ASC Stroke Imaging & Diagnostics 3

Question 1

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

Accepted Answer

Time-of-flight (TOF) MRA

Answer

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

Question 2

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

Accepted Answer

Cerebral microbleeds (CMBs) appearing as small hypointense foci

Answer

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

Question 3

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

Accepted Answer

Non-contrast CT

Answer

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.

Question 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?

Accepted Answer

3 regions

Answer

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.

Question 5

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

Accepted Answer

Absent pial collateral filling on CTA or DSA

Answer

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.

(ASC) Advanced Stroke Coordinator Certification Practice Test

(ASC) Advanced Stroke Coordinator Certification Practice Test

ASC Stroke Imaging & Diagnostics 3