Page 19 Flashcards

1
Q

T1 and T2 signals of chronic noninvasive aspergillus sinusitis and chronic allergic hypersensitivity aspergillus sinusitis?

A

hypo T1 and T2

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2
Q

Site of Isolated obstruction of the maxillary sinus?

A

infunfibulum (of the maxillary ostium)

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3
Q

Combined obstruction of the ipsilateral maxillary, anterior and middle ethmoid, and frontal sinuses?

A

ostiomeatal pattern of obstruction / hiatus semilunaris (middle meatus)

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4
Q

Where do inverting papillomas occur exclusively?

A

lateral nasal wall, centered on the hiatus semilunaris

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4
Q

What ca are inverted papillomas associated?

A

SCC

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5
Q

Retromaxillary pterygopalatine fossa (adjacent to the sphenopalatine foramen) location is a hallmark feature

A

Juvenile nasopharyngeal angiofibroma

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6
Q

High within the nasal vault, involvement of the cribriform plate with extension into
anterior cranial fossa

A

Esthesioneuroblastoma

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7
Q

Where are minor salivary glands most highly concentrated?

A

palate

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8
Q

Superior recess of tympanic membrane between the scutum and neck of the malleus, where pars flaccida cholesteatomas arise

A

Prussak space (medial to pars flaccida - b/w scutum and neck of malleus)

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8
Q

Destructive midline bony mass centered in the clivus with predilection for the
sphenooccipital synchondrosis (horizontal line in the midclivus - sag view)

A

chordoma

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8
Q

Prior radiation or from malignant transformation of Paget dse

A

Osteogenic sarcoma

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9
Q

Trabecular coarsening w/o bony destruction

A

Paget disease

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10
Q

CT moth-eaten destruction /MR salt and pepper signal of jugular fossa

A

Glomus jugulare

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10
Q

Petrous apex: bright T1, bright T2

A

Cholesterol granuloma (because of cholesterol and hemorrhage)

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11
Q

Petrous apex: dark T1, bright T2, no enhancememt

A

retained fluid secretions (fluid signal)

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12
Q

Petrous apex: dark T1, bright T2, ring enhancememt

A

Petrous apicitis (just like abscess)

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13
Q

Petrous apex: bright T1, dark T2, no enhancement

A

Nonaerated petrous apex (normal marrow signal)

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13
Q

Early triad of radiographic findings in mucosal space malignancies

A
  1. superficial nasopharyngeal mucosal asymmetry
  2. ipsilateral retropharyngeal adenopathy
  3. mastoid opacification
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14
Q

Narrow the stylomandibular notch?

A

carotid space masses

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15
Q

Widen the stylomandibular notch / Push styloid process and carotid vessels posteriorly?

A

deep parotid space lesions

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16
Q

Danger space?

A

retropharyngeal space

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17
Q

How do you call paragangliomas arising from Arnold and Jacobson nerves? glomus tympanicum tumors Difference of schwannomas and neurofibromas as carotid space tumors:

A

schwannomas - encapsulated, do not infiltrate substance of nerve; neurofibromas - not encapsulated, multiple, permeate substance of nerve fibers

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17
Q

Characteristic low-intensity center on T1, involve >1 peripheral nerve

A

neurofibromas

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18
Q

Which head and neck nodes may normally measure up to 1.5 cm?

A

jugulodigastric and submandibular nodes

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18
Q

Proclivity for perineural spread w/c serves as a hallmark? (3)

A

Fungal, SCC, adenoid cystic ca

18
Q

What MR sequence can best visualize lymph nodes?

A

T2 fat sat, Gd: normal LNs-homogeneous, fatty hilum; abnormal LNs-heterogeneous, +cystic change, +necrosis

19
Q

Highest node of the IJC?

A

jugulodigastric node

19
Q

What are features suggestive of malignancy and/or infection?

A

Peripheral enhancement with central necrosis, extracapsular spread with infiltration of adjacent
tissues, matted conglomerate mass of nodes

20
Q

What structure the intra and extraconal spaces?

