images

Question 1

1. Modality

radiologic sign

diagnosis

Answer 1

• Modality:
  
  • FLAIR (left) and DWI (right) MRI (noncontrast sequences)
  • Region: brain, axial view
• Radiologic sign: hypertintense lesion representing edema and restricted diffusion in the territory of the right basal ganglions
• Diagnosis: small acute infarction

Question 2

2.

Answer 2

• Modality:
  
  • DWI MRI (left) and
  • 3D TOF (time-of-flight) angiography (noncontrast sequences)
• Region: brain, axial view
• Radiologic sign:
  
  • significant hyperintensity (representing restricted diffusion) in the right parietal lobe with concomitant abrupt filling defect at the right middle cerebral artery
• Diagnosis:
  
  • large acute infarction, acute thrombosis of the right middle cerebral artery

Question 3

3. Modality

region

radiologic sign

diagnosis

Answer 3

• Modality: Non-enhanced CT, brain window setting
  
  • (window level: 40 HU; window width: 80 HU)
• Region: Brain, axial view
• Radiologic sign:
  
  • (blue area) : Cortical-subcortical border disappeared/blurred due to edema
  • (yellow arrow) : “hyperdense media”-sign – acute thrombosis of the right middle cerebral artery
• Diagnosis:
  
  • Subacute ischaemia in the territory of the right MCA

Question 4

4.

Answer 4

• Modality:
  
  • Non-enhanced CT,
  • brain window setting (window level: 40 HU; window width: 80 HU)
• Region: Brain, axial view
• Radiologic sign:
  
  • Extensive hypodense (20-25 HU) brain parenchyma,
  • concomitant dilatation of the right lateral ventricle (arrows) due to brain tissue loss;
  • green arrow : calcifications of the choroideal plexuses (common finding)
• Diagnosis:
  
  • ​Chronic ischemic lesion in the territory of right MCA

4.

Question 5

5.

Answer 5

• Modality:
  
  • Non-enhanced CT,
  • brain window setting (window level: 40 HU; window width: 80 HU)
• Region: Brain, axial view
• Radiologic sign:
  
  • Large hyperdense area (density: 60-70 HU) extending into the ventricles, slight midline shift to the right and compressed right lateral ventricle due to mass effect (yellow arrow)
• Diagnosis:
  
  • Acute cerebral apoplexy, most commonly caused by hypertensive crisis

apoplexy : unconsciousness or incapacity resulting from a cerebral haemorrhage or stroke.

Question 6

6.

Answer 6

• Modality:
  
  • T2W MRI and 3D TOF angiography (noncontrast)
• Region: brain, axial view
• Radiologic sign:
  
  • enlarged “flow-void” on T2W MRI,
  • circumscribeddilatation of the right internal carotid artery on TOF
• Diagnosis: aneurysm of theright internal carotid artery (cavernous part)

Question 7

7.

Answer 7

• Modality: Non-enhanced CT
• Region: Brain, axial view
• Radiologic sign:
  
  • Cast-like hyperdensity filling the basal cisterns and sulci (normal hypodens, liquor-filled cysterns can be observed on the right image)
• Diagnosis:
  
  • Acute subarachnoid hemorrhage, most commonly due to a berry aneurysm rupture

Question 8

8.

Answer 8

• Modality:
  
  • left –SWI axial MRI(magnitude image);
  • middle –T2WI axial MRI;
  • right –T1W sagittal MRI, noncontrast sequences
• Region:
  
  • Brain, axial and sagittal views
• Radiologic sign:
  
  • crescent-shaped hyperintense area on all sequences in the subdural space
• Diagnosis:
  
  • left-sided subdural hematoma, most commonly caused by the rupture of the bridge veins

Question 9

9.

