Mock Test for IMM Radiology

Dr. Muhammad Bin ZulfiqarDr. Tayyaba Niazi

PGR Services Hospital Lahore / Services Institute of Medical Sciences

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• Study• Findings • Diagnosis• Most Common cause• What Next

• Which modality?• What happened?• Solution.• Name two other

examples?

• Study• Findings• Diagnosis• Radiological suggestion

(1). Modality and View

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• Study• Findings• Diagnosis• What Next

Label 2

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Label 4Label 4

Label 4Name the Machine

• Study and View.• Findings• Diagnosis• Differntial Diagnosis.• Name the Sign on IVU

H/O Left Flank Pain

Fill the missing

• The smaller the anode angle, the larger the heel effect.

• The usual shape of a focal spot is the double• Banana???• K X Ray energy of Molybdenum is Kev.• Atomic No of Tungsten is ????• Pair production has role in radiology.

• Name the study.• Findings• Diagnosis.• Conventional radiographic approach regarding

posttraumatic posterior urethral stricture

Poor stream from 2 years

• Label• Name other types• Benefit in single line

• Study• Findings• Diagnosis• Differntial Diagnosis• What Next

• Fill the missing

• Study• Findings• Diagnosis• Differntial Diagnosis• What Next

18 years F H/ O trichotilomania

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• Study• Findings• Diagnosis• Differntial Diagnosis• What Next

• Name above mentioned subject.• Label from A-D

• Studies• Findings• Diagnosis

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• Study• Findings• Diagnosis• Differntial Diagnosis• What Next

CT done for an incidental finding on chest radiograph in otherwise healthy young adult.

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• Study• Findings• Diagnosis• Differntial Diagnosis• What Next

• Name only 1-5

• Study• Findings• Diagnosis• What Next

• Name the View.• Describe Centering.• Indications

• Study• Findings• Diagnosis• Differntial Diagnosis

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• WHAT STUDY?• FINGDINGS?• DIAGNOSIS?

• Name the View?• Detailed Centering?• Indications?

• WHAT STUDY’?• FINDINGS?• DIAGNOSIS?• WHAT NEXT LL U

SUGGEST?

• Identify the Subject.• Describe its types?• Name the most commonly used grid in

Radiology?

• WHAT STUDY?• FINDINGS?• DIAGNOSIS?• DIFFERENTIAL

DIAGNOSIS?• WHAT NEXT?

Fill the missing

• WHAT STUDY??• FINDINGS?• DIAGNOSIS?• DIFFERENTIAL?• WHAT NEXT?

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• Study• Findings• Diagnosis• Differntial Diagnosis• What Next

Label 1

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• WHAT STUDY?WHICH VIEW?

• FINDINGS?• DIAGNOSIS?

• Name Lines, curve and Angle.

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• What study?• Findings?• Diagnosis and types of

it?• What further

investigation can b done?

• Study• Which Radiopharmaceutical is

used?• What is half life• Indications

• H/ O TB• What study• Findings• Diagnosis

1. Superior Cerebellar Vermis

2. Midbrain

3. Orbits

4. Posterior Cerebral Artery

5. Middle Cerebral Artery

• Gray Scale and Doppler abdominal Ultrasound.

• Portal Vein is Distended by echogenic thrombus. On color doppler no flow is seen. Liver echotexture is coarse.

• Portal Vein thrombus.• Hepatitis C, B• Biphasic CT.

• MR Imaging.• Phase encoded motion artifact / Ghosting.• Council, immobilize or sedate patient / swap

phase and frequency.• Any two Artifact.

• Contrast Enhanced Axial CT abdomen Portovenous Phase

• Heterogeneously contrast enhancing lesion in the body of pancreas which is completely encircling the celiac trunk and its branches. Conglomerate lymph nodes also seen.

• Pancreatic Body Malignant Mass.• Tumor is irresectable irresectable.

(1). Coronal Cranial Ultrasound(2). Cavum septum pellucidum(3). Frontal Horne of Lateral Ventricle(4). Cingulate gyrus(5). Falx Cerebri

• Radiograph Chest PA and Lateral View.• Radiograph demonstrates complete opacification of

the left hemithorax with abrupt cutoff of left main bronchus with ipsilateral tracheal and mediastinal shift. Associated marked displacement of right lung anteriorly and posteriorly across midline. Note the marked anterior hyperlucency of the thorax on the lateral view (B).

