HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Abstract Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Newatia, A. Articles by Hines, J. Search for Related Content PubMed PubMed Citation Articles by Newatia, A. Articles by Hines, J. Social Bookmarking                      What's this? Hotlight (NEW!) What's Hotlight?

Subtraction Imaging: Applications for Nonvascular Abdominal MRI

¹ All authors: Department of Radiology, Long Island Jewish Medical Center, 270-05 76th Ave., New Hyde Park, NY 11040.

View larger version (115K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1A —49-year-old woman with acute flank pain. Unenhanced axial CT scan at level of kidneys shows large acute subcapsular hematoma (arrows) in midpole of left kidney.

View larger version (120K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1B —49-year-old woman with acute flank pain. Contrast-enhanced axial CT scan shows peripheral areas of high attenuation (arrows); however, differentiation of enhancement versus high-density blood is difficult.

View larger version (103K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1C —49-year-old woman with acute flank pain. Axial T1-weighted spoiled gradient-recalled echo (SPGR) fat-suppressed image shows heterogeneous signal intensity (arrowheads) within area of hemorrhage.

View larger version (108K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1D —49-year-old woman with acute flank pain. Axial T1-weighted SPGR contrast-enhanced image shows high signal intensity in periphery of hematoma (arrows) suggestive of enhancing tumor.

View larger version (99K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1E —49-year-old woman with acute flank pain. Axial subtraction image confirms presence of enhancing peripheral mass (black arrows) and signal void hematoma (white arrow). Large hemorrhagic renal cell carcinoma was found at nephrectomy.

View larger version (98K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2A —74-year-old man with known history of right adrenal mass who presented for MRI for further characterization. Axial T1-weighted fat-suppressed spoiled gradient-recalled echo (SPGR) image shows 7-cm right adrenal mass with areas of high signal intensity suggestive of hemorrhage (arrow). LK = left kidney.

View larger version (109K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2B —74-year-old man with known history of right adrenal mass who presented for MRI for further characterization. Axial T1-weighted fat-suppressed SPGR gadolinium-enhanced image again shows areas of high signal intensity (arrow). It is difficult to ascertain whether this is due to enhancement or hemorrhage. LK = left kidney.

View larger version (110K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2C —74-year-old man with known history of right adrenal mass who presented for MRI for further characterization. Axial subtraction image shows lack of enhancement within this mass (arrow) consistent with simple hemorrhage. Because of high clinical suspicion for malignancy, patient underwent adrenalectomy. Pathology showed presence of hemorrhage without evidence of neoplasm. Patient was later found to have myelofibrosis. LK = left kidney.

View larger version (107K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3A —72-year-old man with hemorrhagic splenic mass on CT (not shown) and questionable history of trauma. Axial T1-weighted fat-suppressed spoiled gradient-recalled echo (SPGR) unenhanced image through spleen shows large heterogeneous mass with areas of high signal intensity (arrowheads) and more central, focal hyperintense area (arrow). S = spleen.

View larger version (102K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3B —72-year-old man with hemorrhagic splenic mass on CT (not shown) and questionable history of trauma. Axial T1-weighted fat-suppressed SPGR contrast-enhanced image shows enhancement of normal splenic parenchyma (arrows). However, it is difficult to determine whether there is enhancement within mass. S = spleen.

View larger version (112K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3C —72-year-old man with hemorrhagic splenic mass on CT (not shown) and questionable history of trauma. Subtraction image shows definite areas of enhancement consistent with neoplasm (arrowheads). Areas of hematoma are signal void (arrow). Hemorrhagic lymphoma was found at splenectomy. S = spleen.

View larger version (139K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 4A —25-year-old woman after attempted resection of pelvic sidewall mass. Initial pathology only showed hematoma. MRI was performed to determine presence of residual tumor. Axial T1-weighted fat-suppressed spoiled gradient-recalled echo (SPGR) unenhanced image shows hyperintense mass (black arrow) in left perivesical space, displacing urinary bladder to right. Second mass (white arrow) of mixed signal intensity is identified posterior and inferior in relation to this mass with displacement of rectum and lower uterine segment to right (asterisk).

View larger version (139K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 4B —25-year-old woman after attempted resection of pelvic sidewall mass. Initial pathology only showed hematoma. MRI was performed to determine presence of residual tumor. T1-weighted fat-suppressed SPGR gadolinium-enhanced image shows similar areas of high signal intensity in both lesions (arrows).

