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148 Cards in this Set

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mri of the head and neck fig B.1

need photo


1. figure b1 was acquired in the


a. axial


b. sagittal


c. coronal


d. off axis oblique

b


sagittal


is an example of


a. t1


b. t2


c. spin (proton) density


d. t2*


e. none of the above


a


T1

this image is likely to be acquired with


a. short TR and short TE


b. short TR and Long TE


c. Long TR and Long TE


d. Long TR and short TE


a


short TR and short TE. were acquired with a spin echo (SE). T1W1 (se images) are acquired with a short TR (approx. 400-800ms for brain imaging) and short TE (approx. 20ms or below)


arrow a is pointing to the


a. CSF


b. subcutaneous fat


c. superior sagittal sinus


d. frontal sinus

c


superior sagittal sinus


the tissue indicated by arrow A is made up primarily of


a. white matter


b. gray matter


c. CSF


d. flowing blood

d


flowing blood


arrow B is pointing to the


a. frontal lobe


b. parietal lobe


c. occipital lobe


d. temporal lobe

b


parietal lobe


the tissue indicated by arrow B is made up primarily of


a. white matter


b. gray matter


c. CSF


d. bone


b


gray matter. generally speaking, the brain is made up of gray and white matter, whereby the gray matter is located on the outer surface of the brain (known as the cortex) and the white matter is located within the brain. The hemispheres are also covered with gray matter. In this midline sagittal image of the brain, the parietal lobe is imaged in the mid sagittal location, and therefore on the "midline, gray matter covering" of the brain tissue. Even thought arrow b appears to point at an area where white matter would be, this is a mid sagittal imaging section and the hemispheres are covered with gray matter.


arrow c is pointing to the


a. parietal lobe


b. frontal lobe


c. internal auditory canal


d. fourth ventricle


b


frontal lobe


arrow d is pointing to the


a. caudate nucleus


b. Genu of the corpus callosum


c. internal capsule


d. pituitary gland


b


Genu of the corpus collosum


the tissue indicated by arrow D is made up primarily of


a. white matter


b. gray matter


c. CSF


d. Bone


a


white matter. The corpus collosum is the only white matter structure to cross the midline. The anterior position is known as the Genu and the posterior position is known as the splenium


arrow E is pointing to the


a. thalamus


b. corpus callosum


c. lentiform nucleus


d. pituitary stalk (infundibulum)


a


thalamus


arrow F is pointing to the


a. pituitary stalk


b. infundibulum


c. optic chiasm


d. optic nerve


c


optic chiasm


arrow G is pointing to the


a. pituitary gland


b. pineal gland


c. thalamus


d. lentiform nucleus


a


pituitary gland


arrow H is pointing to the


a. medulla oblongata


b. pons


c. spinal cord


d. midbrain


b


pons


arrow H is pointing to a structure that is one component of the brainstem. The components that make up the brain stem include the


a. hypothalamus, hyperthalamus, and right and left thalamus


b. caudate nucleus, lentiform nucleus, and thalamus (right and left)


c. pons, medulla, and midbrain (cerebral peduncles)


d. anterior cerebral arteries (right and left), posterior cerebral arteries (right and left), anterior communicating artery, and posterior communicating arteries (right and left)


c


pons, medulla and midbrain (cerebral peduncles)


the components that make up the basal ganglia include the


a. hypothalamus, hyperthalamus and right and left thalamus


b. caudate nucleus, lentiform nucleus, and thalamus (right and left)


c. pons, medulla and midbrain


d. anterior cerebral arteries (right and left), posterior cerebral arteries (right and left), anterior communicating arteries (right and left)


b


caudate nucleus, lentiform nucleus, and thalamus (right and left)


the components that make up the circle of Willis include the


a. hypothalamus, hyperthalamus and right and left thalamus


b. caudate nucleus, lentiform nucleus, and thalamus (right and left(


c. pons, medulla and midbrain


d. Anterior cerebral arteries (right and left), posterior cerebral arteries, anterior communicating artery and posterior communicating arteries


d


anterior cerebral arteries, posterior cerebral arteries, anterior communicating arteries and posterior communicating arteries


the components that make up the diencephalon include the


a. hypothalamus, hyperthalamus and right and left thalamus


b. caudate nucleus, lentiform nucleus and thalamus


c. pons, medulla and midbrain


d. anterior cerebral arteries, posterior cerebral arteries, anterior communicating artery and posterior communicating arteries