• Lung Mass (Bronchogenic Carcinoma).• CT Chest with IV Contrast.

• Xray tube• Spinning anode• Anode heal effect• Filament cathode• Electron beam

• Ultrasound Pelvis Transverse and Longitudinal.• Well defined cystic lesion is seen in the

urinary bladder at vesico-ureteric junction. No definitive wall defect is seen.

• Ureterocele.• Bladder diverticulum and Pseudoureterocele.• Cobra Head Sign.

• Larger• Double banana • 19• 69• No

• Retrograde Urethrogram.• Strictural narrowing of the bulbous urethra is

seen, however transit of contrast is seen into posterior urethra.

• Stricture Bulbous urethra.• simultaneous antegrade cystourethrography and

retrograde urethrography are often required to determine the length of the urethral defect.

• radiographic rating charts for a given x-ray tube.

• Anode Cooling Chart, Housing cooling chart.• Tube rating charts aid the radiographer in

using acceptable exposure levels to maximize x-ray tube life.

• MD CT Sagittal Reconstructed MIP image.• A homogeneously contrast enhancing lesion in

at the carotid bifurcation with splaying of ECA and ICA. No vascular erosion or luminal narrowing is seen. No definitive Lymphadenopathy seen.

• Carotid Body Tumors.• Neurilemomma,

• Ultrasound Abdomen Through Stomach transverse View.

• An echogenic focus with shadowing seen occupying and distending the stomach.

• Trichobezoar.• Phytobezoar, foreign body, mass.• Ct Abdomen Plain and with IV contrast

• Psoas Muscle• Spinous Process• Rectum• Gluteus medius• Gluteus maximus

• IVU• Right kidney is visualized in the lower abdomen

and pelvis in front of right side of L5 vertebra and is relatively smaller with prominent pelvicalyceal system.

• Right Ectopic Kidney— lower abdomen and pelvis.

• Transplanted Kidney.• DTPA, MR IVU, CT IVU

• A, Trough filter. • B, Wedge filter. • C, “Bow-tie” filter for use in computed

tomography. • D, Conic filters for use in digital fluoroscopy.

• Radiograph Chest PA view. One of spot film of barium swallow.

• Radiograph demonstrate mediastinal widening with a tube like structure extending from neck to the abdomen with air fluid levels.

• A smooth, tapered, beaklike narrowing of the distal esophagus adjacent to the gastroesophageal junction with hold up of contrast in retrograde dilated esophagus.

• Cardiac Achlasia.

• IVC• Right crus of diaphragm• Aorta• Main Portal vein• Fissure / Ligamentum Teres

• CT Chest Axial Slice.• A well defined smooth oval lobulated nodule

seen in posterior basal segment with popcorn calcification. No tail sign and no spiculations.

• Hemartoma.• Granuloma, AVM.• Follow up radiograph 6 months. If no interval

change then yearly and then 2 yearly.

(1). Intercruciate recess(2). Posterior cruciate ligament(3). Body medial meniscus(4). Anterior cruciate ligament(5). Lateral meniscus

• Radiograph Chest PA view of Skeletally immature subject.• Cardiac size is enlarged with boat shape configuration and

cardiac apex pointing upward.• Tetrology of fallot• Other congenital Cyanotic Heart diseases. e.g. total

anomalous pulmonary venous return (TAPVR) , transposition of the great arteries (TGA) truncus arteriosus and large AVSD

• Cardiac MRI / Cardiac CT •

• Ascending Aorta• Descending Aorta• Brachiocephalic Trunk• Right Subclavian Artery• Right CCA

• Radiograph Right Hip and Radiograph right Knee Joint.

• Radiograph demonstrates displaced fracture of the intracapsular portion of the neck of femur at level of its junction with femoral head. Overlying caste is also seen. Foleys catheter is also seen.

• Subcapital Femoral Neck Fracture.• 3 D CT and MRI for pelvic pathologies

• Chest Radiograph PA View• Radiograph demonstrates extensive bilateral

hilar lymphadenopathy with thickened right paratracheal stripe. No definitve lung pathology is seen.