A

muscle cone or annulus of Zinn

21
Q

How can you differentiate benign from metastatic enlarged LN based on shape?

A

Rounded form-suggests neoplastic nodal infiltration; reniform shape-most likely benign reactive change

22
Q

Extensive thickening of the perioptic meninges reflecting peritumoral-reactive meningeal change, common in NF

A

arachnoidal hyperpasia / gliomatosis

22
Q

lymphangioma lam mo na

A
22
Q

<1 yr, regress after 1-2 yrs, infiltrative, flow voids

A

capillary hemangioma

22
Q

Where does the apex of the muscle cone lie?

A

SOF

23
Q

adults, sharply circumscribed, rounded, diffuse enhancement, mottled pattern

A

cavernous hemangioma

24
Q

venous

A

varyx

25
Q

Extraconal lesion with lipid content as a characteristic finding

A

dermoid

25
Q

Unilateral globe diseases in the pedia

A

ocular toxocariasis, Coats disease (bilateral - retinoapthy of prematurity and persistent hyperplastic primary vitreous tumour

26
Q

How can we differentiate recurrence from fibrosis?

A

Recurrence-high T2, fibrosis-low T2

26
Q

What are helpful US signs of thyroid enlargement?

A

Thickening of isthmus >3mm, outward bulge of anterior surface of gland

26
Q

What US finding is highly indicative of papillary thyroid carcinoma?

A

Punctate echogenic foci (microcalcification)

27
Q

This diffuse thyroid disease causes progressive fibrosis that eventually destroys the gland

A

Reidel’s thyroiditis

27
Q

What diffuse thyroid disease shows striking diffuse increased vascularity, aka thyroid inferno?

A

Graves disease

27
Q

What accounts for about 90% of congenital neck lesions?

A

Thyroglossal duct cys

28
Q

Thyroglossal duct normally involutes at what AOG?

A

8-10 weeks

28
Q

What is the usual course of the thyroglossal duct?

A

Foramen cecum (tongue base), anterior to thyrohyoid membrane & strap muscles, thyroid isthmus

29
Q

What is the imaging modality of choice to determine the full extent of TDC?

A

Sagittal MR

29
Q

When do laryngoceles present as a neck mass?

A

When it protrudes above the thyroid cartilage through the thyrohyoid membrane, presents as a lateral neck mass near the hyoid

30
Q

In patients with laryngoceles without a known risk factor, what should be suspected?

A

? Underlying neoplasm obstructing the laryngeal ventricle

30
Q

What is the main cause of laryngocele formation?

A

Chronically increased intraglottic pressure, as in excessive blowing or coughing

30
Q

What are the differentials for TDC?

A

Necrotic anterior cervical LNs, thrombosed IJV, abscess, obstructed laryngocele

30
Q

What are the diagnostic features of a laryngocele?

A

Communicates with laryngeal ventricle, found deep to the strap muscles

30
Q

How do you classify laryngoceles?

A

Internal, external, mixed - accdg to relation to thyrohyoid membrane

31
Q

What is one way we can differentiate TDC from laryngoceles?

A

TDC are either superficial or embedded within the strap muscles; laryngoceles are found deep to strap muscles

31
Q

Majority of branchial cleft anomalies arise from which branchial cleft?

A

2nd branchial cleft

32
Q

How does a branchial cleft cyst usually present?

A

Painless neck mass anterior to SCM

33
Q

What are syndromes associated with fetal cystic hygromas? 3

A

Turner, Noonan, fetal alcohol syndrome

33
Q

Lymphangiomas can be classified into these 3

A

capillary, cavernous, cystic

34
Q

What are the differentials for BCC?

A

Necrotic LNs, abscess, cystic neural lesions, thrombosed vessel

35
Q

Where are lymphangiomas commonly located

A

Posterior triangle of the neck

36
Q

What are characteristic imaging findings of lymphangiomas?

A

Transspatial disease, heterogeneous T2 signal, multiloculated cystic masses with septations, +hemorrhage +fluid, compressible, does not displace adjacent structures