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Which modality? (Final Exam) Flashcards

1
Q

Acute brain bleeds #1

A

CT

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2
Q

Acute brain bleeds #2

A

Diffusion weighted MRI

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3
Q

Looking for hematoma AROUND the brain

A

CT

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4
Q

Stroke or ruptured aneurysm IN the brain

A

EQUAL: CT and diffusion weighted MRI

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5
Q

Head trauma first 48 hours

A

CT

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6
Q

Head trauma after 48 hours

A

MRI

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7
Q

Brain aneurysm #1

A

MRA

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8
Q

Brain aneurysm #2

A

MRI

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9
Q

Brain aneurysm #3

A

CT

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10
Q

MS #1

A

MRI

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11
Q

MS #2

A

CT (not as sensitive)

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12
Q

Arnold-Chiari #1

A

MRI definite first

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13
Q

Arnold-Chiari #2

A

CT distant second

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14
Q

Multiple Sclerosis

A

Image brain first since thats usually where plaque starts

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15
Q

Arnold-Chiari

A

Increased predisposition if other anomalies are present. In order to rule out a syrinx both brain and C-spine need imaging. Type 1: 4mm or less. Type 2: 5mm or more

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16
Q

Brain tumor #1

A

MRI

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17
Q

Brain tumor #2

A

CT close second

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18
Q

Vertebral Artery Dissection or Stenosis #1

A

MRA (not great)

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19
Q

Vertebral Artery Dissection or Stenosis #2

A

MRI (not great)

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20
Q

Carotid Artery Stenosis #1

A

Ultrasound (cheaper if following progress overtime)

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21
Q

Carotid Artery Stenosis #2

A

MRA (more accurate but more expensive)

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22
Q

Finding a fracture #1

A

CT

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23
Q

Finding a fracture #2

A

EQUAL: Bone scan & MRI

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24
Q

Cervical spine fractures

A

CT always #1

15-30% of fx will never be detected on plain film. They are often associated with other visible (on plain film) fx

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25
Q

Aging a fracture: First 4-6 wks

A

MRI (to detect bone marrow edema)

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26
Q

Aging a fracture: 6 weeks or more

A

Bone scan (note: for a child every growth plate will be hot on bone scan)

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27
Q

Fatigue/stress fracture #1

A

MRI (b/c it provides additional info if negative for stress fx)

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28
Q

Fatigue/stress fracture #2

A

Bone scan

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29
Q

Disc herniation #1

A

MRI by a long shot! But it doesn’t change clinical outcome so save money and don’t bother.

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30
Q

Disc herniation #2

A

CT distant distant second

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31
Q

Spinal stenosis #1

A

MRI (especially required for px with cancer phobia)

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32
Q

Spinal stenosis #2

A

CT

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33
Q

Spinal stenosis central and lateral

A

Central - DDD

Lateral - Facet OA

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34
Q

Finding OPLL

A

CT

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35
Q

Impact of OPLL on neural structures

A

MRI

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36
Q

OPLL on imaging sequences

A

Dark because of calcium

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37
Q

Imaging with suspicion of pathology involving Calcium

A

CT

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38
Q

Thyroid lesions #1

A

Ultrasound (when using repeated assessments to track changes)

39
Q

Thyroid lesions #2

A

MRI (image thyroid NOT C-spine)

40
Q

Osteoporosis #1

41
Q

Osteoporosis #2

A

Quantitative CT (hard to justify expense and radiation)

42
Q

Suspicion of skeletal METS #1

A

Bone scan (b/c we can see entire body with one study)

43
Q

Suspicion of skeletal METS #2

A

MRI (for areas of known lesions b/c we can only image one area at a time)

44
Q

High confidence in suspicion of METS

45
Q

Not confident in suspicion of METS

A

Fat suppressed MRI

46
Q

Following METS #1

A

PET scan (see all tissues at once)

47
Q

Following METS #2

A

Bone scan: distant second

b/c only valuable for bone

48
Q

Following METS #3

A

MRI: less sensitive than PET scan

only valuable if you know exactly where the lesion is

49
Q

Px has localized lesion or history of aggressive tumor

50
Q

Not suspecting METS and trying to decide whether or not its aggressive

51
Q

Evaluating compression fracture

A

EQUAL: Bone scan/lab work & MRI

52
Q

MRI: use contrast when

A
  1. Tumor
  2. Suspicion of infection
  3. Prior surgery (scar tissue)
53
Q

Cause of compression fracture

A
  1. Osteoporosis
  2. METS
  3. Multiple myeloma
    Bone scan + lab work allows for ddx btwn the three
54
Q

AVN

A

50% adults bilateral, 15% kids bilateral

55
Q

AVN #1

A

MRI clearly #1

56
Q

AVN #2

57
Q

AVN #2.5

58
Q

Osteochondritis dessicans

A

aka Osteochondral defect

Start with plain film; confirm with MRI

59
Q

Septic arthritis #1

A

MRI by far the best

60
Q

Septic arthritis #2

A

EQUAL: CT & bone scan

61
Q

Cord tumors

62
Q

Bone & MSK soft tissue tumors #1

A

MRI (unless ddx includes Ca lesions; then CT #1)

63
Q

Bone & MSK soft tissue tumors #2

A

CT close second

64
Q

Active/inactive pars defects #1

65
Q

Active/inactive pars defects #2

A

SPECT distant second

66
Q

Active pars defect aka

A

Pedicle stress fracture

67
Q

Inactive pars defect aka

A

fibrous non-union

68
Q

Muscle/tendon/ligament injuries in extremities #1

A

MRI clear first choice

69
Q

Muscle/tendon/ligament injuries in extremities #2

A

Ultrasound distant second

70
Q

Labral & meniscal & articular cartilage damage

71
Q

Meniscal tears type 1

A

Circular areas of increased signal that represent degeneration (OA)

72
Q

Meniscal tears type 2

A

Linear band of signal that does not extend to the articular surface (predisposed to tear)

73
Q

Meniscal tears type 3

A

True tear; linear band of increased signal that extends to at least one articular surface

74
Q

Syringomyelia

75
Q

Chest lesions

A

CT; high resolution/aka thin section

76
Q

GI & abdomen imaging

A

CT; transaxial with contrast (diluted barium?), or helical

77
Q

AAA #1

A

Ultrasound

78
Q

AAA #2

79
Q

AAA #3

80
Q

Thoracic aneurysm

A

CT first choice

81
Q

Pancreas

A

EQUAL: CT=US=MRI

Ultrasound most common

82
Q

Gall bladder #1

A

Ultrasound clear first choice

83
Q

Gall bladder #2

A

EQUAL: CT=MRI

84
Q

Liver #1

A

EQUAL: CT=MRI

85
Q

Liver #3

A

Ultrasound

86
Q

Kidney (IV contrast 3% iodine)

A

EQUAL: US=CT=MRI

87
Q

Kidney FUNCTION assessment

A

Intravenous pyelogram (IVP) gives more info regarding function

88
Q

Female pelvis #1

A

Ultrasound

89
Q

Female pelvis #2

A

EQUAL: CT=MRI

90
Q

Testicles #1

A

Ultrasound

91
Q

Testicles #2

92
Q

Prostate #1

A

Ultrasound; endorectal

93
Q

Prostate #2

94
Q

Prostate imaging needed when

A

+DRE and elevated PSA

Advanced Imaging (3 decks)

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