bluuebunny/crossref_metadata_2025 huggingface dataset:
Case 3.21
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

63-year-old man with recent fever, chills, and jaundice. ERCP performed at an outside institution revealed a hilar stricture concerning for cholangiocarcinoma; a biliary stent was placed

MIP image from 3D FRFSE MRCP (Figure 3.21.1) demonstrates marked focal narrowing of the proximal CBD in the hepatic hilum with intrahepatic biliary dilatation. Axial equilibrium phase postgadolinium 3D SPGR images (...
Case 3.23
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

62-year-old man with jaundice, an elevated CA 19-9 level, and a porta hepatis mass on CT performed at an outside institution

Axial fat-suppressed FSE T2-weighted images (Figure 3.23.1) reveal an ill-defined, spiculated mass in the hepatic hilum encasing the central biliary ducts, with peripheral intrahepatic biliary dilatation. Axial 2D SPGR images obtained 8 minutes after gadolinium injection (...
Case 3.24
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

58-year-old woman who has fatigue and jaundice; ERCP at an outside institution revealed an obstructive hilar lesion

Volume-rendered image from 3D SSFP MRCP (Figure 3.24.1) demonstrates central biliary obstruction extending to the bifurcation of the right and left ducts. Axial arterial (...
Case 3.26
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

52-year-old woman with abdominal discomfort and abnormal results on liver function tests

Axial fat-suppressed FSE T2-weighted image (Figure 3.26.1) and diffusion-weighted image (b=600 s/mm2) (Figure 3.26.2) reveal a large mass with increased signal intensity partially surrounding the right hepatic vein and inferior vena cava. Axial arterial, portal venous, and equilibrium phase postgadolinium 3D SPGR images (...
Case 4.2
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

56-year-old woman with previously resected ileal neuroendocrine tumor; MRI was performed to assess for hepatic metastases

Axial arterial phase postgadolinium 3D SPGR images (Figure 4.2.1) demonstrate enhancing soft tissue extending from the pancreatic head and uncinate process and encircling the second portion of the duodenum. Note also a hyperenhancing metastasis in the inferior right hepatic lobe (...
Case 4.6
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

21-year-old woman with thalassemia major

Axial fat-suppressed FSE T2-weighted images (Figure 4.6.1) demonstrate low signal intensity throughout the liver and pancreas. The spleen is absent (as a result of splenectomy). In-phase (Figure 4.6.2A) and out-of-phase (Figure 4.6.2B) 2D SPGR images reveal markedly low signal intensity in the liver, which changes little from in-phase to out-of-phase images. Signal intensity is lower within the pancreas on the in-phase image than on the out-of-phase image....
Case 4.10
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

73-year-old man with jaundice

MIP image from 3D FRFSE MRCP (Figure 4.10.1) demonstrates dilated intrahepatic and extrahepatic biliary ducts, a distended gallbladder, and irregular narrowing of the pancreatic duct. Axial fat-suppressed FSE T2-weighted image (Figure 4.10.2) and axial venous phase postgadolinium 3D SPGR images (...
Case 4.12
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

71-year-old woman with a possible pseudocyst

Anterior (Figure 4.12.1A) and posterior (Figure 4.12.1B) MIP images from 3D FRFSE MRCP reveal marked irregular cystic dilatation of the main pancreatic duct and dilatation of multiple side-branch ducts.

IPMN involving the main pancreatic duct...
Case 4.14
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

87-year-old man with an abdominal mass

Coronal SSFSE (Figure 4.14.1) and axial fat-suppressed FRFSE T2-weighted (Figure 4.14.2) images reveal a large multilocular cystic mass centered in the pancreatic tail with a central scar. Postcontrast coronal 2D SPGR images (Figure ...
Case 4.19
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

62-year-old woman with a systemic disorder

Axial fat-suppressed FSE T2- weighted (Figure 4.19.1) and coronal SSFSE images (Figure 4.19.2) demonstrate innumerable pancreatic cysts.

VHL syndrome with cystic pancreas

Pancreatic involvement in VHL syndrome is not exactly an afterthought in many texts, but it does tend to be the last abdominal manifestation mentioned. This case is somewhat unusual in that the kidneys were almost completely spared in spite of extensive pancreatic involvement, but this can occur and should not dissuade anyone from making the correct diagnosis....
Case 4.20
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

30-year-old woman with VHL syndrome and prior pancreatic surgery

Axial diffusion-weighted images (b=100 s/mm2) (Figure 4.20.1) reveal multiple hyperintense hepatic lesions. Axial fat-suppressed FSE T2-weighted images (Figure 4.20.2) demonstrate extensive cystic disease involving the pancreas. Note also that several lesions consist of clustered cysts. Axial (...
Case 4.21
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

68-year-old woman with pruritus, jaundice, and generalized weakness

VR image from 3D FRFSE MRCP (Figure 4.21.1) demonstrates biliary and pancreatic ductal dilatation, with obstruction at the level of the pancreatic head, and a small biliary stent extending into the duodenum. Axial arterial phase postgadolinium 3D SPGR image through the hepatic dome (...
Case 4.23
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

69-year-old man with a recent onset of upper abdominal pain

VR image from 3D FRFSE MRCP (Figure 4.23.1) reveals abrupt cutoff of the pancreatic duct in the neck of the pancreas with mild proximal dilatation. Axial T1-weighted in-phase 2D SPGR image (...
Case 4.25
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

