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Résonance magnétique ouverte
Open MR system

IMAGE DU MOIS - CASE OF THE MONTH

Shoulder MRI arthrography, cor T1 WI: tear of superior labrum and of inferior surface of supraspinatus tendon. Degenerative osteoarthritis of glenohumeral and acromioclavicular joints.

(Avertissement: la majorité des images présentées ici ont encore été réalisées sur un modèle d'appareil ouvert qui n'est plus celui que nous utilisons actuellement)
(Warning: most images still presented here have been obtained with an older MRI model which we don't use any more)

Musculosketal cases

• Shoulder: complete supraspinatus tendon rupture (long arrow) with passage of gadolinium into subdeltoid bursa (short arrow)
• Shoulder: spinoglenoid cyst (paralabral cyst) and subdeltoid bursitis with partial supraspinatus tendon rupture
• Shoulder: giant synovial cyst from degenerative acromioclavicular joint - Lateral extension images
• Supraspinatous tendon desinsertion, passage of Gd into subacromial bursa
• Partial rupture of shoulder rotator cuff
• R. shoulder, ax.: subscapular tendon rupture and retraction (yellow arrow) + biceps tendon luxation (blue arrow)
• Shoulder superior labrum tear (SLAP)
• Shoulder: Bankart lesion of the anterior labrum
• Shoulder: post-traumatic adhesive capsulitis with thickening of inferior recess capsula
• Shoulder: inferior paralabral cyst (Most paralabral cysts are superiorly situated and related to a labrum tear. Spinoglenoid cysts may compress the suprascapular nerve)
• Sternum transversal fracture
• Osteoid osteoma of the cubitus; edema of overlying skin (STIR)
• Wrist: de Quervain's tenosynovitis (abductor pollicis longus + extensor pollicis brevis)
• Wrist: Giant cell tumor of synovial sheath between flexor digitorum tendons
• Stress fracture of the left wing of the sacrum
• Hip arthrography: anterosuperior labrum tear with free fragment
• Hip MR arthrography: labrum tear
• Bilateral femoral head osteonecrosis (hemochromatosis)
• Hip spontaneous algodystrophy (transient regional osteoporosis)
• Grade II chondrosarcoma of proximal femur
• Thigh: partial rupture of rectus femoris muscle
• Thigh: benign subcutaneous lipoma
• Femur chronic osteomyelitis with intramuscular abscess
• Knee: osteonecrosis of medial femoral condyle
• Knee, cor. T1 WI: osteochondritis dissecans of medial femoral condyle
• Knee: villonodular synovitis (enhancing proliferation + hemosiderin deposits)
• Double tear of internal meniscus - posterior horn
• Knee: medial meniscus body vertical tear
• Discoid external meniscus
• Knee: fracture of the medial tibial spine. Intact anterior cruciate ligament
• Knee: proximal rupture of the anterior cruciate ligament
• Knee: traumatic rupture of the anterior cruciate ligament
• Knee: ACL rupture with bone bruises, medial meniscus avulsion and blood-liquid level
• Knee, T2WI sag.: Posterior cruciate ligament distal avulsion
• Knee: posterior cruciate ligament rupture; Baker's cyst; intraosseous ganglion (femur)
• Knee: multiple huge intra-articular foreign bodies consistent with synovial osteochondromatosis
• Baker's cyst (popliteal cyst)
• Knee: dysplastic femoro-patellar joint, lateral patellar tilt & subluxation with secondary degenerative arthritis
• Knee: anterior ganglion cyst
• Knee: pain and edema of the tibial tuberosity consistent with Osgood-Schlatter disease
• Patella alta with severe patellofemoral dysplasia and osteochondral degeneration
• Mirroring bone contusions after external patella luxation; rupture of medial alar ligament
• Fracture-luxation of the patella with bone bruise on the anterior aspect of the lateral condyle
• Patella cartilage laceration (DESS 3D transverse 1.5 mm th.slices)
• Patella surface lesion of articular cartilage (DESS 3D transverse 1.9 mm th. slice)
• Knee: medial patellar plica / popliteal (Baker's) cyst
• Jumper's knee (proximal patellar tendinopathy) with thickening and partial rupture of the tendon
• Lateral meniscus radial tear axial reconstruction with normal case comparison
• Torn lateral meniscus with luxation of the fragment into the intercondylar notch
• Fracture of medial tibial plateau with hemarthrosis (blood-liquid level)
• Tibial proximal metaphysis fracture in a 63-y. old woman with osteoporosis
• Knee exostosis (osteochondroma) with reactional bursitis
• Denervation myopathy of the tibial anterior muscle in a recently paraparetic woma (STIR cor.)
• Subacute musculo-aponeurotic haematoma of medial gastrocnemius muscle
• Traumatic rupture of Achilles tendon
• Calcaneum traumatic fracture with edema and fracture line
• Achilles tendon proximal musculo-tendinous junction rupture
• Haglund's Syndrome with retrocalcaneal bursitis and calcaneal spur
• Ankle: traumatic rupture of the anterior talofibular ligament
• Ankle: osteochondritis dissecans (osteochondral fracture) of the talar dome
• Ankle: osteochondral fracture (osteochondritis dissecans) of the talus
• Ankle intra-articular osseous foreign bodies
• Ankle, sag. medial T2WI: tenosynovitis of the flexor digitorum longus pedis
• Ankle: Retrocalcaneal bursitis with Achille's tendinopathy and partial rupture
• Morton's neuroma between 3rd and 4th metatarsal heads
• Morton's neuroma between 2nd and 3rd metatarsal heads
• Left iliofemoral vein thrombosis

