Which imaging technique best demonstrates ureteral patency?
Answer(s): C
Color Doppler imaging can detect ureteral jets, which represent urine entering the bladder from the ureters. The presence of bilateral ureteral jets confirms ureteral patency. Gray scale may show hydronephrosis but does not directly assess flow.According to Rumack's Diagnostic Ultrasound:"Color Doppler demonstrates ureteral jets within the bladder, confirming ureteral patency."
Rumack CM, Wilson SR, Charboneau JW, Levine D. Diagnostic Ultrasound. 5th ed. Elsevier, 2017.AIUM Practice Parameter for Renal Ultrasound, 2020.
Which vessel is most likely to display hepatofugal flow in the presence of portal hypertension?
Answer(s): A
The coronary vein (left gastric vein) is a common collateral pathway in portal hypertension. It often becomes dilated and may demonstrate hepatofugal (reversed) flow as blood diverts from the high- pressure portal system into systemic collaterals.According to Zwiebel's Introduction to Vascular Ultrasound:"The left gastric (coronary) vein is a frequent site of hepatofugal flow in portal hypertension, reflecting collateral development."
Zwiebel WJ, Pellerito JS. Introduction to Vascular Ultrasound. 6th ed. Elsevier, 2019.AIUM Practice Parameter for Portal Venous Doppler Ultrasound, 2020.
Which finding is helpful to differentiate postsurgical breast scarring from a recurrent tumor?
Postsurgical breast scarring may appear hypoechoic and irregular but typically shows no internal vascularity on Doppler imaging. In contrast, recurrent tumors generally exhibit increased internal vascular flow due to neovascularization. Therefore, absent Doppler signal helps suggest scar tissue rather than malignancy.According to Stavros' Breast Ultrasound:"The absence of internal Doppler flow favors scar tissue, whereas recurrent malignancy typically demonstrates internal vascularity."
Stavros AT. Breast Ultrasound. Lippincott Williams & Wilkins, 2004.AIUM Practice Parameter for Breast Ultrasound, 2020.
Where is the main pancreatic duct located?
Answer(s): D
The main pancreatic duct (duct of Wirsung) runs through the central portion of the pancreas, medial and slightly posterior to the superior mesenteric vein (SMV). It converges with the common bile duct near the ampulla of Vater.According to Moore's Clinically Oriented Anatomy:"The main pancreatic duct runs centrally within the gland and lies medial to the superior mesenteric vein."
Moore KL, Dalley AF, Agur AMR. Clinically Oriented Anatomy. 8th ed. Wolters Kluwer, 2018.Gray's Anatomy for Students, 4th ed., Elsevier, 2019.
Which scanning technique is most beneficial when imaging the appendix?
Graded compression technique is the gold standard for ultrasound evaluation of the appendix. It displaces gas and compresses overlying bowel loops to visualize the noncompressible, blind-ending tubular appendix directly at the point of maximal tenderness.According to Rumack's Diagnostic Ultrasound:"Graded compression using steady, increasing pressure displaces gas and bowel to optimize visualization of the appendix."
Rumack CM, Wilson SR, Charboneau JW, Levine D. Diagnostic Ultrasound. 5th ed. Elsevier, 2017.AIUM Practice Parameter for the Performance of an Ultrasound Examination of the Abdomen, 2020.
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