64-year-old man with elevated liver function tests

MIP image from 3D FRFSE MRCP (Figure 4.25.1) reveals a filling defect in the distal common bile duct, diffuse intrahepatic biliary dilatation, and mild dilatation of the pancreatic duct. Coronal oblique SSFSE images (Figure ...
Case 4.27
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

67-year-old man with dilated bile ducts and a pancreatic mass on US

VR image from 3D FRFSE MRCP (Figure 4.27.1) reveals obstruction of the common bile duct and the pancreatic duct at the level of the pancreatic head. Coronal fat-suppressed 2D SSFP images (...
Case 4.29
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

84-year-old woman who palpated a mass in her upper abdomen

Coronal SSFSE images (Figure 4.29.1) demonstrate a large heterogeneous mass in the gastrohepatic ligament originating from the pancreas and displacing the stomach to the left. Note the high-signal-intensity lesion in the anterior left hepatic lobe. Axial fat-suppressed FSE T2-weighted images (...
Case 5.9
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

72-year-old woman with KTS affecting her right lower extremity

Axial fat-suppressed FSE T2-weighted images (Figure 5.9.1) show multiple cystic lesions throughout the spleen.

KTS with splenic lymphangiomatosis

The differential diagnosis for multiple splenic cystic lesions also includes infectious and posttraumatic etiologies; however, the large number of lesions and their simple appearance in combination with the history of KTS makes splenic lymphangiomatosis the best choice....
Case 5.13
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

63-year-old man with a chronic hematologic disorder

Coronal postgadolinium 3D SPGR image (Figure 5.13.1) shows massive splenomegaly. Axial fat-suppressed FSE T2-weighted images (Figure 5.13.2) show splenomegaly and markedly decreased signal intensity in the liver and spleen. Axial images at the same location from a multiple-echo GRE sequence (TE = 2.5, 6.5, 10.5, and 14.5 ms in panels A, B, C, and D, respectively, of ...
Case 5.18
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

49-year-old man with hepatitis C and a remote history of splenectomy after trauma

Axial fat-suppressed FSE T2-weighted images (Figure 5.18.1) show multiple hypointense masses in the left upper quadrant and the right pararenal space. Axial arterial phase postgadolinium 3D SPGR images (...
Case 5.19
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

67-year-old woman with a history of bicuspid aortic valve and ascending aortic aneurysm

Axial (Figure 5.19.1) and coronal (Figure 5.19.2) fat-suppressed SSFP images show midline orientation of the liver and the absence of a spleen. The IVC is also absent, with a prominent hemiazygos vein in the abdomen and azygos and hemiazygos veins in the lower chest. The aortic root and ascending aorta are dilated....
Case 5.20
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

55-year-old woman with a history of complex congenital heart disease

Axial postgadolinium 3D SPGR images (Figure 5.20.1) show a left-sided liver, right-sided stomach, and multiple small accessory spleens in the right upper quadrant. The IVC is absent, and the azygos and hemiazygos veins are prominent. Coronal postgadolinium 3D SPGR images (...
Case 6.4
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

51-year-old man with a history of right flank discomfort and renal stones; a large renal mass was detected on renal stone CT at another medical facility

Coronal SSFSE image (Figure 6.4.1) reveals a large hyperintense right adrenal lesion. Axial fat-suppressed FRFSE image (...
Case 6.5
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

33-year-old woman with infertility and hydronephrosis; an adrenal lesion was incidentally noted on a CT urogram

Axial fat-suppressed FSE T2-weighted images (Figure 6.5.1) reveal a large left adrenal mass with heterogeneous increased T2-signal intensity. Arterial (Figure 6.5.2A), portal venous (...
Case 6.11
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

1-month-old female infant with a renal or adrenal mass

Axial fat-suppressed FSE T2-weighted images (Figure 6.11.1) reveal a large mass originating from the right adrenal gland with heterogeneously increased signal intensity. Extensive small hyperintense metastases essentially replace the visualized hepatic parenchyma. Axial fat-suppressed FSE images from the 6-week follow-up examination (...
Case 7.1
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

74-year-old man with a solitary kidney and new microscopic hematuria

Coronal 2D fat-suppressed SSFP images (Figure 7.1.1) reveal a mass in the upper pole of the right kidney with heterogeneous expansile thrombus in the subhepatic and intrahepatic IVC. Note also the small, more hypointense filling defect in the IVC inferiorly just above the bifurcation, representing bland thrombus. Coronal venous phase 3D SPGR images (...
Case 7.7
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

72-year-old man with hematuria, right flank pain, and weight loss

Axial fat-suppressed FSE T2-weighted images (Figure 7.7.1) and coronal nephrogenic phase postgadolinium 3D SPGR images (Figure 7.7.2) reveal an infiltrative hypoenhancing and mildly T2 hypointense mass in the lower pole of the right kidney....
Case 7.10
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

70-year-old man with recent hematuria; varicocele was noted on physical examination

Axial fat-suppressed FSE T2-weighted images (Figure 7.10.1) and axial arterial phase postgadolinium 3D SPGR images (Figure 7.10.2) show a homogeneous mass surrounding the left kidney, as well as the aorta and left renal artery. Note the moderate left hydronephrosis....
Case 7.12
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

