Neuroradiolgy Quiz for Medical Students

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Neuroradiolgy Quiz for Medical Students

• Dr. Thanh Binh Nguyen
• September 2009

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• Some of the pictures are from the PBL sessions in
  the neuroscience block.
• Go through the cases on your own and write it on
  a piece of paper.
• The answers will be at the end.

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Case 1a) Describe the findingsb) What is the
most likely diagnosis?
Axial T2-weighted images
Axial T1-weighted images
Sagittal proton dense images
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T2-weighted images
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Sag T1-weighted images
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Case 2 a) Identify the anatomical structures.
Artère vertébrale
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2
3
4
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Case 2 b)
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7
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9
10
5
4
3
2
1
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Case 3a) what is the finding?b) what is the
differential diagnosis?
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Case 4a) Describe the findingb) Give a list of
3 diseases which can present as such.
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Case 5 a) what is the finding? b)
Give 2 diagnoses which can present as such
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Case 6 Give the diagnosis in a) and b)
b)
a)
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ANSWERS
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Case 1a) Describe the findingsb) What is the
most likely diagnosis?
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• Axial T2 MR images show multiple hyperintense T2
  lesions in the periventricular white matter (long
  arrow) and in the corpus callosum (short arrow)
• Most likely dx is multiple sclerosis.

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Case 2 a) Identify the anatomical structures.
Artère vertébrale
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2
3
4
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• Ventral ramus (sensory)
• Vertebral artery
• Lamina
• Neural foramen

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Case 2 b)
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9
10
5
4
3
2
1
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• Pons
• Basilar artery
• Mammillary body
• Pituitary gland
• Optic chiasm
• Cingulate gyrus
• Corpus callosum
• Fornix
• Thalamus (massa intermedia)
• Aqueduct of Sylvius

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Case 3a) what is the finding?b) what is the
differential diagnosis?
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• Hyperintense T2 lesion in the right temporal lobe
• The differential diagnosis would include an
  infarct, neoplasm (glioma) and herpes
  encephalitis. In patient with suspected herpes
  encephalitis, an urgent MR is indicated (after
  the patient has been placed on intravenous
  antiviral therapy)

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Case 4a) Describe the findingb) Give a list of
3 diseases which can present as such.
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• There is a left frontoparietal hemorrhage
• Common causes of intraparenchymal hemorrhage
  include vascular malformations (arteriovenous
  malformations, cavernomas), neoplasms, amyloid
  angiopathy.

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Case 5 a) what is the finding? b)
Give 2 diagnoses which can present as such
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• There is subarachnoid hemorrhage in the basal
  cisterns.
• The two most common causes of SAH are ruptured
  aneurysm and trauma.

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Case 6 Give the diagnosis in a) and b)
b)
a)
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• On picture a) there is a right crescentic
  hyperdense collection in keeping with an acute
  subdural hematoma. It is causing subfalcine
  herniaton
• On picture b) there is a lentiform collection in
  the left frontal lobe in keeping with an epidural
  hematoma. There is hemorrhagic contusion also in
  the left parietal lobe.