EURORAD ESR

Case 14824

Abdominal wall endometriosis: MRI findings and the “Gorgon sign”

Author(s)
Tonolini Massimo, M.D.

"Luigi Sacco" University Hospital, Radiology Department; Via G.B. Grassi 74 20157 Milan, Italy; Email:mtonolini@sirm.org
 
Patient
female, 36 year(s)
 
 
  • Figure 1
    Ultrasound

    Sonographically, a sizeable (4x3x2.5 cm) hypechoic mass (calipers) with lobulated margins was seen extending ventrally from the aponeurosis of the left rectus abdominis muscle into the hyperechoic subcutaneous fat.

     
    Area of Interest: Abdominal wall; Imaging Technique: Ultrasound; Procedure: Diagnostic procedure; Special Focus: Haemorrhage;
     
     
  • Figure 2
    MRI - Precontrast images
     

    Axial (a), detail coronal (b) and sagittal (c) T2-weighted images showed complex abdominal wall mass including a central portion (*) with heterogeneous signal, surrounded by several cyst-like structures, the largest...

     
    Area of Interest: Abdominal wall; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Haemorrhage;

    Detail T2-weighted images showed a complex, lobulated abdominal wall mass including a central portion (*) with heterogeneous intermediate-to-high signal, surrounded by several cyst-like structures.

     
    Area of Interest: Abdominal wall; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Haemorrhage;

    Detail T2-weighted images showed a lobulated mass including a central portion (*), surrounded by several cyst-like structures. Note infiltration of rectus abdominis muscle, linear bands (thin arrows) radiating into...

     
    Area of Interest: Abdominal wall; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Haemorrhage;

    Fat-suppressed T2-weighted images confirmed complex, abdominal wall mass including a central portion (*) and peripheral cyst-like structures, linear bands (thin arrows) radiating into the surrounding fat.

     
    Area of Interest: Abdominal wall; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Haemorrhage;

    Fat-suppressed T1-weighted images confirmed complex abdominal wall mass including a solid central portion (*) and peripheral cyst-like structures with T1 hyperintensity indicating recent blood and fluid-fluid level...

     
    Area of Interest: Abdominal wall; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Haemorrhage;
     
     
  • Figure 3
    MRI - Post-gadolinium T1-weighted images
     

    Axial (a) and coronal (b) fat-suppressed, sagittal (c) T1-weighted images showed marked contrast enhancement of the abdominal wall mass, with linear bands (thin arrows) radiating into the adjacent fat ("Gorgon sign").

     
    Area of Interest: Abdominal wall; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Haemorrhage;

    Post-gadolinium T1-weighted images showed marked contrast enhancement of the abdominal wall mass, with linear bands (thin arrows) radiating into the adjacent fat ("Gorgon sign").

     
    Area of Interest: Abdominal wall; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Haemorrhage;

    Post-gadolinium T1-weighted images showed marked contrast enhancement of the abdominal wall mass, which infiltrated the ventral aspect of left rectus muscle. Note linear bands (thin arrows) radiating into the adjacent...

     
    Area of Interest: Abdominal wall; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Haemorrhage;
     
     
Sonographically, a sizeable (4x3x2.5 cm) hypechoic mass (calipers) with lobulated margins was seen extending ventrally from the aponeurosis of the left rectus abdominis muscle into the hyperechoic subcutaneous fat.
 
Axial (a), detail coronal (b) and sagittal (c) T2-weighted images showed complex abdominal wall mass including a central portion (*) with heterogeneous signal, surrounded by several cyst-like structures, the largest with fluid-fluid level (arrowhead).
 
Detail T2-weighted images showed a complex, lobulated abdominal wall mass including a central portion (*) with heterogeneous intermediate-to-high signal, surrounded by several cyst-like structures.
 
Detail T2-weighted images showed a lobulated mass including a central portion (*), surrounded by several cyst-like structures. Note infiltration of rectus abdominis muscle, linear bands (thin arrows) radiating into the surrounding fat.
 
Fat-suppressed T2-weighted images confirmed complex, abdominal wall mass including a central portion (*) and peripheral cyst-like structures, linear bands (thin arrows) radiating into the surrounding fat.
 
Fat-suppressed T1-weighted images confirmed complex abdominal wall mass including a solid central portion (*) and peripheral cyst-like structures with T1 hyperintensity indicating recent blood and fluid-fluid level (arrowhead).
 
Axial (a) and coronal (b) fat-suppressed, sagittal (c) T1-weighted images showed marked contrast enhancement of the abdominal wall mass, with linear bands (thin arrows) radiating into the adjacent fat ("Gorgon sign").
 
Post-gadolinium T1-weighted images showed marked contrast enhancement of the abdominal wall mass, with linear bands (thin arrows) radiating into the adjacent fat ("Gorgon sign").
 
Post-gadolinium T1-weighted images showed marked contrast enhancement of the abdominal wall mass, which infiltrated the ventral aspect of left rectus muscle. Note linear bands (thin arrows) radiating into the adjacent fat ("Gorgon sign").
 
 
 
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