Head and neck cases

• MR angiography: left posterior cerebral artery originating from carotis interna ("fetal origin")
• Bilateral plexus choroideus cyst
• Pineal cyst (asymptomatic)
• Acromegaly - Pituitary macroadenoma (Gd enhanced) encasing carotids & sinus cavernosus; chiasma compression
• Prolactine-secreting microadenoma (cor. T1 + Gd)
• Right pituitary lobe microadenoma (cor. T1 + Gd)
• Right pituitary lobe microadenoma (case # 2)
• Suprasellar arachnoid cyst with omega deformation of sellar diaphragm
• Intracanalar VIIIth nerve schwannoma (neurinoma) gadolinium enhancing; megacisterna magna (*)
• Righ enhancing acoustic neuroma (schwannoma of the VIIIth nerve)
• Ring enhancement of a multiple sclerosis lesion (brain)
• White matter lesions consistent with clinic suspicion of demyelinating disease (multiple sclerosis)
• Brain confluent periventricular white matter lesions - Binswanger's disease (vascular encephalopathy)
• Acute (24 hours) right occipital infarct with edema and diffusion coefficient change still without enhancement
• Small enhancing cortical infarction (25 days, subacute)
• Giant temporal arachnoidal cyst
• Mega cisterna magna
• Cavum septi pellucidi with posterior extension as a cavum vergae (anatomic variants)
• Multiple brain metastases (breast origin) with parietal edematous reaction
• Meningioma of the posterior fossa related to the transverse-sigmoid sinus
• Left orbit arterio-venous malformation with subcutaneous a-v fistula
• Left temporo-occipital encephalomalacia 30 y. after ischemic event
• Persistent cavum septi pellucidi and empty sella (partial)
• Head: multiple scalp epidermic cysts
• Maxillary sinusitis with fluid level and mucous membrane thickening
• Sphenoid sinusitis with mucosa thickening and left-sided liquid level
• Concha bullosa (unilateral)
• Tongue base carcinoma with jugular nodal metastasis
• Carcinoma of left piriform sinus with invasion of the three folds region, nodal and perineural(X) spread, left jugular vein thrombosis
• Neck, coronal T1WI: incidental hemorragic left lobe thyroid mass in Hashimoto Thyroiditis
• Adenoids hypertrophy in a 12 years old girl
• Temporomandibular joint: meniscus tear with anterior luxation in closed mouth position

Spine cases

• Breast metastasis to T1 vertebra with peridural invasion and cord compression
• C5-C6 disc hernia with indentation of the spinal cord
• Spinal cord compression by C3-C4 and C6-C7 herniation with myelopathy plus spinal canal stenosis
• Left C6-C7 disc hernia
• Vertebral artery loop in the left C4-C5 foramen
• Enhancing cervical MS plaque in a young female with tranverse myelitis
• Syringomyelia (almost no neurologic deficit)
• Dorsal spine intradural extramedullary enhancing tumor (meningioma)
• Dorsal renal carcinoma metastasis with invasion of posterior elements and epidural space
• L1-L2 disc hernia
• L5-S1 upward herniated disc
• Lumbar degenerative canal stenosis (L4-L5)
• Giant L3-L4 disc hernia
• Lumbar right foraminal herniated disc fragment (L4-L5 level)
• Lumbar spine: malformative spinal canal stenosis
• Lumbar spine: recent bilateral isthmic fracture of L4 (spondylolysis) with edema
• Extracanalar degenerative synovial cyst of L4-L5 posterior joint
• Lumbar spine S2 Tarlov (radicular) cyst [+ Subserous uterine myoma]
• Florid lumbosacral tuberculosis (Pott's disease) with epidural and sacral abscesses
• Sacral lipomeningocele + tethered cord

Abdominal cases

• Liver: normal MR cholangiography
• Liver: hemangioma signal characteristics in different sequence and after Gadolinium
• Liver: hemangioma signal caracteristics without / with IV superparamagnetic iron oxide particles (SPIO)
• Liver: acute cholecystitis with gallstone in the common bile duct at pancreatic level
• Liver: multiple adenocarcinoma metastases
• Sigmoid colon diverticulosis
• Bladder exophytic tumor with wall thickening and metastatic lymph nodes
• Uterus: double uterus malformation including vagina duplication
• Uterus: bicornuate malformation
• Uterine myoma
• Uterine myomas with typical hypointense signal
• Giant uterine myomas with cystic degeneration (T2)
• Anterior cervix wall adenocarcinoma (endometrioid type) showing no enhancement, with necrotic center
• Partially cystic and enhancing ovarian tumor(T1 & T2 WI, T1 with Gadolinium)
• Pelvimetry (sag. T1)
• Urethra diverticulum
• Rectum carcinoma (endoluminal) and vagina's Gartner's duct cyst (sag. T1&T2)
• Prostatic carcinoma invading bladder wall + paravesical fat, iliac adenopathies and multiple bone metastases

Avertissement: pour de nombreux cas, il n'existe pas de confirmation opératoire ou histologique du diagnostic. Cependant, le choix s'est porté sur des exemples illustratifs où le diagnostic s'impose sur la base de l'anamnèse et de critères diagnostiques reconnus; parfois, il ne s'agit que d'un diagnostic de probabilité élevée mais dont l'intérêt méritait de figurer dans cette liste. L'anonymat des cas présentés ici respecte le secret médical.

Warning: diagnoses on this page are often not surgically or histologically confirmed. However, for most cases diagnosis is unequivocal when considering clinical history and current diagnostic criteria; less often, diagnosis was only highly probable but the case was considered worth to be shown. Patient identity is hidden according to the rules of medical secret.