine I 131

C. Fludeoxyglucose F 18 (FDG)

D. Strontium chloride Sr 89

Answer 284

C. Fludeoxyglucose F 18 (FDG)

Positron emission tomography (PET) is a functional nuclear medicine study utilizing fluorodeoxyglucose F 18 (FDG) as a radiopharmaceutical. During a PET-CT hybrid study, CT technology is used for morphologic (anatomic) visualization of structures, while PET technology provides physiologic information related to radiopharmaceutical uptake.

Question 285

Question 409 of 416

Vascular components of the brain’s blood supply known as the circle of Willis include the:

1. Internal carotid arteries
2. Basilar artery
3. Anterior communicating artery

A. 2 only.

B. 1 and 2 only.

C. 1 and 3 only.

D. 1, 2, and 3.

Answer 285

C. 1 and 3 only.

The circle of Willis is composed of the anterior cerebral, anterior communicating, internal carotid, posterior cerebral, and posterior communicating arteries. The basilar artery is an important vessel supplying blood to the brain, but it is not part of the circle of Willis.

Question 286

Question 410 of 416

Retrospective ECG gating utilizes which of the following portions of the cardiac cycle for image reconstruction?

1. Atrial systole
2. Ventricular systole
3. Cardiac diastole

A. 2 only

B. 3 only

C. 1 and 2 only

D. 2 and 3 only

Answer 286

B. 3 only

Complete cardiac diastole is the period of relaxation after heart contraction. Diastole is the portion of the cardiac cycle when coronary artery motion is the slowest and cardiac motion is at its lowest. For evaluation of the coronary arteries, the MDCT system utilizes only the diastolic portion of the acquisition in the reconstruction process.

Question 287

Question 411 of 416

An enema is indicated prior to a CT examination of the pelvis to administer positive contrast material into the large bowel. Which of the following dosages would be sufficient to opacify the rectosigmoid region?

A. 150 to 250 mL

B. 300 to 500 mL

C. 500 to 750 mL

D. 900 to 1100 mL

Answer 287

A. 150 to 250 mL

Positive contrast material can be administered into the large bowel via enema to achieve thorough opacification. A dosage of 150 to 250 mL should be sufficient to opacify the rectosigmoid region. Doses of 300 to 500 mL may be necessary to opacify the large bowel in its entirety.

Question 288

Question 412 of 416

A CT examination of the lumbar spine reveals a herniated disk at the level of L2-L3. Which of the following reformation planes would best demonstrate posterior compression of the disk material onto the spinal cord?

A. Coronal

B. Sagittal

C. Axial

D. Oblique

Answer 288

B. Sagittal

An image reformatted in the sagittal plane would demonstrate the relationship of the disk material as it protrudes posteriorly into the spinal cord.

Question 289

Question 413 of 416

The Stanford type A dissecting aneurysm affects which portion of the aorta?

A. Ascending thoracic

B. Descending thoracic

C. Abdominal

D. Bifurcation

Answer 289

A. Ascending thoracic

Stanford type A dissecting aneurysms affect the ascending aorta. Stanford type B dissecting aneurysms affect the descending aorta.

Question 290

Question 414 of 416

Which of the following refers to the surgical resection of the pancreas and duodenum for treatment of pancreatic carcinoma?

A. Endoscopic retrograde cholangiopancreatography (ERCP)

B. Cholecystectomy

C. Roux-en-Y anastomosis

D. Whipple procedure

Answer 290

D. Whipple procedure

Whipple procedure is the surgical resection of the pancreas and duodenum (pancreaticoduodenectomy) for the treatment of pancreatic carcinoma.

Question 291

Question 415 of 416

Often evaluated during body CTA examinations, the branches of the celiac axis are the:

1. Left gastric artery
2. Common hepatic artery
3. Splenic artery

A. 1 only.

B. 3 only.

C. 2 and 3 only.

D. 1, 2, and 3.

Answer 291

D. 1, 2, and 3.

The branches of the celiac axis are the left gastric artery, common hepatic artery, and splenic artery.

