2    A 62-year-old male presents with right groin pain. A hernia is suspected, and a CT of the abdomen and pelvis is performed. An incidental 5.1-cm fusiform infrarenal aortic aneurysm is identified. There are no comparison images. At what aneurysm sac size is repair indicated for an asymptomatic abdominal aortic aneurysm in an “average-risk” patient?

  3    A 50-year-old male presents with an enlarged left external iliac lymph node. Percutaneous biopsy is planned. Which of the following approaches is least likely to result in a complication?

  4    A 42-year-old male with pancreatitis and complicated peripancreatic fluid collections presents for catheter drainage. In which space is the fluid collection posterior to the left kidney located?

  5    A 60-year-old female with fatigue and no comorbidities undergoes a CT of the abdomen and pelvis demonstrating multiple enlarged retroperitoneal lymph nodes. A percutaneous core needle biopsy is performed under conscious sedation with a 15-cm-long 18-gauge end-firing biopsy device with a 2-cm throw. Six specimens are obtained, and the patient is taken to recovery.

One hour later, the patient stands up for the first time since the biopsy, becomes queasy, and nearly loses consciousness. She is returned to her bed, and vital signs are obtained: (1) heart rate 40 bpm, (2) blood pressure 80/40 mm Hg, and (3) SpO₂ 100% on room air. She has no abdominal pain or ecchymosis. Two minutes later, she is asymptomatic, and her vital signs are (1) heart rate 72 bpm, (2) blood pressure 115/65 mm Hg, and (3) SpO₂ 100% on room air. What is the best next step?

  6    A 22-year-old male with metastatic testicular cancer undergoes a contrast-enhanced CT of the abdomen and pelvis. There is a single-comparison contrast-enhanced CT of the abdomen and pelvis performed 6 months ago. In addition to development of a new lesion, what defines “progressive disease” according to RECIST 1.1?

  7    Which of the following structures is located in the anterior pararenal space?

  8    A 30-year-old female with right lower quadrant pain undergoes an abdominal MRI. Axial and sagittal T1-weighted contrast-enhanced GRE with fat saturation and axial and sagittal T2-weighted FSE sequences are presented below. What is the most likely diagnosis?

  9    A 54-year-old male with stage V chronic kidney disease undergoes an unenhanced MR angiogram of his abdominal aorta. What best explains the “dark” appearance of fast-flowing blood on spin echo imaging?

  10    A 25-year-old female stabbing victim undergoes a CT of the chest, abdomen, and pelvis. A 13-cm hemorrhage is identified in the right perirenal space related to a 3-cm renal laceration. Her hemoglobin is 7.1 g/dL. What best predicts this patient’s need for operative management?

  11    A 51-year-old female with a 2.0-cm solid inferior pole right renal mass undergoes percutaneous radiofrequency ablation with two thermal ablation probes. An image from the ablation is shown below. What poses the greatest risk to this patient?

  12    A 65-year-old male with a remote history of colon cancer undergoes abdominal MRI after an incidental renal mass is discovered on surveillance CT imaging. Two unenhanced 2D axial gradient-recalled echo (GRE) images obtained from different imaging volumes are shown below. What is the most likely explanation for the appearance of the veins (left image) and arteries (right image)?

  13    A 56-year-old asymptomatic male with microscopic hematuria undergoes a CT urogram that shows anterior displacement of the kidneys and duodenum. What is the best next step?

  14    A 70-year-old male with dyspnea and long-standing pulmonary fibrosis undergoes a contrast-enhanced CT, and a lobular solid mass is identified. Representative images in the axial (left) and coronal (right) plane are shown below. What is the most likely diagnosis?

  15    A 70-year-old male with a 40-pack-year smoking history and L2-L3 spondylodiscitis presents with acute flank pain, and a contrast-enhanced CT of the abdomen and pelvis is performed. The maximum infrarenal aortic caliber is 3.5 cm. What is the best next step?

  16    What are the typical findings of retroperitoneal Erdheim-Chester disease?

  17    A 35-year-old female with fever and low back pain undergoes a contrast-enhanced CT of the abdomen and pelvis. The patient lives in the United States and has no relevant history. What is the most likely offending organism?

  18    A 70-year-old female with atrial fibrillation on warfarin therapy develops severe abdominal pain after a fall. What is the typical range of attenuation for clotted blood on an unenhanced CT of the abdomen?

  19    A 60-year-old male with a 5.5-cm infrarenal aortic aneurysm undergoes percutaneous repair with an aortoiliac endograft. One year later, the sac size is 4.0 cm and a small type II endoleak is identified. What is the best next step?

  20    A 60-year-old male with vague low back pain undergoes a contrast-enhanced CT of the abdomen and pelvis. Which of the following diseases is associated with this imaging finding?

  21    A 25-year-old female who is postoperative day 3 following an emergent cesarean section for fetal distress presents with sepsis and acute respiratory distress syndrome. An abdominal radiograph is performed. What is the most likely diagnosis?

  22    A 54-year-old female who is postoperative day 9 following a partial right nephrectomy presents with persistent flank pain. Axial contrast-enhanced CT of the abdomen is performed (left), and coronal reconstructions are generated (right). What is the most likely diagnosis?

  23    Persistence of the right and left supracardinal veins can result in a “duplicated” or “double” IVC. When this variant manifests, into what structures do the right and left IVC usually drain?

  24    A 65-year-old male with stage V chronic kidney disease presents for an unenhanced MR angiogram. Conventional “black blood” spin echo sequences are planned. For a conventional spin echo–based sequence, when should the 180-degree refocusing pulse be applied?

  25    A 65-year-old male with Gleason 5 + 4 = 9 prostate cancer undergoes a contrast-enhanced CT of the abdomen and pelvis. What is the approximate sensitivity of morphologic CT imaging for the detection of nodal metastasis (on a node-by-node basis)?

  26    A 68-year-old female undergoes a contrast-enhanced CT of the abdomen and pelvis that reveals a large retroperitoneal mass. What is the most likely cell type?

  27    A 65-year-old male with lymphoma enrolls in a clinical trial and undergoes a contrast-enhanced CT reconstructed at 5-mm collimation. What criterion determines whether the lymph node depicted in the image would be considered a “target lesion” according to RECIST 1.1?

  28    A 57-year-old female with adrenocortical carcinoma enrolls in a clinical trial and undergoes a contrast-enhanced CT reconstructed at 5-mm collimation. What criterion determines whether the mass depicted in the image would be considered a “target lesion” according to RECIST 1.1?

  29    A 60-year-old male undergoes a CT angiogram. Isotropic images are acquired in the axial plane. Which of the following lines best represents how the aneurysm sac should be measured?

  30    A 60-year-old male with flank pain and hematuria undergoes a retroperitoneal ultrasound. A 4.5-cm solid renal mass is identified, and there is echogenic material in the renal vein and vena cava. Which of the following best distinguishes tumor thrombus from bland thrombus?