Usually resurrecting a half year old thread is not in the best interest of anyone (especially when the poster has ceased activity ever since). However, this is an interesting case and hence I'll try to contribute rather than just lock the thread.
To answer some of the raised questions:
You can communicate with an NPC in various ways. If the NPC has already a corresponding script running (means you can hail or talk to him) then the MD event
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event_conversation_started conversation="default" />
allows all kind of action to be triggered. One of them is multiple-choice answers via "add_player_choice" which also has a nested option "add_player_choice_sub".
If it is a "new" NPC, i.e. one of your own creation, then you need to start a conversation (previous to the steps above) via
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<start_conversation actor="newNPC" conversation="MyConversation" type="unqueued" />
replacing the "default" by "MyConversation".
As for including your own (or any) picture, that should be possible with the defining files of the new NPC. But I never attempted anything in this direction and hence my help in this respect is rather speculative
Finally, once you have established an NPC/conversation, then all kind of things can be triggered via MD events.
Good luck with the mod!
Cheers Euclid
"In any special doctrine of nature there can be only as much proper science as there is mathematics therein.”
- Immanuel Kant (1724-1804), Metaphysical Foundations of the Science of Nature, 4:470, 1786