"Weeping willow trees” appearance ?

Q..All are true regarding imaging finding in cirrhosis of liver except

a.flying bat pattern on scintigraphy

b.bone marrow uptake of radionuclide

c.corkscrew appearance of intrahepatic areteries on angiography

d.weeping willow trees appearance on hepatic venography

e.Hypointense T2W appearance of regenerative nodules

ANS.----d

“Weeping willow trees” appearance (hepatic vein branches getting close ) on hepatic venography is noted in idiopathic portal hypertension

HIPPOCAMPAL SCLEROSIS

Q.All are true regarding hippocampal sclerosis except

a. The amygdala remains superior to temporal horn

b.  the CSF signal in the uncal recess of temporal horn / the alveus seprate amygdale from hippocampus

c. Both amygdala and hippocampus are hypointense to gray matter on almost all  MR pulse sequences.

d.The hippocampus may be slightly hyperintense to gray matter on FLAIR images

e. the posterior hippocampal boundary for volumetry extend to the crus of the fornix  

ANS.----c

Both amygdala and hippocampus are isointense to gray matter on all MR pulse sequences. The hippocampus, however, may be slightly hyperintense to gray matter on fluid attenuated inversion recovery (FLAIR) images due to incomplete suppression of CSF

MR SPECTROSCOPY

Q.All are true regarding MRS except

a. The acquisition of long echo time data  allows the detection of N-acetylaspartate (NAA), creatine (Cr/PCr) and choline (Cho) in normal brain

b. The methyl resonance of NAA produces a large sharp peak at 2.01 p.p.m

c.choline  produce resonance at 3.22 p.p.m

d. The acquisition of long echo time data  provides spectra with better signal to noise

e. The acquisition of short echo time data provides myo-inositol, glutamate and glutamine

ANS.---d

The acquisition of long echo time data (TE = 270 ms, TR = 3 ms) allows the detection of N-acetylaspartate (NAA), creatine (Cr/PCr) and choline (Cho) in normal brain, and lactate in areas of abnormality. The methyl resonance of NAA produces a large sharp peak at 2.01 p.p.m. and acts as a neuronal marker as it is almost exclusively found in neurons in the human brain, where it is found predominantly in the axons and nerve processes. The creatine peak (3.03 p.p.m.) arises from both phosphocreatine- and creatine-containing substances in the cell and choline (3.22 p.p.m) is thought to arise from choline-containing substances in the cell membrane.

The acquisition of short echo time data (TE = 30 ms, TR = 2s) has become the standard spectroscopy sequence and has the advantage of reduced effects from T2 losses and therefore provides spectra with better signal to noise. In addition, it detects additional resonances from metabolites with complex MR spectra such as myo-inositol, glutamate and glutamine .