a


hypothalamus, hyperthalamus and right and left thalamus


arrow I is pointing to the


a. skull


b. cerebrospinal fluid (CSF)


c. subcutaneous fat


d. meninges


c


subcutaneous fat


arrow J is pointing to the


a. anterior (frontal horn) of the lateral ventricle


b. posterior (occipital) horn of the lateral ventricle


c. third ventricle


d. fourth ventricle


a


anterior (frontal horn) of the lateral ventricle


the tissue indicated by arrow J is made up of primarily


a. white matter


b. gray matter


c. CSF


d. flowing blood


c


CSF


arrow K is pointing to the


a. genu of the corpus collosum


b. body of the corpus collosum


c. splenium of the corpus collosum


d. choroid plexus


c


splenium of the corpus collosum


arrow L is pointing to the


a. anterior horn of the lateral ventricle


b. posterior horn of the lateral ventricle


c. cerebral aqueduct


d. third ventricle


c


cerebral aqueduct


the tissue of indicated by arrow L is made up primarily of


a. white matter


b. gray matter


c. CSF


d. bone


c


CSF


arrow M is pointing to the


a. anterior horn of the lateral ventricle


b. posterior horn of the lateral ventricle


c. third ventricle


d. fourth ventricle


d


fourth ventricle


the tissue indicated by arrow M is made up primarily of


a. white matter


b. gray matter


c. CSF


d. bone


c


CSF


arrow N is pointing to the


a. frontal lobe


b. parietal lobe


c. occipital lobe


d. cerebellar tonsils


d


cerebellar tonsils


arrow O is pointing to the


a. medulla oblongata


b. pons


c. spinal cord


d. midbrain


c


spinal cord


the tissue indicated by arrow O is made up primarily of


a. white matter


b. gray matter


c. CSF


d. bone


b


gray matter. Generally speaking, the spinal cord is made up of gray and white matter, whereby the white matter fibers are located along the outer surface of the cord and the gray matter is within. The cord is essentially "inside-out" when compared to the brain. Since this is a midline section of the brain and spinal cord, the tissues defined by arrow O is within the cord, and therefore gray matter


it is likely that figure b.1 was acquired with a


a. body transmit/receive coil


b. head transmit/receive coil


c. 5 inch round local or surface receive only coil


d. endorectal coil


b


head transmit/receive coil


the best view for the base of the tongue and the epiglottis is the


a. coronal


b. oblique


c. sagittal


d. axial


c


sagittal


To optimize brain imaging when evaluating patients for metastatic disease, an FDA approved contrast agent can be administered


a. with a single dose followed by rapid imaging


b. with a triple dose followed by rapid imaging


c. with single dose and imaging followed by twice the dose again after 30 minutes


d. a and b


c


with single dose and imaging followed by twice the dose again after 30 mins. mets tends to demonstrate delayed enhancement. for this reason, rapid imaging is not used when there is a suspicion of mets. One contrast agent is approved for single dose followed by double dose, giving a triple dose.


The patient with a history of seizures can be imaged using cardiac gating


a. to minimize pulsatile flow motion artifact in the temporal lobes


b. to monitor the patient for potential seizures


c. to avoid talking to the patient throughout the study


d. to make vessels appear black


a


to minimize pulsatile flow motion artifact in the temporal lobes


the best view to evaluate patients with seizures is


a. sagittal


b. axial


c. coronal


d. sagittal oblique


c


coronal


when a patient arrives at the imaging center with a cranial scar, the tech should


a. immediately perform the MRI scan to find out what surgery they underwent


b. screen the patient, their doctor, and/or family to find out what type of surgery they have had


c. ignore the scar


d. cover the head with a sterile drape


b


screen the patient, dr and family

when scanning patients to rule out brain tumors, the weighted images acquired to evaluate the extent of the lesion, after injection of GAD are


a. T1


b. T2


c. proton density


d. T2* gradient echo


a


T1


when imaging a patient with decreased consciousness, an area of high signal intensity is noted on both the T1 and T2 weighted images. the type of lesion is likely to be


a. a mets lesion


b. abscess


c. hemorrhage (methemoglobin)


d. neurofibroma


c


hemorrhage. when imaging a patient with hemorrhagic lesions, the signal intensity of the lesion varies with the "relative age" of the bleed. if imaging is performed immediately after the hemorrhagic lesion has occurred (oxyhemoglobin), the blood is isointense with brain tissue. as time elapses, blood "breaks down" and oxyhemoglogin becomes deoxyhemoglobin. at this point, blood appears bright on T1 and darker on T2. the next phase is the formation of methemoglobin. at this point blood appears bright on both T1 and T2. finally, hemaciderin (essentially iron) forms and this appears dark on T1 and T2, as iron/metal would appear. for these reasons, the RAD can identify the relative age of the hemorrhagic lesion

