Procedures Flashcards
A cardiologist requests coronary images at 50%-75% of the R-to-R interval. What gating method can accomplish this request?
A. Prospective gating
B. Retrospective gating
C. Both prospective and retrospective gating
D. No gating is required
C. Both prospective and retrospective gating
A CT scan is requested to evaluate a patient for a thoracic aorta aneurysm. The patient weighs 147 pounds, they have a history of COPD, and they are in acute renal failure. Which of these contrast injection parameters would be ideal for this patient?
A. 100 ml at 3 ml/second
B. 150 ml at 4 ml/second
C. 100 ml at 4 ml /second
D. 150 ml at 3 ml/second
C. 100 ml at 4 ml /second
A diagnosis of hilar adenopathy is an indication for which of these imaging protocols?
A. CTA chest of the thoracic aorta
B. CTA Chest for Pulmonary Embolism
C. CT Chest in venous phase
D. CT High Resolution Chest
C. CT Chest in venous phase
A general survey of the chest for a trauma patient should be completed using which of these CT protocols?
A. CTA chest of the thoracic aorta
B. CTA chest for pulmonary embolism
C. CT chest in venous phase
D. CT high resolution chest
C. CT chest in venous phase
A general survey of the sinuses is requested on 35 year old female with chronic sinusitis. Compared to 1.25 mm slices, 3.75 mm slices will result in:
A. More image noise
B. More spatial resolution
C. Fewer images
D. Lower dose
C. Fewer images
A known blood clot in the transverse sinus of the brain could be best evaluated with which IV contrast timing method?
A. Bolus tracking in the ascending aorta
B. Timing bolus monitoring in the internal carotid artery
C. 45-second scan delay time
D. 90-second scan delay time
C. 45-second scan delay time
A new CT protocol requires scanning the liver exactly 25 seconds after initiating IV contrast injection. This can be accomplished by which scan timing method?
A. Scan delay time
B. Test bolus
C. Bolus tracking
A. Scan delay time
A patient arrives in the radiology department with complaints of lower back pain and numbness in the lower extremities. Initial evaluation in diagnostic x-ray shows collapse of L3-L4 disc space, with a suspected ruptured disc. What protocol should be used to assess the intrusion of the ruptured disc into the spinal canal?
A. CT spine without contrast
B. CT spine with contrast after 45 second delay time
C. CT spine with contrast after 90 second delay time
D. CT myelogram with intrathecal contrast
D. CT myelogram with intrathecal contrast
A patient arrives in your department after a motor vehicle accident with right flank pain. What CT scan is most likely to be ordered by the attending physician?
A. CT abdomen and pelvis with contrast
B. CT angiography abdomen and pelvis
C. CT multiphase pancreas
D. CT appendicitis
A. CT abdomen and pelvis with contrast
A patient arrives in your department for evaluation of a known renal artery stenosis. What imaging protocol should be performed?
A. CTA abdomen and Pelvis
B. CTA thoracic aorta
C. CT abdomen and pelvis with contrast
D. CT enterography
A. CTA abdomen and Pelvis
A patient arrives in your department unresponsive. No history is known. The appropriate scan to perform is:
A. Routine CT head without contrast
B. Routine CT head with contrast
C. CTA head and neck
D. CT Venogram
A. Routine CT head without contrast
A patient diagnosed with a subdural hematoma is to be evaluated in your department. What is the correct protocol for assessing changes in the subdural hematoma?
A, CT head without contrast
B. CT head with contrast]
C. CT angiography head
D. CT head with and without contrast
A, CT head without contrast
A patient experiencing acute flank pain with hematuria should be evaluated with what CT study?
A. CT abdomen and pelvis without contrast
B. CT abdomen and pelvis with contrast
C. CT angiography abdomen and pelvis
D. CT multiphase kidneys
A. CT abdomen and pelvis without contrast
A patient has experienced trauma to their right eye. Soft tissue changes are best visualized with which image window?
A. 2600 WW and 500 WL
B. 400 WL and 600 WL
C. 80 WW and 40 WL
D. 400 WW and 40 WL
D. 400 WW and 40 WL
A patient is brought to the emergency room following a motor vehicle accident. The patient is experiencing severe upper back pain and an injury to the aorta is suspected. What is the best imaging protocol to evaluate the patient for this condition?
A. CTA chest of thoracic aorta
B. CTA chest for pulmonary embolism
C. CT chest in venous phase
D. CT high resolution chest
A. CTA chest of thoracic aorta
A patient is presented to the ER with extreme right sided abdominal pain for 1 hour. The patient has a surgical history of appendectomy and cholecystectomy. Urinalysis demonstrated micro-hematuria. What study is likely to be used to assess this patient?
A. CT for renal stones
B. CT for pulmonary embolism
C. CT for aortic dissection
D. CT for renal mass
A. CT for renal stones
A patient is suspected as having a tumor obstructing the valve connecting the right ureter to the bladder. This condition is best evaluated with what IV contrast scan delay time?
A. 30 seconds
B. 60 seconds
C. 90 seconds
D. 5 minutes
D. 5 minutes
A patient presenting with symptoms of stroke and no prior imaging should be evaluated with which CT scanning protocol?
A. CT head without contrast
B. CT head with contrast
C. CT angiography head
D. CT head with and without contrast
A. CT head without contrast
A patient presents to the radiology department for imaging of a soft-tissue tumor on the lower leg. What scan protocol should be used?
A. CT with IV contrast
B. CT with intra-articular acontrast
C. MRI with IV contrast
D. CT without contrast
C. MRI with IV contrast
A patient requires imaging of a known aneurysm of the anterior communicating artery. The appropriate scan to perform is:
A. Routine CT head without contrast
B. Routine CT head with contrast
C. CTA head
D. CTA head and neck
C. CTA head
A patient with a dental abscess is suspected as having an infection in the brain. The correct CT protocol is:
A. CT head without contrast
B. CT head with contrast
C. CT angiography head
D. CT head with and without contrast.
D. CT head with and without contrast.
A patient with a history of a cigarette smoking and COPD is suspected as having a primary lung cancer. What CT imaging procedure should be used to scan this patient?
