ARKANSAS DIAGNOSTIC RADIOLOGY
SPECIALIST EXAM 70 QUESTIONS WITH
CORRECT ANSWERS AND RATIONALES 2026-
2027 TREND|EXCELLENCY ALL THE WAY
Questions 1–70
1. A 55-year-old patient presents with sudden neurologic deficits. Noncontrast CT of the head is
performed first. What is the primary purpose?
A. Detect cerebral aneurysms
B. Identify acute intracranial hemorrhage
C. Evaluate cerebral perfusion
D. Assess venous sinus thrombosis
Answer: B. Identify acute intracranial hemorrhage
Rationale: Noncontrast head CT is rapid and highly sensitive for acute intracranial hemorrhage
and is a standard initial study in suspected acute stroke.
2. Which CT finding is most characteristic of an acute subdural hematoma?
A. Biconvex extra-axial collection
B. Crescent-shaped extra-axial collection
C. Ring-enhancing lesion
D. Intraventricular hyperdensity only
Answer: B. Crescent-shaped extra-axial collection
Rationale: Subdural hematomas typically spread along the cerebral convexity and have a
crescent shape. Epidural hematomas are classically biconvex or lentiform.
3. Which imaging modality uses ionizing radiation?
A. MRI
B. Ultrasound
C. CT
D. MRI spectroscopy
Answer: C. CT
Rationale: CT uses X-rays and therefore involves ionizing radiation. MRI and ultrasound do not
use ionizing radiation.
,4. Which MRI sequence is particularly sensitive to bone marrow edema?
A. T1-weighted imaging
B. Fluid-sensitive fat-suppressed imaging
C. Gradient-echo only
D. MR angiography only
Answer: B. Fluid-sensitive fat-suppressed imaging
Rationale: STIR and other fat-suppressed fluid-sensitive sequences demonstrate increased water
content and are highly sensitive to marrow edema.
5. A patient has suspected acute ischemic stroke. Which MRI sequence is most sensitive for
early acute infarction?
A. DWI
B. T1-weighted imaging
C. T2-weighted imaging
D. MRCP
Answer: A. DWI
Rationale: Diffusion-weighted imaging detects restricted water diffusion very early after
cerebral ischemia.
6. What does ADC imaging help determine in acute stroke MRI?
A. Cerebral blood volume only
B. Whether DWI hyperintensity represents true restricted diffusion
C. Skull thickness
D. Calcification
Answer: B. Whether DWI hyperintensity represents true restricted diffusion
Rationale: True acute infarction generally demonstrates high DWI signal with corresponding
low ADC values.
7. Which contrast agent is commonly used for MRI?
A. Iodinated contrast
B. Gadolinium-based contrast
C. Barium sulfate
D. Technetium only
, Answer: B. Gadolinium-based contrast
Rationale: Gadolinium-based contrast agents are commonly used in MRI to improve
visualization of vascularity, inflammation, tumors, and breakdown of the blood-brain barrier.
8. Which imaging feature most strongly suggests a malignant pulmonary nodule?
A. Smooth margins and central calcification
B. Spiculated margins
C. Complete resolution
D. Stable size for many years
Answer: B. Spiculated margins
Rationale: Spiculation is an important imaging feature associated with a higher probability of
malignancy.
9. A solitary pulmonary nodule is discovered on CT. Which factor is important when assessing
malignancy risk?
A. Patient age
B. Smoking history
C. Nodule morphology
D. All of the above
Answer: D. All of the above
Rationale: Clinical risk factors and imaging characteristics must be considered together when
assessing a pulmonary nodule.
10. Which radiographic sign is classically associated with pneumothorax?
A. Air bronchograms
B. Visceral pleural line with absent peripheral lung markings
C. Air-fluid level in the stomach
D. Kerley B lines
Answer: B. Visceral pleural line with absent peripheral lung markings
Rationale: A visible visceral pleural line with absent lung markings beyond it is characteristic of
pneumothorax.