To best visualize the pituitary gland in MRI, the optimal planes for high resolution T1 weighted images is


a. sagittal and coronal


b. coronal and axial


c. axial and sagittal


d. sagittal, axial and coronal

a sagittal and coronal


for a patient with a suspected pituitary microadenoma, contrast is injected and imaging is performed


a. rapidly because lesions enhance early


b. rapidly because lesions have low signal intensity compared to the enhanced pituitary gland


c. with delayed imaging because lesions enhance slowly and the pituitary gland does not enhance


d. with no specific timing considerations


b


rapidly because lesions have low signal intensity compared to the enhanced pituitary gland


the optimal plane(s) for high resolution T1 weighted images of the internal auditory canal(IAC's) include


1. sagittal


2. axial


3. coronal


4. oblique


a. 1 and 3 only


b. 2 and 3 only


c. 1 and 2 only


d. all of the above


b axial and coronal


to evaluate structures within the body(particulary smaller structures within the head), the optimal imaging plane is the "view" that demonstrates the structure in "profile". The IAC's are positioned bilaterally and run from the pons to the EAM (external auditory meatus). for this reason, the best views include the axial plane and the coronal plane.


when imaging the brain of a child under 1 year of age (since the brain is not fully developed or myelinated), the BEST visualization of gray and white matter differences is demonstrated on ___________________________, whereby white matter is hyperintense to gray matter


a. T1 spin echo


b. T2 spin echo


c. spoiled gradient echo


d. inversion recovery


d


inversion recovery. inversion recovery imaging sequences rely on T1 relaxation. The T1 (inversion time or time to inversion) allows time for T1 recovery to occur in the gray and white matter, while in the presence of the magnetic field. This phenomenon tends to enhance gray/white matter differences more than conventional spin echo T1 weighted images or spoiled gradient echoes. for this reason, IR sequences with T1 times of approximately 600ms (at 1.5T) would be optimal for infant imaging


