SAJR CPD .indd


CPD QUESTIONNAIRE

159     SAJR  November 2013  Vol. 17  No. 4

Concerning endovascular therapy for acute tumour-related 
obstruction of the superior vena cava using a self-expanding Nitinol 
stent:
1.    Superior vena cava syndrome is characterised by venous congestion 

and increased pressure resulting from a displacement or compression 
of the superior vena cava (SVC), which takes a fast and acute course 
in most circumstances.

2.    The Stanford classification divides stenoses into four types, with 
type III being complete obstruction with reverse circulation in the 
azygos vein.

3.    General and pharmacotherapeutic treatments can alleviate and cure 
symptoms with great clinical success.

4.    In the event of severe symptoms, endovascular stent implantation 
represents the method of choice for acute treatment and is capable 
of providing rapid relief in up to 90% of cases.

5.     Failures after stent implantation may be linked to tumour invasion 
into the SVC through the stent mesh and thrombus formation, with 
relevant stenosis defined as a constriction of the lumen by more 
than 50%.

Concerning cerebral schistosomiasis:
6.    Schistosomiasis is one of the most common parasitic infections 

among humans, and infection of the nervous system is rare.
7.    On MRI, cerebral schistosomiasis has a pseudo-tumour-like 

appearance that is hyperintense on T1W images and hyperintense 
on T2W images.

Concerning adrenal lesions encountered in current medical practice 
– a review of their radiological imaging:
8.    Most incidental adrenal lesions in patients without a background 

history of malignancy are benign, with the incidence almost zero.
9.    CT is the cornerstone of adrenal imaging with morphology, CT 

densitometry, washout percentage and distant spread being crucial 
determinants that help to characterise an adrenal mass and guide 
diagnosis.

10.  Chemical shift imaging is the principal technique employed in 
the MR evaluation of adrenal lesions using in- and out-of-phase 
techniques, and exploits the presence of abundant intracellular lipid 
in adenomas that helps to distinguish them from non-adenomatous 
lesions.

11.  When classifying an adrenal neoplasm, it is not imperative to broadly 
establish if the lesion is hyper-functioning or non-hyper-functioning.

12.  Metastases are the most common malignant lesion affecting the 
adrenal gland, found in approximately 37% of cancer patients at 
autopsy.

13.  Myelolipoma is a benign, non-functioning adrenal neoplasm 
composed of an admixture of mature adipose tissue and 
haemopoietic elements, with macroscopic fat being the hallmark 
feature.

14.  Most adrenal lesions are successfully detected and accurately 
characterised on a single patient visit, using CT methods only 
with very few lesions requiring further evaluation by specialised 
techniques or expertise.

Concerning CT-guided biopsy of suspected malignancy: A potential 
pitfall:
15.  Any manipulation of paragangliomas, without appropriate medical 

therapy, can result in excess catecholamine release leading to a 
catecholamine crisis.

16.  Thirteen per cent of patients with a catecholamine-secreting tumour 
will not be hypertensive, and 8% will be asymptomatic altogether.

Concerning dual (Type IV) left anterior descending artery:
17.  This is seen relatively often with congenital malformations such 

as complete transposition of the great arteries and tetralogy of 
Fallot.

18.  Dual left anterior descending coronary artery is defined as the 
presence of two LADs within the anterior inter-ventricular sulcus: 
a short LAD that courses and terminates low in the AIVS, and a 
long LAD that originates from either the LAD proper or the right 
coronary artery, then enters the distal AIVS and courses to the 
apex.

Concerning cribriform pattern in brain MRI: A diagnostic clue for 
mucopolysaccharidosis:
19.  The earliest and most common abnormality found in patients 

with MPS is cystic lesions that correspond to enlargement of the 
Virchow-Robin perivascular spaces (PVS), which are arachnoid-
lined spaces that accompany penetrating arteries and arterioles into 
the brain parenchyma.

20.  Pituitary sellar abnormalities include a J-shaped, elongated sella 
with a shallow anterior convexity owing to an exaggerated normal 
shallow impression of the sulcus chiasmaticus.

Mark each numbered statement as true (A) or false (B).

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