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Stroke Imaging & Diagnostics Flashcards

7 cards from real ASC practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

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  1. A patient with acute stroke undergoes MR angiography. Which technique best evaluates collateral blood flow without contrast injection?

    Answer: Time-of-flight (TOF) MRA

    TOF MRA relies on flow-related enhancement without contrast, making it ideal for assessing vessel patency and collateral flow when contrast is contraindicated.

  2. Which finding on susceptibility-weighted imaging (SWI) is characteristic of cerebral microangiopathy and increases hemorrhagic transformation risk after thrombolysis?

    Answer: Cerebral microbleeds (CMBs) appearing as small hypointense foci

    Cerebral microbleeds appear as small hypointense foci on SWI due to hemosiderin deposits and signal an increased risk of hemorrhagic transformation after tPA.

  3. In a posterior circulation stroke, which imaging modality is most limited due to bone artifact and should be supplemented?

    Answer: Non-contrast CT

    Non-contrast CT has significant limitations in the posterior fossa due to bone artifact, making MRI DWI the preferred modality for detecting posterior circulation ischemia.

  4. When interpreting an ASPECTS (Alberta Stroke Program Early CT Score), a score of 7 out of 10 means that how many regions show early ischemic changes?

    Answer: 3 regions

    ASPECTS starts at 10 points and subtracts 1 point for each affected region; a score of 7 means 3 out of 10 MCA territory regions show early ischemic changes.

  5. Which vessel imaging finding best predicts poor collateral circulation and worse clinical outcome in proximal MCA occlusion?

    Answer: Absent pial collateral filling on CTA or DSA

    Absent or poor pial collateral filling on CTA or DSA correlates with rapid core expansion and is a strong predictor of poor outcome in proximal MCA occlusion.

  6. What does the 'DWI-FLAIR mismatch' pattern suggest about stroke onset timing?

    Answer: Stroke is likely within 4.5 hours of onset (wake-up or unknown onset)

    DWI-FLAIR mismatch (DWI positive, FLAIR negative) indicates the stroke is likely within 4.5 hours, as FLAIR changes typically lag behind DWI by several hours.

  7. A carotid ultrasound shows a 75% stenosis by NASCET criteria. Which measurement method defines this calculation?

    Answer: Residual lumen diameter divided by the distal normal ICA diameter

    The NASCET method calculates stenosis as (1 - residual lumen / distal normal ICA lumen) × 100%, comparing the narrowest point to the normal vessel distal to the stenosis.