EURORAD ESR

Case 3081

Why such a different appearance?

Author(s)
Pugliese F, Radecka E, Dahlman P, Wassberg C, Wikström J
 
Patient
male, 67 year(s)
 
 
  • Figure 1
    A transverse US scan of the left lobe of the liver obtained after the administration of an...

    The US image showing the treated unenhanced lesion on the left (arrow). A second abnormal area is seen close to the latter on the right side (arrowheads). Such a lesion, which has a hypoechoic core and enhances at...

     
    Area of Interest: unknown; Imaging Technique: Transverse US scan of the left lobe of the liver obtained after administration of an echo-amplifier medium;
     
     
  • Figure 2
    Transverse 1.5T MR images (8mm slice thickness)
     

    An MR image showing the new lesion (arrowheads) as being hypointense on the FFE T1w scan. The old lesion (arrow) is seen to be hyperintense on the same sequence.

     
    Area of Interest: unknown; Imaging Technique: 8mm-thick transverse 1.5T MR scans;

    An MR image showing the new lesion (arrowheads), which is bright on the TSE T2w image, whereas the old one (arrow) is seen to be dark on the same scan.

     
    Area of Interest: unknown; Imaging Technique: 8mm-thick transverse 1.5T MR scans;

    Neither the new (arrowheads) nor the old (arrow) lesions displaying a significant signal decay in the FFE T1w image acquired at out-of-phase TE when compared to the in-phase FFE T1w scan. The possibility of focal...

     
    Area of Interest: unknown; Imaging Technique: 8mm-thick transverse 1.5T MR scans;

    The FFE T1w scan obtained after an administration of a paramagnetic substance, showing the new lesion (arrowheads) with a peripheral rim of contrast-enhancement; the differential diagnosis of a hemangioma is unlikely...

     
    Area of Interest: unknown; Imaging Technique: 8mm-thick transverse 1.5T MR scans;
     
     
The US image showing the treated unenhanced lesion on the left (arrow). A second abnormal area is seen close to the latter on the right side (arrowheads). Such a lesion, which has a hypoechoic core and enhances at its periphery, is typical of neuroendocrine tumor metastases.
 
An MR image showing the new lesion (arrowheads) as being hypointense on the FFE T1w scan. The old lesion (arrow) is seen to be hyperintense on the same sequence.
 
An MR image showing the new lesion (arrowheads), which is bright on the TSE T2w image, whereas the old one (arrow) is seen to be dark on the same scan.
 
Neither the new (arrowheads) nor the old (arrow) lesions displaying a significant signal decay in the FFE T1w image acquired at out-of-phase TE when compared to the in-phase FFE T1w scan. The possibility of focal steatosis can be ruled out.
 
The FFE T1w scan obtained after an administration of a paramagnetic substance, showing the new lesion (arrowheads) with a peripheral rim of contrast-enhancement; the differential diagnosis of a hemangioma is unlikely due to the sharpness of the enhancing ring. The treated metastasis (arrow) does not enhance at all.
 
 
 
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