Neuroimaging: brain abscess: 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 · Neuroimaging: brain abscess

Sample item

Which MRI feature best distinguishes a pyogenic brain abscess from a necrotic tumour?

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

The answer and the reasoning

A. Central restricted diffusion with a thin smooth enhancing wall

The thick pus within an abscess has high viscosity and restricts diffusion (bright on DWI, low ADC), whereas necrotic tumours are usually dark on DWI. The abscess wall is thin and smooth, often thinner on the ventricular side. A dual rim sign on susceptibility imaging is also supportive.

Option by option

  • A. Central restricted diffusion with a thin smooth enhancing wall (correct)

    Correct. Central restricted diffusion with a thin smooth wall indicates abscess.

  • B. Lack of enhancement

    Abscesses show rim enhancement.

  • C. Thick irregular nodular wall

    A thick irregular nodular wall favours necrotic tumour.

  • D. Absence of surrounding oedema

    Abscesses are associated with marked oedema.

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 A, Central restricted diffusion with a thin smooth enhancing wall. The thick pus within an abscess has high viscosity and restricts diffusion (bright on DWI, low ADC), whereas necrotic tumours are usually dark on DWI.

Why is "Lack of enhancement" not the answer?

Abscesses show rim enhancement.

Why is "Thick irregular nodular wall" not the answer?

A thick irregular nodular wall favours necrotic tumour.

Why is "Absence of surrounding oedema" not the answer?

Abscesses are associated with marked oedema.

What concept does this question test?

It tests Neuroimaging: brain abscess in Radiology. The abscess wall is thin and smooth, often thinner on the ventricular side. A dual rim sign on susceptibility imaging is also supportive.

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 Neuroimaging: brain abscess?

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.