typically brain protocols consist of


1. sag T1 spin echo


2. axial T2 fast spin echo


3. axial spoiled gradient echo


4. axial FLAIR images or axial PDWI


5. coronal T2 fast spin echo


6. axial diffusion


a. 1, 2 and 3 only


b. 1, 2 and 4 only


c. 1, 2, 4 and 6 only


d. all of the above


c


sag T1, axial T2, axial FLAIR, axial diffusion


figure b.2 was acquired in the


a. axial


b. sag


c. cor


d. off axis oblique


a


axial


figure b.2 is an example of a


a. t1


b. T2


c. spin (proton) density


d. T2*


e. all of the above


c


spin proton density


arrow a is pointing to the


a. corpus callosum


b. caudate nucleus


c. cerebral cortex


d. lateral ventricle


c


cerebral cortex


arrow a is pointing to a structure composed of tissue made up of primarily


a. white matter


b. gray matter


c. CSF


d. muscle

b


gray matter

arrow b is pointing to the


a. Genu of the Corpus Callosum


b. body of the corpus callosum


c. splenium of the corpus callosum


d. lateral ventricle


a


genu of the corpus callosum


the structure indicated by arrow b is composed of tissue made up primarily of


a. white matter


b. gray matter


c. CSF


d. muscle


a


white matter


arrow c is pointing to the


a. caudate nucleus


b. lentiform nucleus


c. internal capsule


d. claustrum


a


caudate nucleus


the structure indicated by arrow C is composed of tissue made primarily of


a. white matter


b. gray matter


c. CSF


d. muscle


b


gray matter


arrow d is pointing to the


a. caudate nucleus


b. lentiform nucleus


c. internal capsule


d. claustrum


c


internal capsule


the structure indicated by arrow d is composed of tissue made up primarily of


a. white matter


b. gray matter


c. CSF


d. muscle


a


white matter


it is likely that figure b.2 was acquired with a


a. short TR and short TE


b. long TR and long TE


c. short TR and long TE


d. long TR and short TE


d


long TR and short TE


arrow E is pointing to the


a. caudate nucleus


b. lentiform nucleus


c. internal capsule


d. claustrum


b


lentiform nucleus


arrow f is pointing to the


a. caudate nucleus


b. lentiform nucleus


c. internal capsule


d. thalamus


d


thalamus


arrow G is pointing to the


a. right, anterior (frontal) horn of the lateral ventricle


b. left, anterior (frontal) horn of the lateral ventricle


c. left, posterior (occipital) horn of the lateral ventricle


d. right, posterior (occipital) horn of the lateral ventricle


d


right, posterior (occipital) horn of the lateral ventricle


arrow H is pointing to the


a. genu of the corpus callosum


b. body of the corpus callosum


c. splenium of the corpus callosum


d. lateral ventricle


c


splenium


on short TR/TE spin echo (or fast spin echo) imaging sequences, white matter appears


a. hyperintense to gray matter


b. hypointense to gray matter


c. hypointense to CSF


d. isointense to gray matter


a


hyperintense to gray matter. depending upon the type of image acquired (T1, T2, PD, and/or FLAIR images), particular structures are brighter than or darker than other structures on the image. for example, when T2 images are acquired, water is hyperintense to fat and brain tissue. On T1, water is hypointense to fat and brain tissue. The white matter sheath consists of interwoven fat and protein; fat is brighter than gray matter on T1. Remember fat is bright on T1


the cranial nerves running through the internal auditory canals are


a. IV and V


b. V and VI


c. VI and VII


d. VII and VIII


e. VIII and IX


d


VIII and IX. There are 12 cranial nerves that are visible on MR images. The seventh (acoustic or vestibulocochlear) and eight (facial) cranial nerves run through the IAC's and are often visible on high resolution MR images. Regarding other cranial nerves commonly evaluated by MR, the second cranial nerve is the optic nerve, the fifth is the trigeminal, and the 10th (vagus nerve) is the largest cranial nerve running from the brain to the diaphragm


the ACR guidelines for brain imaging suggest that the minimum imaging procedure should include a three plane localizer (or scout) image and


1. sagittal T1


2. axial T2


3. axial proton density and/or axial FLAIR


4. axial T1 pre and post gad


5. coronal T1


6. diffusion imaging


a 1,2,3,4 and 5


b. 1,2,4 and 6


c. 1,2,3 and 6


d. all of the above


c


1, 2, 3 and 6.


sag T1, axial T2, axial proton density and/or FLAIR and diffusion imaging


figure b.3. the images were acquired in the


a. axial


b. sagittal


c. coronal


d. oblique off axis


a


axial


typical diffusion images are typically acquires with a B value of


a. 4000 ms


b. 100ms


c. 2200 ms


d. 1000ms


d


1000 ms


arrow a is pointing to the


a. sylvian fissue


b. lateral fissure


c. middle cerebral artery


d. frontal lobe of the brain


d


frontal lobe of the brain


arrow b is pointing to a structure know as ALL of the following except:


a. sylvian fissure


b. lateral fissure


c. middle cerebral artery


d. frontal lobe of the brain


d


frontal lobe of the brain


arrow C is pointing to the


a. frontal horn of the lateral ventricle


b. posterior horn of the lateral ventricle


c. temporal horn of the ventricle


d. third ventricle


e. fourth ventricle


d


third ventricle


arrow d is pointing to the


a. frontal horn of the lateral ventricle


b. posterior horn of the lateral ventricle


c. temporal horn of the ventricle


d. third ventricle


e. fourth ventricle


b


posterior horn of the lateral ventricle


on a typical diffusion image, the high signal indicated by arrow e represents


a. chronic infarct


b. old stroke


c. transient ischemic attack (TIA)


d. early infarct (hyperacute)


d


hyperacute, early infarct


high signal in the right posterior portion of the brain is visualized on the diffusion image but nog the FLAIR image because