85-year-old woman with nausea; CT performed in the emergency department revealed a large right renal mass

Coronal SSFP (Figure 7.12.1), axial fat-suppressed FSE (Figure 7.12.2), and axial postgadolinium 3D SPGR (Figure 7.12.3) images show a heterogeneous mass in the upper pole of the right kidney, with the suggestion of a central scar....
Case 7.13
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

61-year-old man presents for routine surveillance after right nephrectomy

Coronal SSFSE (Figure 7.13.1) and axial postgadolinium 2D SPGR (Figure 7.13.2) images show a prior right nephrectomy and multiple hypoenhancing left renal masses, which are also mildly hypointense on the SSFSE image....
Case 7.14
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

43-year-old man with a systemic disorder

Axial fat-suppressed FSE T2-weighted images (Figure 7.14.1) show multiple cysts and solid masses in the kidneys bilaterally. Coronal postgadolinium 2D SPGR images (Figure 7.14.2) show similar findings.

von Hippel-Lindau disease with bilateral renal cysts and bilateral renal cell carcinomas...
Case 7.16
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

31-year-old woman with epigastric discomfort found to have a renal mass on CT at an outside institution

Axial fat-suppressed T2-weighted FSE (Figure 7.16.1), axial IP-OP 2D SPGR (Figure 7.16.2), and axial postgadolinium 3D SPGR (Figure 7.16.3) images show a mass originating from the posterior right kidney with heterogeneous increased T2-signal intensity and irregular enhancement. No definite fat content is identified....
Case 7.19
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

50-year-old man with Crohn disease and urinary frequency and urgency; a cystic renal mass was found at renal sonography

Axial fat-suppressed T2-weighted FSE (Figure 7.19.1), coronal SSFSE (Figure 7.19.2), and coronal postgadolinium 2D SPGR (Figure 7.19.3) images show multiple small cystic lesions without significant enhancement clustered in the upper pole of the right kidney....
Case 7.21
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

40-year-old woman with chronic disease

Coronal SSFSE images (Figure 7.21.1) reveal bilateral enlarged kidneys containing innumerable cysts of various sizes, including some with hemorrhagic debris. Note also the multiple small hepatic cysts.

Autosomal dominant polycystic kidney disease

ADPKD is one of the most common hereditary renal disorders, with an estimated prevalence between 1 in 300 and 1 in 1,000 persons. It accounts for approximately 8% to 10% of patients with end-stage renal disease in the United States and Europe. ADPKD has autosomal dominant inheritance in 90% of cases; 10% occur sporadically. Two separate genetic mutations are responsible for most cases of ADPKD: the ...
Case 7.23
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

21-year-old woman with chronic abdominal pain; CT revealed an incidental left renal mass

Coronal SSFSE (Figure 7.23.1) and axial fat-suppressed FSE T2-weighted (Figure 7.23.2) images show a complex cystic lesion in the upper pole of the left kidney. Note also innumerable round lesions throughout the cortex of the left kidney showing markedly decreased T2-signal intensity. Axial arterial phase (...
Case 7.25
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

30-year-old man with decreased renal function

Coronal SSFSE (Figure 7.25.1) and axial fat-suppressed T2-weighted FSE (Figure 7.25.2) images reveal hydronephrosis in the upper pole of the right kidney and an atrophic left kidney with hydronephrosis. Note the rind of hypointense soft tissue surrounding both kidneys. Coronal (...
Case 7.27
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

72-year-old man with aortic dissection who underwent aortic root replacement and prosthetic aortic valve replacement 14 years ago; the patient has had worsening periprosthetic regurgitation and cardiac failure and has required multiple transfusions

Two axial GRE images from a BOLD acquisition (Figure 7.27.1...
Case 7.30
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

32-year-old woman with a history of bilateral perinephric hematomas approximately 4 months ago that resulted in acute renal failure and new onset of hypertension; renal failure has resolved, but she has persistent hypertension

Axial fat-suppressed SSFP images (Figure 7.30.1) and a coronal SSFSE image (...
Case 7.32
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

62-year-old woman with chest discomfort and right upper quadrant pain

Coronal source image from 3D contrast-enhanced MRA (Figure 7.32.1) shows a prominent eccentric thrombus in the lumen of the posterior aortic arch. Post-MRA, 2D SPGR axial images (Figure 7.32.2) through the upper abdomen demonstrate a large region of absent perfusion in the right kidney, with preserved capsular enhancement....
Case 7.33
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

63-year-old woman with mitral valve vegetations, septicemia, and new left upper quadrant pain

Axial breath-hold T2-weighted FRFSE images (Figure 7.33.1) show mild soft tissue stranding around the right kidney, as well as several small, T2-hyperintense lesions throughout the right kidney. Axial nephrogenic phase postgadolinium 3D SPGR images (...
Case 8.2
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

31-year-old woman with stress urinary incontinence

Axial fat-suppressed FSE T2-weighted images (Figure 8.2.1) demonstrate a small round structure anterior to the urethra emerging from the bladder base. A sagittal FSE T2-weighted image (Figure 8.2.2) shows 2 urethras extending from the base of the bladder, and a similar appearance is shown on an image from a voiding cystourethrogram (...
Case 8.7
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

