UTC Ultrasound Technologist Diagnostic Imaging & Interpretation 3 — Questions and Answers
Question 1: Which hepatic lesion appears as a hyperechoic homogeneous mass with peripheral nodular enhancement on contrast-enhanced ultrasound (CEUS)?
- Hepatocellular carcinoma
- Metastatic lesion
- Cavernous hemangioma (Correct answer)
- Focal nodular hyperplasia
Correct answer: Cavernous hemangioma
Cavernous hemangiomas classically show peripheral nodular enhancement filling in centripetally on CEUS, corresponding to their vascular lake structure.
Question 2: During a thyroid ultrasound, a nodule with microcalcifications, irregular margins, and taller-than-wide orientation is assigned which ACR TI-RADS category?
- TR1 (benign)
- TR3 (mildly suspicious)
- TR5 (highly suspicious) (Correct answer)
- TR2 (not suspicious)
Correct answer: TR5 (highly suspicious)
Microcalcifications, irregular margins, and taller-than-wide shape each carry high suspicion points; their combination typically scores TR5 under ACR TI-RADS.
Question 3: Color Doppler aliasing occurs when:
- The gain is set too high
- The Doppler angle exceeds 60 degrees
- The Nyquist limit is exceeded by the sampled velocity (Correct answer)
- The focal zone is placed incorrectly
Correct answer: The Nyquist limit is exceeded by the sampled velocity
Aliasing results when blood flow velocity exceeds the Nyquist limit (half the pulse repetition frequency), causing color wrap-around.
Question 4: An adnexal mass with thin septations (<3 mm), no solid components, and no internal vascularity in a premenopausal woman is best classified as:
- Complex cyst requiring immediate surgical referral
- Simple cyst with no follow-up needed
- Minimally complex cyst (IOTA simple rules benign) (Correct answer)
- Indeterminate mass requiring MRI
Correct answer: Minimally complex cyst (IOTA simple rules benign)
Under IOTA simple rules, a cyst with thin septa and no solid areas or Doppler flow is classified as likely benign with conservative follow-up recommended.
Question 5: Which sonographic finding in the neonatal brain, best seen through the anterior fontanelle, indicates germinal matrix hemorrhage Grade III?
- Echogenic focus in the caudothalamic groove only
- Intraventricular hemorrhage with ventricular dilatation (Correct answer)
- Periventricular leukomalacia (PVL)
- Choroid plexus cyst
Correct answer: Intraventricular hemorrhage with ventricular dilatation
Grade III germinal matrix hemorrhage is characterized by intraventricular hemorrhage with associated ventricular dilatation.
Question 6: When performing a musculoskeletal ultrasound of the rotator cuff, which finding is most consistent with a full-thickness supraspinatus tear?
- Diffuse tendon thickening with heterogeneous echotexture
- Focal non-visualization of tendon fibers with fluid filling the defect (Correct answer)
- Calcific deposit with posterior shadowing
- Bursal effusion without tendon discontinuity
Correct answer: Focal non-visualization of tendon fibers with fluid filling the defect
A full-thickness tear shows complete fiber discontinuity with anechoic or echogenic fluid replacing the tendon at the tear site.
Question 7: On a testicular ultrasound, a small avascular hypoechoic nodule adjacent to the testis, within the tunica vaginalis, is most likely:
- Testicular torsion
- Epididymo-orchitis
- Scrotal pearl (fibrous body) (Correct answer)
- Testicular microlithiasis
Correct answer: Scrotal pearl (fibrous body)
A scrotal pearl (fibrous body or loose body) is an avascular, calcified or fibrous nodule floating free within the tunica vaginalis.
UTC Ultrasound Technologist Diagnostic Imaging & Interpretation 3
Which hepatic lesion appears as a hyperechoic homogeneous mass with peripheral nodular enhancement on contrast-enhanced ultrasound (CEUS)?