a. old stroke has a high fluid content


b. old stroke has unrestricted molecular diffusion


c. new stroke has restricted molecular diffusion


d. new stroke demonstrates T2 shine through

c


new stroke has restricted molecular diffusion. diffusion imaging is performed with the use of echo planar imaging (T2* gradient echo acquisitions) and the application of "diffusion gradients'. Diffusion gradients utilize the application of additional gradient pulses applied along the x, y and z directions. the strength and duration of these diffusion gradient pulses is selected by a user selectable parameter known as the "B" value. Tissues with 'restricted" diffusion (like tissues in a new stroke or hyperacute infarct) appear bright on diffusion weighted imaging. Even though there is intracellular and extracellular fluid associated with stroke, such lesions are not visualized on conventional FLAIR, PD and/or T2


for most brain imaging procedures, the patient is positioned___________and centered for landmark at the ________________


a. prone/acantho-meatal line


b. supine/nasion


c. supine/external auditory meatus


d. none of the above


b


supine and at the nasion


for the evaluation of a patient with "tinnitus" images should be "centered" at the level of the


a. submento-vertex


b. nasion


c. glabella


d. external auditory meatus


d


eam. the terms 'landmark' and 'centering' as used in MRI need to be differentiated. the term landmark is used when the patient is placed into the bore for their imaging procedure. for typical brain imaging, all patients are 'landmarked' at the location of the nasion. This will 'center' the head within isocenter of the bore for head imaging. when a particular pathologic condition or anatomic location is to be imaged, the slices are 'centered' at the location of the pathology or anatomy of interest. b.2 and b.3 the concept of landmark was utilized for 'general head imaging' the concept of 'centering' was used for the evaluation of a patient with 'tinnitus'. for this reason, the slices should be 'centered' to the EAM


for optimal imaging of the thyroid gland, patients are positioned


a. supine, and the head coil is pulled all the way down over the neck


b. supine and local coils are placed on the anterior neck


c. supine and the body coil is used to ensure large FOV


d. prone and local coils are placed on the posterior neck


b


supine and local coils are placed on the anterior neck


figure b.4


this was acquired in the


a. axial


b. sagittal


c. coronal


d. oblique off axis


c


coronal


this is an example of a


a. T1


b. T2


c. spin (proton) density


d. T2*


e. all of the above


b


T2


it was likely acquired with a spin echo or fast spin echo acquisition with a


a. short TR and short TE


b. short TR and long TE


c. long TR and long TE


d. long TR and short TE


c


long TR and long TE


arrow a is pointing to the


a. superior sagittal sinus


b. inferior sagittal sinus


c. straight sinus


d. transverse sinus


a


superior sagittal sinus


arrow b is pointing to the


a. longitudinal fissure


b. sylvian fissure


c. lateral fissure


d. tentorium


a


longitudinal fissure


arrow c is pointing to the


a. genu of the corpus callosum


b. body of the corpus callosum


c. splenium of the corpus callosum


d. lateral ventricle


b


body of the corpus callosum


arrow d is pointing to the


a. right, anterior (frontal) horn of the lateral ventricle


b. left, anterior horn of the lateral ventricle


c. left, posterior horn of the lateral ventricle


d. right, posterior horn of the lateral ventricle


a


right, anterior horn of the lateral ventricle


arrow e is pointing to the


a. longitudinal fissure


b. sylvian fissure


c. lateral fissure


d. b and c


d


sylvian and lateral fissure


arrow f is pointing to the


a. frontal lobe


b. parietal lobe


c. thalamus


d. occipital lobe


c


thalamus


arrow g is pointing to the


a. frontal lobe


b. parietal lobe


c. temporal lobe (hippocampus)


d. occipital lobe

c


temporal lobe...hippocampus


arrow h is pointing to the


a. longitudinal fissure


b. sylvian fissure


c. lateral fissure


d. tentorium


d


tentorium


arrow I is pointing to the


a. right, anterior frontal horn of the lateral ventricle


b. left, anterior frontal horn of the lateral ventricle


c. third ventricle


d. fourth ventricle


d


fourth ventricle


arrow j is pointing to the


a. frontal lobe


b. parietal lobe


c. occipital lobe


d. cerebellum


d


cerebellum


on figure b.4 the CSF appears bright because


a. water has a short T2 relaxation time


b. water has a long T2 relaxation time


c. water has a short T1 relaxation time


d. water has a high proton density


b


water has a long T2 relaxation time


the differences between the images demonstrated in b.5 is the


a. image on the left is a fat suppressed image


b. image on the right is a fat suppressed image


c. image on the left shows gad enhancement


d. image on the right shows gad enhancement


c


image on the left shows gad enhancement


gadolinium contrast media provides images whereby enhancing structures appear __________on T1 weighted images