Question 292

Question 416 of 416

Vital components of a CT urogram (CT-IVP) protocol include:

1. Administration of 1200 to 1500 mL of a positive oral contrast agent 90 minutes prior to examination
2. Thin-section excretory phase imaging of the entire urinary tract
3. Volume-rendered 3-D and maximum intensity projection (MIP) imaging of the urinary tract

A. 2 only.

B. 1 and 2 only.

C. 2 and 3 only.

D. 1, 2, and 3.

Answer 292

C. 2 and 3 only.

Water is the preferred oral contrast material for CT urograms, because its use avoids the interference seen with denser materials when one is producing volume-rendered and MIP images. Additional protocol considerations include pre-contrast acquisition of the urinary tract and post-contrast nephrographic phase imaging. Excretory phase imaging occurs after a delay of 5 to 15 minutes and may be aided by the IV drip administration of approximately 250 mL of normal (0.9%) saline to improve urinary tract opacification.

Question 293

Question 243 of 416

Number 1 corresponds to which of the following? See Fig.

A. Renal artery

B. Hepatic vein

C. Superior mesenteric artery

D. Celiac trunk

Answer 293

C. Superior mesenteric artery

Number 1 corresponds to the superior mesenteric artery (SMA).

Question 294

Question 244 of 416

Which of the following would best describe the position of the patient during data acquisition? See Fig.

A. Supine

B. Prone

C. Right lateral decubitus

D. Left lateral decubitus

Answer 294

A. Supine

The obvious air-fluid level in the transverse colon (5) indicates that the patient was imaged in the supine position.

Question 295

Question 245 of 416

Number 3 corresponds to which of the following? See Fig.

A. Renal artery

B. Hepatic vein

C. Superior mesenteric artery

D. Celiac trunk

Answer 295

D. Celiac trunk

Number 3 corresponds to the celiac trunk.

Question 296

Question 246 of 416

Number 2 corresponds to which of the following? See Fig.

A. Spleen

B. Liver

C. Kidney

D. Pancreas

Answer 296

B. Liver

Number 2 corresponds to the liver.

Question 297

Question 259 of 416

The region of interest measurement in the figure has an average Hounsfield value of +10. Given its position in this female pelvis, this density most likely represents a(n): See Fig.

A. fibroid uterus.

B. ovarian cyst.

C. diverticular abscess.

D. endometrial tumor.

Answer 297

B. ovarian cyst.

Because of its location and attenuation value, this structure is most likely an ovarian cyst. The cyst is present on the right kidney and has an attenuation value of +10. Cysts of the ovary, as well as those occurring elsewhere in the body, have attenuation values close to that of water or near zero.

Question 298

Question 260 of 416

Number 5 corresponds to which of the following? See Fig.

A. Right ovary

B. Bladder

C. Uterus

D. Prostate gland

Answer 298

C. Uterus

Question 299

Question 261 of 416

Number 1 corresponds to which of the following? See Fig.

A. Iliacus muscle

B. Gluteus minimus muscle

C. Superior gluteal artery

D. Psoas major muscle

Answer 299

D. Psoas major muscle

Question 300

Question 262 of 416

Which number corresponds to the ilium? See Fig.

A. 3

B. 6

C. 4

D. 2

Answer 300

B. 6

Question 301

Question 265 of 416

Which of the following type(s) of contrast material was/were administered to this patient? See Fig.

1. Oral
2. IV
3. Rectal

A. 1 only

B. 2 only

C. 1 and 2 only

D. 1, 2, and 3

Answer 301

B. 2 only

Question 302

Question 266 of 416

Number 3 corresponds to which of the following? See Fig.

A. Seminal vesicles

B. Rectal tendon

C. Anus

D. Ureters

Answer 302

A. Seminal vesicles

Question 303

Question 267 of 416

Number 2 corresponds to which of the following? See Fig.

A. Iliac artery

B. Femoral vein

C. Iliac vein

D. Femoral artery

Answer 303

D. Femoral artery

Question 304

Question 268 of 416

Number 1 corresponds to which of the following? See Fig.

A. Iliopsoas muscle

B. Sartorius muscle

C. Gluteus minimus muscle

D. Rectus femoris muscle

Answer 304

B. Sartorius muscle

Question 305

Question 269 of 416

Number 4 corresponds to which of the following? See Fig.

A. Iliac crest

B. Anterior superior iliac spine

C. Anterior inferior iliac spine

D. Posterior inferior iliac spine

Answer 305

B. Anterior superior iliac spine

Question 306

Question 270 of 416

Which of the following best describes the position of the patient? See Fig.