A. CTA chest of the thoracic aorta
B. CTA Chest for Pulmonary Embolism
C. CT Chest in venous phase
D. CT High Resolution Chest
C. CT Chest in venous phase
A patient with advanced bladder cancer needs a CT scan to check for metastatic disease in the lungs. The appropriate imaging protocol is:
A. CTA chest of the thoracic aorta
B. CTA chest for pulmonary embolism
C. CT chest in venous phase
D. CT high resolution chest
C. CT chest in venous phase
A positive D-dimer test may indicate the need for which of these CT protocols?
A. CTA chest of the thoracic aorta
B. CTA Chest for Pulmonary Embolism
C. CT Chest in venous phase
D. CT High Resolution Chest
B. CTA Chest for Pulmonary Embolism
A suspected liver mass is an indication for which of these studies?
A. CT abdomen pelvis in portal venous phase
B. CT abdomen in multiple phases
C. CT abdomen without contrast
D. CTA of the abdomen
B. CT abdomen in multiple phases
A Type-B aortic dissection should be evaluated using which of these contrast-timing methods?
A. 30- second delay time
B. Bolus tracking in the pulmonary arteries
C. Bolus tracking in the descending aorta
D. Non-contrast
C. Bolus tracking in the descending aorta
A _______ (also called prep time) is the amount of time between the initiation of contrast injection and the initiation of the scan.
Scan delay time.
A _______ is known to enhance image quality in the chest and reduce the total contrast volume needed for the scan.
Saline trailer
A. patient with a current history of colon cancer arrives in the emergency department with sudden onset blurred vision. What is the correct CT protocol for initial evaluation of the patient?
A. CT head without contrast
B. CT head with contrast
C. CT angiography head
D. CT head without and with contrast
A. CT head without contrast
Advantages of helical scanning over axial scanning include:*
- Decreased scan time
- Decreased patient dose
- Increased spatial resolution
A. 1 only
B. 2 only
C. 1 and 2 only
D. 1, 2 and 3
C. 1 and 2 only
After scanning a chest, abdomen, and pelvis with contrast on a trauma patient, the attending physician requests lumbar spine reconstructions to evaluate for spinal fractures. What slice parameters should be used for the axial images?
A. 1.25 mm slice thickness and 0.625 mm slice interval
B. 5.0 mm slice thickness and 5.0 mm slice interval
C. 2.5 mm slice thickness and 2.5 mm slice interval
D. 3.75 mm slice thickness and 3.75 mm slice interval
C. 2.5 mm slice thickness and 2.5 mm slice interval
An elderly patient with a prior history of breast cancer arrives in the emergency department with sudden onset mental status change. What is the correct CT protocol for initial evaluation of the patient?
A. CT head without contrast
B. CT head with contrast
C. CT angiography head
D. CT head without and with contrast
A. CT head without contrast
An ER physician requests that you scan a patient’s liver to evaluate for traumatic injuries. What phase of contrast should be used?
- Non-contrast
- Arterial phase
- Portal venous phase
- Delayed phase
A. 1 only
B. 2 only
C. 3 only
D. 1, 2, 3 and 4
C. 3 only
An evaluation of known cerebral metastasis indicates which CT imaging procedure:
A. CT head without contrast
B. CT head with contrast
C. CT angiography head
D. CT head without and with contrast
D. CT head without and with contrast
An evaluation of known cerebral metastasis indicates which CT imaging procedure:
A. CT head without contrast
B. CT head with contrast
C. CT angiography head
D. CT head with and without contrast
D. CT head with and without contrast
An ordering physician requests high resolution images of a patient to evaluate for pulmonary embolism. The patient has a cough and the chest x-rays show consolidations in the lower lungs. What is the appropriate protocol to use?
A. CTA chest of the thoracic aorta
B. CTA chest for pulmonary embolism
C. CT chest in venous phase
D. CT high resolution chest
B. CTA chest for pulmonary embolism
Angiographic imaging of the cerebrum can successfully be performed with which of these contrast injection flow rates?
A. 5 mL/sec
B. 2 mL/sec
C. 1 mL/sec
D. Flowrate does not affect imaging.
A. 5 mL/sec
Ankylosing spondylitis is an arthritic condition of the spine resulting in the fusion of adjacent vertebrae. What imaging protocol should be used to evaluate this condition?
A. CT spine without contrast
B. CT spine with intravenous contrast
C. CT Myelogram
D. MRI is preferred
A. CT spine without contrast
Axial images of the abdomen to be used for multiplanar reformations (MPR) should be reconstructed as:
A. 5.0 mm slices in a smoothing algorithm
B. 1.0 mm slices in an edge enhancing algorithm
C. 5.0 mm slices in an edge enhancing algorithm
D. 1.0 mm slices in a smoothing algorithm
D. 1.0 mm slices in a smoothing algorithm
Axial images of the CT abdomen and pelvis for routine viewing are typically reconstructed as:
A. 5 mm slices in a smoothing algorithm
B. 1 mm slices in an edge-enhancing algorithm
C. 5 mm slices in an edge-enhancing algorithm
D. 1 mm slices in a smoothing algorithm
A. 5 mm slices in a smoothing algorithm
Axial imaging of the facial bones should be oriented:
A. Parallel to the hard palate
B. Perpendicular to the floor of the maxillary sinus
C. Parallel to the supra-orbital meatal line
D. Perpendicular to the supra-orbital meatal line
A. Parallel to the hard palate
Based on the appearance of the image below, what scan delay time was used to acquire the image?
A. non-contrast
B. 30 seconds
C. 60 seconds
D. 5 minutes
C. 60 seconds
Based on the appearance of this image what imaging protocol was used to scan the patient?
