FRCR FRCR Neuroradiology 2

Question 1

What is the imaging modality of choice for evaluating a suspected pituitary adenoma?

Accepted Answer

MRI of the pituitary with gadolinium

Answer

Gadolinium-enhanced MRI provides superior soft tissue resolution of the pituitary gland and its relationship to the optic chiasm and cavernous sinuses.

Question 2

Which finding on MRI best differentiates a posterior fossa epidermoid cyst from an arachnoid cyst?

Accepted Answer

Restricted diffusion on diffusion-weighted imaging

Answer

Epidermoid cysts show characteristic restricted diffusion due to their densely packed lamellar keratin content, whereas arachnoid cysts follow CSF signal on all sequences including DWI.

Question 3

What is the most common location of cavernous malformations (cavernomas) in the brain?

Accepted Answer

Cerebral hemispheres (supratentorial)

Answer

Approximately 75–80% of cavernomas are supratentorial, reflecting the larger volume of cerebral hemispheric tissue.

Question 4

Which MRI finding is pathognomonic of a cerebral cavernous malformation (cavernoma)?

Accepted Answer

Mixed-signal 'popcorn' lesion with complete hemosiderin rim on T2* GRE or SWI

Answer

The 'popcorn' appearance with a complete low-signal hemosiderin rim on T2*-weighted sequences reflects blood products of varying ages within the malformation.

Question 5

In which condition are T1 hypointense 'black holes' on MRI a recognized finding that correlates with permanent neurological disability?

Accepted Answer

Multiple sclerosis

Answer

Chronic T1 'black holes' in MS represent areas of severe, irreversible axonal loss and correlate with the degree of permanent disability.

FRCR - Fellow of the Royal College of Radiologists Practice Test

FRCR - Fellow of the Royal College of Radiologists Practice Test

FRCR FRCR Neuroradiology 2