Imaging SBAs Unit 6

Question 1

Child, Cerebellar mass, extending into cerebellopontine angle. Intense enhancement and diffusion restriction with surrounding oedema

Answer 1

Atypical teratoid/rhabdoid

Question 2

Primary CNS Lymphoma vs Toxoplasmosis

Answer 2

CNS:
Usually single lesion,
Subependymal spread,
Solid enhancement pattern
Toxoplasmosis:
Multiple lesions
Usually basal ganglia
Ring enhancement

Question 3

Most posterosuperior ethmoid air cell, separated from optic nerve and ICA by very thin bone

Answer 3

Onodi cell

Question 4

Most anterior ethmoidal air cell

Answer 4

Agger Nasi cell

Question 5

Enhancing mass at base of tongue in midline

Answer 5

Lingual thyroid

Question 6

Definitive Ix for herpes encephalitis

Answer 6

Lumbar puncture

Question 7

Carotid body tumour MRI

Answer 7

Iso T1, High T2, multiple flow voids

Question 8

Causes of high T1 in basal ganlgia

Answer 8

Calcification,
Haemorrhage, Wilsons, Long term TPN,
Chronic liver disease,
NF1 hamartomas

Question 9

MIR signs of malignant transformation of pleomorphic adenoma

Answer 9

Heterogenous signal,
Irregular margins,
Lymphadenopathy,
adjacent soft tissue or bone spread,
Facial perineural spread

Question 10

Pleomorphic adenoma MRI

Answer 10

Low T1, High T2.

Question 11

Causes of visual field defects

Answer 11

Temporal lobe = contralateral superior quadrantinopia
Visual cortex = contralateral homonymous hemianopia
Occipital lobe = homonomous hemianopia with macula sparing
Optic chiasm = bitemporal hemianopia
Optic nerve = ipsilateral anopsia

Question 12

Renal impairment, hypertension, intracranial aneurysm

Answer 12

ADPKD

Question 13

Acute carbon monoxide poisoning MRI

Answer 13

High T2 signal in basal ganglia and globus pallidus with diffusion restriction

Question 14

Multiple rounded cystic intracranial lesions, surrounding oedema, immunosuppressed.

Answer 14

Toxoplasmosis

Question 15

Von-Hippel-Lindau associations

Answer 15

Cerebellar haemangioblastoma,
Spinal cord haemangioblastoma,
Retinal Haemangioblastoma,
Pancreatic cysts,
Renal cysts,
RCC,

Question 16

Causes of basal ganglia calcification

Answer 16

Toxic (CO, Pb, radiation, chemo),
Infection (Torch),
Metabolic (hypothyroid, hypoparathyroid, pseudohypooparathyroid, hyperparathyroid)

Question 17

Laryngoceles are associated with

Answer 17

Laryngeal Cancer

Question 18

Intermittent cyanosis on crying in neonate (Dx and Ix)

Answer 18

Bilateral choanal atresia,
CT nasal passage

Question 19

Swelling and high signal in hippocampi and amygdala.
Poor memory, hyponatraemia, seizures

Answer 19

Limbic encephalitis, often paraneoplastic

Question 20

Sturge Weber caused by

Answer 20

Cortical venous angioma with gradual calcification

Question 21

Heterogenous cystic mass with solid enhancing components and calcification - Suprasellar

Answer 21

craniopharyngioma

Question 22

NF1 diagnostic criteria

Answer 22

2 or more of the following:
6 cafe-au-lait spots during 1 year.
2 or more neurofibromas or one plexiform neurofibroma
optic nerve glioma
distinctive osseous lesion
sphenoid wing dysplasia
2 or more Lisch nodules
Axillary or inguinal freckling
Primary relative wit NF1

Question 23

Risk factors for future haemorrage in brain AVM

Answer 23

Intranidal aneurysms,
Venous ectasia,
Posterior fossa location,
Previous haemorrhage

Question 24

Epidermoid cyst vs arachnoid cyst

Answer 24

Epidermoid demonstrate diffusion restriction

Question 25

Base of infundibulum lesion, isointense to brain on all images

Answer 25

Hypothalamic hamartoma/Tuber cinereum hamartoma

Question 26

Cortical lesion, central high intensity on T1/T2 with low T2 rim

Answer 26

Cavernoma

Question 27

Normal cranial suture width for 2YO

Answer 27

<1mm

Question 28

Metabolic storage disease associated with

Answer 28

Macrocephaly

Question 29

J shaped sella

Answer 29

Flattened tuberculum sellae, caused by: Normal variant, Optic chiasm glioma, NF, Achondroplasia, Mucopolysaccharidoses, Chronic hydrocephalus

Question 30

Orbital pseudotumour

Answer 30

Low T1 and T2 signal in occular muscle, sparing tendons

Question 31

Floating teeth causes

Answer 31

No obvious supporting bone for teeth. Seen in: Severe peridontal disease, LCH, Hyperparathyroidism, Mets & myeloma

Question 32

Frontal sinuses mucosal disease caused by obstruction at

Answer 32

Anterior hiatus semilunaris

Question 33

Contents of jugular foramen

Answer 33

Pars nervosa: Inferior petrosal sinus, Glossopharyngeal nerve (CN 9) Pars Vascularis: Jugular bulb, Vagus nerve (CN 10) Spinal accessory nerve (CN 11)