A. 30-second scan delay time
B. Bolus tracking in the pulmonary arteries
C. Bolus tracking in the ascending aorta
D. Non-contrast
C. Bolus tracking in the ascending aorta
Based on the appearance of this image, what imaging protocol was used to scan the patient?
A. CTA chest of the thoracic aorta
B. CTA chest of pulmonary embolism
C. CT chest in venous phase
D. CT High resolution chest
B. CTA chest of pulmonary embolism
Based on the appearance of this image, what imaging protocol was used to scan this patient?
A. 30- second delay time
B. Bolus tracking in the pulmonary arteries
C. Bolus tracking in the descending aorta
D. Non-contrast
A. 30- second delay time
Based on the appearance of this image, what imaging protocol was used for this patient?
A. CTA of the head and neck
B. CTA of the circle of Willis
C. CT soft tissue neck
D. CT head with and without contrast.
A. CTA of the head and neck
Based on the appearance of this image, why is this image inappropriate for diagnostic interpretation?
A. Failure to include the entire cervical spine
B. Incorrect orientation of the sagittal reformation
C. Failure to process in the correct algorithm
D. Incorrect windowing presentation
D. Incorrect windowing presentation
Based on the image below, what is the maximum intraluminal pressure that will be allowed during the IV contrast injection?
A. 4.5 ml/sec
B. 45 ml
C. 72 ml
D. 325 psi
D. 325 psi
Based on the smooth appearance of anatomic structures, what reconstruction algorithm may have been used to create this image?
A. Standard algorithm
B. Bone algorithm
C. Edge enhancing.
A. Standard algorithm
Claudication is a medical term that refers to
A. Ulceration
B. Difficult walking
C. Loss of blood flow
D. Loss of feeling
B. Difficult walking
Consider a patient admitted to the emergency department for flank pain, hematuria, and suspected renal stone. CT imaging for the initial assessment of the collecting system should be performed during which phase of contrast enhancement?
A. Non-contrast
B. Excretory phase
C. Arterial phase
D. Portal venous phase
A. Non-contrast
Consider a patient being evaluated for flank pain. If a non-contrast CT scan identifies a large hepatic tumor, what phase of contrast would be used in further characterizing the tumor?
- Arterial
- Venous phase
- Delayed phase
A. 1 only
B. 2 only
C. 1 and 2 only
D. 1, 2 and 3
D. 1, 2 and 3
Consider a patient scheduled for a CTA pulmonary embolism scan. After testing the peripheral IV, the technologist decreases the contrast injection rate to 2.5 ml per second to avoid infiltration. This scan may lack diagnostic quality as a result of:
A. Unacceptable image noise
B. Poor contrast enhancement
C. Increased patient dose
D. Loss of spatial resolution
B. Poor contrast enhancement
Consider a patient that arrives in your department with a weak pulse in the lower extremities. What CT protocol would be most appropriate for evaluating this condition?
A. CTA for pulmonary embolism
B. CTA thoracic aorta
C. CT Abdomen and pelvis with contrast
D. CTA runoff
D. CTA runoff
Consider a patient with the symptoms of stroke. If routine imaging shows no focal ischemia or hemorrhage, what CT procedure may be indicated?
A. CT head without contrast
B. CT head without and with contrast
C. CTA head
D. CTA head and neck
D. CTA head and neck
Contrast-enhanced imaging of the orbits (in venous phase) can be accomplished by:
A. Initiating contrast injection 30 seconds prior to scanning
B. Initiating contrast injection 60 seconds prior to scanning
C. Initiating contrast injection 120 seconds prior to scanning
D. Initiating contrast injection 15 seconds prior to scanning
B. Initiating contrast injection 60 seconds prior to scanning
Crohn’s disease is a condition that is best imaged using which of these CT protocols?
A. CT abdomen and pelvis with contrast
B. CTA abdomen and pelvis
C. CT enterography
D. CT liver
C. CT enterography
CT angiography images of the coronary arteries should be acquired during what phase of the cardiac cycle?
A. Ventricular systole
B. Ventricular diastole
C. Atrial systole
D. Atrial diastole
B. Ventricular diastole
CT evaluation of tibial neoplasm requires which of the following contrast protocols?
A. Oral contrast
B. Rectal contrast
C. Intra-articular contrast
D. Intravenous contrast
D. Intravenous contrast
CTA imaging of the abdomen and pelvis can be accomplished using bolus tracking in the:
A. Ascending aorta
B. Aorta at the level of the diaphragm
C. Aorta at the level of the iliac bifurcation
D. Descending aorta at the level of the carina
B. Aorta at the level of the diaphragm
Diabetic ulcers may be an indication for which of these CT examinations?
A. CTA for pulmonary embolism
B. CTA thoracic aorta
C. CT abdomen and pelvis with contrast
D. CTA runoff
D. CTA runoff
Displayed CT images are processed to display a specific amount of anatomical data in each image. This is the:
A. Reconstruction slice thickness
B. Reconstruction slice interval
C. Acquisition slice thickness
D. Beam width
A. Reconstruction slice thickness
During a cardiac CT, what medication may be administered to correct tachycardia prior to imaging?
A. Glucagon
B. Beta blockers
C. Nitroglycerin
D. Analgesics
B. Beta blockers
During a CT of the chest for pulmonary embolism, the technologist injects 50% of the recommended of volume of contrast. How will this affect the scan?
A. Unacceptable image noise
B. Poor contrast enhancement
C. Increased patient dose
D. Loss of spatial resolution
B. Poor contrast enhancement
During coronary CTA, an excessive heart rate could result in:
A. Motion blur
B. Poor contrast enhancement
C. Ring artifact
D. Vascular spasm
A. Motion blur
During the monitoring phase of bolus tracking you see several images showing no contrast at all. Possible explanations include:
A. The contrast injection was never initiated
B. The contrast has infiltrated
C. The saline and contrast syringes were loaded backwards
D. All of the answer options listed are correct
D. All of the answer options listed are correct
Emphysema is a condition of the lung parenchyma that is best diagnosed using which of these contrast regimens?