A. Prone with hands behind the back

B. Ventral recumbent with hands over the head

C. Dorsal recumbent with hands above the head

D. Supine with hands crossed over the chest

Answer 306

C. Dorsal recumbent with hands above the head

Question 307

Question 271 of 416

Number 1 corresponds to which of the following? See Fig.

A. Ascending colon

B. Hepatic flexure

C. Splenic flexure

D. Transverse colon

Answer 307

C. Splenic flexure

Question 308

Question 272 of 416

The localizer (scanogram) image could be used to program which of the following CT examinations? See Fig.

1. Abdomen only
2. Chest and abdomen
3. Abdomen and pelvis

A. 1 only

B. 1 and 2 only

C. 1 and 3 only

D. 1, 2, and 3

Answer 308

C. 1 and 3 only

The localizer (scout) image includes the areas of the abdomen and pelvis. The chest is not included in its entirety, and therefore this scout image should not be used to prescribe a CT study of the chest. Ideally, CT studies of just the abdomen should be prescribed from a scout image including the area from above the diaphragm to the level of the iliac crests, so as to limit unnecessary exposure to the pelvis.

Question 309

Question 273 of 416

Number 3 corresponds to which of the following? See Fig.

A. Pelvic outlet

B. Pubic arch

C. Greater sciatic notch

D. Obturator foramen

Answer 309

D. Obturator foramen

Question 310

Question 278 of 416

Which number corresponds to the gluteus medius muscle? See Fig.

A. 5

B. 7

C. 2

D. 3

Answer 310

B. 7

Number 7 corresponds to the gluteus medius muscle.

Question 311

Question 279 of 416

Number 1 corresponds to which of the following? See Fig.

A. Iliac vein

B. Femoral vein

C. Iliac artery

D. Femoral artery

Answer 311

D. Femoral artery

Question 312

Question 280 of 416

Number 5 corresponds to which of the following? See Fig.

A. Iliopsoas muscle

B. Sartorius muscle

C. Obturator internus muscle

D. Gluteus minimus muscle

Answer 312

C. Obturator internus muscle

Question 313

Question 281 of 416

Number 8 corresponds to which of the following? See Fig.

A. Iliac vein

B. Femoral vein

C. Iliac artery

D. Femoral artery

Answer 313

B. Femoral vein

Question 314

Question 286 of 416

Number 7 corresponds to which of the following? See Fig.

A. Bladder

B. Uterus

C. Cervix

D. Vagina

Answer 314

B. Uterus

Question 315

Question 287 of 416

Number 2 corresponds to which of the following? See Fig.

A. Ileum

B. Jejunum

C. Sigmoid colon

D. Cecum

Answer 315

C. Sigmoid colon

Question 316

Question 288 of 416

On the basis of the appearance of the image, by which of the following routes was a positive contrast agent administered? See Fig.

1. Rectal
2. Oral
3. IV

A. 2 only

B. 1 and 2 only

C. 1 and 3 only

D. 2 and 3 only

Answer 316

D. 2 and 3 only

Question 317

Question 289 of 416

Number 8 corresponds to which of the following? See Fig.

A. Ureter

B. Appendicolith

C. Iliac vein

D. Common iliac artery

Answer 317

A. Ureter

Question 318

Question 290 of 416

Number 1 corresponds to which of the following? See Fig.

A. Ilium

B. Jejunum

C. Ileum

D. Sigmoid colon

Answer 318

C. Ileum

Question 319

Question 291 of 416

Number 3 corresponds to which of the following? See Fig.

A. Piriformis muscle

B. Gluteus minimus muscle

C. Gluteus medius muscle

D. Gluteus maximus muscle

Answer 319

B. Gluteus minimus muscle

Question 320

Question 292 of 416

Number 10 corresponds to which of the following? See Fig.

A. Ilium

B. Ischium

C. Ileum

D. Obturator

Answer 320

A. Ilium

Question 321

Question 293 of 416

This image of the pelvis was most likely acquired in which of the following IV contrast enhancement phases? See Fig.

A. Pre-contrast

B. Corticomedullary

C. Nephrographic

D. Excretory

Answer 321

D. Excretory

The well-opacified ureters indicate that the acquisition of this image occurred during the excretory phase of IV contrast enhancement.