Answer 9

• Modality:
  
  • Non-enhanced CT ;
  • left – brain window setting (window level: 40 HU; window width: 80 HU),
  • right – bone window setting (window level: 600 HU; window width: 2800 HU)
• Region:
  
  • Brain, axial views
• Radiologic sign:
  
  • Lens-shaped hyperdense mass and skull vault fracture at the identical position (yellow arrow)
• Diagnosis: Right-sided epidural hematoma

Question 10

10.

Answer 10

• Modality:
  
  • left panels –noncontrastCT,
  • right panels –CE T1WI MRI (upper–sagittalview, lower–axialview) after iv. gadolinium administration
• Region:
  
  • Brain, axial and sagittalviews
• Radiologic sign:
  
  • Intraaxialparenchymal mass with rim-enhancement, which compresses the right lateral ventricle (arrow);
  • MRI’s superior soft tissue resolution over CT’s is clearly oservable
• Diagnosis: Glioblastoma multiforme (GBM)

10.

Question 11

11.

Answer 11

• Modality:
  
  • left – DWI MRI;
  • middle – CE T1W SE with fat saturation MRI after iv. gadolinium administration;
  • right – T2W fatsat MRI (axial view)
• Region: Brain, axial views
• Radiologic sign:
  
  • bilateral enhancing intrabulbar masses,
  • restricted diffusion
• Diagnosis: bilateral retinoblastoma

Question 12

12.

Answer 12

• Modality:
  
  • Non-enhanced MRI
  • (left: T1WI sagittal,
  • center: T2WI sagittal,
  • right: T2WI axial)
• Region:
  
  • Lumbar spine
• Radiologic sign:
  
  • Btw L2/3 hypointense(signing low water content) discprotrudesinto the spinal canal (yellow arrow)
• Diagnosis:
  
  • Discherniation between L2 and L3 level; dehydrated disc(s)

Question 13

13

Answer 13

• Modality:
  
  • left – T1W fatsat postcontrast MRI after iv. gadolinium administration;
  • right – T2W fatsat MRI (sagittal view)
• Region: thoracic spine
• Radiologic sign:
  
  • epidural enhancing mass at the level of Th 9-12th vertebras,
  • no signal loss on fatsat image;
  • non-enhancing fluid signal intensity inside of the mass
• Diagnosis: epidural abscess

Question 14

14

Answer 14

14.

Modality:
Noncontrast CT

Region:
Upper abdomen, axial views

Radiologic sign:
-Diffusely & homogenously decreased density (cca. -20 HU) of the liver
(normal density is cca. 50-60 HU).
-The vessels (blue arrows) → denser -relative to the liver parenchyma-

Diagnosis:
Steatosis Hepatis (Fatty liver)

Question 15

15

Answer 15

• Modality:
  
  • Contrast-enhanced CT,
  • portal phase,
  • iv. iodine-based contrast agent
• Region: Upper abdomen, axial view
• Radiologic sign:
  
  • Multiple hypoenhancing lesions of the liver, normal spleen
• Diagnosis: Multiple liver metastases (most commonly from colon adenocc.)
• Modality :
  
  • Liver ultrasound with convex probe (3.5-5 MHz),
  • B-mode
• Region: Liver, right subcostal view
• Radiologic sign: Hypoechoic lesions of the liver
• Diagnosis: Multiple liver metastases

Question 16

16

Answer 16

Modality:
FDG PET-CT (right panel: non-contrast CT) → 18(F)-fluoro-deoxy-glucose

Region:
upper abdomen, axial view

• *Sign:**
• increased focal uptake in the liver
• physiological high up take in the kidney

Diagnosis:
Malignant tumor → colorectal cc. metastasis → liver

16.

