A.    Arthrographic MRI of the shoulder is 

known to increase diagnostic accuracy 

compared with conventional MRI.

B.    MRI arthrography is the most sensitive 

technique in the detection of shoulder 

joint abnormalities.

C.    MRI arthrography changes conventional 

MRI into a minimally invasive 

examination.

D.    By using real-time ultrasound, the 

procedure is not only quicker but, 

unlike the case of fluoroscopically-

guided arthrography, there is no 

ionising radiation. Administration 

of radio-opaque contrast medium is 

recommended.

2.  Which of the following 
statements associated with MRI 
arthrography is false?

CPD QUESTIONNAIRE

Give ONE correct answer for each 
question.

80         SA JOURNAL OF RADIOLOGY • October 2008

Instructions:
1. CPD questionnaires must be completed 

online via www.cpdjournals.org.za. After 
submission, you can check the answers 
and print your certificate. Questions may be 
answered up to 6 months after publication 
of each issue.

2. Read the articles in the journal to find the 
answers to the questions.

3. Go to www.cpdjournals.org.za to answer 
the questions.

1.   Regarding MRI arthrography, 
choose one false answer.

A.    The technique of arthroscopy generally 

follows the posterior route.

B.    The path lies between the infraspinatus 

muscle and the teres minor muscle, with 

the point of entry 1 cm inferior and 2 

cm medial to the posterior angle of the 

acromion.

C.    A potential risk is contact with the 

suprascapular nerve and the circumflex 

scapular vessels.

D.    If an entry point inferior to the 

teres minor muscle (through the 

quadrangular space) is used, other 

potential risks are contact with the 

axillary nerve and the posterior humeral 

circumflex artery.

3.   Which of the following 
statements is false?

A.    Hyperparathyroidism is a term used to 

describe the consequences of excessive 

secretion of parathyroid hormone 

(PTH), due to either primary disease of 

the parathyroid gland or secondary to 

renal disease.

B.   Primary hyperparathyroidism is usually 

due to a single parathyroid adenoma. 

Occasionally there may be multiple 

adenomas. Malignant transformation 

does not occur.

C.    Parathyroid glands are usually 4 in 

number, each measuring 5 mm in 

diameter. The 2 superior glands tend 

to be posterior, and the 2 inferior ones, 

anterior.

D.    The inferior glands are supplied by 

the inferior thyroidal artery and 

the superior glands by the superior 

thyroidal artery.

5.   Which of the following 
statements is false?

A.   Benign strictures are said to occur in up 

to 11% of ulcerative colitis cases.

B.   Long-standing UC does not only affect 

the mucosa. In the chronic phase, wall 

thickening, marked loss of haustration 

and colonic shortening can also occur.

C.   Fibrosis is dominant and accounts for 

most cases of stricturing.

D.   Stricturing is mostly the result of 

hypertrophy and thickening of the 

muscularis mucosa.

6.   Identify the correct statement 
from the following choices.

      The associated MRI features of 
schizencephaly include all the 
following, except:

A.   absent cavum septum pellucidum (80 - 

90 %)

B.   focally thin or absent corpus callosum

C.   polymicrogyria and hetertopias

D.   tenting of the ventricle, pointing away 

from the defect.

7.   The following is true about PET/
CT except:

A.   The introduction of F-18 FDG PET/

CT renders information on both 

morphology and metabolism.

B.   Size criteria to classify lymph nodes 

as normal or pathological remains 

acceptable in clinical practice.

C.   PET-CT expected to provide the 

clinician with accurate information 

for response assessment in lymphoma, 

possibly leading to major changes in the 

treatment and prognosis.

D.   The physical principle in PET/CT relates 

directly to Einstein’s formula E=mc2.

8.   Identify the false statement 
among the following:

A.   Positron emission tomography (PET) 

uses the glucose analogue F-18 FDG.

B.   PET/CT was first introduced in the late 

1970s.

C.   International sentiments express the 

‘unparalleled contribution of F-18 FDG 

PET to medicine over 3 decades’.

D.   Potential users of PET/CT in South 

Africa have established an ideal working 

relationship to ensure financial viability 

and access to all.

9.   Regarding PET/CT, identify a 
single false statement:

A.   PET has the ability to demonstrate 

abnormal metabolic activity (at the 

molecular level) in organs that as yet do 

not show an abnormal appearance based 

on morphologic criteria.

B.   Precisely co-registered functional and 

anatomical images are obtained by 

performing a PET study and a CT study 

on the same scanner without moving the 

patient.

C.   FDG is a radiopharmaceutical analogue 

of glucose that is taken up metabolically 

by active tumour cells using facilitated 

transport unlike those used by glucose.

D.   Like glucose, it undergoes 

phosphorylation to form FDG-6-

phosphate; however, unlike glucose, it 

does not undergo further metabolism, 

thereby becoming trapped in 

metabolically active cells.

10.  The approximate price of a 
PET/CT scan is:

A.   10 000 000 000 000 000 000 000 0000 

00000 Zim Dollars

B.   When (if) Wall Street opens tomorrow: 

$US100 000

C.   Icelandic Krona: ∞ 

     [currency effectively no longer exists]

D.  R12 000 in South Africa

4.   Which of the following 
ultrasound findings signs is not 
associated with parathyroid 
adenoma?

A.   An abnormal gland as it enlarges appears 

as a hypo-echoic, often anechoic, lesion, 

often posterior in location to the thyroid.

B.    As the gland enlarges, it can develop 

lobularity and foci of echogenicity.

C.    Parathyroid glands of at least 1 cm have 

vascularity by Colour Doppler or Power 

Doppler characterised by high resistance 

waveforms on spectral analysis.

D.    An extrathyroidal artery that feeds the 

parathyroid adenoma is commonly 

noted by sonography with both Colour 

and Power Doppler, and its visualisation 

helps in the parathyroid delineation.

CPD.indd   80 10/15/08   11:38:56 AM