Question 322

Question 294 of 416

Number 5 corresponds to which of the following? See Fig.

A. Piriformis muscle

B. Gluteus minimus muscle

C. Gluteus medius muscle

D. Gluteus maximus muscle

Answer 322

A. Piriformis muscle

Question 323

Question 295 of 416

Number 9 corresponds to which of the following? See Fig.

A. Piriformis muscle

B. Gluteus minimus muscle

C. Gluteus medius muscle

D. Gluteus maximus muscle

Answer 323

D. Gluteus maximus muscle

Question 324

Question 296 of 416

Number 3 corresponds to which of the following? See Fig.

A. External iliac artery

B. Femoral artery

C. External iliac vein

D. Femoral vein

Answer 324

A. External iliac artery

Question 325

Question 297 of 416

Number 6 corresponds to which of the following? See Fig.

A. Cervix

B. Vagina

C. Cecum

D. Rectum

Answer 325

D. Rectum

Question 326

Question 298 of 416

On the basis of the appearance of the image, by which of the following routes was a positive contrast agent administered? See Fig.

1. Rectal
2. Oral
3. IV

A. 1 only

B. 3 only

C. 2 and 3 only

D. 1, 2, and 3 only

Answer 326

C. 2 and 3 only

The uterus, bladder wall, and pelvic vasculature show evidence of iodinated IV contrast agent administration. There is no evidence of opacified bowel by either the oral or rectal administration route.

Question 327

Question 299 of 416

Number 2 corresponds to which of the following? See Fig.

A. Uterus

B. Prostate gland

C. Seminal vesicles

D. Cervix

Answer 327

A. Uterus

Question 328

Question 300 of 416

Number 7 corresponds to which of the following? See Fig.

A. Ovary

B. Bladder

C. Uterus

D. Cul-de-sac

Answer 328

B. Bladder

Question 329

Question 301 of 416

Number 1 corresponds to which of the following? See Fig.

A. External iliac artery

B. Femoral artery

C. External iliac vein

D. Femoral vein

Answer 329

C. External iliac vein

Question 330

Question 302 of 416

Number 4 corresponds to which of the following? See Fig.

A. Ilium

B. Ischium

C. Pubis

D. Obturator

Answer 330

B. Ischium

Question 331

Question 303 of 416

Number 2 corresponds to which of the following? See Fig.

A. Inferior vena cava

B. Superior mesenteric vein

C. Aorta

D. Superior mesenteric artery

Answer 331

C. Aorta

Question 332

Question 305 of 416

Number 4 corresponds to which of the following? See Fig.

A. Prostate gland

B. Ovary

C. Vagina

D. Uterus

Answer 332

D. Uterus

Question 333

Question 306 of 416

Number 1 corresponds to which of the following? See Fig.

A. Inferior vena cava

B. Superior mesenteric vein

C. Aorta

D. Superior mesenteric artery

Answer 333

D. Superior mesenteric artery

Question 334

Question 311 of 416

Number 4 corresponds to which of the following? See Fig.

A. Lateral condyle

B. Medial condyle

C. Lateral epicondyle

D. Medial epicondyle

Answer 334

A. Lateral condyle

Question 335

Question 312 of 416

Number 3 corresponds to which of the following? See Fig.

A. Retropatellar space

B. Medial meniscus

C. Tibial collateral ligament

D. Intercondylar fossa

Answer 335

D. Intercondylar fossa

Question 336

Question 314 of 416

Number 4 corresponds to which of the following? See Fig.

A. Pedicle

B. Spinous process

C. Lamina

D. Transverse process

Answer 336

C. Lamina

Question 337

Question 315 of 416

Number 6 corresponds to which of the following? See Fig.

A. Anterior process

B. Lamina

C. Body

D. Superior articulating process

Answer 337

C. Body

Question 338

Question 316 of 416

Which number corresponds to the foramen transversarium? See Fig.

A. 1

B. 2

C. 3

D. 5

Answer 338

A. 1

Number 1 corresponds to the foramen transversarium.

Question 339

Question 318 of 416

Number 6 corresponds to which of the following? See Fig.

A. Transverse process

B. Pedicle

C. Lamina

D. Spinous process

Answer 339

B. Pedicle

Question 340

Question 319 of 416

The image was formed using a large scan field of view (48 cm). Which of the following display field of view sizes was used to display the image? See Fig.

