87 Splenic Lesions on Magnetic Resonance Imaging

CLINICAL IMAGAGINGAN ATLAS OF DIFFERENTIAL DAIGNOSIS

EISENBERG

DR. Muhammad Bin Zulfiqar PGR-FCPS III SIMS/SHL

• Fig GI 87-1 Epithelial cyst. Contrast T1-weighted image shows a huge homogeneous, nonenhancing mass that causes lateral displacement of the normal splenic parenchyma.192

• Fig GI 87-2 Echinococcal cyst. T2-weighted coronal image shows a septated hyperintense lesion. The small peripheral cyst represents a daughter cyst (arrow).192

• Fig GI 87-3 Hematoma. Axial T2-weighted image shows a round, hypointense mass in the anterior portion of the spleen, representing an old, healed hematoma.192

• Fig GI 87-4 Bacterial abscess. Contrast T1-weighted, fat-saturated image shows peripheral enhancement of a huge cyst-appearing lesion in a man with endocarditis.192

• Fig GI 87-5 Fungal abscess. T2-weighted, fat-saturated image shows multiple, round, hyperintense lesions in the liver and spleen (arrowheads) representing Candida microabscesses.192

• Fig GI 87-6 Hemangioma. (A) Coronal fat-saturated T2-weighted image shows multiple hyperintense splenic nodules. (B) Immediate, (C) one minute, and (D) delayed T1-weighted images after contrast administration shows the progressive centripetal enhancement pattern that is typical of hemangioma. By the final image, the nodules have become almost completely isointense to the splenic parenchyma.

• Fig GI 87-7 Lymphangioma. Contrast T1-weighted image shows a subcapsular multilocular mass with hypoitense (arrowheads) and hyperintense (arrow) nonenhancing areas, revealing their cystic nature. The hyperintense areas were secondary to proteinaceous content.

• Fig GI 87-8 Hamartoma. Coronal fat-saturated T2-weighted image shows a heterogeneous hyperintense mass in the inferior pole of the spleen.

• Fig GI 87-9 Lymphoma. Immediate postcontrast T1-weighted image (A) shows multiple small hypovascular nodules that are not detectable on a delayed scan (B). The precontrast image (not shown) appeared normal.

• Fig GI 87-10 Metastasis (colon cancer). T2-weighted image shows a heterogeneous mass with central hyperintense areas representing regions of necrosis.

• Fig GI 87-11 Intrasplenic pseudocyst. Sagittal unenhanced T1-weighted image shows a bilobulated mass surrounding and extending to the spleen (*). Note the presence of a fluidfluid level within the superior component of the mass with hyperintense signal of the dependent compartment, indicating its hemorrhagic content.

• Fig GI 87-12 Peliosis. Immediate postcontrast T1-weighted image in a patient with disseminated tuberculosis shows a multicystic mass (arrows) with septal and peripheral enhancement. Note the several liver lesions with peripheral enhancement (arrowheads), which were not detectable on the unenhanced image (not shown).