a. hyperintense


b. hypointense


c. isointense


d. dark


a


hyper brighter than


hypo darker than


iso same intensity as


tissues with short T1 relaxation times (like fat and gad=enhancing structures) appear___________ as compared to normal structures on T1 weighted images


a. hyperintense/brighter than


b. hypointense/darker than


c. isointense/the same signal intensity as


d. dark


a


hyperintense


dynamic susceptibility-weighted imaging (DCWI) is performed for the evaluation of stroke. T2* images are acquired before, during and after the administration of gad, to provide images whereby normal brain appears______________to brain affected by stroke


a. hyperintense


b. hypointense


c. isointense


d. dark


b


hypointense


b.5 was likely to have been acquired with a spin echo or fast spin echo sequence using


a. long TR/long TE


b. long TR/short TE


c. short TR/short TE


d. short TR/long TE


c


short TR/short TE


figure b.5 was acquired in the


a. axial


b. sagittal


c. coronal


d. oblique off axis


a


axial


arrow a is pointing to the


a. anterior horn of the lateral ventricle


b. posterior horn


c. third ventricle


d. fourth ventricle


a


anterior horn of the lateral ventricle


b.5 the tissue indicated by arrow a is made up primarily of


a. white matter


b. gray matter


c. CSF


d. Bone


c


CSF


arrow b is pointing to the


a. septum pellucidum


b. lateral ventricle


c. sylvian fissure


d. lateral fissure


e. c and d


a


septum pellucidum


arrow c is pointing to the


a. septum pellucidum


b. lateral ventricle


c. sylvian fissure


d. lateral fissure


e c and d


e


sylvian fissure/lateral fissure


arrow d is pointing to the


a. right, anterior cerebral arteries


b. left, posterior cerebral arteries


c. left, lacunar branches of the middle cerebral artery


d. right, basilar artery


c


left, lacunar branches of the middle cerebral artery


arrow e is pointing to the


a. right, anterior horn of the lateral ventricle


b. left, posterior horn of the lateral ventricle


c. third ventricle


d. fourth ventricle


c


third ventricle

arrow f is pointing to the


a. septum pellucidum


b. falx cerebri


c. falx cerebelli


d. choroid plexus


b


falx cerebri


arrow g is pointing to the


a. superior sagittal sinus


b. inferior sagittal sinus


c. transverse sinus


d. sigmoid sinus


a


superior sagittal sinus


arrow H is pointing to the


a. frontal lobe


b. parietal lobe


c. temporal lobe


d. occipital lobe


d


occipital lobe


the mr images in figure b.6a are displayed without and with contrast media. the images are T1 without and with contrast. The lesion on the enhanced image appears bright because gadolinium


a. shortens the T1 relaxation time


b. increases (lengthens) the T1 relaxation time


c. shortens the T2 relaxation time


d. increases the T2 relaxation time


a


shortens the T1 relaxation time. because GAD is paramagnetic it shortens the T1 relaxation time.


the series of nine T2* images B.6b, are EPI gradient echo sequence acquired before(upper left), during and after the administration of contrast(bottom right). The brain tissue on the enhanced image appears darker because gadolinium


a. shortens the T1 relaxation time


b. increases the T1 relaxation time


c. shortens the T2 and T2* relaxation times


d. increases the T2 and T2* relaxation times


c


shortens the T2 and T2* relaxation times


the decreased myelination found in brains of children under 1 year old results in a lack of image contrast. consequently, in comparison to scanning adults, to achieve T2 weighted images during pediatric brain imaging often requires a


a. longer TE


b. longer TR


c. longer T1


d. higher flip angle


a


longer TE


when performing an MRA of the cerebral arteries, a saturation band should be placed____________to axial slices


