Question 1

Match each of the following radiographic appearances with the corresponding pathologic indication.(Use each selection only once.)
-Enlarged sella turcica

Accepted Answer

An enlarged sella turcica is often associated with pituitary adenomas.

Question 2

Which of the following structures passes through the superior orbital fissure?

Accepted Answer

Cranial nerves III to VI (oculomotor, trochlear, abducens and opthalmic branch of trigeminal nerve) all pass through the superior orbital fissure.

Question 3

A radiograph of a parietoacanthial (Waters) projection for sinuses reveals that the petrous pyramids are projected over the maxillary sinuses.What positioning error is present on this radiograph?

Accepted Answer

Excessive flexion of the head and neck during a parietoacanthial (Waters) projection for sinuses causes the petrous pyramids to project over the maxillary sinuses, indicating the positioning error.

Question 4

Select the imaging modality that would best demonstrate the following pathologies.
-Recent bleeding within the brain

Accepted Answer

CT is the best imaging modality to demonstrate recent bleeding within the brain because CT scans are more sensitive to acute bleeds and can rapidly identify active hemorrhage. MRI may also demonstrate acute bleeds, but it may not be as readily available as a CT scan in emergency situations. Nuclear medicine, ultrasound, and conventional radiography are not typically used for detecting acute bleeds within the brain.

Question 5

The pathway of communication between the frontal, maxillary, and ethmoid sinuses that provides drainage between them is termed:

Accepted Answer

The osteomeatal complex is the pathway of communication between the frontal, maxillary, and ethmoid sinuses that provides drainage between them. The other answer choices are not correct descriptions of this pathway.

Question 6

Select the imaging modality that would best demonstrate the following pathologies.
-Intracranial hemorrhage in premature infants

Accepted Answer

Ultrasound is the best modality for demonstrating intracranial hemorrhage in premature infants because it is non-invasive, does not use ionizing radiation, and can be performed at the bedside. It also allows for real-time monitoring of changes in the hemorrhage. CT and MRI may also be used, but they require transport of the infant to the radiology department and may not be feasible in critical cases. Nuclear medicine and conventional radiography are not typically used for intracranial hemorrhage in premature infants.

Question 7

A radiograph of a parietoacanthial transoral (open-mouth Waters) projection reveals that the mouth is open but the sphenoid sinus is superimposed over the maxilla and upper teeth.What positioning error led to this radiographic outcome?

Accepted Answer

Insufficient extension of the head and neck can cause the sphenoid sinus to be superimposed over the maxilla and upper teeth in an open-mouth Waters projection.

Question 8

Select the imaging modality that would best demonstrate the following pathologies.
-Paget's disease

Accepted Answer

Conventional radiography is the best choice to demonstrate Paget's disease, which is characterized by abnormal bone growth and remodeling. Radiographs can show the classic "cotton wool" appearance of the affected bones, where the bone appears fuzzy and disorganized due to increased osteoclast and osteoblast activity. Other modalities may also be used to evaluate for complications or associated conditions, but radiography is the primary tool for diagnosis and monitoring of Paget's disease.

Question 9

The most common radiographic sign for secondary osteomyelitis of the paranasal sinuses is:

Accepted Answer

Erosion of the bony margins is the most common radiographic sign for secondary osteomyelitis of the paranasal sinuses. This can be seen on X-ray or CT scans as loss of bony definition or destruction of the bony margins. Other signs such as mucosal thickening, polyps, or deviation of the bony nasal septum may also be present but are less specific for osteomyelitis.

Question 10

Select the imaging modality that would best demonstrate the following pathologies.
-Craniosynostosis (premature suture closing in neonate skull)

Accepted Answer

The answer of Select the imaging modality that would best...

Question 11

A patient comes to radiology for a sinus series.She cannot fully extend her head and neck for the submentovertical projection.What else can the technologist do to produce a diagnostic submentovertical projection?

Accepted Answer

When a patient cannot fully extend their head and neck, angling the CR to place it perpendicular to the IOML (inferior orbital meatus line) can help produce a diagnostic submentovertical projection. This line does not require full extension of the neck, as it is located near the base of the skull. Options A and D are not as effective in this situation, as angling the CR to the OML (orbitomeatal line) or placing sandbags on the forehead may still require significant neck extension. Option C, performing the projection with the patient recumbent, may not be feasible or optimal for visualizing the sinuses in certain cases.

Question 12

Select the imaging modality that would best demonstrate the following pathologies.
-Early detection of metastases

Accepted Answer

Nuclear medicine, specifically PET/CT, is the best imaging modality for early detection of metastases. This is because it allows for functional imaging and can detect metabolic changes associated with cancer cells before structural changes are visible on other imaging modalities.

Question 13

Match each of the following radiographic appearances with the corresponding pathologic indication.(Use each selection only once.)
-Distinctive lesions with moth-eaten appearance, a combination of increased density and destructive irregular border lesions

Accepted Answer

Metastases often present with a "moth-eaten" appearance on radiographs, characterized by a combination of increased density and destructive irregular border lesions.

Question 14

Match each of the following radiographic appearances with the corresponding pathologic indication.(Use each selection only once.)
-Radiolucent areas within the bony cranium

Accepted Answer

Multiple myeloma often presents with radiolucent areas within the bony cranium due to the presence of lytic bone lesions.

