Neuroimaging: MRI ageing of haemorrhage: 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: MRI ageing of haemorrhage

Sample item

A haematoma in the brain appears hyperintense on T1-weighted images and hyperintense on T2-weighted images, without a dark rim. In which stage of evolution is this haematoma?

ALate subacute, with extracellular methaemoglobinBChronic, with haemosiderinCAcute, with intracellular deoxyhaemoglobinDHyperacute, with oxyhaemoglobin

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

The answer and the reasoning

A. Late subacute, with extracellular methaemoglobin

Extracellular methaemoglobin in the late subacute stage, from about one week to some weeks, is bright on both T1 and T2. Intracellular methaemoglobin in the early subacute stage is bright on T1 but dark on T2. Acute deoxyhaemoglobin is dark on T2, and chronic haemosiderin forms a dark rim.

Option by option

A. Late subacute, with extracellular methaemoglobin (correct)
Correct. Extracellular methaemoglobin is bright on T1 and T2.
B. Chronic, with haemosiderin
Haemosiderin is dark on all sequences and rims the old lesion.
C. Acute, with intracellular deoxyhaemoglobin
Deoxyhaemoglobin is isointense on T1 and dark on T2.
D. Hyperacute, with oxyhaemoglobin
Oxyhaemoglobin in the hyperacute phase is isointense on T1 and bright on T2.

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 A, Late subacute, with extracellular methaemoglobin. Extracellular methaemoglobin in the late subacute stage, from about one week to some weeks, is bright on both T1 and T2.

Why is "Chronic, with haemosiderin" not the answer?

Haemosiderin is dark on all sequences and rims the old lesion.

Why is "Acute, with intracellular deoxyhaemoglobin" not the answer?

Deoxyhaemoglobin is isointense on T1 and dark on T2.

Why is "Hyperacute, with oxyhaemoglobin" not the answer?

Oxyhaemoglobin in the hyperacute phase is isointense on T1 and bright on T2.

What concept does this question test?

It tests Neuroimaging: MRI ageing of haemorrhage in Radiology. Intracellular methaemoglobin in the early subacute stage is bright on T1 but dark on T2. Acute deoxyhaemoglobin is dark on T2, and chronic haemosiderin forms a dark rim.

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: MRI ageing of haemorrhage?

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.