11. What is the primary role of Doppler ultrasound?
A. Measure bone density
B. Evaluate blood flow
SPECIALIST EXAM 70 QUESTIONS WITH
CORRECT ANSWERS AND RATIONALES 2026-
2027 TREND|EXCELLENCY ALL THE WAY
Questions 1–70
1. A 55-year-old patient presents with sudden neurologic deficits. Noncontrast CT of the head is
performed first. What is the primary purpose?
A. Detect cerebral aneurysms
B. Identify acute intracranial hemorrhage
C. Evaluate cerebral perfusion
D. Assess venous sinus thrombosis
Answer: B. Identify acute intracranial hemorrhage
Rationale: Noncontrast head CT is rapid and highly sensitive for acute intracranial hemorrhage
and is a standard initial study in suspected acute stroke.
2. Which CT finding is most characteristic of an acute subdural hematoma?
A. Biconvex extra-axial collection
B. Crescent-shaped extra-axial collection
C. Ring-enhancing lesion
D. Intraventricular hyperdensity only
Answer: B. Crescent-shaped extra-axial collection
Rationale: Subdural hematomas typically spread along the cerebral convexity and have a
crescent shape. Epidural hematomas are classically biconvex or lentiform.
3. Which imaging modality uses ionizing radiation?
A. MRI
B. Ultrasound
C. CT
D. MRI spectroscopy
Answer: C. CT
Rationale: CT uses X-rays and therefore involves ionizing radiation. MRI and ultrasound do not
use ionizing radiation.
,4. Which MRI sequence is particularly sensitive to bone marrow edema?
A. T1-weighted imaging
B. Fluid-sensitive fat-suppressed imaging
C. Gradient-echo only
D. MR angiography only
Answer: B. Fluid-sensitive fat-suppressed imaging
Rationale: STIR and other fat-suppressed fluid-sensitive sequences demonstrate increased water
content and are highly sensitive to marrow edema.
5. A patient has suspected acute ischemic stroke. Which MRI sequence is most sensitive for
early acute infarction?
A. DWI
B. T1-weighted imaging
C. T2-weighted imaging
D. MRCP
Answer: A. DWI
Rationale: Diffusion-weighted imaging detects restricted water diffusion very early after
cerebral ischemia.
6. What does ADC imaging help determine in acute stroke MRI?
A. Cerebral blood volume only
B. Whether DWI hyperintensity represents true restricted diffusion
C. Skull thickness
D. Calcification
Answer: B. Whether DWI hyperintensity represents true restricted diffusion
Rationale: True acute infarction generally demonstrates high DWI signal with corresponding
low ADC values.
7. Which contrast agent is commonly used for MRI?
A. Iodinated contrast
B. Gadolinium-based contrast
C. Barium sulfate
D. Technetium only
, Answer: B. Gadolinium-based contrast
Rationale: Gadolinium-based contrast agents are commonly used in MRI to improve
visualization of vascularity, inflammation, tumors, and breakdown of the blood-brain barrier.
8. Which imaging feature most strongly suggests a malignant pulmonary nodule?
A. Smooth margins and central calcification
B. Spiculated margins
C. Complete resolution
D. Stable size for many years
Answer: B. Spiculated margins
Rationale: Spiculation is an important imaging feature associated with a higher probability of
malignancy.
9. A solitary pulmonary nodule is discovered on CT. Which factor is important when assessing
malignancy risk?
A. Patient age
B. Smoking history
C. Nodule morphology
D. All of the above
Answer: D. All of the above
Rationale: Clinical risk factors and imaging characteristics must be considered together when
assessing a pulmonary nodule.
10. Which radiographic sign is classically associated with pneumothorax?
A. Air bronchograms
B. Visceral pleural line with absent peripheral lung markings
C. Air-fluid level in the stomach
D. Kerley B lines
Answer: B. Visceral pleural line with absent peripheral lung markings
Rationale: A visible visceral pleural line with absent lung markings beyond it is characteristic of
pneumothorax.
11. What is the primary role of Doppler ultrasound?
A. Measure bone density
B. Evaluate blood flow