A. 30- second delay time
B. Bolus tracking in the pulmonary arteries
C. Bolus tracking in the ascending aorta
D. Non-contrast
D. Non-contrast
Evaluation of an uncharacterized pancreatic mass is best accomplished with which of these CT studies?
A. CT abdomen with IV contrast in the portal venous phase
B. CT abdomen with IV contrast in multiple phases
C. CT abdomen without contrast
D. CT enterography
B. CT abdomen with IV contrast in multiple phases
Evaluation of chronic sinusitis can be accomplished with which CT protocol?
A. CT neck with contrast
B. CT facial bones with contrast
C. CT facial bones without contrast
D. CT sinuses screening.
D. CT sinuses screening.
Evaluation of the neck in arterial phase of contrast enhancement can be accomplished with what scan delay time?
A. 120 seconds
B. 20 seconds
C. 45 seconds
D. 90 seconds
B. 20 seconds
Evaluation of the neck in venous phase of IV contrast enhancement can be accomplished with what scan delay time?
A. 10 seconds
B. 20 seconds
C. 40 seconds
D. 90 seconds
C. 40 seconds
For arterial imaging of the pancreas, what scan delay time may be used?
A. 5 seconds
B. 25 seconds
C. 55 seconds
D. 90 seconds
B. 25 seconds
For specialized imaging of the adrenal glands, the display field-of view may be assigned as:
A. 18 cm
B. 8 cm
C. 80 cm
D. 32 cm
A. 18 cm
Hepatic hemangioma will fill with contrast at what scan delay time?
A. 15 seconds
B. 30 seconds
C. 60 seconds
D. 6 minutes
D. 6 minutes
High spatial resolution imaging of the facial bones can be accomplished using which of these slice parameters?
A. 1.25 mm slices with matching slice interval
B. 5 mm slices with matching slice interval
C. 5. mm slices with 2.5 mm interval
D. 1. 25 mm slices with 5 mm interval
A. 1.25 mm slices with matching slice interval
High spatial resolution imaging of the orbits is accomplished by:
A. 1.25 mm slices
B. 2.5 mm slices
C. 3.75 mm slices
D. 5 mm slices
A. 1.25 mm slices
High spatial resolution imaging of the orbits is accomplished by:
A. 1.25 mm slices
B. 2.5 mm slices
C. 3. 75 mm slices
D. 5 mm slices
A. 1.25 mm slices
High-resolution imaging of the chest may use which of these algorithms?
A. Bone algorithm
B. Standard algorithm
C. Brain algorithm
D. Smoothing algorithm
A. Bone algorithm
High-resolution imaging of the chest should use which reconstruction slice thickness?
A. 1.25 mm
B. 2.5 mm
C. 5 mm
D. >5 mm
A. 1.25 mm
How should axial slices be oriented for imaging of the brain?
A. Parallel to the hard pallet
B. Perpendicular to the floor of the maxillary sinus
C. Parallel to the supra-orbital meatal line
D. Perpendicular to the supra-orbital meatal line.
C. Parallel to the supra-orbital meatal line
How should axial slices be oriented for imaging of the brain?
A. Parallel to the hard pallet
B. Perpendicular to the floor of the maxillary sinus
C. Parallel to the supraorbital meatal line
D. Perpendicular to the supraorbital meatal line
C. Parallel to the supraorbital meatal line
How should axial slices be oriented for imaging of the orbits?
A. Parallel to the hard palate
B. Perpendicular to the floor of the maxillary sinus
C. Parallel to the supra-orbital meatal line
D. Perpendicular to the supra-orbital meatal line.
A. Parallel to the hard palate
How should coronal reformations of the orbits be oriented?
A. Parallel to the hard pallet
B. Perpendicular to the floor of the maxillary sinus
C. Parallel to the supra-orbital meatal line
D. Perpendicular to the supra-orbital meatal line
B. Perpendicular to the floor of the maxillary sinus
How should the gantry be oriented when scanning direct coronal CT sinuses with the patient in the prone position?
A. Parallel to the hard palate
B. Perpendicular to the hard palate
C. Parallel to the supra-orbital meatal line
D. Perpendicular to the supra-orbital meatal line
B. Perpendicular to the hard palate
Identify the pathology visible in the image below:
A. Basilar artery aneurysm
B. Subarachnoid hemorrhage
C. Subdural hemorrhage
D. Arterial-Venous malformation
A. Basilar artery aneurysm
If glucagon is being administered for a CT study, when should it be given to the patient?
A. With the administration of oral contrast
B. Immediately prior to scanning
C. Thirty minutes prior to scanning
D. With the administration of rectal contrast
B. Immediately prior to scanning
If metoclopramide (Reglan) is being used for a CT enterography study, when should it be administered?
A. With the administration of oral contrast
B. Immediately prior to scanning
C. Thirty minutes prior to scanning
D. With the administration of rectal contrast
A. With the administration of oral contrast
If oral contrast is to be visualized within the small bowels, when should the contrast be administered to the patient?
A. Immediately prior to scanning.
B. 10 minutes prior to scanning
C. 50 minutes prior to scanning
D. 5 hours prior to scanning
C. 50 minutes prior to scanning
If performing a CTA abdominal aorta study on a 90 lb geriatric patient, how could the contrast injection protocol be changed without compromising the quality of the scan?
A. Decrease contrast volume
B. Increase contrast volume
C. Decrease injection rate
D. Increase injection rate
A. Decrease contrast volume
Imaging of the abdomen and pelvis in the portal venous phase will usually use which of these IV contrast protocols?