52-year-old man with an episode of gross hematuria

Coronal fat-suppressed FSE T2-weighted image (Figure 8.7.1) demonstrates moderate thickening of the right lateral and inferior bladder wall. Axial postgadolinium 2D SPGR images (Figure 8.7.2) again show thickening and mild enhancement of the right bladder wall, as well as focal thickening and enhancement of the anterior wall....
Case 8.8
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

48-year-old woman who has dysfunctional uterine bleeding and cyclic bladder irritation; pelvic US revealed a bladder mass

Axial (Figure 8.8.1) and sagittal (Figure 8.8.2) FSE T2-weighted images demonstrate a hyperintense mass near the ureterovesical junction. Venous phase postgadolinium 3D SPGR image (...
Case 8.9
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

20-year-old man with intermittent rectal bleeding

Axial T1-weighted (Figure 8.9.1) and fat-suppressed T2-weighted (Figure 8.9.2) FSE images demonstrate infiltration of the bladder wall by innumerable small, cystic lesions. Note infiltration of the mesorectal fat by nodular serpiginous structures also bright on T2-weighted images....
Case 8.10
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

40-year-old man with hypertension and hyperaldosteronism; a CT performed at an outside institution demonstrated an incidental bladder mass

Axial (Figure 8.10.1) and sagittal (Figure 8.10.2) fat-suppressed FSE T2-weighted images show a round, well-circumscribed mass in the posterior wall of the bladder with uniformly low T2-signal intensity....
Case 8.11
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

37-year-old woman with a history of neurofibromatosis and menometrorrhagia

Sagittal fat-suppressed 3D FSE T2-weighted image (Figure 8.11.1) and axial 2D fat-suppressed FSE images (Figure 8.11.2) reveal masslike thickening of the posterior and superior bladder walls, with relatively low signal intensity. Sagittal arterial phase postgadolinium 3D SPGR image (...
Case 8.15
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

59-year-old man with voiding dysfunction; a bladder mass was found at cystoscopy

Axial (Figure 8.15.1) and coronal (Figure 8.15.2) postgadolinium 3D SPGR images show a complex, partially cystic or necrotic mass extending from the bladder superiorly along the anterior abdominal wall toward the umbilicus....
Case 8.19
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

75-year-old man with history of gross hematuria

Axial fat-suppressed FSE T2-weighted images (Figure 8.19.1) show a mass in the bladder posteriorly near the right ureterovesical junction with mild increased signal intensity obstructing the distal right ureter. Arterial phase and 10-minute delayed postgadolinium coronal 3D SPGR images from an MR urogram (...
Case 8.20
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

51-year-old woman with chronic UTIs

Coronal SSFSE image (Figure 8.20.1) shows a cystic filling defect centrally in the bladder. A much smaller ovoid cystic structure is faintly visible on the right side of the bladder. Posterior volume-rendered image from a 3D FRFSE MR urogram (...
Case 8.21
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

68-year-old woman with severe intermittent right abdominal pain; MRA was performed for suspected mesenteric ischemia

Coronal SSFSE images (Figure 8.21.1) demonstrate mild hydronephrosis of the right kidney with a small, hypointense filling defect in the ureteropelvic junction. Note also mild right-sided perinephric soft tissue stranding. Axial image from noncontrast CT (...
Case 8.23
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

73-year-old man presenting for surveillance examination 9 months following cystectomy for an invasive urothelial tumor

Coronal oblique arterial phase (Figure 8.23.1) and excretory phase (Figure 8.23.2) postgadolinium 3D SPGR images from gadolinium MR urography show marked periureteral peripelvic soft tissue thickening and mild enhancement involving the left kidney and proximal ureter, with mild associated hydronephrosis. Bilateral nephroureteral stents are present and can be perceived faintly on the excretory phase image. Note also the right renal cysts and a small filling defect in a left lower pole calyx; this was a small calculus....
Case 9.1
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

56-year-old asymptomatic woman with liver mass thought to be focal nodular hyperplasia on CT

Image from a double-contrast esophagram (Figure 9.1.1) demonstrates a relatively subtle mural lesion in the distal esophagus with a small central ulceration. Axial fat-suppressed T2-weighted FSE images (...
Case 9.5
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

75-year-old woman with abdominal cramping and diarrhea; CT at an outside institution found an indeterminate mass, possibly an exophytic hepatic hemangioma

Axial arterial phase (Figure 9.5.1) and equilibrium phase (Figure 9.5.2.) 3D SPGR images reveal a heterogeneously enhancing mass in the gastrohepatic ligament originating from the lesser curvature of the stomach. Equilibrium phase images show some accumulation of contrast agent within the lesion. Axial fat-suppressed 2D SSFP images (...
Case 9.10
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

24-year-old man with 5-year history of Crohn disease now with worsening right lower quadrant pain, difficulty eating, and diarrhea

Coronal SSFSE (Figure 9.10.1), fat-suppressed 2D SSFP (Figure 9.10.2), and postgadolinium 3D SPGR (Figure 9.10.3) images show marked thickening of the distal ileum, with matted loops of ileum in the right lower quadrant. Note the prominent enteroenteric fistula in the distal ileum....
Case 9.13
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

86-year-old man with rectal bleeding; colonoscopy demonstrated a polyp in the ascending colon