Question 17

17

Answer 17

• Modality:
  
  • PET-CT, 18-fluorodeoxyglucose (18F-FDG) radiotracer;
  • Hybrid imaging method: PET – metabolic activity,
  • CT – morphology
• Region:
  
  • Whole-body, coronal view
• Radiologic sign:
  
  • Increased fluorodeoxyglucose (18F-FDG) uptake in liver and pubic bone,
  • high physiologic activity is shown in the bladder (normal finding)
• Diagnosis:
  
  • Multiple metastases (liver, pubic bone)

Question 18

18

Answer 18

• *Modality:**
• left –contrast-enhanced ultrasonography (CEUS) after iv. microbubble administration (arterial phase)
• right–CEUS, late phase

Region:
liver right subcostal view

• *Radiologic sign:**
• Hepatic mass (peripheral nodular enhancement) -in the arterial phase- (L)
• complete filling in the late phase (R)

Diagnosis:
Hepatic hemangioma

Question 19

19

Answer 19

• Modality:
  
  • Digital subtraction angiography (DSA), intraarterial iodine-based contrast agent; noncontrast CT (inlet)
• Region: Upper abdomen, liver
• Radiologic sign:
  
  • large hepatic mass in the righ lobe with intensive arterial supply, (hyperdense mass after embolization - inlet);
  • selective catheterization of the right hepatic artery
• Diagnosis:
  
  • transcatheter arterial embolization of a giant hepatic hemangioma with Lipiodol; Lipiodol appears hyperdense on the noncontrast CT

Question 20

21

Answer 20

• Modality:
  
  • left – Noncontrast CT,
  • right – Contast-enhanced CT, iv. iodine-based contrast agent
• Region: Upper abdomen
• Radiologic sign:
  
  • Enlarged pancreas with indistinct margins;
  • yellow arrow: Enhancing head – living tissue;
  • red arrow : Non-enhancing body necrosis
  • increased density of the surrounding mesenterial fat (fat necrosis);
  • decreased liver density (see Image 14)
• Diagnosis: Acute necrotizing pancreatitis; fatty liver

Question 21

20

Answer 21

Modality:“mDIXON” dynamic contrast-enhanced MR after iv. gadolinium
(noncontrast, arterial phase, portal phase, venous phase)

Region:
upper abdominal MR study (axial view)

• *Radiologic sign:**
• large hepatic mass
• intensive arterial enhancement
• no „wash-out”
• non-enhancing/hypointense central scar (red arrow)

Diagnosis:
hepatic focal nodular hyperplasia (FNH)

Question 22

22

Answer 22

• *Modality:**
• Ultrasound of gallbladder with convex probe (3.5–5 MHz)
• B-mode
• *Region:**
• Gallbladder
• right subcostal view
• *Radiologic sign:**
• Yellow arrow → Echo-dense structure in the gallbladder lumen, with acoustic shadowing
• Red arrow → Thick, stratified, oedematous wall

Diagnosis:
Acute cholecystitis with gallstone

Question 23

23

Answer 23

• Modality:
  
  • T2W MRI, axial plane (left);
  • 3D MRCP (heavily T2-weighted sequence), coronal plane (right), noncontrast study
• Region:
  
  • upper abdominal MR study, axial (left) and
  • coronal (right) views
• Radiologic sign:
  
  • filling defect in the common bile duct
• Diagnosis: choledocholithiasis

Question 24

24

Answer 24

• *Modality:**
• yellow → Sonogram of the appendix -linear 7,5–10 MHzprobe-
• Green → convex 3,5-5 MHz probe -B-mode-
• Red: power Doppler
• *Region:**
• Appendix
• longitudinal and cross-sectional views
• *Radiologic sign:**
• -yellow →* Small amount of free periappendiceal fluid is also present (yellow arrow).
• green → Thickened (more than 6 mm), non-compressible tubular structure
• -red arrow →* showing signs of edema and hyperVascularisation

Diagnosis:
Acute appendicitis

Question 25

25

Answer 25

• Modality:
  
  • left – PA chest radiograph, frontal projection (upright position);
  • right – noncontrast CT, axial view
• Region:
  
  • ​Chest, upper abdomen
• Radiologic sign:
  
