History (HX):
Known case of prostate cancer
Male 75yr
Findings:
T2 low signal tumor in peripheral zone of prostate tumor extension to seminal vesicles, invasion of periprostatic fat, invasion to urinary bladder wall and anterior rectal wall as well as osseous metastases in pelvic bones and both femursDiagnostic (DX):
Stage 4 prostate cancer with bone metastases
History (HX):
Flank pain and hematuria
Female 56 yr
Findings:
MRU (MIP and thick slab images shows ) staghorn calculus and mild hydronephrosis in right kidney, small stone at UPJ of left kidney resulting in hydronephrosis and 3 other stones in lower calyceal group. All stones are signal void.
Diagnostic (DX):
Staghorm calculus in right kidney and multiple stones in left kidney
Discussion:
MR urography is currently considered the method of choice for imaging of the renal parenchyma and the collecting systems who cannot undergo routine radiographic studies such as pregnant women , pediatric patients, patient’s allergic to iodinated contrast agents or patients with impaired renal function.
History (HX):
RUQ pain and obstructive jaundice, Male 67yr
Findings:
MRCP (MIP and thick slab images) show:
Mild to moderate dilatation of the intrahepatic bile ducts and proximal CHD with a stenotic segments at insertion site of cystic duct
The gallbladder is contracted and contains a gallstone
Diagnostic (DX):
Extrahepatic cholangiocarcinoma (proved)
Patient ID: 87094912
HX: Abdominal pain and a large palpable mass.female 41y
DX: Giant hemangioma in right liver lobe
Findings:
Huge lobulated mass in right liver lobe high signal on T2WI (with thin hypointense septations) and low signal on T1WI with a large central scar.
After IV contrast peripheral discontinous nodular enhancement in arterial and portal venous phases with centripetal progression on delayed phase and no enhancement of the central scar.
Patient ID: 87101225
HX: Abdomen pain /male 87y
(DX: Fibrolamellar carcinoma (proved
Findings:
Large mass in liver mildly high signal on T2WI and low signal on T1WI with a relatively large central scar and heterogeneous enhancement on post-Gd images. Its central scar does not enhance even on delayed images
Discussion:
This tumor is a rare subtype of HCC with distinct clinical, pathologic and imaging features. As opposed to HCC most patient’s with (FL-HCC) do not have a history of cirrhosis or other liver disease. FL-HCC is usually large (mean diameter of 13 cm) and have a central fibrous scar
Patient ID: 87021998
HX: Abdominal pain and mild jaundice .female 65y
( DX: Biliary stones (gallstones and choleducolithiasis
Findings:
Moderate dilatation of the intra and extrahepatic bile ducts and multiple small signal void foci within the CBD, CHD, right and left hepatic ducts and also in gallbladder compatible with stones
Discussion:
MRCP is a non-invasive method of imaging the biliary tree. Although ERCP has been the mainstay for diagnosing and treating pancreaticobiliary disease. Complications such as pancreatitis, cholangitis, hemorrhage and duodenal perforation have limited its use as a routine diagnostic test and MRCP can replace diagnostic ERCP where it is difficult or impossible to perform
Patient ID: 8701975
HX: Abdominal pain and progressive jaundice .male 36y
DX: Adenocarcinoma of the pancreatic head (proved)
Findings:
Moderate dilatation of the intra and extrahepatic bile ducts with severe narrowing of distal CBD and an ill-defined mildly high T2 signal mass in pancreatic head
Discussion:
MRI has a triple role in evaluating pancreatic neoplasm which is tumor detection, characterization and staging and today is the best modality in this regard.
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