Axial SSFSE images (Figure 9.13.1) and coronal fat-suppressed SSFP images (Figure 9.13.2) show focal mural thickening in the distal ileum. The underlying lumen is dilated, and no proximal obstruction is visible. Axial (...
Case 9.15
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

23-year-old pregnant woman with worsening abdominal pain

Coronal (Figure 9.15.1), axial (Figure 9.15.2), and sagittal (Figure 9.15.3) SSFSE images show a dilated, fluid-filled appendix. A structure at the junction of the appendix and the cecum has low signal intensity and represents an obstructing appendicolith. Note also the mild edema and stranding in the periappendiceal fat....
Case 9.20
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

70-year-old woman with 20-lb weight loss over the past 6 months and crampy lower abdominal pain

Axial fat-suppressed FSE T2-weighted images (Figure 9.20.1) and postgadolinium axial (Figure 9.20.2) and sagittal (Figure 9.20.3) 3D SPGR images demonstrate a large, heterogeneously enhancing mass in the pelvis, with markedly increased T2-signal intensity and multiple cystic regions on postcontrast images. The origin of the lesion from the sigmoid colon is difficult to discern, but it is probably best appreciated on the axial postgadolinium images. Note the invasion of the bladder dome, with a gas pocket in the anterior bladder....
Case 9.21
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

50-year-old man with hematochezia; colonoscopy showed a rectal mass

Axial FSE T2-weighted images (Figure 9.21.1) obtained after endorectal administration of US gel show a crescentic mass involving the right and posterior walls of the rectum and extending into the lumen. Note the stranding in the mesorectal fat extending toward the margin of the mesorectal fascia and loss of delineation of the rectal wall. Axial arterial phase, postgadolinium 3D SPGR images (...
Case 9.23
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

66-year-old man with recent rectal bleeding underwent colonoscopy at an outside institution, where a biopsy was performed but yielded benign tissue. Sigmoidoscopy at Mayo Clinic suggested a vascular lesion, and pelvic MRI was requested for further evaluation

Axial fat-suppressed T2-weighted FSE images (Figure ...
Case 9.24
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

45-year-old man with chronic portal and superior mesenteric vein thrombosis and new onset of rectal bleeding

Axial T1-weighted (Figure 9.24.1) and fat-suppressed T2-weighted (Figure 9.24.2) FSE images demonstrate nodular thickening of the rectal wall with surrounding serpiginous structures, all with high T2-signal intensity. Axial 2D fat-suppressed SSFP images (...
Case 10.1
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

69-year-old woman with chronic left labial swelling

Axial T1-weighted (Figure 10.1.1) and axial and coronal fat-suppressed T2-weighted (Figure 10.1.2) FSE images reveal a well-defined T2-hyperintense lesion in the left labia. Axial and coronal postgadolinium 2D SPGR images (Figure 10.1.3...
Case 10.4
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

69-year-old woman with vaginal bleeding

Axial FSE T2-weighted images (Figure 10.4.1) reveal a large infiltrative mass expanding the walls of the vagina and extending laterally into the left pelvic sidewall. Note that the tumor partially encases the rectum and extends into the posterior bladder wall. The lesion shows high signal intensity on axial DWI (b=800 s/mm...
Case 10.7
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

45-year-old woman with abnormal uterine bleeding

Axial oblique FSE T2-weighted images (Figure 10.7.1) show a banana-shaped uterus with a single horn. Note also small nabothian cysts in the cervix.

Unicornuate uterus

Müllerian duct anomalies are not common, but their importance lies in the fact that some of them represent treatable causes of infertility. The female reproductive tract develops primarily from the paired müllerian ducts, which form the fallopian tubes, uterus, cervix, and upper two-thirds of the vagina. Normal development requires completion of organogenesis, fusion, and septal resorption. Failure of organogenesis leads to class I and class II anomalies (agenesis/hypoplasia and unicornuate uterus). Abnormalities of fusion result in bicornuate and didelphic configurations (class III and class VI). Incomplete or absent septal resorption results in a septate (class V) or arcuate (class VI) uterus....
Case 10.9
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

15-year-old girl with abdominal pain, irregular periods, and suspected uterine anomaly

Coronal oblique FSE T2-weighted images (Figure 10.9.1) reveal 2 distinct uterine horns, with the right endometrial cavity distended with fluid. Note that 2 cervices are present on Figure 10.9.1C. There are 2 vaginal cavities: the right massively dilated and fluid-filled and the left collapsed and barely perceptible. Coronal oblique T1-weighted images (...
Case 10.10
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

30-year-old woman with a possible uterine anomaly on pelvic US

Axial (Figure 10.10.1) and coronal oblique (Figure 10.10.2) fat-suppressed FSE T2-weighted images reveal 2 uterine horns with a moderate uterine cleft and a septum extending throughout the endometrial cavity and cervix. A coronal large field-of-view SSFSE image (...
Case 10.14
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

53-year-old woman with abnormal uterine bleeding

Sagittal oblique fat-suppressed FSE T2-weighted images (Figure 10.14.1) reveal a hyperintense mass originating in the cervix and extending inferiorly into the upper vagina. Axial DWI (b=600 s/mm2) (Figure 10.14.2) again shows the cervical mass, with marked hyperintensity. The lesion is hypointense relative to myometrium on postgadolinium axial arterial and equilibrium phase images (...
Case 10.15
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

