Cardiac imaging: cardiac MRI: 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.

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Radiology · Cardiac imaging: cardiac MRI

Sample item

Late gadolinium enhancement on cardiac MRI in the subendocardium of a ventricular territory suggests which of the following?

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

The answer and the reasoning

D. Myocardial infarction (scar)

Gadolinium accumulates in the extracellular space of scarred myocardium, causing late enhancement that begins subendocardially in ischaemic injury and extends toward the epicardium with transmurality. Non-ischaemic cardiomyopathies show mid-wall or epicardial patterns. The extent of enhancement predicts viability.

Option by option

  • A. Normal myocardium

    Normal myocardium washes out contrast quickly.

  • B. Lipomatous hypertrophy

    Lipomatous hypertrophy shows fat signal.

  • C. Pericardial calcification

    Pericardial calcification is not demonstrated by LGE.

  • D. Myocardial infarction (scar) (correct)

    Correct. Subendocardial late enhancement indicates infarct scar.

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.

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Questions about this Radiology question

What is the answer to this Radiology question?

The best answer is D, Myocardial infarction (scar). Gadolinium accumulates in the extracellular space of scarred myocardium, causing late enhancement that begins subendocardially in ischaemic injury and extends toward the epicardium with transmurality.

Why is "Normal myocardium" not the answer?

Normal myocardium washes out contrast quickly.

Why is "Lipomatous hypertrophy" not the answer?

Lipomatous hypertrophy shows fat signal.

Why is "Pericardial calcification" not the answer?

Pericardial calcification is not demonstrated by LGE.

What concept does this question test?

It tests Cardiac imaging: cardiac MRI in Radiology. Non-ischaemic cardiomyopathies show mid-wall or epicardial patterns. The extent of enhancement predicts viability.

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 Cardiac imaging: cardiac MRI?

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.