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March 9, 2026

Free Radiology Sample Questions from the DXIT/Core 2026 Question Bank

Written By: The TrueLearn Team | Share:
| Last Modified: March 11, 2026

Radiology residents preparing for the DXIT and CORE exams benefit from practicing questions that mirror the format and rigor of the real test. Working through realistic, exam-style questions helps reinforce key imaging concepts and build confidence before test day. Explore the radiology sample questions below from TrueLearn’s DXIT/CORE 2026 SmartBank.

Your First Free Radiology Sample Question from the 2026 Edition

A 71-year-old woman with a history of hypertension and atrial fibrillation presents with new neurologic deficits. A non-contrast CT of the head is performed. 

What vessel is MOST likely occluded?

Axial noncontrast CT scan of the head showing the skull base and posterior fossa structures.

  • A. Anterior inferior cerebellar artery
  • B. Posterior cerebral artery
  • C. Posterior inferior cerebellar artery
  • D. Superior cerebellar artery
  • E. Basilar artery

The Answer and Explanation

Did you get it right? The correct answer is: D

The superior cerebellar artery (SCA) originates just distal to the basilar artery bifurcation and supplies the superior cerebellar hemispheres, the superior vermis, dentate nuclei, and portions of the superior pons and midbrain. Infarction in this vascular territory presents with vertigo, nausea, dysmetria, and truncal ataxia. Embolic events, particularly from atrial fibrillation, are a common etiology.
In this case, non-contrast CT demonstrates hypoattenuation of the right superior cerebellar hemisphere (teal arrow), consistent with acute to subacute infarction. The corresponding CTA MIP image shows absence of opacification of the right SCA (orange arrow), which should normally be visible as part of the characteristic “double-T” configuration just distal to the basilar bifurcation. This absence confirms occlusion of the right SCA.

Axial noncontrast CT of the brain and coronal CT angiography showing the posterior circulation, with arrows indicating vascular findings.

Incorrect Answer Explanations

Answer A: Anterior inferior cerebellar artery occlusion typically affects the flocculus, middle cerebellar peduncle, and lateral pons, and may cause hearing loss or facial weakness.

Answer B: Posterior cerebral artery infarction involves the occipital lobes, thalamus, and posterior corpus callosum, presenting with visual field deficits or thalamic syndromes.

Answer C: Posterior inferior cerebellar artery infarcts involve the inferior cerebellar hemisphere and lateral medulla, producing Wallenberg syndrome with findings such as hoarseness, dysphagia, and contralateral body sensory loss.

Answer E: Basilar occlusion typically causes bilateral brainstem or cerebellar ischemia, often with catastrophic findings such as coma or locked-in syndrome, rather than an isolated unilateral superior cerebellar infarct.

Bottom Line

The superior cerebellar arteries form the characteristic “double T” configuration on CTA. Occlusion leads to infarction of the superior cerebellar hemisphere, vermis, and dentate nucleus. Patients typically present with vertigo, dysmetria, and truncal ataxia.

For more information, see:

Kumral, E., Kisabay, A., Ataç, C., et al. (2005). Lesion patterns and etiology of ischemia in superior cerebellar artery territory infarcts. Cerebrovascular Diseases, 19(5), 283–290.

Your Second Free Radiology Sample Question

A 48-year-old woman presents with new-onset swelling and discomfort of the left breast 10 years after cosmetic breast augmentation with silicone implants. Breast MRI is performed. What is the MOST likely diagnosis?

Axial MRI of the head at the level of the orbits showing darker ocular globes with a central area of brighter signal in the midline structures.
Axial MRI of the head at the level of the orbits showing bilateral ocular globes and surrounding soft tissues.
Axial MRI of the head at the level of the orbits showing predominantly dark signal with a bright crescent-shaped area within the right ocular globe.

  • A. Silicone implant rupture with silicone granuloma formation
  • B. Seroma due to late-onset implant infection
  • C. Breast implant-associated anaplastic large cell lymphoma
  • D. Capsular contracture with intracapsular implant rupture

The Answer and Explanation

Did you get it right? The correct answer is: C

Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is a rare T-cell lymphoma arising in association with breast implants, particularly textured implants. It typically occurs 8–10 years post-implantation and presents with peri-implant effusion, swelling, and/or a mass. Most cases are confined to the fibrous capsule and peri-implant fluid. Management involves complete surgical removal of the implant and surrounding capsule. Systemic therapy is reserved for advanced disease.
On MRI, BIA-ALCL often demonstrates a large peri-implant fluid collection (T2; yellow arrow) and capsular thickening with or without associated enhancing soft tissue along the capsule (post-contrast T1; teal arrow). The absence of diffuse implant rupture signs and the presence of fluid with capsular thickening are key diagnostic clues distinguishing BIA-ALCL from other implant-related complications.

Axial MRI of the head at the level of the orbits showing a bright crescent-shaped collection within the right ocular globe, highlighted by an arrow.
Axial MRI of the head at the level of the orbits showing a crescent-shaped brighter area along the right ocular globe, indicated by an arrow.

In the provided case, US-guided fine needle aspiration of the peri-implant collection confirmed BIA-ALCL.

Ultrasound image of the left breast upper outer quadrant showing heterogeneous tissue with a hypoechoic area in the region of a fine needle aspiration site.

Incorrect Answer Explanations

Answer A: Silicone implant rupture with silicone granuloma formation is characterized by the linguine sign (collapsed implant shell) and silicone leakage, which may show the snowstorm appearance on ultrasound. There is typically no significant peri-implant fluid or enhancing capsular mass.

Answer B: Seroma due to late-onset implant infection can mimic BIA-ALCL, but usually occurs shortly after surgery or trauma, not years later. Infection often presents with pain, erythema, and systemic symptoms. Additionally, if an enhancing capsular mass is present on MRI, that would be characteristic of lymphoma.

Answer D: Capsular contracture with intracapsular implant rupture demonstrates implant shell collapse and silicone leakage contained within the capsule. Unlike BIA-ALCL, there is no large peri-implant effusion or nodular capsular enhancement.

Bottom Line

A delayed peri-implant effusion occurring years after implantation, especially with associated capsular nodularity, should raise suspicion for breast implant-associated anaplastic large cell lymphoma and prompt aspiration of the fluid for cytology (CD30-positive, ALK-negative).

For more information, see:
Clemens MW, Horwitz SM. Breast Implant–Associated Anaplastic Large Cell Lymphoma: Epidemiology, Clinical Presentation, and Surveillance. Radiographics. 2020;40(2):335-355.

Keep building your confidence with more exam-style radiology questions designed for the DXIT and CORE exams.

Access the 2026 DXIT/Core SmartBank

 

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