Mastering Radiology for NEET-PG and INI-CET in Just 2 Days

Daily Targets

  • Read/Revise 3–4 hours.
  • Solve 100–120 MCQs/day (25–30 per block, timed) with an error log.
  • Make 3–5 mini‑cards/day (classic signs, lines/angles, contrast reactions, CT/MRI sequences, emergency algorithms).

Day 1 — Physics & Safety, Modalities, Chest & Emergency Imaging

Imaging physics & safety (must‑know)

  • X‑ray basics: bremsstrahlung vs characteristic radiation; kVp (penetration) vs mAs (quantity); inverse square law.
  • Interaction with matter: photoelectric effect (↑Z dependence), Compton scatter (noise), pair production (high energies).
  • Film–screen & digital systems (CR/DR): DQE, MTF concepts; window/level.
  • CT: Hounsfield units (air −1000, fat −100, water 0, soft tissue +20–80, bone +1000); pitch; helical vs axial; artifacts (beam hardening, motion, metal, partial volume).
  • MRI: T1 vs T2 weighting; PD; inversion recovery (STIR—fat nulling; FLAIR—CSF nulling); DWI/ADC (acute infarct ↓ADC); GRE/SWI (blood/hemosiderin); common artifacts (chemical shift, susceptibility, motion, aliasing).
  • Ultrasound: impedance, reflection, attenuation; frequency vs penetration trade‑off; Doppler (color, power, spectral; aliasing; RI/PI idea); artifacts (acoustic shadow, enhancement, reverberation, mirror, ring‑down).
  • Nuclear medicine: gamma camera basics; SPECT vs PET (FDG uptake patterns); thyroid, bone, renal scans (DMSA, DTPA, MAG3 concept level).
  • Radiation protection: ALARA; time–distance–shielding; tissue weighting; deterministic vs stochastic effects; pregnancy concerns.
  • Dose metrics: DAP/DLP/CTDIvol; effective dose (mSv) ballparks (CXR ~0.02, CT head ~2, CT chest ~7, CT abdomen/pelvis ~10; awareness only).

Contrast media & reactions

  • Iodinated contrast: osmolality types; contraindications (severe CKD risk of CIN—concept), precautions (hydration), metformin hold logic (idea level); anaphylactoid reactions—prevention & treatment (H1/H2/steroids, epinephrine for severe).
  • Gadolinium: NSF risk in severe renal failure; macrocyclic vs linear idea; pregnancy/lactation snapshot.
  • US contrast (microbubbles) — concept.

Chest radiography & CT chest (pattern approach)

  • Systematic CXR read: patient data, projection (PA/AP), rotation/clavicles, exposure, airway/trachea, lungs/pleura, mediastinum/cardiac silhouette, diaphragm/CP angles, bones/soft tissues, lines/tubes.
  • Classic CXR signs: silhouette sign, air bronchogram, deep sulcus (pneumothorax supine), bat wing (pulmonary edema), meniscus (effusion), S‑sign of Golden (RUL collapse w/ mass), Westermark/Hampton’s hump (PE, concept level), rib notching (coarctation), honeycombing (fibrosis), cavitation walls (TB vs abscess idea).
  • HRCT patterns (awareness): ground‑glass, consolidation, crazy paving, tree‑in‑bud, mosaic attenuation; upper vs lower lobe predominance.
  • TB pointers: cavitation, tree‑in‑bud; miliary nodules; pleural effusion—concept level.

Emergency radiology (first‑steps mindset)

  • Trauma primary survey imaging: trauma CXR, FAST/eFAST windows (RUQ Morrison, LUQ, pelvis, subxiphoid; lung sliding – pneumothorax); unstable → OR vs stable → CT.
  • Cervical spine lines (anterior/posterior vertebral, spinolaminar); odontoid open mouth view; Jefferson/burst, hangman’s, teardrop injuries—awareness.
  • Head CT non‑contrast: extra‑axial vs intra‑axial; EDH (biconvex, does not cross sutures), SDH (crescent), SAH (sulci/basal cisterns), contusions; midline shift; herniation signs; infarct signs (loss of insular ribbon, hyperdense MCA); acute hemorrhage hyperdense → evolves.
  • Thorax trauma on CT: pneumothorax, hemothorax, pulmonary contusion, aortic injury (isthmus), flail chest.
  • Abdomen trauma: splenic/liver lacerations, active contrast extravasation; retroperitoneal hematoma zones.
  • Fracture basics on trauma series: pelvis AP; femoral neck; long bone alignment.