A. 12 cm

B. 24 cm

C. 36 cm

D. 48 cm

Answer 340

A. 12 cm

CT images of the spine are commonly reconstructed with the use of small display field of view sizes within the range of 12 to 15 cm. DFOV values within this range reconstruct the spine in an enlarged fashion while maintaining good detail.

Question 341

Question 320 of 416

Number 2 corresponds to which of the following? See Fig.

A. Costotransverse articulation

B. Intervertebral articulation

C. Intervertebral foramen

D. Costovertebral articulation

Answer 341

D. Costovertebral articulation

Question 342

Question 321 of 416

Number 1 corresponds to which of the following? See Fig.

A. Azygous vein

B. Inferior vena cava

C. Descending aorta

D. Esophagus

Answer 342

C. Descending aorta

Question 343

Question 322 of 416

The image is displayed in which of the following anatomic planes? See Fig.

A. Coronal

B. Axial

C. Sagittal

D. Oblique

Answer 343

B. Axial

The axial plane divides the body into inferior and superior portions. This section bisects the foot perpendicular to its long axis and is said to be an axial image in reference to the standard anatomic position.

Question 344

Question 323 of 416

Number 1 corresponds to which of the following? See Fig.

A. First metatarsal

B. Second metatarsal

C. Third metatarsal

D. Fourth metatarsal

Answer 344

A. First metatarsal

Question 345

Question 324 of 416

Number 2 corresponds to which of the following? See Fig.

A. Proximal phalanges

B. Lateral and medial cuneiforms

C. Sesamoid bones

D. Bone spurs

Answer 345

C. Sesamoid bones

Question 346

Question 325 of 416

Which of the following is/are accurate method(s) that could be used to center this patient’s hip within the gantry? See Fig.

1. Palpate approximately 6 inches below iliac crest.
2. Have the patient rotate the leg and palpate the greater trochanter.
3. Palpate the pubic bone.

A. 1 and 2 only

B. 1 and 3 only

C. 2 and 3 only

D. 1, 2, and 3

Answer 346

C. 2 and 3 only

The hip joint is located at the same level as the greater trochanter of the femur and the pubic bone. Palpation of either of these areas should be used to accurately center the hip within the gantry.

Question 347

Question 326 of 416

Number 3 corresponds to which of the following? See Fig.

A. Pubis

B. Ilium

C. Ischium

D. Lesser trochanter

Answer 347

C. Ischium

Question 348

Question 327 of 416

Which number corresponds to the acetabulum? See Fig.

A. 5

B. 3

C. 1

D. 2

Answer 348

D. 2

Question 349

Question 328 of 416

Number 1 corresponds to which of the following? See Fig.

A. Pubis

B. Ischium

C. Tuberosity of ischium

D. Ilium

Answer 349

A. Pubis

Question 350

Question 329 of 416

Number 4 corresponds to which of the following? See Fig.

A. Greater trochanter

B. Sciatic tubercle

C. Lesser trochanter

D. Coracoid

Answer 350

A. Greater trochanter

Question 351

Question 330 of 416

Which of the following scan parameters should be used for a 3-D disarticulation study of the hip, such as the model shown? See Fig.

1. 1- to 2-mm section width
2. Small scan field of view (SFOV)
3. Overlapping sections

A. 1 only

B. 1 and 2 only

C. 1 and 3 only

D. 1, 2, and 3

Answer 351

C. 1 and 3 only

The image quality of 3-D reconstructed images is greatly improved with the use of narrow, overlapping sections. This approach increases the total volume of information used to construct the 3-D model. The use of a small scan field of view in the area of the hip would cause an out-of-field artifact.

Question 352

Question 331 of 416

Number 1 corresponds to which of the following? See Fig.

A. Ischium

B. Pubis

C. Ilium

D. Acetabulum

Answer 352

C. Ilium

Question 353

Question 332 of 416

Number 5 corresponds to which of the following? See Fig.

A. Sciatic notch

B. Humeral neck

C. Gluteal tuberosity

D. Femoral neck

Answer 353

D. Femoral neck

Question 354

Question 333 of 416

Which number corresponds to the ischium? See Fig.

A. 1

B. 4

C. 2

D. 3

Answer 354

D. 3

Question 355

Question 334 of 416

Which of the following statements regarding the image is correct? See Fig.