A. 100 ml at 3 ml/sec
B. 150 ml at 3 ml/sec
C. 100 ml at 5 ml/sec
D. 150 ml at 4 ml/sec
A. 100 ml at 3 ml/sec
In the image below, the absence of contrast media in the descending colon likely means that the patient did NOT receive:
A. Intravenous contrast
B. Oral contrast
C. Rectal contrast
D. Intra-articular contrast
C. Rectal contrast
In the image below, the high concentration of contrast in the inferior portion of the intrathecal space could be a result of:
A. The patient standing after the contrast
B. The patient laying supine after the injection
C. The patient laying prone after the injection
D. The radiologist injecting above the level of L2
A. The patient standing after the contrast
In the image below, the right internal jugular vein has experienced:
A. Stenosis
B. Dissection
C. Aneurysm
D. Occlusion
D. Occlusion
In the image, the arrow is pointing at a condition called:
A. Colitis
B. Appendicitis
C. Hepatitis
D. Pancreatitis
A. Colitis
In what direction should the thoracic aorta be scaned when using iodinated contrast?
A. Superior to inferior in the direction of blood flow
B. Superior to inferior against the direction of blood flow
C. Inferior to superior in the direction of blood flow
D. Inferior to superior against the direction of blood flow
A. Superior to inferior in the direction of blood flow
Increasing the reconstruction slice thickness results in:
A. Visualization of more anatomy with increased spatial resolution
B. Visualization of more anatomy with decreased spatial resolution
C. Visualization of less anatomy with increased spatial resolution
D. Visualization of less anatomy with decreased spatial resolution
B. Visualization of more anatomy with decreased spatial resolution
Instructing the patient NOT to void prior to a urogram procedure helps to:
A. Maintain contrast filling in the collecting system
B. Maintain contrast enhancement in the circulatory system
C. Dislodge renal stones from the ureters
D. Test the patient’s continence
A. Maintain contrast filling in the collecting system
Intravenously injected contrast can be viewed exiting organs during which phase of enhancement?
A. Venous phase
B. Arterial phase
C. Delayed phase
D. Equilibrium phase
A. Venous phase
Maximum contrast enhancement for CTA imaging of the head and neck could be accomplished by:
A. Bolus tracking in the abdominal aorta
B. Timing bolus monitoring in the internal carotid artery
C. 40-second scan delay time
D. 55-second scan delay time
B. Timing bolus monitoring in the internal carotid artery
Measuring the degree of spinal cord compression caused by spondylolisthesis is best achieved with which of these imaging protocols?
A. Routine CT spine without contrast
B. Routine CT spine with contrast
C. Diagnostic radiography
D. CT myelogram
D. CT myelogram
Neck pain following an MVA is an indication for:
A. CT soft tissue neck
B. CT angiography neck
C. CT cervical spine
C. CT cervical spine
One reason for decreasing the IV injection rate during CT scanning is:
A. High-speed scanner (16 rows or more)
B. Poor IV catheter patency
C. Angiographic scanning
D. Geriatric imaging
B. Poor IV catheter patency
Peripheral Vascular Disease (PVD) is an indication for which of these CT protocols?
A. CTA for Pulmonary Embolism
B. CTA Thoracic Aorta
C. CT Abdomen and Pelvis with Contrast
D. CTA Runoff
D. CTA Runoff
Primary liver cancer will be brightest during which phase of IV contrast enhancement?
A. non-contrast
B. arterial phase
C. portal venous phase
D. delayed phase
B. arterial phase
Proptosis is an indication for:
A. CT head
B. CT facial bones
C. CT sinuses
D. CT orbits
D. CT orbits
Radiculopathy is a condition best evaluated with which of these imaging procedures?
A. CT spine without contrast
B. CT spine with contrast after 45 second scan delay time
C. CT spine with contrast after 90 second delay time
D. CT myelogram with intrathecal contrast
D. CT myelogram with intrathecal contrast
Refers to peak contrast enhancement of arteries as contrast enters the organ; for any organ this is the first phase of contrast enhancement.
Arterial phase
Refers to peak contrast enhancement of veins as contrast leaves the organ; for any organ this is the second phase of contrast enhancement.
Venous phase
Refers to the peak enhancement of the portal venous system; occurs at about 60 seconds, post-contrast injection.
Portal Venous Phase
Refers to the time period after all contrast has washed out of most organs; only certain pathologies are visible during this phase; also called equilibrium phase.
Delayed Phase
Spinal cord impingement is a possible effect of all of the following conditions EXCEPT:
A. Disc injuries
B. Arthritic disease
C. Spinal tumors
D. Dehydration
D. Dehydration
Spinal ependymoma is a primary tumor of the brain or spinal cord. Suspicion of ependymoma should initially be assessed using which imaging procedure?
A. CT spine without contrast
B. CT spine with contrast
C. CT myelogram
D. Magnetic resonance imaging (MRI)
D. Magnetic resonance imaging (MRI)
Stenosis of the carotid bifurcation is best evaluated with:
A. CT soft tissue neck
B. CT angiography neck
C. CT cervical spine
B. CT angiography neck
Swelling in the neck (with an unknown cause) is an indication for what CT protocol?
