Vascular, Angiographic, and Lymphatic System Anatomy — WACS Viva & Clinical Scenarios (Radiological Anatomy and Normal Imaging Variants)

Exam-style vascular, angiographic, and lymphatic system anatomy viva scenarios with examiner probes and model answers for Radiology candidates.

Scenarios covered

• SCENARIO 1: Angiographic and Cross-Sectional Neurovascular Anatomy: A 3D-reconstructed digital subtraction angiogram (DSA) and contrast-enhanced CT angiogram (CTA) of the head and neck are presented. Identify the seven segments of the internal carotid artery (ICA) according to the Bouthillier classification (C1 through C7), specify their anatomical boundaries, and identify the origins and courses of the major branches arising from the C4, C6, and C7 segments, as well as the complete components of the Circle of Willis.
• SCENARIO 2: Splanchnic Visceral Vasculature and Collateral Pathways: An abdominal contrast-enhanced arterial-phase CT and selective mesenteric angiogram are displayed. Identify the celiac trunk and superior mesenteric artery (SMA) along with their classical branches. Trace the collateral pathways connecting the celiac trunk and SMA, as well as the SMA and inferior mesenteric artery (IMA), delineating the pancreaticoduodenal arcades, the Marginal Artery of Drummond, and the Arc of Riolan.
• SCENARIO 3: Portal Venous System and Portosystemic Collateral Networks: An axial and coronal portal-venous-phase CT of the abdomen is provided. Detail the precise confluence forming the main portal vein, its normal caliber, branching pattern within the liver, and relationship to the biliary tree and hepatic artery within the hepatoduodenal ligament. Map the major portosystemic anastomotic pathways that dilate in portal hypertension, including esophageal, paraumbilical, retroperitoneal, and rectal routes.
• SCENARIO 4: Cross-Sectional Venous Anatomy of the Thorax and Abdomen: A contrast-enhanced chest and abdominal CT is presented showing the caval systems. Identify the four embryological and anatomical segments of the inferior vena cava (IVC) and their normal visceral and parietal tributaries. Trace the course of the azygos, hemiazygos, and accessory hemiazygos venous systems and describe the drainage pathways of the left renal vein in relation to adjacent retroperitoneal arterial structures.
• SCENARIO 5: Lymphatic Drainage Pathways and Nodal Staging Stations: A schematic and corresponding cross-sectional CT series of the mediastinum, abdomen, and pelvis are displayed. Trace the anatomical origin, course, and termination of the thoracic duct. Delineate the standard radiological boundaries of the mediastinal lymph node stations (IASLC map) and retroperitoneal para-aortic/paracaval nodal groups according to international staging guidelines.