Neuroradiolgy Quiz
for Medical Students
Dr. Thanh Binh Nguyen
September 2009
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.
Case 1
a) Describe the findings
b) What is the most likely diagnosis?
Axial T2-weighted images
Axial T1-weighted images Sagittal proton dense images
T2-weighted images
Sag T1-weighted images
Case 2 a) Identify the anatomical
structures.
1
Artère vertébrale
2
3
4
Case 2 b)
6
7
8
9
10
5
4
3
2
1
Case 3
a) what is the finding?
b) what is the differential diagnosis?
Case 4
a) Describe the finding
b) Give a list of 3 diseases which can
present as such.
Case 5 a) what is the finding?
b) Give 2 diagnoses which
can present as such
Case 6
Give the diagnosis in a) and b)
a)
b)
ANSWERS
Case 1
a) Describe the findings
b) What is the most likely diagnosis?


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.
Case 2 a) Identify the anatomical
structures.
1
Artère vertébrale
2
3
4
1.
2.
3.
4.
Ventral ramus (sensory)
Vertebral artery
Lamina
Neural foramen
Case 2 b)
6
7
8
9
10
5
4
3
2
1
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
Pons
Basilar artery
Mammillary body
Pituitary gland
Optic chiasm
Cingulate gyrus
Corpus callosum
Fornix
Thalamus (massa intermedia)
Aqueduct of Sylvius
Case 3
a) what is the finding?
b) what is the differential diagnosis?


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)
Case 4
a) Describe the finding
b) Give a list of 3 diseases which can
present as such.


There is a left frontoparietal hemorrhage
Common causes of intraparenchymal
hemorrhage include vascular malformations
(arteriovenous malformations, cavernomas),
neoplasms, amyloid angiopathy.
Case 5 a) what is the finding?
b) Give 2 diagnoses which
can present as such


There is subarachnoid hemorrhage in the basal
cisterns.
The two most common causes of SAH are
ruptured aneurysm and trauma.
Case 6
Give the diagnosis in a) and b)
a)
b)


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.