EURORAD ESR

Case 9583

Crohn's disease as a very unusual cause of vulvar inflammation

Author(s)
Tonolini Massimo, MD.

"Luigi Sacco" University Hospital, Radiology Department;
Via G.B. Grassi 74 20157 Milan, Italy; Email:mtonolini@sirm.org
 
Patient
female, 29 year(s)
 
 
  • Figure 1
    Initial pelvic-perineal MRI
     

    Axial T1 (a), STIR (b), axial (c) and sagittal (d) T2-weighted images show marked unilateral left vulvar thickening with abnormal signal intensity consistent with skin and subcutaneous inflammatory changes.

     
    Area of Interest: Genital / Reproductive system female; Imaging Technique: MR; Procedure: Abscess delineation; Special Focus: Inflammation;

    Axial T1 (a), STIR (b), axial (c) and sagittal (d) T2-weighted images show marked unilateral left vulvar thickening with abnormal signal intensity consistent with skin and subcutaneous inflammatory changes.

     
    Area of Interest: Genital / Reproductive system female; Imaging Technique: MR; Procedure: Abscess delineation; Special Focus: Inflammation;

    Axial T1 (a), STIR (b), axial (c) and sagittal (d) T2-weighted images show marked unilateral left vulvar thickening with abnormal signal intensity consistent with skin and subcutaneous inflammatory changes.

     
    Area of Interest: Genital / Reproductive system female; Imaging Technique: MR; Procedure: Abscess delineation; Special Focus: Inflammation;

    Sagittal T2-weighted image show entire longitudinal extent of vulvar skin and subcutaneous inflammatory changes. Note rectal wall thickening and abnormal signal indicating Crohn's proctitis.

     
    Area of Interest: Genital / Reproductive system female; Imaging Technique: MR; Procedure: Abscess delineation; Special Focus: Inflammation;

    Post-contrast fat-suppressed (e), axial (f) and sagittal (g) T1-weighted images show marked, inhomogeneous enhancement of the left vulvar skin and subcutaneous consistent with acute inflammation with...

     
    Area of Interest: Genital / Reproductive system female; Imaging Technique: MR; Procedure: Abscess delineation; Special Focus: Inflammation;

    Post-contrast fat-suppressed (e), axial (f) and sagittal (g) T1-weighted images show marked, inhomogeneous enhancement of the left vulvar skin and subcutaneous consistent with acute inflammation with...

     
    Area of Interest: Genital / Reproductive system female; Imaging Technique: MR; Procedure: Abscess delineation; Special Focus: Inflammation;

    Post-contrast sagittal (g) T1-weighted image show marked enhancement of the left vulvar skin and subcutaneous involved by acute inflammation. Note mucosal inflammatory enhancement of rectal wall.

     
    Area of Interest: Genital / Reproductive system female; Imaging Technique: MR; Procedure: Abscess delineation; Special Focus: Inflammation;

    Axial T2-(h) and postcontrast fat-suppressed T1-weighted (i) images exclude ischioanal, perianal and anovaginal fistulas and/or abscesses indicating Crohn's perianal disease.

     
    Area of Interest: Genital / Reproductive system female; Imaging Technique: MR; Procedure: Abscess delineation; Special Focus: Inflammation;

    Axial T2-(h) and postcontrast fat-suppressed T1-weighted (i) images exclude ischioanal, perianal and anovaginal fistulas and/or abscesses indicating Crohn's perianal disease.

     
    Area of Interest: Genital / Reproductive system female; Imaging Technique: MR; Procedure: Abscess delineation; Special Focus: Inflammation;
     
     
  • Figure 2
    Follow-up MRI 4 months after diagnosis
     

    Sagittal (a) and axial (b,c) T2-weighted, axial STIR (d) images document resolution of thickening and inflammatory changes involving left vulva.

     
    Area of Interest: Genital / Reproductive system female; Imaging Technique: MR; Procedure: Abscess delineation; Special Focus: Inflammation;

    Sagittal (a) and axial (b,c) T2-weighted, axial STIR (d) images document resolution of thickening and inflammatory changes involving left vulva.