View larger version (128K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 4C —25-year-old woman after attempted resection of pelvic sidewall mass. Initial pathology only showed hematoma. MRI was performed to determine presence of residual tumor. Axial subtraction image shows marked enhancement of deep left pelvic mass (black arrows) confirming presence of residual neoplasm. Left perivesical mass (white arrow) is now signal void, consistent with postoperative hematoma. Pathologic reanalysis showed desmoid tumor.

View larger version (102K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 5A —45-year-old man presenting with hematuria. Unenhanced CT scan shows indeterminate hyperdense, exophytic renal mass (arrow) in midpole of left kidney. MRI was performed to exclude underlying mass.

View larger version (107K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 5B —45-year-old man presenting with hematuria. Axial T1-weighted spoiled gradient-recalled echo (SPGR) unenhanced MR image shows high signal intensity within renal mass (arrow).

View larger version (81K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 5C —45-year-old man presenting with hematuria. It is difficult to visually determine whether high signal within mass (arrow) is due to enhancement or to intrinsic T1 brightness from hemorrhage or protein.

View larger version (98K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 5D —45-year-old man presenting with hematuria. Axial subtraction image shows complete lack of enhancement within lesion (arrow), consistent with benign cyst.

View larger version (130K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 6A —36-year-old man with metastatic disease to ribs and spine, without known primary tumor. Contrast-enhanced CT image shows indeterminate small left renal lesion (arrow).

View larger version (87K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 6B —36-year-old man with metastatic disease to ribs and spine, without known primary tumor. Axial T1-weighted fat-suppressed spoiled gradient-recalled echo (SPGR) unenhanced image shows mildly hyperintense mass in upper pole of left kidney (arrow).

View larger version (84K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 6C —36-year-old man with metastatic disease to ribs and spine, without known primary tumor. Axial T1-weighted fat-suppressed SPGR contrast-enhanced image. It is difficult to determine whether high signal intensity within mass (arrow) is due to enhancement or intrinsic high signal.

View larger version (101K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 6D —36-year-old man with metastatic disease to ribs and spine, without known primary tumor. Axial subtraction image clearly shows nodular internal enhancement (arrow), consistent with small renal cell carcinoma. Biopsy of bone lesion showed carcinoma consistent with renal origin.

View larger version (87K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 7A —65-year-old cirrhotic man after radiofrequency ablation for hepatocellular carcinoma. Axial T1-weighted fat-suppressed spoiled gradient-recalled echo (SPGR) unenhanced image shows heterogeneous but mostly hyperintense mass (arrowheads).

View larger version (88K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 7B —65-year-old cirrhotic man after radiofrequency ablation for hepatocellular carcinoma. Axial T1-weighted fat-suppressed SPGR contrast-enhanced image shows areas of high signal intensity (arrows) that could be compatible with either hemorrhagic necrosis or tumor recurrence. Arrowheads indicate mass.

View larger version (118K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 7C —65-year-old cirrhotic man after radiofrequency ablation for hepatocellular carcinoma. Axial T1 subtraction image shows conspicuous area of nodular enhancement, consistent with tumor recurrence (arrow). Arrowheads indicate mass.

View larger version (135K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 8A —67-year-old man with fever secondary to Escherichia coli bacteremia. Contrast-enhanced axial CT image shows softtissue density along posterior wall of gallbladder (arrowheads). Differential diagnosis includes tumefactive sludge or gallbladder neoplasm.

View larger version (122K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 8B —67-year-old man with fever secondary to Escherichia coli bacteremia. Axial T1-weighted fat-suppressed spoiled gradientrecalled echo (SPGR) unenhanced image shows isointense polypoid lesion (arrow) along posterior wall of gallbladder.

View larger version (126K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 8C —67-year-old man with fever secondary to Escherichia coli bacteremia. Axial T1-weighted fat-suppressed SPGR contrastenhanced image shows probable enhancement within mass (arrow).

View larger version (112K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 8D —67-year-old man with fever secondary to Escherichia coli bacteremia. Axial subtraction image shows avid enhancement of mass (arrow), highly suspicious for gallbladder neoplasm. Localized gallbladder cancer was found at cholecystectomy.

CiteULike

Complore

Connotea

Del.icio.us

Digg

Reddit

Technorati