Quiz 4 imaging

Question 1

Cephalization of flow

Answer 1

Seen with pulmonary edema

-distention is vessels of upper lobe instead of lower lobe

Question 2

Aortic dissection imaging

Answer 2

thoracic MRI

Question 3

Loss of sharp definition of pulmonary vessels and peribronchial cuffing = signs of?

Answer 3

Interstitial pulmonary edema

-central interstitium

Question 4

kerley lines =

A vs B?

Answer 4

thickened interlobular septa

Kerley B

• horizontal and short
• Lower lateral parts of lung

Kerley A
-longer

Question 5

Fissural thickened is a sign of?

Answer 5

subpleural interstitial edema

Question 6

Batwing edema (perihilar consolidation) seen in

Answer 6

acute development of pulmonary edema

Question 7

ARDS progression on imaging

Answer 7

EARLY
Normal -> diffuse ground glass opacity with consolidative opacities in dependent areas of the lung

LATE
-fibrosis: traction bronchiectasis + cysts

Question 8

First test to do when PE is suspected? Why?

Answer 8

CXR - to rule out other things on the ddx

Question 9

Westmark sign

Answer 9

SEEN IN PE

Oligemia -> pulmonary vessels distal to obstruction are smaller

Question 10

Hampton hump

Answer 10

Circumscribed, subpleural opacity with a rounded medial border facing toward the hilum

pulmonary infarct OR hemorrhagic edema

-CHF patients more likely to have true infarct

Question 11

If PE suspected and normal V/Q scan, what’s the next step?

Answer 11

End workup for PE

Question 12

Most frequently done test for PE

Answer 12

CTPA

-contrast used

Question 13

When might CTPA be non-diagnostic? What should be done instead?

Answer 13

If patient can’t hold breath -> do V/Q scan

or if patient can’t get contrast to do CTPA

Question 14

2 most radiosensitive organs in women?

Answer 14

Breast and Lung

Question 15

Benign pattern of calcification

-temporal assessment

Answer 15

• central -> bull’s eye
• diffuse solid
• laminated
• “popcornlike”

If nodule hasn’t changed for 2 years -> benign

Question 16

CT assessment of solitary nodule. More likely to be cancer if: 
Size
Shape
Edge
Calcification

Answer 16

• Size - larger
• Shape - irregular, lobular
• Edge - spiculated, ill-defined
• Calcification - look for benign pattern

Question 17

Fat and calcification in nodule think?

Answer 17

Hamartoma

Question 18

Typical carcinoid tumor CT

Answer 18

Central

associated w/ bronchus -> tip of iceberg sign

Question 19

PET for nodules greater than or equal to how many cm?

Answer 19

1

Question 20

Which lung tumors may be PET neg

Answer 20

Carcinoid

Adenocarcinoma

Question 21

What can be PET + but no tumor

Answer 21

infection
granulomatous disease (e.g. histo)

Question 22

Cavitary nodule in upper lobes or superior segments or lower lobes think?

Answer 22

Tb

cavitation = necrosis

Question 23

Round pneumonia can be seen in?

Answer 23

younger patients (especially kids)
-can mimic tumor

Question 24

Peripheral lobulated mass along pleural surface think?

Answer 24

malignant mesothelioma or mets

Question 25

Sarcoid presents in which zone of lung

Answer 25

Upper zone

Question 26

Sarcoid nodules tend to have a (blank) distrubution

Answer 26

perilymphatic

• around vessels
• subpleural

sometimes interlobular septum

Question 27

Ill defined “Ground glass” nodules centered around bronchus

Answer 27

hypersensitivity pneumonitis

Question 28

Imaging technique to distinguish sarcoid for hypersensitivity pneumonitis?

Answer 28

HRCT

Question 29

UIP effects mostly which lobes?

Answer 29

Lower and peripheral

Question 30

Organizing pneumonia on CXR

Answer 30

patchy air space opacities

Question 31

Best imaging for routine sinus eval

Answer 31

non contrast CT

contrast for sinonasal mass lesions

Question 32

When is MRI preferred for sinus imaging

Answer 32

fungal disease

sinonasal malignancies - distinguish tumor from retained secretions