  • Crescents of radiolucency under the hemidiaphragms (red arrows),
  • free air accumulation at the convexity of the liver and at the liver hilum, its density is -1000 HU (right panel, red arows);
  • perihepatic and perisplenic free fluid, its density is 0 HU (yellow arrows)
• Diagnosis: Free abdominal air (due to perforation of luminal abdominal organ)

Question 26

26

Answer 26

.Modality:
-left image → Abdominal plain radiograph, standing posture;
-right image → Contrast-enhanced CT scan, iv. iodine-based contrast agent
Region:
Abdomen and pelvis

• *Radiologic sign:**
• yellow arrows → Distended colon with air–fluid levels. In the sigmoid colon an obstructing contrast-enhancing mass
• red arrow → In the sigmoid colon an obstructing contrast-enhancing mass (conglomerate is shown)

Diagnosis:
Large-bowel obstruction caused by sigmoid cancer

Question 27

27

Answer 27

• Modality: Barium swallow test, fluoroscopy
• Region: Esophagus
• Radiologic sign:
  
  • Outpouching (red arrow) filled with contrast material near the pharyngo-esophageal junction;
  • air-fluid level (yellow arrow) in the outpouching;
  • dilated, sclerotic aorta (green arrow);
  • glass with contrast material (blue arrow)
• Diagnosis: Zenker diverticulum

Question 28

28

Answer 28

• *Modality:**
• -**left* -Barium enema study, double-contrast method(barium and air)
• right–contrast-enhanced CT, venous phase, iv. iodine-based contrast agent
• *Region:**
• *-**Abdomen
• axial view
• *Radiologic sign:**
• *-**Annular irregular stenosis & bowel wall thickening (apple-core sign)
• Tumorous infiltration of the surrounding fat (increased density)

Diagnosis:
Colon adenocarcinoma

Question 29

29

Answer 29

• Modality:
  
  • ​DWI MR (left),
  • dynamic mDIXON contrast-enhanced MR (middle) after iv. gadolinium,
  • T2W MRI (right)
• Region:
  
  • ​pelvic MR study,
  • axial view (left) and
  • sagittal view (right)
• Radiologic sign:
  
  • thickened rectal wall/intraluminal mass with intensive contrast enhancement and
  • concomitant restricted diffusion (red arrow); local staging MRI
• Diagnosis: rectal adenocarcinoma

Question 30

30

Answer 30

Modality:
Low-dose non-enhanced CT scan

• *Region:**
• abdomen
• coronal view

Radiologic sign:
JuxtaVesical hyperdensity
-in the L.Ureter

Diagnosis:
JuxtaVesical stone

Question 31

31

Answer 31

• Modality: Contrast-enhanced CT; arterial phase
• Region: Abdomen
• Radiologic sign: Enlarged right kidney with patchy hypoenhancement
• Diagnosis: Acute pyelonephritis
• Modality: Kidney ultrasound with convex probe (3.5–5 MHz), B mode & color Doppler
• Region: Abdomen
• Radiologic sign: Enlarged right kidney shows ill-marginated central echo group and parenchymal hypovascularisation
• Diagnosis: Acute pyelonephritis (right side)

Question 32

32

Answer 32

Modality:
-yellow: Non-enhanced CT,
the rest: Multiphase contrast-enhanced CT
(early arterial, portal and venous phase)
-iv. iodine-based contrast agent

• *Region:**
• Abdomen
• retroperitoneum
• *Radiologic sign:**
• Yellow arrow → Aortic aneurysm with wall calcifications
• Blue arrown → hypoDense wall thrombus,
• Red arrow → hyperdense retroperitoneal fluid collection

Diagnosis:
Abdominal aortic aneurysm rupture

Question 33

33

Answer 33

• Modality:
  
  • aortic CT angiography;
• Region:
  
  • chest; left – coronal view,
  • right – sagittal view, iv. iodine-based contrast agent
• Radiologic sign:
  
  • intima flap (yellow arrow),
  • crescent-shaped false lumen (green arrow),
  • oval true lumen (blue arrow).
  • True lumen is denser due to its higher contrast agent concentration.
• Diagnosis:
  