     
    Area of Interest: Genital / Reproductive system female; Imaging Technique: MR; Procedure: Abscess delineation; Special Focus: Inflammation;

    Sagittal (a) and axial (b,c) T2-weighted, axial STIR (d) images document resolution of thickening and inflammatory changes involving left vulva.

     
    Area of Interest: Genital / Reproductive system female; Imaging Technique: MR; Procedure: Abscess delineation; Special Focus: Inflammation;

    Sagittal (a) and axial (b,c) T2-weighted, axial STIR (d) images document resolution of thickening and inflammatory changes involving left vulva.

     
    Area of Interest: Genital / Reproductive system female; Imaging Technique: MR; Procedure: Abscess delineation; Special Focus: Inflammation;

    Post-contrast axial fat-suppressed (e) and sagittal (f) T1-weighted images document resolution of abnormal enhancement in the external genitalia, consistent with disappearance of active inflammation.

     
    Area of Interest: Genital / Reproductive system female; Imaging Technique: MR; Procedure: Abscess delineation; Special Focus: Inflammation;

    Post-contrast axial fat-suppressed (e) and sagittal (f) T1-weighted images document resolution of abnormal enhancement in the external genitalia, consistent with disappearance of active inflammation.

     
    Area of Interest: Genital / Reproductive system female; Imaging Technique: MR; Procedure: Abscess delineation; Special Focus: Inflammation;
     
     
Axial T1 (a), STIR (b), axial (c) and sagittal (d) T2-weighted images show marked unilateral left vulvar thickening with abnormal signal intensity consistent with skin and subcutaneous inflammatory changes.
 
Axial T1 (a), STIR (b), axial (c) and sagittal (d) T2-weighted images show marked unilateral left vulvar thickening with abnormal signal intensity consistent with skin and subcutaneous inflammatory changes.
 
Axial T1 (a), STIR (b), axial (c) and sagittal (d) T2-weighted images show marked unilateral left vulvar thickening with abnormal signal intensity consistent with skin and subcutaneous inflammatory changes.
 
Sagittal T2-weighted image show entire longitudinal extent of vulvar skin and subcutaneous inflammatory changes. Note rectal wall thickening and abnormal signal indicating Crohn's proctitis.
 
Post-contrast fat-suppressed (e), axial (f) and sagittal (g) T1-weighted images show marked, inhomogeneous enhancement of the left vulvar skin and subcutaneous consistent with acute inflammation with necrotic-abscessual portions.
 
Post-contrast fat-suppressed (e), axial (f) and sagittal (g) T1-weighted images show marked, inhomogeneous enhancement of the left vulvar skin and subcutaneous consistent with acute inflammation with necrotic-abscessual portions.
 
Post-contrast sagittal (g) T1-weighted image show marked enhancement of the left vulvar skin and subcutaneous involved by acute inflammation. Note mucosal inflammatory enhancement of rectal wall.
 
Axial T2-(h) and postcontrast fat-suppressed T1-weighted (i) images exclude ischioanal, perianal and anovaginal fistulas and/or abscesses indicating Crohn's perianal disease.
 
Axial T2-(h) and postcontrast fat-suppressed T1-weighted (i) images exclude ischioanal, perianal and anovaginal fistulas and/or abscesses indicating Crohn's perianal disease.
 
Sagittal (a) and axial (b,c) T2-weighted, axial STIR (d) images document resolution of thickening and inflammatory changes involving left vulva.
 
Sagittal (a) and axial (b,c) T2-weighted, axial STIR (d) images document resolution of thickening and inflammatory changes involving left vulva.
 
Sagittal (a) and axial (b,c) T2-weighted, axial STIR (d) images document resolution of thickening and inflammatory changes involving left vulva.
 
Sagittal (a) and axial (b,c) T2-weighted, axial STIR (d) images document resolution of thickening and inflammatory changes involving left vulva.
 
Post-contrast axial fat-suppressed (e) and sagittal (f) T1-weighted images document resolution of abnormal enhancement in the external genitalia, consistent with disappearance of active inflammation.
 
Post-contrast axial fat-suppressed (e) and sagittal (f) T1-weighted images document resolution of abnormal enhancement in the external genitalia, consistent with disappearance of active inflammation.
 
 
 
Home Search Sections Teaching Cases History FAQ Case Archives Contact Login Disclaimer Imprint Switch to MOBILE version
View desktop version