Imaging SBAs Unit 4

Question 1

Enhancement curve comparison

Answer 1

After the initial enhancement:
Type 1: Persistent enhancement curve
Type 2: Sharp bend and plateau
Type 3: Decline and washout
Type 1 is benign

Question 2

US features of malignant breast lesion

Answer 2

Spiculation,
Angular margins,
Hypoechogenicity,
Calcification,
Shadowing,
Duct extension,
Branch pattern,
Microlobulation

Question 3

US features of benign breast lesion

Answer 3

Hyperechogenicity,
Ellipsoid shape,
Gentle bi or tri lobulations,
Thin echogenic capsule

Question 4

19YO, mobile firm mass in peripheral breast. Ill defined on US

Answer 4

Juvenile Papillomatosis

Question 5

Concerned woman, sister (both young) has b/l breast Ca. Next Ix

Answer 5

Genetic testing for both

Question 6

US features of pathological lymph node (axilla)

Answer 6

Thickened, bulging cortex,
Dimished hilum,
Hyperaemic hilum on doppler,
Cortical blood flow

Question 7

Echogenic medulla on US, normal cortex

Answer 7

Medullary sponge kidney

Question 8

MRI signal characteristics for urothelial bladder cancer

Answer 8

Iso T1, Iso T2

Question 9

Newly diagnosed renal tract TCC, next step (before treatment)

Answer 9

Upper tract TCC: Cystoscopy to evaluate lower tracts
Lower tract TCC: CT urography to evaluate upper tracts

Question 10

Renal injury grading

Answer 10

1: Subcapsular haematoma and/or contusion, without laceration
2: Superficial laceration <1cm, not involving collecting system.
Perirenal haematoma confined to perirenal fascia
3: Laceration >1cm, not involving collecting system
Vascular injury or bleeding confined within perirenal fascia
4: Laceration involving collecting system with urinary extravasation.
Active bleeding beyond renal fascia.
Segmental infarctions without associated bleeding
5: Shattered kidney

Question 11

Neonate with megaureter, otherwise normal MCUG. next step:

Answer 11

DMSA to assess renal function

Question 12

Enlarged kidney with high amplitude echos in the parenchyma

Answer 12

Emphysematous pyelonephritis

Question 13

Relevance of renal cyst size in VHL

Answer 13

No correlation between cyst size and number and malignant potential

Question 14

Underlying pathology of intraperitoneal bladder rupture

Answer 14

Blunt trauma causing tear in bladder dome

Question 15

Diffusely hypoechoic testis with thickening of tunica albuginea and scrotal wall

Answer 15

Testicular TB. Get CXR

Question 16

Hydronephrosis with no focal lesion on US, pyuria and microscopic haematuria

Answer 16

Renal TB, can cause ureteric strictures

Question 17

Endometrial cancer MRI

Answer 17

Iso to myometrium on T1, Hypointense to endometrium on T2

Question 18

Ovarian mucinous vs serous cystadenoma

Answer 18

Serous:
Can be uni or multilocular
More often bilateral
More often cause peritoneal carcinomatosis

Mucinous:
Multilocular,
Larger than serous,
Can cause pseudomyxoma peritonei

Question 19

FIGO staging of ovarian cancer

Answer 19

1: limited to one or both ovaries
2: Extra-ovarian spread limited to pelvis
3: Diffuse peritoneal involving upper abdomen
4: distant mets including hepatic lesions

Question 20

Ix for evaluation pre-myomectomy

Answer 20

HSG

Question 21

3rd trimester bleeding, placenta near to or overlying cervical os

Answer 21

Placenta previa

Question 22

Endometrial carcinoma vs hyperplasia, Ix

Answer 22

Difficult to distinguish on MRI.
Needs biopsy

Question 23

MRI sequence for uterine zonal anatomy

Answer 23

T2 coronal or perpendicular to long axis of uterus