  • Stanford A aortic dissection, affecting the left subclavian artery (red arroW)

Question 34

34

Answer 34

Modality:
T2W MRI and dynamic contrast-enhanced MRI of the prostate
(after iv. gadolinium contrast agent administration)

• *Region:**
• Pelvis
• axial views
• *Radiologic sign:**
• Yellow → T2 hypointensity in the peripheral zone;
• Red → intensive contrast-enhencing mass in the same area
• Blue → normal central zone

Diagnosis:
prostate adenocarcinoma

Question 35

35

Answer 35

• Modality:
  
  • ​ PA (left) and
  • lateral (right) chest radiograph;
  • hard-beam technique (120–140 kV)
• Region:
  
  • chest, pleura
• Radiologic sign:
  
  • Decreased transparency at the right lung base showing a meniscus-shaped contour on the right side.
  • Diaphragm and lateral sinuses cannot be differentiated on the right.
  • Left side is normal.
• Diagnosis: Right-sided pleural effusion

Question 36

36

Answer 36

• Modality:
  
  • Chest radiograph in frontal projection(PA-film)
• Region:
  
  • Chest, pleura
• Radiologic sign:
  
  • Peripheralspace is radiolucent with no lung markings(yellow arrow);
  • visible visceral pleural line (blue arrow);
  • partially collapsed leftlungbasis (red arrow);
  • slight mediastinal shift to theright;
  • left diaphragm and lateral sinus cannot be differentiated.
• Diagnosis:
  
  • Left-sided pneumothorax and hydrothorax

Question 37

37

Answer 37

• Modality:
  
  • Bedside chest radiograph (AP radiograph)
• Region: Chest, lung
• Radiologic sign:
  
  • Decreased tranparency (consolidation) in the right upper lobe with radiolucent aerobronchogram (red arrow)
  • left-sided jugular catheter, ECG electrodes
• Diagnosis:
  
  • Right-sided lobar pneumonia in the upper lobe

Question 38

38

Answer 38

• Modality:
  
  • Contrast-enhanced chest CT,
  • lung window setting (right panel);
  • mediastinal window setting (left panel),
  • iv. iodine-basedcontrastagent
• Region: Chest, axial views
• Radiologic sign:
  
  • ​Air-containing (red arrow) fluid collection with
  • thick enhancing rim (yellow arrow)
• Diagnosis:
  
  • Left-sided lung abscess

Question 39

39

Answer 39

• Modality:
  
  • left image – PA chest radiograph (upright);
  • right image – post-contrast chest CT; lung window setting, iv. iodine-based contrast agent
• Region: Chest, lung
• Radiologic sign:
  
  • Multiple soft tissue lesions showing different size and rounded shape (yellow arrows), number of nodules is higher at the base than the apex due to its higher perfusion.
• Diagnosis:
  
  • Multiple lung metastases

Question 40

40

Answer 40

• Modality:
  
  • LEFT: ​PET-CT; 18-fluorodeoxyglucose (18F-FDG) radiotracer fused image
  • Right: non-enhanced chest CT bone window, core biopsy
• Region:Chest, lung
• Radiologic sign:
  
  • Increased18F-FDG uptake in the right apical mass;
  • CT-guided core biopsy from the right apical mass
• Diagnosis:
  
  • ​Pancoast tumor, thoracic core biopsy

Question 41

41

Answer 41

• Modality:
  
  • HRCT of the lung (noncontrast study), lung window
• Region:
  
  • Chest, lung, axial view
• Radiologic sign:
  
  • ​Bilateral dorsobasal honeycombing pattern (yellow arrow),
  • traction bronchiectasis (green arrow)
• Diagnosis:
  
  • Pulmonary fibrosis

Question 42

42

Answer 42

• Modality:
  
