UTC Ultrasound Technologist Diagnostic Imaging & Interpretation 2 — Questions and Answers
Question 1: Which Doppler waveform pattern is characteristic of a high-resistance peripheral artery in a normal resting adult?
- Monophasic continuous flow
- Triphasic with reverse flow component (Correct answer)
- Biphasic without reverse flow
- Continuous low-resistance flow
Correct answer: Triphasic with reverse flow component
Normal peripheral arteries (e.g., femoral) show triphasic waveforms with a brief reverse flow component in diastole due to high downstream resistance.
Question 2: On a B-mode ultrasound image, a gallstone is typically identified by which combination of findings?
- Hyperechoic focus with posterior acoustic enhancement
- Hypoechoic mass with posterior shadowing
- Echogenic focus with posterior acoustic shadowing and mobility (Correct answer)
- Anechoic structure with thin walls
Correct answer: Echogenic focus with posterior acoustic shadowing and mobility
Gallstones appear as echogenic (bright) foci that cast a clean posterior acoustic shadow and move with patient repositioning.
Question 3: When scanning a patient with suspected deep vein thrombosis (DVT), the PRIMARY compression ultrasound criterion for acute thrombus is:
- Absence of color flow on Doppler
- Non-compressibility of the vein lumen (Correct answer)
- Echogenic material visualized within the vessel
- Loss of respiratory phasicity
Correct answer: Non-compressibility of the vein lumen
Non-compressibility of the vein under transducer pressure is the gold-standard sonographic criterion for DVT diagnosis.
Question 4: A hypoechoic solid renal mass with internal vascularity on color Doppler should prompt the sonographer to:
- Document as a simple cyst and end the exam
- Note the finding and recommend CT or MRI correlation (Correct answer)
- Apply harmonic imaging only and dismiss the finding
- Diagnose renal cell carcinoma without additional imaging
Correct answer: Note the finding and recommend CT or MRI correlation
A solid vascular renal mass is indeterminate on ultrasound alone, requiring CT or MRI for characterization and staging.
Question 5: Which artifact causes a bright echogenic line at the same depth as the transducer face, obscuring near-field structures?
- Side lobe artifact
- Reverberation artifact (Correct answer)
- Refraction artifact
- Mirror image artifact
Correct answer: Reverberation artifact
Reverberation artifacts occur when sound bounces repeatedly between the transducer and a reflective surface, creating equally spaced echogenic lines.
Question 6: On fetal ultrasound at 20 weeks, the cisterna magna is measured in the posterior fossa. A measurement greater than 10 mm suggests:
- Normal variant
- Dandy-Walker malformation or mega cisterna magna (Correct answer)
- Vein of Galen malformation
- Hydranencephaly
Correct answer: Dandy-Walker malformation or mega cisterna magna
A cisterna magna >10 mm raises concern for Dandy-Walker malformation, Dandy-Walker variant, or mega cisterna magna, requiring further evaluation.
Question 7: The resistive index (RI) is calculated using which formula?
- (Peak systolic velocity − End diastolic velocity) / Peak systolic velocity (Correct answer)
- End diastolic velocity / Peak systolic velocity
- Peak systolic velocity / End diastolic velocity
- (Peak systolic velocity + End diastolic velocity) / 2
Correct answer: (Peak systolic velocity − End diastolic velocity) / Peak systolic velocity
RI = (PSV − EDV) / PSV and reflects downstream resistance; values above 0.70 in renal arteries suggest elevated resistance.
UTC Ultrasound Technologist Diagnostic Imaging & Interpretation 2
Which Doppler waveform pattern is characteristic of a high-resistance peripheral artery in a normal resting adult?