34-year-old woman with abnormal uterine bleeding

Axial oblique FSE T2-weighted images (Figure 10.15.1) reveal a hyperintense mass originating in the cervix and extending into the lower uterine segment. Sagittal fat-suppressed FSE T2-weighted images (Figure 10.15.2) show similar findings, and postgadolinium sagittal 3D SPGR images (...
Case 10.16
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

68-year-old woman with a remote history of cervical cancer treated with cobalt therapy, now with rectal bleeding

Sagittal oblique fat-suppressed FSE T2-weighted (Figure 10.16.1) and postgadolinium 2D SPGR (Figure 10.16.2) images reveal a heterogeneous mass involving both the cervix and the rectosigmoid colon....
Case 10.17
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

64-year-old woman with a metastatic lesion in her right distal femur

Axial oblique (Figure 10.17.1) and sagittal oblique (Figure 10.17.2) FSE T2-weighted images and postgadolinium 2D SPGR images (Figures 10.17.3 and 10.17.4) reveal a large infiltrative mass expanding the endometrial cavity and invading the myometrium. Note also the mildly enlarged lymph node in the right pelvic sidewall....
Case 10.21
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

48-year-old woman with an abdominal mass noted on physical examination

Coronal oblique FSE T2-weighted images (Figure 10.21.1), axial fat-suppressed SSFP images (Figure 10.21.2), and postgadolinium sagittal 3D SPGR images (Figure 10.21.3) demonstrate a large, complex mass arising from the uterine fundus. The mass has both cystic and solid components and shows heterogeneous enhancement after gadolinium administration....
Case 10.22
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

58-year-old postmenopausal woman with abnormal uterine bleeding

Axial oblique fat-suppressed 3D FRFSE T2-weighted images (Figure 10.22.1) reveal diffuse irregular thickening of the endometrial cavity with multiple small cystic lesions. Similar complex cystic expansion of the endometrium is also seen on coronal oblique fat-suppressed SSFP images (...
Case 10.23
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

24-year-old pregnant woman with recent uterine bleeding

Axial oblique 3D FRFSE (Figure 10.23.1) and sagittal oblique 2D FSE (Figure 10.23.2) images show a complex mass along the margin of the cervix with a central cystic region containing a small soft tissue structure....
Case 10.25
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

35-year-old pregnant woman with abnormal obstetric US

Sagittal oblique fat-suppressed 2D SSFP images (Figure 10.25.1) demonstrate a large complex, multiloculated, and predominantly cystic mass in the anterior fetal neck, with some solid components. Note also polyhydramnios.

Fetal cervical teratoma

This is a companion case to the fetal intracranial teratoma case (...
Case 11.2
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

31-year-old woman with a history of Crohn colitis and rectovaginal fistula, now presenting with new, left lower quadrant pain

Axial fat-suppressed FSE T2-weighted images (Figure 11.2.1) demonstrate a complex high-signal-intensity lesion in the left adnexa. Notice also pelvic ascites and a tubular cystic structure traversing the ascites within the posterior right pelvis. Axial postgadolinium 2D SPGR images (...
Case 11.5
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

27-year-old woman with left lower quadrant pain and a history of endometriosis

Axial FSE T2-weighted images (Figure 11.5.1) demonstrate a large, lobulated left adnexal lesion with regions of high and low signal intensity. Coronal fat-suppressed FSE T2-weighted images (Figure 11.5.2) reveal similar findings. Coronal fat-suppressed FSE T1-weighted images (...
Case 11.6
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

50-year-old woman with intermittent rectal bleeding

Axial FSE T2-weighted images (Figure 11.6.1) demonstrate a dilated serpiginous cystic structure in the upper pelvis that connects to larger complex fluid collections inferiorly. Sagittal fat-suppressed FSE T1-weighted images (Figure 11.6.2) show high signal intensity within the tubular structure....
Case 11.7
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

50-year-old perimenopausal woman with intermittent mild abdominopelvic pain

Axial FSE T1-weighted images (Figure 11.7.1) demonstrate a large left adnexal mass with predominantly high signal intensity containing a donut-shaped internal nodule with lower signal intensity along the posterior margin of the lesion. Axial FSE T2-weighted images (...
Case 11.12
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

46-year-old woman with pelvic pain and dysuria; pelvic US demonstrated an adnexal mass

Axial fat-suppressed FSE T2-weighted images (Figure 11.12.1) demonstrate a large right adnexal lesion with moderately high signal intensity except for a small anterior component. Axial FSE T1-weighted image (...
Case 11.13
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

54-year-old postmenopausal woman with vague pelvic pain

Axial T2-weighted images from a DWI acquisition (b=0 s/mm2) (Figure 11.13.1) demonstrate a complex central pelvic mass containing an anterior cystic component, as well as a lobulated posterior solid component with mixed, but predominantly low, signal intensity. Corresponding axial diffusion-weighted images (b=800 s/mm...
Case 11.19
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

53-year-old postmenopausal woman with recently diagnosed breast cancer and 6-month history of bloody vaginal discharge

Coronal FSE T2-weighted images (Figure 11.19.1) demonstrate an ovoid soft tissue mass expanding the ampulla and isthmus of the left fallopian tube, with a small associated cystic lesion adjacent to the isthmus. Axial fat-suppressed FSE T2-weighted images (...
Case 12.4
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