a. anterior


b. posterior


c. superior


d. inferior


d


inferior


b.7 is projected in the


a. axial imaging plane


b. sagittal imaging plane


c. coronal imaging plane


d. off axia oblique imaging plane


a


axial


acquired by magnetic resonance angiography (MRA), b.7 is an example of a


a. reformatted image


b. segmented image


c. collapsed image


d. contrast enhanced image


c


collapsed image


arrow a is pointing to the


a. right anterior cerebral artery


b. left anterior cerebral artery


c. right middle cerebral artery


d. left middle cerebral artery


a


right anterior cerebral artery


arrow b is pointing to the


a. right anterior cerebral artery


b . left anterior cerebral artery


c. right middle cerebral artery


d. left middle cerebral artery


a


right middle cerebral artery


arrow c is pointing to the


a. right anterior cerebral artery


b. left anterior cerebral artery


c. right middle cerebral artery


d. left middle cerebral artery

c


right middle cerebral artery


arrow d is pointing to the


a. posterior communicating artery


b. middle cerebral artery


c. vertebral basilar artery


d. anterior cerebral artery


e. anterior communicating artery


e


anterior communicating artery


arrow e is pointing to the


a. posterior communicating artery


b. middle cerebral artery


c. vertebral basilar artery


d. anterior cerebral artery


e. anterior communicating artery


a


posterior communicating artery


arrow f is pointing to the


a. right anterior cerebral artery


b. left anterior cerebral artery


c. right posterior cerebral artery


d. left posterior cerebral artery


c


right posterior cerebral artery


arrow g is pointing to the


a. right anterior cerebral artery


b. left anterior cerebral artery


c. right posterior cerebral artery


d. left posterior cerebral artery


d


left posterior cerebral artery


when using MRA to evaluate intracranial vascularity, flow within smaller (high velocity blood flow) can best be demonstrated by


a. 2D time of flight MRA


b. 3D time of flight MRA


c. 3D phase contrast MRA


d. a and b


b


3D time of flight MRA. the high flow velocity in the brain requires 3D MRA techniques. 3D time of flight is better for small vascular structures with high flow velocities, especially when used with magnetization transfer techniques


when using MRA to evaluate extracranial vascular flow, such as that within the carotid arteries, a recommended technique is


a. 2D time of flight


b. 3D time of flight


c. 3D phase contrast


d. a and b


a


2D time of flight. with the slower peripheral flow in the neck, 2D techniques are recommended so that blood flow is not suppressed along with stationary tissues


when using MRA to evaluate peripheral vascular flow, such as that within the arteries of the legs, saturation pulses are


a. placed superior to the acquired slices


b. placed in the acquired slices


c. placed inferior to the acquired slices


d. not necessary


c


placed inferior to the acquired slices to suppress the signal from venous blood (flowing up from the feet) and allow better visualization of arterial blood (flowing down from the heart)


the cranial nerve associated with the optic nerve is the


a. first cranial nerve


b. second cranial nerve


c. third cranial nerve


d. vagus nerve


b second cranial nerve.


1. on olfactory


2. old optic


3. Olympus occulomotor


4. towering trochlear


5. tops trigeminal


6. a Abducens


7. fin facial


8. and Acoustic/vestibulocochlear


9. german Glossopharyngeal


10. viewed Vagus


11. a accessory


12. hopps hypoglossal


the standard dose for gadolinium contrast media for imaging of the central nervous system is


a. 1.0 mL/kg or cc/kg


b. 10 ml/kg


c. 1 mmol/kg


d. 0.1 mL/mmol cc/mmol


d


0.1 mL/mmol = 10cc for a 100lb patient


=1cc/lb


the MRA technique that is typically used for the evaluation of venous structures of the head is