• Sarcoidosis• Lymphoma, T.B.• HRCT Chest / CT Chest with IV Contrast

• Posterior oblique – both hands (ball catcher’s or Norgaard projection)

• The vertical central ray is centred to a point midway between the hands at the level of the fifth metacarpo-phalangeal joints.

• This projection may be used in the diagnosis of rheumatoid arthritis. It can also be used to demonstrate a fracture of the base of the fifth metacarpal.

• CT Skull Scout View and Axial CT Scan with Bone Window.

• Numerous well defined lytic lesions of variable size and shape are seen diffusely scattered in the calvarium.

• Multiple Myeloma• Metastasis, Lymphoma.• Skeletal Survey, Whole body low dose CT, MRI,

PET CT.

(1). Scaphoid(2). Capitate(3). Triquetral(4). Pisiform(5). Hook of Hamate

• Ct BRAIN (PLAIN) Axial slice• Hyperdense cresentric shaped lesion in right

parietal region,effacement of ipsilateral lateral ventricle and adjacent sulci. Fracture of underlying bone with associated scalp hematoma .no midline shift,no subarachnoid extension.

• Subdural hematoma.

• Tunnel View.• Centre immediately below the apex of the patella,

with the following angulations to demonstrate either the anterior or posterior aspects of the notch:– 110 degrees angulation along long axis of tibia to look

for Anterior aspect of the notch.– 90 degrees angulation along long axis of tibia to look for

Posterior aspect of the notch.• Loose bodies and Fracture of tibial Spine.

• CT brain(plain) axial slice• Hypodense lesion involving the right MCA

territory, loss of grey and white matter differentiation, effacement of sulci…vanishing basal ganglia sign.mass effect causing effacement of ipsilateral lateral ventricle.no midline shift

• Acute Infacrt in Right MCA territory

• Carotid Doppler and echocardiography

• Crossed Grid.• Parallel grid, Crossed Grid, Focused Grid,

Moving grid.• Moving Grid.

• X Ray chest PLAIN PA view• lobulated soft tissue opacities in both hilar

regions , lung fields are normal and cp angles are clear,

• Sarcoidosis• Dd Lymphoma , Tuberculosis , histoplasmosis • Blood ACE levels

• X ray wrist frontal projection• Expansile Lytic lesion located at the distal end of

radius with multiple trabeculations/sepate , no fracture of bone noted. No intra articular extention.

• Giant cell tumor• Dd aneurysmal bone cyst, simple bone cyst,

fibrous dysplasia, metastasis• CT or MRI (show fluid fluid levels)

(1). Cervical Portion of ICA(2). Supraclinoid portion of ICA(3). Ophthalmic Artery(4). ACA(5). MCA

• HRCT• Axial CT at the level of the lower part of the chest

shows bilateral bronchiectasis in the right middle lobe and the left lower lobe with some mucoid impactions. Note the presence of bronchial wall thickening and multiple foci of ‘tree-in-bud’ sign, reflecting infectious bronchiolitis.

• Situs inversus (Kartagener’s syndrome).• Cystic Fibrosis.

(1). Subscapularis(2). Supraspinatus(3). Tendon of long head of bicep(4). Acromioclavicular Joint(5). Glenoid

• Mamography MLO view• A large thin walled well defined encapsulated

lesion with heterogeneous density in retroareolar region of right breast. It consists of both fat and soft tissue density. No intralesional calcification is noted. No skin thickening or nipple retraction is noted.

• Possibility of benign hamartomatous lesion (fibroadenolipoma). Also called as BREAST WITHIN BREAST appearance

(1). Perkin's line(2). Hilgenreiner's line(3). Shenton's curve(4). Acetabular angle(5). Acetabular Line

• Plain X ray Chest PA view• Multiple gas locules within the lower left chest,

the majority of the rest of the left lung opacified. The left hemidiaphragm can not be seen. The mediastinum and the heart are deviated to the contralateral right side.

• congenital Diaphragmatic hernia. Two types bochdAalek and morgagni

• Barium study(follow through) and ct scan

• Thyroid Scan• 99m TC• 6hours• Thyroid nodule, Thyroiditis

• Plain x ray chest frontal projection

• A cavity in the left upper zone with the formation of intra-cavitary bodies and surrounding fibrosis, suggestive of mycetoma formation. The left lower zone reveals bronchiectatic changes.

• Mycetoma formation on background of tuberculosis.

THANK YOU