EURORAD ESR

Case 14366

Multimodality imaging findings of an adrenal pseudocyst.

Author(s)
Irini Nikolaou1, Vasileios Rafailidis1, Georgios Papadopoulos1, Konstantina Kofina2, Konstantinos Kouskouras1, Afroditi Charitanti-Kouridou1

1 Department of Radiology, AHEPA University General Hospital of Thessaloniki, Greece.
2 1st Department of Propaedeutic Surgery, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Email:billraf@hotmail.com
 
Patient
female, 27 year(s)
 
 
  • Figure 1
    Ultrasonographic findings
     

    A predominantly anechoic lesion was identified near the left kidney, containing echogenic septa and material, consistent with a hemorrhagic cyst.

     
    Area of Interest: Abdomen; Imaging Technique: Ultrasound; Procedure: Diagnostic procedure; Special Focus: Cysts;

    Colour Doppler imaging shoed no blood flow signals within the lesion.

     
    Area of Interest: Abdomen; Imaging Technique: Ultrasound-Colour Doppler; Procedure: Diagnostic procedure; Special Focus: Cysts;
     
     
  • Figure 2
    CT findings
     

    Axial CT image showing a hypodense cystic lesion containing hyperdense material.

     
    Area of Interest: Abdomen; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Cysts;

    Axial CT image showing partial thickening of the cystic wall.

     
    Area of Interest: Abdomen; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Cysts;

    Axial CT image showing hyperdense material within the lesion and partial thickening of the cystic wall.

     
    Area of Interest: Abdomen; Imaging Technique: Absorptiometry / Bone densiometry; Procedure: Diagnostic procedure; Special Focus: Cysts;

    Axial CT image showing minimal pelvic fluid.

     
    Area of Interest: Abdomen; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Cysts;

    Axial thin slice showing the lesion’s proximity to the left adrenal gland.

     
    Area of Interest: Abdomen; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Cysts;

    Α coronal reformatted image showing the lesion’s relationship with the pancreas.

     
    Area of Interest: Abdomen; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Cysts;

    Oblique sagittal reformatted image showing the lesion’s location in close proximity with the kidney.

     
    Area of Interest: Abdomen; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Cysts;

    Oblique sagittal reformatted image showing the lesion’s location in close proximity with the spleen and stomach.

     
    Area of Interest: Abdomen; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Cysts;
     
     
  • Figure 3
    MRI findings
     

    T2-weighted image showing the lesion predominantly with high signal intensity but containing material of low signal intensity.

     
    Area of Interest: Abdomen; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Cysts;

    T2-weighted image with fat-suppression showed similar findings with the T2-weighted image without fat suppression, suggesting the cystic nature of the lesion.

     
    Area of Interest: Abdomen; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Cysts;

    T2-weighted image with fat-suppression showed similar findings with the T2-weighted image without fat suppression.

     
    Area of Interest: Abdomen; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Cysts;

    T1-weighted in-phase image showing the lesion with low signal intensity.

     
    Area of Interest: Abdomen; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Cysts;

    T1-weighted in-phase image showing the lesion with low signal intensity.

     
    Area of Interest: Abdomen; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Cysts;

    T1-weighted out-of-phase image showing no signal drop within the lesion, excluding the presence of fat.

     
    Area of Interest: Abdomen; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Cysts;

    T1-weighted out-of-phase image showing no signal drop within the lesion, excluding the presence of fat.

     
    Area of Interest: Abdomen; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Cysts;

    T1-weighted out-of-phase image showing no signal drop within the lesion, excluding the presence of fat.

     
    Area of Interest: Abdomen; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Cysts;

    T1-weighted out-of-phase image showing no signal drop within the lesion, excluding the presence of fat.

     
    Area of Interest: Abdomen; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Cysts;

    MRCP image excluding the communication of the lesion with the pancreatic duct.

     
    Area of Interest: Abdomen; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Cysts;

    Gradient-echo image for identification of haemorrhagic material identified material of low signal intensity within the lesion which was in keeping with haemorrhage.

