Aortic Diseases, Pulmonary Embolism, and Thoracic Vascular Pathology — WACS Viva & Clinical Scenarios (Chest and Cardiovascular Imaging)

Exam-style aortic diseases, pulmonary embolism, and thoracic vascular pathology viva scenarios with examiner probes and model answers for Radiology candidates.

Scenarios covered

• SCENARIO 1: Image Interpretation and Differential Diagnosis: A contrast-enhanced CT angiography of the chest is presented in an adult patient presenting with sudden-onset, tearing retrosternal chest pain radiating to the interscapular region. Describe the systematic evaluation, luminal differentiation, and classification of the pathology.
• SCENARIO 2: Clinical Case-Based Viva: Detail the protocol design, image acquisition optimization, and cross-sectional imaging assessment of acute pulmonary embolism and associated right ventricular strain on CT pulmonary angiography (CTPA).
• SCENARIO 3: Structured Viva on Acute Aortic Syndromes: Discuss the pathophysiology, distinguishing cross-sectional imaging features, classification, and complication analysis of intramural haematoma (IMH) versus penetrating atherosclerotic ulcer (PAU) and classic aortic dissection.
• SCENARIO 4: Technical and Protocol Management: Explain the mechanisms, identification, and troubleshooting of common thoracic vascular CT artifacts, including ascending aortic pulsation artifacts, beam hardening, and transient interruption of contrast during CTPA.
• SCENARIO 5: Long Case and Spotter Station: Differentiate the cross-sectional imaging features, vessel involvement patterns, and complications of thoracic inflammatory aortitis (such as Takayasu arteritis), thoracic aortic pseudoaneurysms, and congenital thoracic vascular anomalies including aortic coarctation.