Trauma imaging: contrast blush on CT: practice question

A Radiology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

Try it

Radiology · Trauma imaging: contrast blush on CT

Sample item

A haemodynamically stable man with blunt abdominal trauma has a CT showing a grade 4 splenic laceration with a focus of arterial phase contrast pooling that increases on the delayed phase. What does this indicate and what is the next step?

AA haemangioma, so follow-upBActive arterial bleeding, so angioembolisation or surgery is consideredCNormal enhancement, so dischargeDAn old calcified granuloma

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Active arterial bleeding, so angioembolisation or surgery is considered

A contrast blush that grows between phases denotes active extravasation, and carries a high risk of failure of observation. In a stable patient, angioembolisation is often used, and an unstable patient goes to theatre.

Option by option

A. A haemangioma, so follow-up
A haemangioma enhances peripherally and is not an acute trauma finding.
B. Active arterial bleeding, so angioembolisation or surgery is considered (correct)
Correct. Expanding contrast pooling signals ongoing arterial haemorrhage.
C. Normal enhancement, so discharge
Normal enhancement does not enlarge between phases.
D. An old calcified granuloma
A granuloma does not change between phases.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Radiology question

What is the answer to this Radiology question?

The best answer is B, Active arterial bleeding, so angioembolisation or surgery is considered. A contrast blush that grows between phases denotes active extravasation, and carries a high risk of failure of observation.

Why is "A haemangioma, so follow-up" not the answer?

A haemangioma enhances peripherally and is not an acute trauma finding.

Why is "Normal enhancement, so discharge" not the answer?

Normal enhancement does not enlarge between phases.

Why is "An old calcified granuloma" not the answer?

A granuloma does not change between phases.

What concept does this question test?

It tests Trauma imaging: contrast blush on CT in Radiology. In a stable patient, angioembolisation is often used, and an unstable patient goes to theatre.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Trauma imaging: contrast blush on CT?

Learn signs with the image, and the disease they point to. Then use the flashcards and the other Radiology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.