A. CT soft tissue neck
B. CTA neck
C. CT cervical spine
A. CT soft tissue neck
The abrupt starting and stopping of the patient table during axial scanning can result in:
A. Increased patient dose
B. Motion artifact on the images
C. Decreased scan time
D. Decreased spatial resolution from interpolation
B. Motion artifact on the images
The acquisition slice thickness used during a scan is determined by the technologist. The acquisition thickness refers to:
A. The thickness of activated detector rows
B. The thickness of anatomical data averaged into each image
C. The total width of the x-ray beam
D. The space between adjacent slices
A. The thickness of activated detector rows
The appearance of inflamed tissue surrounding the appendix is called:
A. Stranding
B. Claudication
C. Hematoma
D. Hemangiomas
A. Stranding
The appendix is an appendage of the:
A. Large bowel
B. Small bowel
C. Spleen
D. Mesentery
A. Large bowel
The arrow in the image below is pointing at a condition called:
A. Adrenal adenoma
B. Aortic aneurysm
C. IVC filling defect
D. Ovarian cyst
A. Adrenal adenoma
The arterial phase of IV contrast enhancement in the kidneys is also called:
A. Corticomedullary phase
B. Nephrographic phase
C. Excretory phase
D. Portal venous phase
A. Corticomedullary phase
The average flow rate recommended for venous phase imaging of the abdomen is:
A. 1 ml per second
B. 3 ml per second
C. 5 ml per second
D. 10 ml per second
B. 3 ml per second
The benefit of increased flow rate in angiographic imaging is:
A. Decreased patient dose
B. Increased contrast enhancement
C. Decreased scan time
D. Decreased intraluminal pressure
B. Increased contrast enhancement
The contrast- enhanced tissues behind the eye are most likely:
A. Malignant
B. Normal
C. Bleeding
D. Inflammation
A. Malignant
The CT enterography study should use which of the following contrast injection parameters?
A. 100 ml at 3 ml/sec
B. 150 ml at 2.5ml/sec
C. 75 ml at 5 ml/sec
D. 100 ml at 4 ml/sec
D. 100 ml at 4 ml/sec
The CT venogram protocol of the head is best suited to diagnose which of these pathologies?
A. Occlusion of the internal carotid arteries
B. Dissection of the vertebral arteries
C. Thrombosis of the superior sagittal sinus
D. Subarachnoid hemorrhage
C. Thrombosis of the superior sagittal sinus
The device in this image is a:
A. Peripherally inserted central catheter (PICC)
B. Central line (port)
C. Dialysis catheter
D. Peripheral catheter
D. Peripheral catheter
The first phase of IV contrast enhancement for most organs is the:
A. Portal venous phase
B. Arterial phase
C. Delayed phase
D. Capillary phase
B. Arterial phase
The following images were aquired on the same patient during a multiphase liver study. The images are NOT in sequential order. Based on the appearance of the images, which image was acquired 5 minutes after IV contrast injection?
Image A
The goal of administering oral contrast for CT enterography is to fill the:
A. Small bowel
B. Large bowel
C. Stomach
D. Rectum
A. Small bowel
The images below were acquired on the same patient during a multiphase liver study. The images are NOT in sequential order. Based on the appearance of the images, which image was acquired in portal venous phase?
Image D
The images below were acquired on the same patient during a multiphase kidney examination. These images are NOT in sequential order. What image best demonstrates the renal collecting system?
Image C
The images below were acquired on the same patient during multiphase kidney examination. These images are NOT in sequential order. What image was acquired with a 70-second delay time?
Image B
The main advantage of coronary imaging in the catheterization lab compared to CTA imaging is:
A. Increased spatial resolution
B. Decreased risk of complications
C. Ability to intervene immediately
D. No IV contrast is required
C. Ability to intervene immediately
The main advantage of CTA imaging of the coronary arteries compared to imaging in the catheterization lab is:
A. Increased spatial resolution
B. Decreased risk of complications
C. Ability to intervene immediately
D. No IV contrast is required
B. Decreased risk of complications
The major difference between these two images is the:
A. Slice thickness
B. Slice interval
C. Display field-of-view
D. Scan type
C. Display field-of-view
The major difference in these two images is mostly likely the:
A. Slice thickness
B. Slice interval
C. Display field-of-view
D. Scan type
A. Slice thickness
The most common and most accurate method for timing angiography scans. During the contrast injection, an ROI is used to measure the enhancement of a selected vessel as contrast enters the system. When contrast enhancement reaches a prescribed threshold, the scan is initiated. This method ensures that the scan is initiated at the exact moment of peak contrast enhancement.
Bolus tracking.
The most inferior extent of CTA imaging of the head and neck is the:
A. Aortic Arch
B. Carotid bifurcation
C. Union of the vertebral arteries
D. Origin of the basilar artery
A. Aortic Arch
The nephrographic portion of the kidneys will experience maximum contrast enhancement at what scan delay time?
A. 30 seconds
B. 60 seconds
C. 90 seconds
D. 5 minutes
C. 90 seconds
The patient in the image below has experienced chronic shortness of breath for several years. Based on the appearance of the image, what is the most likely cause of their symptoms?
A. Saddle embolism
B. Emphysema
C. Type B Dissection
D. Mass lesion
B. Emphysema
The purpose of rolling a patient prior to CT myelogram imaging is to:
A. Evenly diffuse intrathecal contrast
B. Loosen the intervertebral ligaments
C. Relax the spinal muscles
D. Reduce curvature of the spine
A. Evenly diffuse intrathecal contrast
The red arrow is pointing to what abnormality?
A. Occlusion of the external iliac artery
B. Stenosis of the internal iliac artery
C. Aneurysm of the common iliac artery
D. Dissection of the superficial femoral artery
A. Occlusion of the external iliac artery
The technique used to create this image is called:
A. Multiplanar Reformation (MPR)
B. Volume rendering
C. Maximum Intensity Projection (MIP)
D. Shaded Surface Display (SSD)
C. Maximum Intensity Projection (MIP)
The venous phase of IV contrast enhancement in the kidneys is also called:
A. Corticomedullary phase
B. Nephrographic phase
C. Excretory phase
D. Portal venous phase
B. Nephrographic phase
The _______ is the area selected for processing, which is usually smaller than the total area being scanned.
Display field-of-view (DFOV)
The _______ thickness is the amount of anatomical data averaged into each image. Thinner slices have higher spatial resolution in the z-axis, while thicker slices demonstrate lower image noise.
Reconstruction thickness
The _______ thickness is the width of each detector row used during the scan. High-resolution scans use the thinner detector rows, whereas high-speed scans combine rows together to form thicker rows.
Acquisition thickness
The “delayed phase” of adrenal imaging is acquired at what scan delay time?