A. Oral iodinated contrast was administered 2 hours prior to scanning.

B. A small scan field of view (SFOV) was used.

C. The width of the window used to display the image is approximately 2000 HU.

D. The level of the window used to display the image is approximately −150 HU.

Answer 355

C. The width of the window used to display the image is approximately 2000 HU.

The window width used to provide maximum detail of bony structures is approximately 1200 to 2000. This relatively large width allows for complete visualization of the variable densities present in bony anatomic areas.

Question 356

Question 335 of 416

Number 3 corresponds to which of the following? See Fig.

A. Vertebral foramen

B. Pedicle

C. Sacral canal

D. Sacral foramen

Answer 356

D. Sacral foramen

Question 357

Question 336 of 416

Which of the following best describes the pathologic abnormality present? See Fig.

A. Metastatic disease of the sacrum

B. Sacral cyst

C. Fracture of sacrum

D. Dislocated sacroiliac joint

Answer 357

C. Fracture of sacrum

The pathology present in the figure is a fractured sacrum. Notice the interruption in the smooth delineation of the right anterior sacrum.

Question 358

Question 349 of 416

Number 3 corresponds to which of the following? See Fig.

A. Navicular

B. Cuboid

C. Calcaneus

D. Talus

Answer 358

D. Talus

Question 359

Question 350 of 416

Number 1 corresponds to which of the following?

A. Fibula

B. Tibia

C. Cuboid

D. Cuneiform

Answer 359

A. Fibula

Question 360

Question 351 of 416

Number 5 corresponds to which of the following? See Fig.

A. Navicular

B. Cuboid

C. Calcaneus

D. Talus

Answer 360

C. Calcaneus

Question 361

Question 352 of 416

Number 2 corresponds to which of the following? See Fig.

A. Erector spinae muscle

B. Psoas major muscle

C. Latissimus dorsi muscle

D. Internal abdominal oblique muscle

Answer 361

B. Psoas major muscle

Question 362

Question 353 of 416

In this image at the level of the L4-L5 disk space, number 6 corresponds to which of the following? See Fig.

A. Spinal cord

B. Conus medullaris

C. Cauda equina

D. Denticulate ligament

Answer 362

C. Cauda equina

The spinal cord extends inferiorly from the brain’s medulla and terminates at approximately the level of T12-L1. At its distal end, the spinal cord tapers into the conus medullaris. The cauda equina is the nerve bundle extending inferiorly from the spinal cord.

Question 363

Question 354 of 416

Number 1 corresponds to which of the following? See Fig.

A. Inferior vena cava

B. Superior mesenteric artery

C. Iliac vein

D. Aorta

Answer 363

A. Inferior vena cava

Question 364

Question 355 of 416

Number 5 corresponds to which of the following? See Fig.

A. Lamina

B. Inferior articular process

C. Pedicle

D. Superior articular process

Answer 364

D. Superior articular process

Question 365

Question 356 of 416

Number 5 corresponds to which of the following? See Fig.

A. First metatarsal

B. First metacarpal

C. Fifth metatarsal

D. Fifth metacarpal

Answer 365

A. First metatarsal

Question 366

Question 357 of 416

Number 2 corresponds to which of the following? See Fig.

A. Navicular

B. Cuboid

C. Calcaneus

D. Talus

Answer 366

D. Talus

Question 367

Question 358 of 416

The anatomic plane of the image can be best described as the: See Fig.

A. coronal plane.

B. sagittal plane.

C. axial plane.

D. oblique axial plane.

Answer 367

D. oblique axial plane.

The oblique axial plane is parallel to the metatarsals, approximately 20 to 30 degrees caudal to the direct axial plane. MPR images such as these are used to assess the tarsal–metatarsal joint.

Question 368

Question 359 of 416

Number 4 corresponds to which of the following? See Fig.

A. Medial cuneiform

B. Intermediate cuneiform

C. Lateral cuneiform

D. Cuboid

Answer 368

C. Lateral cuneiform

Question 369

Question 360 of 416

Number 4 corresponds to which of the following? See Fig.

A. Clavicle

B. First rib

C. Scapula

D. Acromion

Answer 369

C. Scapula

Question 370

Question 361 of 416

What scan field of view (SFOV) value was most likely used for the acquisition of this CT image? See Fig.

