Case 17.24

64-year-old woman with pancreatic cancer and suspected hepatic metastases VR image from 3D MRCP (Figure 17.24.1) demonstrates moderate dilatation of intrahepatic ducts and marked extrahepatic biliary dilatation extending to the pancreatic head, where there is also obstruction of the pancreatic duct. Axial hepatobiliary phase 3D SPGR images obtained 20 minutes following gadoxetate disodium (Eovist) injection (...

Case 17.22

51-year-old woman with a complex cystic lesion in the left kidney Axial precontrast 3D SPGR images (Figure 17.22.1) reveal an exophytic lesion in the lower pole of the left kidney containing a posterior region with low signal intensity, a thin septation encompassing a small lateral nodule with markedly high signal intensity, and an anterior component with moderately high signal intensity. Axial venous phase postgadolinium images in the same location (...

Case 17.19

60-year-old man with history of urothelial carcinoma Coronal oblique early excretory phase images from gadolinium-enhanced 3D SPGR MR urogram (Figure 17.19.1) demonstrate multiple small filling defects within the left renal pelvis, with incomplete filling of the renal pelvis. Delayed images (Figure ...

Case 17.18

39-year-old woman with Crohn disease and suspected primary sclerosing cholangitis Consecutive IP images from a 2D SPGR IP-OP acquisition (Figure 17.18.1) demonstrate high signal intensity within the IVC and hepatic veins on the superior 2 images which disappears on the bottom images. Note the appearance of high signal intensity within the aorta and celiac artery on the inferior images....

Case 17.15

53-year-old woman with chronic kidney disease Coronal SSFSE image (Figure 17.15.1) demonstrates massive enlargement of the right kidney, which contains multiple fatty lesions as well as several round nodules. The left kidney is surgically absent. Coronal respiratory-triggered FSE T2-weighted image (Figure ...

Case 17.11

62-year-old woman with possible pancreatic intraductal papillary mucinous neoplasm Superiormost image from a venous phase postgadolinium 3D SPGR acquisition (Figure 17.11.1) shows artifact superimposing the lower thorax as well as a possible enhancing lesion in a lower thoracic vertebral body. The inferiormost image is relatively artifact-free (...

Case 17.10

54-year-old man with cirrhosis Axial precontrast 3D SPGR image (Figure 17.10.1A) demonstrates a nodular hepatic contour and moderate splenomegaly. Postgadolinium arterial (Figure 17.10.1B), portal venous (Figure 17.10.1C), and equilibrium phase (Figure 17.10.1D) images reveal a finger superimposing the left side of the abdomen (and pointing toward 2 arterial phase enhancing nodules in the periphery of the right hepatic lobe). Axial 2D SPGR image (...

Case 17.8

57-year-old woman with an adnexal mass seen on pelvic US Coronal FSE T2-weighted images (Figure 17.8.1) reveal abnormal signal superimposing the interior of the pelvis. A second set of coronal FSE images (Figure 17.8.2) demonstrates improved visualization of the pelvis but with persistent linear artifacts. Bright signal from subcutaneous fat superimposes the anterior and posterior margins of sagittal FSE images (...

Case 16.16

82-year-old woman with drug-resistant hypertension and a blood pressure discrepancy between upper and lower extremities MIP image from 3D CE MRA of the thoracic aorta (Figure 16.16.1) shows an irregular filling defect in the distal thoracic aorta, which causes significant narrowing of the aorta. Coronal oblique reformatted image from the 3D CE MRA (...

Case 16.2

59-year-old man with a history of hypertension MIP image from 3D CE MRA (Figure 16.2.1) reveals prominent beading of the mid-distal right main renal artery. Fibromuscular dysplasia FMD, first reported by Leadbetter and Burkland in 1938, is a nonatherosclerotic, noninflammatory vascular disorder that occurs most often in women aged 20 to 60 years. It commonly involves the renal and extracranial carotid arteries, although any vascular territory can be affected. The renal arteries are affected in 75% of FMD patients, with bilateral involvement in more than 35%. Renal artery aneurysms are a fairly common complication of renal FMD and have been reported in 9% of patients. The incidence of FMD in the extracranial carotid arteries is uncertain. It was long accepted that carotid artery FMD occurred in 25% to 30% of patients with FMD; however, a much higher incidence of 70% has been identified for the first 200 patients enrolled in the FMD international registry. Vertebral arteries are less commonly involved than the carotid arteries. The etiology of FMD is unknown, but speculation has centered on hormonal and genetic factors....