Day‑1 MCQs focus

  • T1 vs T2 vs STIR/FLAIR; DWI/ADC in stroke; HU values; common artifacts; contrast reaction steps; eFAST windows; EDH vs SDH vs SAH on CT; CXR signs (silhouette, deep sulcus, meniscus).

Day 2 — Neuro & Head–Neck, Abdomen & Pelvis, OB/Gyn & Pediatrics

Neuroimaging

  • Stroke protocol: NCCT to exclude bleed; early infarct signs; CTA for large vessel occlusion; CT perfusion concept; MRI DWI/FLAIR mismatch (wake‑up stroke idea).
  • Intracranial hemorrhage types recap; hypertensive bleed locations (BG, thalamus, pons, cerebellum).
  • Tumors (snapshot): meningioma (dural tail), gliomas (infiltrative), metastases (multiple gray–white junction); ring‑enhancing ddx (abscess—restricted diffusion, Toxoplasma idea, GBM, mets).
  • Demyelination: MS periventricular Dawson’s fingers; acute disseminated encephalomyelitis concept.
  • Infection: neurocysticercosis stages (vesicular → colloid → granular → calcified); tuberculoma (T2 hypointense rim, MR spectroscopy lipid‑lactate concept).
  • Hydrocephalus vs atrophy; midline shift signs; herniations.
  • Spine MRI basics: disc herniation levels, Modic changes (awareness), cord compression red flags; TB spine (skip lesions, gibbus, paravertebral abscess concept).

Head & neck

  • PNS/CT coronal for sinusitis; sinusitis patterns; mucormycosis red flags (DKA/immunosuppressed—black turbinate sign on MRI concept).
  • Temporal bone CT: cholesteatoma signs; ossicular chain.
  • Neck spaces: retropharyngeal abscess pointers; thyroid US—TI‑RADS idea (very high level); salivary stones on non‑contrast CT.

Abdomen & pelvis

  • Abdominal X‑ray: air–fluid levels; sentinel loop vs generalized ileus; Rigler sign (pneumoperitoneum); porcelain GB notion.
  • US abdomen: biliary (gallstones—posterior shadowing; cholecystitis—sonographic Murphy, wall thickening; CBD size awareness); renal (hydronephrosis grades; renal stones echogenic focus with shadow); appendicitis graded compression concept.
  • CT abdomen: appendicitis (appendix >6 mm, fat stranding); pancreatitis (Balthazar awareness); bowel obstruction (transition point); ischemia signs (pneumatosis, lack of enhancement); diverticulitis vs colitis clues.
  • Uro‑radiology: KUB vs NCCT for urolithiasis; HU of stones (uric acid ~<500 HU); obstructive uropathy signs; IVU historical context.
  • Gynec/pelvis CT/MRI: fibroid vs adenomyosis MRI clues; ovarian torsion (whirlpool sign); ectopic pregnancy US clues (adnexal mass, free fluid) — concept.

Breast imaging (snapshot)

  • Mammography: CC/MLO views; spiculated mass, microcalcifications; BIRADS categories (idea); US features of benign vs malignant (oval, parallel, circumscribed vs irregular, non‑parallel).

OB/Gyn ultrasound

  • First trimester: IUGS/YS/FHS milestones; ectopic red flags.
  • Second/third: biometry (BPD/HC/AC/FL); placenta previa/accreta spectrum concept; AFI; Doppler (umbilical artery RI, MCA—awareness only).
  • Fetal anomalies concept list: anencephaly, spina bifida lemon/banana signs, diaphragmatic hernia, hydronephrosis.

Pediatric radiology

  • Neonatal chest: TTN vs RDS vs meconium aspiration patterns.
  • NEC X‑ray: pneumatosis intestinalis; portal venous gas.
  • Intussusception US: target/doughnut sign; enema reduction concept; malrotation/volvulus (corkscrew sign) awareness.
  • DDH US basics (Graf idea), SCFE (Klein’s line), Perthes X‑ray stages (awareness).

Day‑2 MCQs focus

  • DWI/ADC infarct; meningioma dural tail; ring‑enhancing ddx with diffusion; neurocysticercosis stages; mucormycosis MRI cue; Rigler sign; appendicitis CT criteria; pancreatitis severity hint; urolithiasis HU; intussusception US sign; placenta previa vs accreta pointers.

