FRCR FRCR Image Interpretation and Anatomy 1 — Questions and Answers
Question 1: On a chest radiograph, which structure forms the right heart border?
- Right atrium (Correct answer)
- Right ventricle
- Superior vena cava only
- Ascending aorta
Correct answer: Right atrium
The right heart border on a PA chest radiograph is formed by the right atrium (lower portion) and the superior vena cava (upper portion).
Question 2: Which radiological sign indicates collapse of the right middle lobe on a PA chest radiograph?
- Obscured right heart border with a triangular opacity (Correct answer)
- Elevated right hemidiaphragm with tracheal deviation
- Opacification of the right costophrenic angle
- Widening of the right paratracheal stripe
Correct answer: Obscured right heart border with a triangular opacity
Right middle lobe collapse produces a triangular opacity in the right lower zone with loss of the right heart border (silhouette sign), because the collapsed lobe is adjacent to the heart.
Question 3: On an abdominal CT, which structure lies immediately anterior to the abdominal aorta at the level of L1?
- Body of the pancreas (Correct answer)
- Third part of the duodenum
- Left renal vein
- Superior mesenteric artery origin
Correct answer: Body of the pancreas
At the L1 level, the body and tail of the pancreas lie anterior to the aorta, with the splenic vein running along the posterior surface of the pancreas.
Question 4: What is the 'Golden S sign' on chest radiograph and what does it indicate?
- S-shaped border of collapsed right upper lobe indicating a central mass (Correct answer)
- S-shaped curve of the trachea suggesting mediastinal shift
- Sigmoidal deformity of the right hilum in pulmonary hypertension
- Curved opacity at the right base indicating pleural effusion
Correct answer: S-shaped border of collapsed right upper lobe indicating a central mass
The Golden S sign is an S-shaped curved border seen with right upper lobe collapse, caused by the juxtaposition of the concave minor fissure and a convex central mass (usually a tumor) at the hilum.
Question 5: On brain MRI, which sequence is most sensitive for detecting acute ischemic stroke within the first few hours?
- Diffusion-weighted imaging (DWI) (Correct answer)
- T2-weighted FLAIR
- T1-weighted post-contrast
- Gradient echo (GRE) sequence
Correct answer: Diffusion-weighted imaging (DWI)
DWI detects restriction of water diffusion in acutely infarcted tissue within minutes of onset, appearing bright on DWI with corresponding dark areas on ADC maps.
Question 6: Which feature on mammography is most suspicious for malignancy?
- Spiculated mass with associated microcalcifications (Correct answer)
- Round well-circumscribed mass with smooth margins
- Benign-appearing calcifications in a cluster
- Oval asymmetric density without calcification
Correct answer: Spiculated mass with associated microcalcifications
A spiculated margin with associated pleomorphic microcalcifications is the most suspicious mammographic finding, with a high positive predictive value for invasive carcinoma.
FRCR FRCR Image Interpretation and Anatomy 1
On a chest radiograph, which structure forms the right heart border?