     
    Area of Interest: Abdomen; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Cysts;

    ADC map of the lesion showing high signal intensity (suggesting increased diffusion) within the cystic part of the lesion but low signal intensity (consistent with restriction of diffusion) in the solid parts of the...

     
    Area of Interest: Abdomen; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Cysts;

    Dynamic contrast-enhanced MRI sequence highlighting the gradual mild capsular enhancement of the lesion but no enhancement within the lesion itself.

     
    Area of Interest: Abdomen; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Cysts;

    Dynamic contrast-enhanced MRI sequence highlighting the gradual mild capsular enhancement of the lesion but no enhancement within the lesion itself.

     
    Area of Interest: Abdomen; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Cysts;

    Dynamic contrast-enhanced MRI sequence highlighting the gradual mild capsular enhancement of the lesion but no enhancement within the lesion itself.

     
    Area of Interest: Abdomen; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Cysts;

    Dynamic contrast-enhanced MRI sequence highlighting the gradual mild capsular enhancement of the lesion but no enhancement within the lesion itself.

     
    Area of Interest: Abdomen; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Cysts;

    Coronal MRI image after the administration of contrast agent showing the capsular enhancement.

     
    Area of Interest: Abdomen; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Cysts;
     
     
A predominantly anechoic lesion was identified near the left kidney, containing echogenic septa and material, consistent with a hemorrhagic cyst.
 
Colour Doppler imaging shoed no blood flow signals within the lesion.
 
Axial CT image showing a hypodense cystic lesion containing hyperdense material.
 
Axial CT image showing partial thickening of the cystic wall.
 
Axial CT image showing hyperdense material within the lesion and partial thickening of the cystic wall.
 
Axial CT image showing minimal pelvic fluid.
 
Axial thin slice showing the lesion’s proximity to the left adrenal gland.
 
Α coronal reformatted image showing the lesion’s relationship with the pancreas.
 
Oblique sagittal reformatted image showing the lesion’s location in close proximity with the kidney.
 
Oblique sagittal reformatted image showing the lesion’s location in close proximity with the spleen and stomach.
 
T2-weighted image showing the lesion predominantly with high signal intensity but containing material of low signal intensity.
 
T2-weighted image with fat-suppression showed similar findings with the T2-weighted image without fat suppression, suggesting the cystic nature of the lesion.
 
T2-weighted image with fat-suppression showed similar findings with the T2-weighted image without fat suppression.
 
T1-weighted in-phase image showing the lesion with low signal intensity.
 
T1-weighted in-phase image showing the lesion with low signal intensity.
 
T1-weighted out-of-phase image showing no signal drop within the lesion, excluding the presence of fat.
 
T1-weighted out-of-phase image showing no signal drop within the lesion, excluding the presence of fat.
 
T1-weighted out-of-phase image showing no signal drop within the lesion, excluding the presence of fat.
 
T1-weighted out-of-phase image showing no signal drop within the lesion, excluding the presence of fat.
 
MRCP image excluding the communication of the lesion with the pancreatic duct.
 
Gradient-echo image for identification of haemorrhagic material identified material of low signal intensity within the lesion which was in keeping with haemorrhage.
 
ADC map of the lesion showing high signal intensity (suggesting increased diffusion) within the cystic part of the lesion but low signal intensity (consistent with restriction of diffusion) in the solid parts of the lesion.
 
Dynamic contrast-enhanced MRI sequence highlighting the gradual mild capsular enhancement of the lesion but no enhancement within the lesion itself.
 
Dynamic contrast-enhanced MRI sequence highlighting the gradual mild capsular enhancement of the lesion but no enhancement within the lesion itself.
 
Dynamic contrast-enhanced MRI sequence highlighting the gradual mild capsular enhancement of the lesion but no enhancement within the lesion itself.
 
Dynamic contrast-enhanced MRI sequence highlighting the gradual mild capsular enhancement of the lesion but no enhancement within the lesion itself.
 
Coronal MRI image after the administration of contrast agent showing the capsular enhancement.
 
 
 
Home Search Sections Teaching Cases History FAQ Case Archives Contact Login Disclaimer Imprint Switch to MOBILE version
View desktop version