A. 9.6 cm

B. 15.0 cm

C. 25.0 cm

D. 50.0 cm

Answer 370

D. 50.0 cm

The acquisition was most likely made with use of a large scan field of view (SFOV), 48 to 50 cm. Any smaller SFOV would result in out-of-field artifact, because portions of the upper shoulder area would lie beyond the range of the detector array. A smaller display field of view (DFOV) value was used for image reconstruction, targeting the side of interest.

Question 371

Question 362 of 416

Number 1 corresponds to which of the following? See Fig.

A. Acromion

B. Glenoid process

C. Coracoid process

D. Coronoid process

Answer 371

C. Coracoid process

Question 372

Question 363 of 416

Number 2 corresponds to which of the following? See Fig.

A. Clavicle

B. First rib

C. Scapula

D. Acromion

Answer 372

A. Clavicle

Question 373

Question 364 of 416

Number 2 corresponds to which of the following? See Fig.

A. Ischium

B. Superior pubic ramus

C. Inferior pubic ramus

D. Ischial tuberosity

Answer 373

B. Superior pubic ramus

Question 374

Question 365 of 416

Number 4 corresponds to which of the following? See Fig.

A. Inferior pubic ramus

B. Ischial tuberosity

C. Sacrum

D. Coccyx

Answer 374

D. Coccyx

Question 375

Question 366 of 416

Which of the following statements regarding the image is accurate? See Fig.

A. The patient is lying in the prone position.

B. The image is displayed in a soft tissue window.

C. The image is reconstructed with a high-spatial-frequency algorithm.

D. Iodinated IV contrast has been

Answer 375

C. The image is reconstructed with a high-spatial-frequency algorithm.

The level of bony detail displayed indicates that the image was reconstructed using a high-spatial-frequency algorithm and is displayed in a bone window.

Question 376

Question 367 of 416

Number 3 corresponds to which of the following? See Fig.

A. Ischium

B. Superior pubic ramus

C. Inferior pubic ramus

D. Ischial tuberosity

Answer 376

A. Ischium

Question 377

Question 368 of 416

Number 5 corresponds to which of the following? See Fig.

A. Greater trochanter

B. Gluteal tuberosity

C. Lesser trochanter

D. Linea aspera

Answer 377

A. Greater trochanter

Question 378

Question 369 of 416

Number 1 corresponds to which of the following? See Fig.

A. Acetabular fossa

B. Fovea capitis

C. Zona orbicularis

D. Obturator foramen

Answer 378

B. Fovea capitis

Question 379

Question 370 of 416

Number 5 corresponds to which of the following? See Fig.

A. Lesser trochanter

B. Gluteal tuberosity

C. Greater trochanter

D. Linea aspera

Answer 379

A. Lesser trochanter

Question 380

Question 371 of 416

For trauma indications, CT examinations of the pelvis and hips such as the one illustrated in the figure may include which of the following advanced applications? See Fig.

1. CT enteroclysis
2. CT angiography
3. CT cystography

A. 2 only

B. 3 only

C. 1 and 2 only

D. 2 and 3 only

Answer 380

D. 2 and 3 only

Contrast-enhanced MDCT acquisitions of the post-traumatic pelvis may include CTA evaluation for vascular injury as well as assessment of the bladder via CT cystography.

Question 381

Question 372 of 416

Number 4 corresponds to which of the following? See Fig.

A. Ischium

B. Pubic ramus

C. Posterior column

D. Ischial tuberosity

Answer 381

B. Pubic ramus

Question 382

Question 373 of 416

Number 2 corresponds to which of the following? See Fig.

A. Radial head

B. Coronoid process

C. Trochlea

D. Capitulum

Answer 382

C. Trochlea

Question 383

Question 374 of 416

Number 5 corresponds to which of the following? See Fig.

A. Humerus

B. Ulna

C. Radius

D. Olecranon

Answer 383

B. Ulna

Question 384

Question 375 of 416

Which of the following best describes the anatomic plane of the image? See Fig.

A. Axial

B. Coronal

C. Oblique axial

D. Sagittal

Answer 384

D. Sagittal

Question 385

Question 376 of 416

Number 4 corresponds to which of the following? See Fig.

A. Radial head

B. Coronoid process

C. Trochlea

D. Capitulum

Answer 385

B. Coronoid process