41-year-old man with previous pelvic trauma, now with erectile dysfunction

Axial FSE T1-weighted (Figure 12.4.1) and T2-weighted (Figure 12.4.2) images demonstrate a hypointense linear defect crossing the corpora cavernosa of the proximal penis. Sagittal (Figure 12.4.3) and coronal (...
Case 12.6
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

56-year-old man with a malfunctioning penile prosthesis

Axial FSE T2-weighted images (Figure 12.6.1) and sagittal fat-suppressed FSE T2-weighted images (Figure 12.6.2) demonstrate marked displacement of the right-sided penile prosthesis cylinder, the majority of which is contained within the scrotum. Note that the reservoir is incompletely visualized in the pelvis anterior to the bladder....
Case 12.7
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

74-year-old man with a penile prosthesis and a new enlargement and discomfort of the right penile shaft

Sagittal fat-suppressed FSE T2-weighted image (Figure 12.7.1) through the right corporus cavernosum demonstrates fluid surrounding the cylinder of the penile prosthesis. Note also the focal angulation at the base of the cylinder with discontinuity of the prosthesis components. Sagittal oblique postinflation FSE T2-weighted images (...
Case 12.15
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

42-year-old man with painless hematospermia

Axial fat-suppressed T2-weighted FRFSE images (Figure 12.15.1) obtained with an endorectal coil demonstrate a cystic lesion containing a fluid-fluid level as well as a hypointense calculus originating in the left seminal vesicle and extending inferiorly into the prostate. Note that on the most inferior image there is a second smaller midline cyst. Coronal fat-suppressed T2-weighted FRFSE images (...
Case 12.16
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

61-year-old man with an elevated PSA on routine physical examination

Axial (Figure 12.16.1) and sagittal (Figure 12.16.2) T2-weighted FRFSE images obtained with an endorectal coil demonstrate marked enlargement of the central gland of the prostate, which contains numerous heterogeneous nodules of variable signal intensity. The peripheral zone is compressed and difficult to visualize on the axial images, but it can be seen as a thin lip of tissue projecting along the posterior margin of the prostate on the sagittal image....
Case 12.18
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

62-year-old man with a recent diagnosis of prostate cancer; the Gleason score is 7 (3+4) on the left and 6 on the right

Axial FRFSE T2-weighted images (Figure 12.18.1) obtained with an endorectal coil demonstrate a triangular region of low signal intensity within the peripheral zone of the prostate centrally. There is more heterogeneous decreased signal intensity in the anterior right peripheral zone and in the central zone. Axial arterial phase postgadolinium 3D SPGR images (...
Case 12.19
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

62-year-old man with a history of prostate carcinoma (Gleason score 3+3) on ultrasound-guided biopsy

Axial T2-weighted FRFSE images (Figure 12.19.1) obtained with an endorectal coil demonstrate a hypointense lesion in the left anterior peripheral zone with probable involvement of the central gland. The lesion shows high signal intensity on axial diffusion-weighted images (b=1,000 s/mm...
Case 12.23
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

45-year-old man with hematuria and difficulty voiding

Axial T2-weighted FRFSE images (Figure 12.23.1) obtained using an endorectal coil demonstrate a large infiltrative mass in the peripheral zone of the prostate. The mass invades the seminal vesicles and extends into the central zone in the apex. Note the loss of the well-defined posterior capsular margin indicating extracapsular extension, involvement of the right and probably the left neurovascular bundles, continuity of the mass with the anterior wall of the rectum, and the large perirectal lymph node on the first image....
Case 13.3
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

59-year-old woman with a hereditary disorder and gastrointestinal tract bleeding

VR images (Figure 13.3.1) and subvolume maximum intensity projection images (Figure 13.3.2) from gadolinium-enhanced 3D MRA demonstrate a lobulated vascular structure in the anterior medial right lung with a prominent feeding artery and draining vein....
Case 13.5
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

72-year-old woman with a nonproductive cough and a mass on chest radiograph

Axial (Figure 13.5.1) and sagittal (Figure 13.5.2) fat-suppressed FSE T2-weighted images reveal a large centrally necrotic mass in the posterior left lower lobe. Notice the subtle tail of soft tissue extending across the pleura with minimal extension into the chest wall. Axial postgadolinium 3D SPGR images (...
Case 13.7
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

75-year-old man with a pleural mass on chest radiograph

An elliptical lesion in the left costophrenic angle shows mildly heterogeneous low signal intensity on axial fat-suppressed FRFSE T2-weighted image (Figure 13.7.1) and intermediate signal intensity on axial T1-weighted FSE image (Figure ...
Case 13.9
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

54-year-old woman with medullary thyroid carcinoma

Axial fat-suppressed FSE T2-weighted images (Figure 13.9.1) demonstrate nodular soft tissue thickening of the pleura at the right lung base. Diffusion-weighted image (b=600 s/mm2) (Figure 13.9.2) reveals high-signal-intensity pleural lesions and focal lesions in the left hepatic lobe and thoracic spine, which are more conspicuous than in the T2-weighted images. Axial postgadolinium 3D SPGR images (...
Case 13.19
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

