Neuroradiology Flashcards
Which of the following features in an MRI scan does not help to differentiate a brain abscess from a glioblastoma?
(a) Susceptibility Weighted Imaging
(b) Deep Transfer Learning
(c) Hand-crafted Radiomics
(d) Contrast-enhanced MRI
d
* Cerebral abscesses on SWI—high-intensity line (granulation tissue) lies internal to the low-intensity rim—The dual rim sign
Which of the following is not a characterizing magnetic resonance spectros- copy finding in a glioblastoma?
(a) Increased choline
(b) Increased myoinositol (c) Increased lactate
(d) Increased lipids
b
Match the following subtypes of medulloblastomas with the corresponding likely location or spectroscopy feature.
(a) WNT
(b) SHH
(c) Group 3 or 4
(d) SHH
(e) Group 3 or 4
1. Midline
2. Cerebellar peduncle/foramen of Luschka
3. Cerebellar hemisphere
4. Taurine peak
5. No taurine
a - 2
b - 3
c - 1
d - 5
e - 4
What is the usual location of a posterior fossa type A ependymoma?
(a) Apex of the fourth ventricle
(b) Lateral recess of the fourth ventricle
(c) The midline of the fourth ventricle near the obex
(d) Superior medullary velum
b
* PFA Ependymoma—Lateral recess of the fourth ventricle
* PFB Ependymoma—Midline of the fourth ventricle near the obex
Match the following radiological signs with the corresponding tumors.
(a) Periwinkle sign
(b) Yin-yang sign
(c) Notch sign
(d) Spoke wheel sign
(e) Mother-in-law sign on angiography (f) Pool sign
(g) Flat floor of fourth ventricle sign
(h) Bright rim sign
(i) T2-FLAIR mismatch sign
(j) Trumpeted internal acoustic meatus sign
(k) Snowman sign
(l) Volcano sign
(m) Sugar coating sign
1. Brain stem glioma
2. Primary CNS lymphoma
3. Solitary fibrous tumor of the dura
4. Meningioma
5. Leptomeningeal carcinomatosis
6. Supratentorial ependymoma
7. Metastatic adenocarcinoma
8. Dyembryoplastic neuroepithelial tumor
9.Vestibular schwannoma
10. Meningioma
11. Meningioma
12. Diffuse astrocytoma
13. Pituitary macroadenoma
Periwinkle sign - Supratentorial ependymoma
Yin-yang sign - Solitary fibrous tumor of the dura
Notch sign - Primary CNS lymphoma
Spoke wheel sign - Meningioma
Mother-in-law sign on angiography - Meningioma
Pool sign - Metastatic adenocarcinoma
Flat floor of fourth ventricle sign - Brainstem glioma
Bright rim sign - Dysembryoplastic neuroepithelial tumor
T2-FLAIR mismatch sign - Diffuse astrocytoma
Trumpeted internal acoustic meatus sign - Vestibular schwannoma
Snowman sign - Pituitary macroadenoma
Volcano sign - Meningioma
Sugar coating sign - Leptomeningeal carcinomatosis
The term “pseudoprogression” refers to the occurrence of a progressively enhancing lesion on magnetic resonance imaging scan within what duration of radiotherapy?
(a) 4 weeks
(b) 8 weeks
(c) 12 weeks
(d) 24 weeks
c. 12 weeks
Which of the following is a characteristic feature present in vasogenic tumoral edema that differentiates it from cytotoxic edema on imaging?
(a) Violates the boundary at gray matter-white matter junction
(b) Does not violate the boundary at gray matter-white matter junction (c) Follows a circular pattern
(d) Follows an oval pattern
b
Cytotoxic edema affects predominantly the gray matter causing a loss of gray- white differentiation.
Match the following tumors with their peculiar metabolites on magnetic reso- nance imaging:
(a) PNET
(b) Meningioma
(c) Glioblastoma
(d) Low-grade astrocytomas
(e) Oligodendroglioma, demyelination
1. GLX (Glutamate, Glutamine, GABA)
2. Alanine
3. Myoinositol
4. Taurine
5. Glycine
PNET - Taurine
Meningioma - Alanine
Glioblastoma - Glycine
Low-grade astrocytomas - Myoinositol
Oligodendroglioma, demyelination - GLX (Glutamate, Glutamine, GABA)
Which of the following is used as the internal reference standard for character- izing other peaks during MRS?
(a) Choline (b) Creatinine (c) NAA
(d) Lactate
b
Gallium-68 DOTATATE PET scan is useful in the characterization of
(a) High-grade glioma (b) Low-grade glioma (c) Metastases
(d) Meningioma
d
Which tumor is not a part of the MISME syndrome?
(a) Schwannoma
(b) Meningioma
(c) Ependymoma
(d) Medulloblastoma
d
MISME—Multiple Inherited Schwannomas, Meningiomas, and Ependymomas.
Which of the following is not a criterion to be met for a positive “dural tail” sign?
(a) The tail should be seen on two consecutive images through the tumor (b) The tail should taper away from the tumor
(c) The tail should enhance more than the tumor
(d) The tail should be shorter than half the diameter of the tumor
d
The tram-track sign on contrast-enhanced CT/MRI helps differentiate which of the following conditions?
(a) Tuberculum sellae and suprasellar meningioma
(b) Cerebellopontine angle schwannoma and meningioma (c) Optic nerve sheath meningioma and glioma
(d) Falx meningioma from petroclival meningioma
c
* Tram-track sign—Two enhancing areas of tumor separated by the negative defect due to optic nerve.
* Classically seen in optic nerve sheath meningioma and absent in optic glioma. * Also seen in orbital pseudotumor, perioptic neuritis, sarcoidosis, and
lymphomas.
The “bare orbit” sign is seen in which condition?
(a) Orbital pseudotumor (b) Neurofibromatosis 1 (c) Orbital lymphangioma (d) Orbital hemangioma
b
Bare orbit sign:
Seen in a frontal radiograph
Absence of innominate line (projection of greater wing of sphenoid) Seen in sphenoid wing dysplasia—neurofibromatosis 1
Radial bands sign is seen in
(a) Neurofibromatosis 1
(b) Neurofibromatosis 2
(c) Tuberous sclerosis
(d) Von Hippel-Lindau syndrome
c
Radial bands sign:
* Linear signal intensities from periventricular to subcortical regions in FLAIR sequences.
* Seen in tuberous sclerosis (also known as Bourneville disease or Bourneville-Pringle disease)
* Abnormal migration of dysplastic stem cells.