Question 15

A pediatric patient enters radiology for a paranasal sinus series.Because of her age, the child is unable to hold still for the projections even with the use of immobilization devices.The decision is to hold the child during each exposure.Which of the following individuals should be asked to hold the child?

Accepted Answer

The guardian would be the best choice to hold the child during the exposures as they are likely the most familiar and comforting to the child. It is not appropriate to ask a student to hold the child as they may not be fully trained or experienced in handling pediatric patients. The technologist should be responsible for positioning the child and taking the images, not holding the child. It is not necessary to involve the referring physician in this decision.

Question 16

A radiograph of a PA projection of the sinuses reveals that the petrous ridges are projected over the ethmoid sinuses.Which of the following modifications will eliminate this superimposition while not compromising diagnostic quality of the study?

Accepted Answer

Increasing extension of the head and neck slightly will move the petrous ridges out of the way of the ethmoid sinuses, providing a clearer view without compromising the diagnostic quality of the study.

Question 17

A radiograph of a submentovertical projection reveals that the mandible is superimposed over the ethmoid and sphenoid sinuses.Which of the following modifications will eliminate this problem?

Accepted Answer

Increasing the extension of the head and neck during a submentovertical projection helps to project the mandible clear of the ethmoid and sphenoid sinuses, thus eliminating the superimposition.

Question 18

A patient comes to radiology for a sinus series on a cart (gurney).She is unable to stand or sit erect for any of the projections.Which of the following projections will best detect any air/fluid levels present in the maxillary sinuses?

Accepted Answer

The horizontal beam lateral projection is the best choice for detecting air/fluid levels present in the maxillary sinuses when the patient is unable to stand or sit erect. This projection allows gravity to pull any fluid in the sinuses downward, making it visible on the radiograph. The PA projection would be difficult to perform on a patient lying on their back, and the parietoacanthial and parietoacanthial transoral projections would not provide enough visualization of the maxillary sinuses.

Question 19

Select the imaging modality that would best demonstrate the following pathologies.
-Most sensitive modality for detecting differences between normal and abnormal brain tissues

Accepted Answer

MRI has the best sensitivity for detecting differences between normal and abnormal brain tissues due to its ability to provide detailed images with high contrast resolution. MRI can also differentiate between different types of tissues based on their intrinsic contrast properties, such as water content and relaxation times.

Question 20

Select the imaging modality that would best demonstrate the following pathologies.
-Hydrocephalus (in neonate)

Accepted Answer

Ultrasound is the best imaging modality to demonstrate hydrocephalus in neonates. It is non-invasive, does not involve ionizing radiation, and can provide real-time images of the brain and the flow of cerebrospinal fluid. MRI is another option but may require sedation or anesthesia, and is not as readily available in neonatal units as ultrasound. CT and conventional radiography involve ionizing radiation and are less sensitive than ultrasound or MRI for assessing hydrocephalus. Nuclear medicine imaging may be used to evaluate shunt patency or function, but is not typically used for initial diagnosis of hydrocephalus.

Quiz 11: Cranium, Facial Bones, and Paranasal Sinuses

Match each of the following radiographic appearances with the corresponding pathologic indication.(Use each selection only once.) -Enlarged sella turcica

Which of the following structures passes through the superior orbital fissure?

A radiograph of a parietoacanthial (Waters) projection for sinuses reveals that the petrous pyramids are projected over the maxillary sinuses.What positioning error is present on this radiograph?

Select the imaging modality that would best demonstrate the following pathologies. -Recent bleeding within the brain

The pathway of communication between the frontal, maxillary, and ethmoid sinuses that provides drainage between them is termed:

Select the imaging modality that would best demonstrate the following pathologies. -Intracranial hemorrhage in premature infants

A radiograph of a parietoacanthial transoral (open-mouth Waters) projection reveals that the mouth is open but the sphenoid sinus is superimposed over the maxilla and upper teeth.What positioning error led to this radiographic outcome?

Select the imaging modality that would best demonstrate the following pathologies. -Paget's disease

The most common radiographic sign for secondary osteomyelitis of the paranasal sinuses is:

Select the imaging modality that would best demonstrate the following pathologies. -Craniosynostosis (premature suture closing in neonate skull)

A patient comes to radiology for a sinus series.She cannot fully extend her head and neck for the submentovertical projection.What else can the technologist do to produce a diagnostic submentovertical projection?

Select the imaging modality that would best demonstrate the following pathologies. -Early detection of metastases

Match each of the following radiographic appearances with the corresponding pathologic indication.(Use each selection only once.) -Distinctive lesions with moth-eaten appearance, a combination of increased density and destructive irregular border lesions

Match each of the following radiographic appearances with the corresponding pathologic indication.(Use each selection only once.) -Radiolucent areas within the bony cranium

A radiograph of a PA projection of the sinuses reveals that the petrous ridges are projected over the ethmoid sinuses.Which of the following modifications will eliminate this superimposition while not compromising diagnostic quality of the study?

A radiograph of a submentovertical projection reveals that the mandible is superimposed over the ethmoid and sphenoid sinuses.Which of the following modifications will eliminate this problem?

A patient comes to radiology for a sinus series on a cart (gurney) .She is unable to stand or sit erect for any of the projections.Which of the following projections will best detect any air/fluid levels present in the maxillary sinuses?

Select the imaging modality that would best demonstrate the following pathologies. -Most sensitive modality for detecting differences between normal and abnormal brain tissues

Select the imaging modality that would best demonstrate the following pathologies. -Hydrocephalus (in neonate)