74-year-old woman with hypertension; a dilated aorta was noted on chest CT

SSFP images obtained at end systole through the aortic valve in transverse (Figure 13.19.1) and coronal oblique (Figure 13.19.2) orientations demonstrate a tricuspid aortic valve with minimal excursion of the valve leaflets. Axial SSFP image at the level of the right main pulmonary artery (...
Case 13.24
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

46-year-old man with a right ventricular mass detected incidentally on echocardiography

A lobulated, well-defined mass in the right ventricular free wall demonstrates mild hyperintensity relative to myocardium on axial double inversion recovery proton density-weighted FSE (Figure 13.24.1) and short-axis SSFP (Figure ...
Case 13.28
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

73-year-old man with nausea and epigastric pain; echocardiography showed a large mass in the epicardial space

Axial (Figure 13.28.1) and sagittal (Figure 13.28.2) double inversion recovery proton density-weighted FSE images reveal an infiltrative, fairly homogeneous mass involving the pericardium and right ventricular free wall and extending inferiorly to the diaphragm. Note thickening of the pericardium overlying the posterior right and left atria. The mass shows mildly increased signal intensity relative to myocardium on an axial T2-weighted triple inversion recovery FSE image (...
Case 13.29
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

73-year-old woman with chest discomfort and a history of coronary artery disease; preoperative echocardiography revealed a left atrial mass thought to be a myxoma

Axial double (Figure 13.29.1) and triple (Figure 13.29.2) inversion recovery FSE images with proton density- and T2-weighting reveal a large mass with very low T2-signal intensity occupying the entire left atrium, a prominent right pleural effusion, and right base atelectasis. Coronal postgadolinium 3D SPGR image (...
Case 14.1
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

72-year-old man with a history of prostate cancer and new posterior right buttock pain

Axial (Figure 14.1.1) and coronal oblique (Figure 14.1.2) T1-weighted images and axial (Figure 14.1.3) and coronal oblique (Figure 14.1.4) fat-suppressed T2-weighted FSE images demonstrate a linear defect in the right side of the sacrum with low signal intensity on T1-weighted images and mildly increased T2-signal intensity. Axial diffusion-weighted image (b=800 s/mm...
Case 14.2
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

42-year-old woman with bilateral hip pain

Axial (Figure 14.2.1) and coronal (Figure 14.2.2) fat-suppressed FSE T2-weighted images reveal crescentic fluid collections adjacent to the greater trochanters bilaterally.

Trochanteric bursitis

Greater trochanteric pain syndrome is a clinical diagnosis made in the setting of lateral hip pain exacerbated by movement of the leg or lying on the affected hip, with associated tenderness on palpation of the greater trochanter. ...
Case 14.3
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

31-year-old man with chronic midline back pain; recent spinal MRI suggested a marrow infiltrative disorder

Axial FSE T1-weighted images (Figure 14.3.1) demonstrate diffuse decreased signal intensity within the marrow of the iliac bones, with some regions slightly hypointense to adjacent skeletal muscle. Axial fat-suppressed FSE T2-weighted images (...
Case 14.4
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

80-year-old man with primary sclerosing cholangitis and end-stage liver disease

Axial fat-suppressed FSE T2-weighted image (Figure 14.4.1) demonstrates increased signal intensity in a lumbar vertebral body. There is corresponding enhancement on a postgadolinium 2D SPGR image (Figure 14.4.2). Note also abdominal ascites, peritoneal enhancement, and a cirrhotic liver. Coronal and sagittal reformatted views (...
Case 14.5
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

31-year-old man with quadriplegia after a motor vehicle accident now has a draining decubitus ulcer

Axial FSE T1-weighted images (Figure 14.5.1) and fat-suppressed T2-weighted images (Figure 14.5.2) demonstrate a large soft tissue defect in the left lower buttock extending to the ischial tuberosity. The ischial tuberosity shows abnormally decreased T1-signal intensity and increased T2-signal intensity. Note also the abnormally increased signal intensity in the adjacent left obturator externus muscle....
Case 14.6
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

26-year-old woman with a large presacral mass discovered on prenatal US during a recent pregnancy

Axial (Figure 14.6.1) and sagittal (Figure 14.6.2) fat-suppressed FSE T2-weighted images demonstrate a large cystic mass in the posterior pelvis. On the sagittal image there is communication with the spinal canal through a small neck. Note also a second small cystic lesion extending inferiorly from the spinal canal. Axial postgadolinium 3D SPGR image (...
Case 14.7
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

40-year-old woman with previously resected ileal gastrointestinal stromal tumor; CT performed for postoperative surveillance demonstrated a complex mass in the pelvis

Axial FSE T2-weighted images (Figure 14.7.1) and sagittal fat suppressed FSE images (Figure 14.7.2) demonstrate a complex cystic lesion posterior to the rectum. There is a large dominant cyst with additional adjacent smaller cysts. Axial postgadolinium 3D SPGR images (...
Case 14.14
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

59-year-old man with a history of lymphoma; a presacral mass was noted on a recent CT

Axial FSE T1-weighted images (Figure 14.14.1), fat-suppressed FSE T2-weighted images (Figure 14.14.2), and coronal FSE T2-weighted images (Figure 14.14.3) demonstrate an ovoid mass in the left perineum predominantly composed of fat. The mass has multiple septations and a more nodular component near the anterior margin....