Day 3 — MSK, Spine & Joints, Interventional, Nuclear Medicine & “Classic Signs” Roundup

MSK radiology

  • Fracture descriptions: site, morphology (transverse/oblique/spiral/comminuted), displacement/angulation/rotation; intra‑ vs extra‑articular.
  • Lines & angles: Shenton’s line (hip), Bohler’s angle (calcaneus), scapholunate interval (Terry Thomas sign), ankle mortise, sacroiliitis grading idea.
  • Shoulder: dislocations (anterior—Bankart/Hill‑Sachs); rotator cuff tear MRI basics; AC separation.
  • Wrist/hand: scaphoid fracture signs; perilunate vs lunate dislocation; ulnar variance; Colles/Smith/Barton.
  • Knee: ACL/PCL on MRI; meniscus tears (bucket‑handle, posterior horn); osteochondral lesions.
  • Osteomyelitis: X‑ray vs MRI; sequestrum/involucrum; Brodie abscess.
  • Arthritis patterns: OA (osteophytes, JSN), RA (periarticular osteopenia, symmetric JSN, erosions), seronegative (sacroiliitis, syndesmophytes); gout tophi.

Interventional radiology (concept, exam‑style)

  • Vascular: DSA basics; angioplasty/stenting; embolization (PPH, hemoptysis, pseudoaneurysm); TACE (HCC) concept.
  • Non‑vascular: image‑guided biopsy/ablation (RFA/MWA), drainage (pigtail), nephrostomy, biliary drainage (PTBD), TIPS idea.
  • Complications & consent basics; anticoagulation snapshot.

Nuclear medicine (more detail)

  • Thyroid scintigraphy (hot vs cold nodules); radioactive iodine therapy idea.
  • Bone scan (Tc‑MDP): metastasis, fractures, infection; flare phenomenon.
  • Renal scans: DTPA/MAG3 (function & drainage), DMSA (cortical scars).
  • PET‑CT FDG uptake physiology vs pathology; standardized uptake value (SUV) awareness; lymphoma/solid tumors staging utility.

Radiology QA & reporting

  • Structured reporting basics; checklists; critical findings communication; discrepancy meetings; BI‑RADS/TI‑RADS/LI‑RADS idea.

Classic radiology signs (must‑memorize one‑liners)

  • Head/neck: “thumb sign” (epiglottitis), “steeple sign” (croup).
  • Chest: “deep sulcus” (supine pneumothorax), “air bronchogram”, “silhouette sign”.
  • Cardiac: “boot‑shaped heart” (TOF), “snowman” (TAPVR supracardiac).
  • GI: “Rigler sign” (pneumoperitoneum), “double bubble” (duodenal atresia), “string sign” (Crohn), “coffee bean” (sigmoid volvulus).
  • GU: “bear paw” (xanthogranulomatous pyelonephritis), “cobra head” (ureterocele).
  • MSK: “onion skin” (Ewing), “sunburst/Codman” (osteosarcoma), “fallen fragment” (unicameral bone cyst), “dense metaphyseal lines” (lead), “rugger‑jersey spine” (hyperparathyroidism).
  • Neuro: “dural tail” (meningioma), “ring diffusion restriction” (abscess), “tram track” (Sturge‑Weber—awareness), “lemon/banana” (spina bifida).

Day‑3 MCQs focus

  • MRI sequences and what they highlight; rotator cuff vs labral lesions basics; sacroiliitis vs OA; IR procedures DOC scenarios; thyroid/bone/renal scans uses; PET‑CT common indications; match‑the‑sign questions.

Rapid Revision (Evening of Day 3)

  • CT HU ladder; MRI T1/T2/STIR/FLAIR/DWI/GRE quick map; US artifacts; Doppler aliasing.
  • Contrast reactions protocol; gadolinium & NSF; metformin hold logic (idea level).
  • CXR/CNS emergency signs (silhouette, deep sulcus; EDH vs SDH vs SAH; hyperdense MCA).
  • Stroke CT→CTA→Perfusion flow; DWI/ADC infarct.
  • Appendicitis criteria; pancreatitis stages; urolithiasis HU; intussusception target sign.
  • MSK: scaphoid AVN risk; Hill‑Sachs/Bankart; Bohler’s & Shenton’s lines; sacroiliitis vs OA.
  • Nuclear: thyroid/bone/renal scan pearls; PET‑CT uses.

Practice Pattern (all days)

  • Timed MCQ blocks → immediate review → write one rule learned from each error.
  • Vignette flow: pick best modality → pick best sequence/protocol → identify key sign → state first step.
  • Mini‑cards to carry: MRI sequences table; CT HU ladder; contrast reactions steps; eFAST windows; ring‑enhancing ddx; pediatric target signs; classic signs roundup.
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