A. 60 seconds
B. 90 seconds
C. 4 minutes
D. 15 minutes
D. 15 minutes
This contrast enhancement in the abdomen peaks at 50-60 seconds after initiating IV contrast injection.
A. Portal venous phase
B. Arterial phase
C. Delayed phase
D. Capillary phase
A. Portal venous phase
This coronal image of the facial bones was reformed from axial slices. What is the recommended orientation of these coronal slices?
A. Parallel to the hard palate
B. Perpendicular to the hard palate
C. Parallel to the supra-orbital meatal line
D. Perpendicular to the supra-orbital meatal line
B. Perpendicular to the hard palate
This image is from a CTA procedure to evaluate for pulmonary embolsm, but the pulmonary arteries are not very well enhanced. Based on the appearance of the image, what did the technologist do wrong?
A. The scan was initiated too late
B. The scan was initiated too soon
C. The scan did not use IV contrast
D. The scan was initiated 15 seconds after injection
A. The scan was initiated too late
This image is of a bolus-tracking chart 12 seconds into contrast IV injection. What happens when threshold of 110 HU is crossed?
A. The injection should stop
B. The scan should stop
C. The scan should start
D. Nothing.
C. The scan should start
This image of the brain is described as a:
A. Maximum intensity projection
B. Volume rendering
C. Sagittal reformation
D. Axial reconstruction
A. Maximum intensity projection
This image of the lower facial bones is ideal for viewing:
A. Structural changes in the mandible
B. Bone degradation around an abscessed tooth
C. Inflammatory changes in the soft tissues of the face
D. Fractures of the facial bones.
C. Inflammatory changes in the soft tissues of the face
This image was acquired to evaluate a patient for a thoracic aorta dissection. What is the main factor limiting the diagnostic quality of the scan?
A. Excessive image noise
B. Artifact obstructing the view of the anatomy
C. Poor enhancement of the aorta
D. Excessively small field of view
C. Poor enhancement of the aorta
This image was presented to the radiologist for viewing the soft tissues of the brain. The appearance of excessive image noise may be a result of:
A. Incorrect algorithm selection
B. Incorrect gantry tilt
C. Incorrect window width
D. Incorrect slice interval.
A. Incorrect algorithm selection
This is an image acquired with a 30-second scan delay time. What pathology should be reported to the attending physician?
A. Pulmonary embolism
B. Pulmonary fibrosis
C. Aortic dissection
D. Pneumothorax
A. Pulmonary embolism
This series of images was performed on the same patient during different phases of intravenous contrast enhancement. A contrast-enhancing liver lesion (arrow) is best visualized in what phase?
A. Non-contrast
B. Arterial phase
C. Portal venous phase
D. Delayed phase
B. Arterial phase
To ensure filling of duodenum for a CT pancreas study, when should oral contrast be administered to the patient?
A. Immediately prior to scanning
B. 20 minutes prior to scanning
C. 5 minutes prior to scanning
D. 5 hours prior to scanning
A. Immediately prior to scanning
Uses principles from both the scan delay method and bolus tracking method. A small bolus of contrast is injected into the patient and monitored at the control console. After the test bolus is finished, an ROI is used to identify the time of the highest contrast enhancement. This time is set as the scan delay time for the full contrast bolus tracking in angiographic imaging.
Timing bolus.
Venous-phase imaging of the chest is usually accomplished using a:
A. 30- second delay time
B. Bolus tracking in the pulmonary arteries
C. Bolus tracking in the descending aorta
D. Non-contrast
A. 30- second delay time
Vision changes should be evaluated in CT using which imaging protocol?
A. CT orbits with contrast
B. CT facial bones with contrast
C. CT sinuses without contrast
D. CT head with and without contrast
A. CT orbits with contrast
What abnormality is visible in this image of a CTA head and neck scan?
A. Occlusion of the carotid arteries
B. Dissection of the vertebral arteries
C. Basilar tip aneurysm
D. Accessory vessels branching from the aortic arch
A. Occlusion of the carotid arteries
What body cavity should be scanned when evaluating a patient for acute appendicitis?
A. Abdomen only
B. Pelvis only
C. Abdomen and pelvis
D. Chest, abdomen, and pelvis
C. Abdomen and pelvis
What cardiac gating technique acquires scan data only during specific phases of the heart cycle?
A. Prospective gating
B. Retrospective gating
C. Both prospective and retrospective gating
D. No gating is required
A. Prospective gating
What contrast injection protocol is necessary for diagnosis of interstitial lung disease?
A. 30- second delay time
B. Bolus tracking in the pulmonary arteries
C. Bolus tracking in the descending aorta
D. Non-contrast
D. Non-contrast
What contrast timing method might have been used to acquire this image of the brain?
A. Bolus tracking in the abdominal aorta
B. Timing bolus in the aortic arch
C. 45-second scan delay time
D. 60-second scan delay time
B. Timing bolus in the aortic arch
What contrast timing method was used to acquire this image of the brain?
A. Bolus tracking in the ascending aorta
B. Timing bolus monitoring in the internal carotid artery
C. 45-second scan delay time
D. 90-second scan delay time
C. 45-second scan delay time
What CT protocol is most useful in evaluating bowel disease?
A. CT abdomen and pelvis with contrast
B. CTA abdomen and pelvis
C. CT enterography
D. CT appendicitis
C. CT enterography
What CT protocol should be used to diagnose abnormal narrowing of the abdominal aorta?
A. CTA abdomen and pelvis
B. CTA thoracic aorta
C. CT Abdomen and pelvis with contrast
D. CT enterography
A. CTA abdomen and pelvis
What CT protocol should be used to evaluate an arterial dissection extending from the aortic bifurcation through the popliteal arteries?
A. CTA abdomen and pelvis
B. CTA thoracic aorta
C. CT abdomen and pelvis with contrast
D. CTA Runoff
D. CTA Runoff
What image windowing was used to display the image below?