a. 2D TOF


b. 3D TOF


c. contrast enhanced MRA


d. PC MRA


d


PC MRA


figure b.8 arrow a is pointing to the


a. right transverse sinus


b. left transverse sinus


c. superior sagittal sinus


d. inferior sagittal sinus


c


superior sagittal sinus


arrow b is pointing to the


a. right transverse sinus


b. left transverse sinus


c. superior sagittal sinus


d. inferior sagittal sinus


c


superior sagittal sinus


arrow c is pointing to the


a. right transverse sinus


b. left transverse sinus


c. superior sagittal sinus


d. inferior sagittal sinus


b


left transverse sinus


arrow d is pointing to the


a. right transverse sinus


b. left transverse sinus


c. superior sagittal sinus


d. inferior sagittal sinus


a


right transverse sinus


arrow e is pointing to the


a. transverse sinus


b. superior sagittal sinus


c. confluence of sinuses


d. sigmoid sinus


e. internal jugular vein


c


confluence of sinuses


arrow f is pointing to the


a. transverse sinus


b. superior sagittal sinus


c. confluence of sinuses


d. sigmoid sinus


e. internal jugular vein


d


sigmoid sinus


arrow G is pointing to the


a. transverse sinus


b. superior sagittal sinus


c. confluence of sinuses


d. sigmoid sinus


e. internal jugular vein


e


internal jugular vein

b.9 arrow a is pointing to the


a. internal carotid artery


b. external carotid artery


c. vertebral artery


d. subclavian artery


a


internal carotid artery


arrow b is pointing to the


a. internal carotid artery


b. external carotid artery


c. vertebral artery


d. subclavian artery


a


internal carotid artery


arrow c is pointing to the


a. internal carotid


b. external carotid


c. vertebral artery


d. subclavian artery


a


internal carotid artery


arrow d is pointing to the


a. internal


b. external


c. vertebral


d. subclavian


b


external carotid artery


arrow e is pointing to the


a. internal


b. external


c. vertebral


d. subclavian


c


vertebral


arrow f is pointing to the


a. internal


b. external


c. common carotid


d. subclavian


c


common carotid


arrow g is pointing to the


a. internal


b. external


c. vertebral


d. subclavian


d


subclavian


the 3D contrast enhanced MRA images of the neck vasculature shown in b.9 is acquired in the


a. sagittal


b. axial


c. coronal


d. oblique


c


coronal


on the coronal display of the neck vasculature, the vertebral arteries are located


a. medial to the carotid arteries


b. superior to the carotids


c. lateral to the carotids


d. inferior to the carotids


a


medial to the carotids.

ABC's for the great vessels


A. blood flows through the Ascending aorta


B. the first vessel that arises at the arch is known as the Brachiocephalic artery, this vessel provides blood supply to the right arm (brachio) by way of the right subclavian artery; and to the head (cephalic) by way of the right common carotid artery and vertebral artery. the common carotid arteries bifurcate into the internal carotid artery (supplies blood to the frontal, temporal, and parietal lobes of the brain) and external (supplies blood to the structures external to the brain such as the neck, face, and scalp). the right vertebral artery supplies blood to the posterior aspect of the head (occipital lobe and cerebellum)


C. the second vessel that originates on the aortic arch is the left Common carotid artery. This bifurcates into the internal carotid artery (blood to the frontal, temporal and parietal lobes of the brain) and external carotid artery (blood to structures "external" to the brain, such as the neck, face and scalp)


S. the third vessel that originates on the aortic arch is the left Subclavian artery. the left vertebral artery supplies blood to the posterior aspect of the head (occipital and cerebellum)


for optimal imaging of the thyroid gland, patients are positioned


a. supine and the head coil is pulled all the way down over the neck


b. supine and local coils are placed on the anterior neck


c. supine and the body coil is used to ensure a large FOV


d. Prone and local coils are placed on the posterior neck


b


supine and local coils are placed on the anterior neck


contrast media are utilized in CNS imaging for the evaluation of


a. infection


b. infarction


c. inflammation


d. neoplasm


e. all of the above


e


all of the above

for stroke


axial imaging plane


center for entire brain


image contrast: diffusion imaging, perfusion imaging, MRA of the COW, MRA of the carotids

vascular lesions of the head such as aneurysm


axial imaging plane


3D TOF (for smaller vessels) like intracranial vessels, COW

vascular lesions of the neck such as stenosis


axial imaging plane


2D TOF (for long areas of coverage), like extracranial vessels carotid arteries of the neck

vascular lesions of the head such as sagittal sinus thrombosis


axial imaging plane


PCMRA (for flow direction and flow velocity)

seizures


coronal imaging plane


centering, landmark hippocampus (temporal lobes)


image contrast: T2 and FLAIR

sensory neural hearing loss


coronal and axial imaging planes


center for IAC's


T2, T1 pre and post contrast

pituitary adenoma


sagittal and coronal imaging planes


center for sella turcica


T2, T1 pre and post

Arnold-chiari malformation


sagittal


entire brain


craniocervical junction (brain+spinal cord for syrinx), hi resolution imaging T1 pre and post contrast

infection, infarction, inflammation, neoplasm (tumor)


all planes


entire brain


T1 pre and post