Interventional Radiology MCQs

Radiology · 31 free questions with answers & explanations.

1. A 65-year-old man with hepatocellular carcinoma unsuitable for surgery undergoes transarterial chemoembolization (TACE). The rationale for using the hepatic artery route for this procedure is based on the fact that:
2. A 70-year-old woman with bilateral lower limb claudication undergoes CT angiography showing severe stenosis of the right common iliac artery. She is referred for percutaneous transluminal angioplasty (PTA) with possible stenting. Which fluoroscopic landmark is used to access the femoral artery safely below the inguinal ligament?
3. During TIPSS (transjugular intrahepatic portosystemic shunt) procedure, the stent is placed between which two hepatic structures?
4. In uterine artery embolization (UAE) for symptomatic fibroids, the embolization material of choice currently is:
5. In the Seldinger technique for vascular access, the correct sequence of steps after skin puncture is:
6. In trans-arterial chemoembolization (TACE) for hepatocellular carcinoma, the rationale for combining chemotherapy with embolization is based on:
7. During percutaneous nephrostomy (PCN), the preferred access route to minimize vascular injury is:
8. A 55-year-old patient with hepatocellular carcinoma (single 4 cm lesion) undergoes transarterial chemoembolisation (TACE). What is the principle underlying selective tumour embolisation in HCC?
9. In percutaneous transluminal angioplasty (PTA), the Seldinger technique involves initial puncture of the artery with a needle, followed by insertion of a guidewire through the needle. What is the next step?
10. Transjugular intrahepatic portosystemic shunt (TIPS) is most urgently indicated in which clinical scenario?
11. Uterine artery embolisation (UAE) for symptomatic fibroids uses which embolic material as the first-line agent?
12. In image-guided percutaneous biopsy, co-axial technique is preferred over direct (single-pass) technique because it:
13. A 65-year-old with inoperable hepatocellular carcinoma (HCC) and Child-Pugh A cirrhosis undergoes transarterial chemoembolisation (TACE). The procedure involves selective catheterisation of the hepatic artery supplying the tumour and injection of a chemotherapeutic-Lipiodol mixture followed by embolic material. The therapeutic principle exploiting HCC's unique blood supply is:
14. A patient with symptomatic uterine fibroids (menorrhagia, bulk symptoms) undergoes uterine artery embolisation (UAE). Post-procedure MRI at 3 months shows all fibroids are non-enhancing (infarcted). However, the patient develops fever, malodorous vaginal discharge, and uterine tenderness at 6 weeks. The most serious complication being considered is:
15. A 70-year-old with a 5.8 cm infrarenal abdominal aortic aneurysm undergoes endovascular aneurysm repair (EVAR). Post-procedure CT angiogram at 12 months shows persistent contrast within the aneurysm sac after the endograft is deployed, without a graft defect. The contrast enters the sac from the inferior mesenteric artery origin (IMA) which was covered by the graft proximally but fills retrogradely from the internal iliac collaterals. This is classified as:
16. A patient with a large spontaneous pneumothorax (>2 cm rim on CXR, symptomatic) is referred for needle aspiration versus chest drain. The BTS guidelines recommend image-guided pleural access for drainage. Under ultrasound guidance for pleural interventions, the 'safe triangle' for chest drain insertion is defined by:
17. A 55-year-old with occlusive disease of the left superficial femoral artery (SFA) causing claudication undergoes percutaneous transluminal angioplasty (PTA). Post-angioplasty, the vessel shows a dissection with flow limitation on DSA (digital subtraction angiography). A bare-metal stent is deployed. The primary mechanism by which balloon angioplasty achieves luminal gain is:
18. In TIPS (transjugular intrahepatic portosystemic shunt) procedure for refractory ascites, the target post-procedure portosystemic pressure gradient (PPG) is:
19. In percutaneous transhepatic biliary drainage (PTBD), which access route is preferred to minimise risk of haemobilia and allow biliary drainage without traversing major vascular structures?
20. In uterine artery embolization (UAE) for fibroids, the endpoint of embolization is determined by:
21. The Seldinger technique, which forms the basis of modern vascular interventional radiology, involves the following sequence:
22. In CT-guided percutaneous biopsy of a lung lesion, which complication is MOST common and is related to the distance the needle traverses through aerated lung?
23. In TIPS (Transjugular Intrahepatic Portosystemic Shunt) placement for variceal bleeding, which measurement guides the adequacy of shunt function?
24. During percutaneous transhepatic cholangiography (PTC) or ERCP-guided biliary stenting, which type of stent is PREFERRED for malignant biliary obstruction to provide longer patency?
25. In uterine artery embolisation (UAE) for symptomatic fibroids, the target of embolisation is the uterine arteries. Which embolic agent size is MOST appropriate to achieve fibroid infarction without compromising the uterine myometrium?
26. A patient with unresectable hepatocellular carcinoma undergoes Transarterial Chemoembolisation (TACE). The rationale for selective hepatic arterial embolisation in HCC is based on which vascular principle?
27. In radiofrequency ablation (RFA) of liver tumours, the clinically recommended minimum ablation margin around a tumour to minimise local recurrence is:
28. A 65-year-old male with unresectable hepatocellular carcinoma (HCC) confined to the liver (Barcelona Clinic Liver Cancer stage B — intermediate) is planned for transarterial chemoembolisation (TACE). The principle behind TACE is:
29. Transjugular intrahepatic portosystemic shunt (TIPS) is created to reduce portal pressure. The target post-TIPS portosystemic gradient is:
30. Image-guided percutaneous biopsy of a 3 cm right hepatic lobe lesion is planned. Compared to CT guidance, the advantage of ultrasound guidance for this procedure is:
31. A patient with cirrhosis and refractory hepatic hydrothorax not controlled by diuretics or thoracentesis is referred for TIPS (transjugular intrahepatic portosystemic shunt). Which absolute contraindication to TIPS should be excluded before the procedure?