A. 2600 WW and 500 WL
B. 400 WL and 600 WL
C. 80 WW and 30 WL
D. 400 WW and 40 WL
C. 80 WW and 30 WL
What imaging plane is best suited for viewing the pulmonary trunk where it bifurcates into the right and left pulmonary arteries?
A. Axial
B. Sagittal
C. Coronal
D. Oblique
A. Axial
What imaging protocol should be followed for evaluation of a known arterial-venous malformation (AVM) in the right upper parietal lobe?
A. CT head without contrast
B. CT head with and without contrast
C. CTA head
D. CTA head and neck
C. CTA head
What imaging technique was used to produce the image below?
A. Curved MPR
B. Maximum intensity projection (MIP)
C. Volume rendering
D. Shaded Surface Display
B. Maximum intensity projection (MIP)
What is a common image window for viewing images in the bone algorithm?
A. 2500 WW and 600 WL
B. 600 WW and 2500 WL
C. 400 WW and 40 WL
D. 80 WW and 30 WL
A. 2500 WW and 600 WL
What is a common reconstructed slice parameter for CT angiography imaging of the brain?
A. 0.625 mm slices with matching interval
B. 3.75 mm slices with overlapping interval
C. 5 mm slices with a larger interval
D. 1.25 mm slices with a larger interval
A. 0.625 mm slices with matching interval
What is an appropriate windowing technique for displaying axial images of the pelvis in the bone algorithm?
A. 2500 WW and 600 WL
B. 80 WW and 30 WL
C. 1800 WW and -600 WL
D. 400 WW and 40 WL
A. 2500 WW and 600 WL
What is the bright artifact anterior to the bridge of the patient’s nose?
A. Bismuth eye shield
B. EKG lead
C. Oxygen tubing
D. Motion artifact
A. Bismuth eye shield
What is the brightly enhanced structure in the left lower quadrant of the patient imaged below?
A. Appendicitis
B. Large bowel
C. Uterine tumor
D. Urinary bladder
B. Large bowel
What is the ideal heart rate for coronary imaging in CT?
A. Less than 65 beats per minute
B. 65-85 beat per minute
C. 85-100 beats per minute
D. Greater than 100 beats per minute
A. Less than 65 beats per minute
What is the lower limit of a routine CT Chest protocol?
A. Lung apices
B. Costophrenic angles
C. Adrenal glands
D. 1st lumbar vertebra
C. Adrenal glands
What is the minimum volume of rectal contrast expected to fill most of the large bowel?
A. 10 ml
B. 100 ml
C. 1,000 ml
D. 10,000 ml
C. 1,000 ml
What is the most common image window for viewing images in the standard algorithm?
A. 2500 WW and 600 WL
B. 600 WW and 2500 WL
C. 400 WW and 40 WL
D. 80 WW and 30 WL
C. 400 WW and 40 WL
What is the most likely explanation for the different appearances of these images?
A. Different reconstruction algorithm
B. Different window width
C. Different window level
D. Different gantry
A. Different reconstruction algorithm
What is the purpose of reconstructing thin slices of the lungs for the high-resolution protocol?
A. Increased spatial resolution in the axial images
B. Increased contrast resolution in the axial images
C. Increased quality of multiplanar reformations
D. Decreased image noise in the axial images
A. Increased spatial resolution in the axial images
What is the purpose of warming intravenous contrast prior to injection?
A. Decrease viscosity
B. Increase radiopacity
C. Decrease chemical toxicity
A. Decrease viscosity
What is the recommended CT scanning procedure for a patient with traumatic injuries to the face from a motorcycle accident?
A. CT neck with contrast
B. CT facial bones with contrast
C. CT facial bones without contrast
D. CT sinuses screening
C. CT facial bones without contrast
What is the technical classification for this pathology?
A. Saddle embolism
B. Pulmonary Fibrosis
C. Type B Dissection
D. Type A Dissection
C. Type B Dissection
What is the technical classification of a thoracic aorta aneurysm that originates in the ascending aorta?
A. Type A
B. Type B
C. Type C
D. Type D
A. Type A
What is the typical image presentation for the CTA Runoff procedure?
A. 400 WW and 40 WL
B. 80 WW and 30 WL
C. 1800 WW and -600 WL
D. 2500 WW and 600 WL
A. 400 WW and 40 WL
What IV contrast injection protocol is most appropriate for multiphase renal imaging on an average sized patient?
A. 100 ml at 3 ml per second
B. 150 ml at 3 ml per second
C. 100 ml at 5 ml per second
D. 150 ml at 5 ml per second
A. 100 ml at 3 ml per second
What kind of contrast may be administered immediately prior to scanning to fill the cecum of the large bowel?
A. Oral contrast
B. Rectal contrast
C. IV contrast
B. Rectal contrast
What kind of IV contrast is traditionally used for imaging the abdomen and pelvis?
A. Iodine
B. Barium
C. Water
A. Iodine
What kind of reconstruction algorithm is traditionally used for angiography imaging of the heart?
A. Smoothing algorithm
B. Sharpening algorithm
C. Edge-enhancing algorithm
D. Lung algorithm
A. Smoothing algorithm
What medication has be effect of temporarily stopping peristalsis?
A. Metoclopramide (Relgan)
B. Glucagon
C. Nitroglycerin
D. Beta blocker
B. Glucagon
What medication has the effect of dilating the coronary arteries?
A. Glucagon
B. Beta blockers
C. Nitroglycerin
D. Analgesics
C. Nitroglycerin
What medication helps fill the bowels with oral contrast?
A. Metoclopramide (Reglan)
B. Glucagon
C. Nitroglycerin
D. Beta blocker
A. Metoclopramide (Reglan)
What multiplanar reformation (MPR) technique can be used to visualize very tortuous coronary arteries in a single plane?
A. Curved MPR
B. Thick MPR
C. Thin MPR
D. MIP technique
A. Curved MPR