  • Pulmonary CT-angiography (contrast-enhanced series in pulmonary arterial phase), iv. iodine-based contrast agent
• Region:
  
  • Chest, axial views at the level of the pulmonary bifurcation
• Radiologic sign:
  
  • Large hypodense filling defects in the pulmonary arteries at both sides.
• Diagnosis:
  
  • Bilateral pulmonary embolism

Question 43

43

Answer 43

• Modality:
  
  • Lower extremity venous ultrasound, linear probe (7,5-10 MHz),
  • B-mode and Color-Doppler mode (right panel)
• Region:
  
  • V. femoral superficial and popliteal vein;
  • Left image - transverse section,
  • right image – transverse section
• Radiologic sign:
  
  • Veins are filled with hypoechoic thrombus, the lumen is non-compressible demonstrating no flow (lack of Doppler–signal);
  • beneath the popliteal artery has normal flow signal (green arrow)
• Diagnosis:
  
  • Deep vein thrombosis (DVT)

Question 44

44

Answer 44

• *Modality:**
• Digital subtraction angiography (DSA)
• Catheter angiography, intra-arterial iodine-based contrast agent

Region:
carotid bifurcation

• *Radiologic sign:**
• left image →* Significant internal carotid artery stenosis
• center image → balloon dilatation and stenting,
• right image → Control angiography, normal flow

Diagnosis:
Carotid angioplasty and stenting of a significant carotid stenosis

Question 45

45

Answer 45

• Modality:
  
  • Digital subtraction angiography (DSA), Catheter angiography, intraarterial iodine-based contrast agent
• Region:
  
  • Lower extremity, popliteal artery
• Radiologic sign:
  
  • left image – Significant right popliteal artery stenosis (yellow arrow), collateral circulation;
  • right image – Control angiography after balloon dilatation (NO stents were used), collateral circulation is diminished
• Diagnosis:
  
  • ​Chronic popliteal artery stenosis, balloon angioplasty (PTA)

Question 46

46

Answer 46

• *Modality:**
• fluoroscopy
• iv. iodine-based contrast agent
• *Region:**
• *-**upper abdomen, liver
• *Radiologic sign:**
• yellow arrow → Stent
• red arrow → placement between the portal and hepatic v
• blue arrow → hepatic vein to create a lasting connection for the purpose of decreasing the portal pressure.
• *Diagnosis:**
• TIPS (transjugular intrahepatic porto-systemic shunt) in liver fibrosis
• proper contrast filling of the stent

Question 47

47

Answer 47

• Modality:
  
  • ankle X-ray – lateral view (left image),
  • CT 3D reconstruction (right image)
• Region: Left ankle
• Radiologic sign:
  
  • ​abrupt discontinuity of the cortex of the calcaneus, lucent fracture lines
• Diagnosis:
  
  • Comminuted fracture of the calcaneus. (Lover’s fracture or Don Juan-fracture)

Question 48

48

Answer 48

• *Modality:**
• left → X-ray of the left knee in two projection
• middle → PD FS (proton density fatsat)
• right → T1W post-contrast MRI

Region:
Left knee, lateral view (radiograph), coronal views (MRI)

• *Radiologic sign:**
• Inhomogeneous destructive metaphyseal lesion of the left femur|
• red area → Periosteal reaction, Codman triangle
• radiograph→ invasion to the surrounding soft tissue is also present. - Inhomogenously enhancing metaphyseal mass infliltrating the surrounding soft tissue.

Diagnosis:
Osteosarcoma of the femur

Question 49

49

Answer 49

• Modality:
  
  • bone scintigraphy with 99mTc with methylene diphosphonate (MDP) radiotracer
• Region:
  
  • ​ whole body, AP and PA views
• Sign:
  
  • multiple foci of increased radiopharmaceutical uptake in the bones
• Diagnosis:
  
  • multiplex osseal metastases, scoliosis

Question 50

50

Answer 50

Modality:
Radiograph of the left hallux in two projections

Region:
Left foot, hallux

Radiologic sign:
Marked ill-defined bone resorption in distal tuberosity (= ungual process) with significant soft tissue swelling.

