GI & Hepatobiliary Imaging MCQs

Radiology · 5 free questions with answers & explanations.

1. A 55-year-old woman presents with right upper quadrant pain and jaundice. MRCP shows a stricture at the biliary confluence with proximal intrahepatic biliary dilatation isolated to the right lobe; the left intrahepatic ducts are also dilated but do not communicate with the right system. The common bile duct and gallbladder are normal. Which Bismuth-Corlette classification does this represent?
2. A 40-year-old woman undergoes MRI liver for a 3 cm lesion incidentally found on ultrasound. On dynamic contrast-enhanced MRI, the lesion shows peripheral nodular enhancement in the arterial phase, progressive centripetal fill-in on portal venous and equilibrium phases, with the centre remaining non-enhancing. What is the most likely diagnosis?
3. A 65-year-old man with alcoholic cirrhosis undergoes surveillance ultrasound showing a new 2.5 cm arterially-enhancing hepatic nodule. Contrast-enhanced CT confirms arterial hyperenhancement and portal venous phase washout with an enhancing capsule. Based on LI-RADS criteria, what category should be assigned?
4. A 30-year-old man presents with sudden onset severe central abdominal pain. Plain X-ray shows free intraperitoneal gas (pneumoperitoneum) as a thin crescent of air under the right hemidiaphragm. He is haemodynamically stable. Which plain film sign confirms the presence of extraluminal free air on a supine film when erect views are not obtainable?
5. A 55-year-old woman with known inflammatory bowel disease undergoes small bowel MRI (MR enterography). The terminal ileum shows mural thickening greater than 4 mm with a layered 'target' sign of mural stratification, restricted diffusion on DWI, and marked mural and perienteric hypervascularity on post-contrast images. Mesenteric fat shows fibro-fatty proliferation. What do these findings collectively indicate?