Diagnosis:
Acute osteomyelitis

Question 51

51

Answer 51

• Modality:
  
  • left image – X-ray of the sinuses;
  • right image – noncontrast CT of the sinuses, low-dose, bone window
• Region: Maxillary region, paranasal sinuses
• Radiologic sign:
  
  • Right maxillary sinus shows homogenous decreased transparency,
  • the left one has rounded mucous thickening
• Diagnosis:
  
  • Bilateral sinusitis

Question 52

52

Answer 52

• *Modality:**
• left image → Contrast-enhanced head-and-neck CT -axial view-
• -right image →* coronal view, iv. iodine-based contrast agent
• *Region:**
• Head and neck, axial (L)
• Coronal (R) view
• *Radiologic sign:**
• -**red arrow →* Right-sided submandibular fluid collection with thick enhancing wall.
• Fluid inside the abscess has a density of 0-10 HU (shows no enhancement)
• Patient had prior wisdomtooth extraction.

Diagnosis:
Neck abscess

Question 53

53

Answer 53

• Modality:
  
  • linear probe (7,5–10 MHz),
  • left - B-mode US,
  • middle – Color Doppler US,
  • right – B-mode US
• Region: neck, thyroid gland
• Radiologic sign:
  
  • well-circumscribed Isoechoic vascularized nodule,
  • right - FNAB (fine-needle aspiration biopsy) (yellow arrow)
• Diagnosis:
  
  • Suspicious thyroid nodule, cytology proves benignity

Question 54

54

Answer 54

• *Modality:**
• Thyroid gland scintigram
• Technetium-99m (99m Tc)-pertechnetate scintigraphy

Region:
Thyroid

• *Radiologic sign:**
• yello warrow →* Focal lesion showing decreased tracer activity in the right lobe

Diagnosis:
Cold nodule

Question 55

55

Answer 55

• Modality:
  
  • thyroid scintigraphy; Technetium-99m (99m Tc)-pertechnetate radiotracer
• Region: thyroid gland
• Sign:
  
  • Increased uptake in the left lobe of the thyroid,
  • low uptake in the other parts of the gland.
• Diagnosis:
  
  • Hot nodule in the thyroid (toxic nodule), other parts of the thyroid are supressed.

Question 56

56

Answer 56

Modality:
Mammography of the right and left breast, soft-beamtechnique (30 kV)

Region:
Craniocaudal (CC) views of the right and left breasts

• *Radiologic sign:**
• Soft tissue mass with spiculated contour and micro-calcifications in the right breast.
• The breast type is fatty/almost fatty, in which it is easier to detect masses than in dense breasts.
• *Diagnosis:**
• Right-sided breast cancer
• Normal left breast

Question 57

57

Answer 57

• Modality:
  
  • Breast sonography with linear probe (7.5–10 MHz), B-mode
• Region: Breast, axilla
• Radiologic sign:
  
  • left image – well-defined anechoic lesion with posterior acoustic enhancement (btw yellow lines);
  • right image – ill-defined hypoechogenic lesion with partial acoustic shadowing (btw red olines),
  • “taller than wide”: solid structure, suspicious of cancer
• Diagnosis:
  
  • cyst (left) and
  • breast carcinoma (right)

Question 58

58

Answer 58

• Modality:
  
  • ​FAST (Focused Assessment with Sonography for Trauma) scan
• Region:
  
  • ​Abdomen, pleural sinuses, pericardium, aorta
• Radiologic sign:
  
  • ​Free abdominal fluid in the
    
    • hepatorenal fossa,
    • around the spleen,
    • among the bowel loops
    • and in Douglas pouch.
  • Patient sustained blunt trauma.
• Diagnosis:
  
  • ​Free abdominal fluid after blunt trauma, suspicious for internal hemorrhage.