366 Index

Notes: Page numbers in italics refer to figures; page numbers in bold refer to tables

atypical, inhomogeneous images adrenocortical carcinoma, primary A 186, 188 189–190, 191 abdominal aorta children 360 children 360 aneurysm see aortic aneurysm functioning 185, 186 adrenocortical hyperplasia/hyperse- (abdominal aorta) lipid-containing 182, 186, 187,193 cretion 185, 185 anterior branches 311–312, 312 malignant tumors vs 186 adrenocortical insufficiency 184 atherosclerotic occlusions 317–318, nonfunctioning 184, 186, 187, 188 ampullary cancer 77, 77 318 SIrel cut-off values 183 anal canal 127–141, 128, 129 dissection see aortic dissection adrenal glands 181–194 indications for MRI127 intramural hematoma see aortic in- abscess 185 MRIimaging technique 127 –128 tramural hematoma (IMH) aim of MRI193 normal MRIappearance 128 –129, lateral branches 311, 312 angiomyolipoma/myelolipoma 188, 129, 130, 131 long intraluminal thrombosis 189 pathologic conditions, MRI136 315–316 benign conditions 184–189 see also rectum normal MR angiography 311–312, benign vs malignant lesions 183, anal cancer 120, 127, 136, 137 312 184, 186, 193 anal cushions (corpora cavernosa posterior branches 311, 312 central liquefaction 185 recti) 129 thrombosis 313, 317, 318 cortex, destruction 184 anal sphincters 128–129, 130, 131 wall inflammation (aortitis) 316, cysts 186, 186 androgen, excess production 185 316–317 ganglioneuroma in children 359 aneurysm wall thickening 315,315–316 hemangioma 188, 190 abdominal aorta see aortic aneu- abdominal arteries hemorrhage 356, 357 rysm (abdominal aorta) normal MR angiography 311–312, hyperplasia 185, 185 inflammatory (aortic) 317, 317 312 indications for MRI181 renal arteries 322 pathologic conditions, MRA inflammatory conditions 184–185, visceral arteries 319 313–321 193 angiography, MR see MR angiography abdominal belt 219 lipid-containing tumors see adrenal (MRA) abdominal lymph nodes see intra- adenoma angioma, renal 356 abdominal lymph nodes malignant tumor 184, 189–193 angiomatosis, systemic cystic 96 abdominal trauma carcinoma see adrenocortical car- angiomyolipoma kidneys 151, 152 cinoma, primary adrenal 189 liver, children 348 children 358–360, 359 hepatic, children 347 spleen 102, 350 lymphoma 190 renal 160, 160, 161 abdominal vascular malformations metastases 181, 190, 191 children 356 350–351 neuroblastoma see neuroblas- angiosarcoma see also under MR angiography toma renal 171 (MRA) pheochromocytoma 190, 192, spleen 100 abdominal veins 192, 193,359–360 anocutaneous line 128 normal MR angiography 312 masses 181, 184 anorectal abnormalities, children/in- pathologic entities, MRA 325–328, characterization, flowchart fants 342–343 350–351 193–194, 194 anorectal abscess, MRIpulse sequen- abscess see individual types of abscess MRIimaging technique 181 –184 ces/parameters 129 ACTH, ectopic secretion 185 contrast media 182, 184 anorectal angle 140 Addison disease 184 image analysis 182–184 anorectal fistula adenoma index of signal intensities (SI) 183 children/infants 342, 343, 345 adrenal see adrenal adenoma in-phase/opposed-phase imaging MRIpulse sequences/parameters colon 119, 131–132 181, 181,182,183,193 129 hepatocellular 11, 14, 18,346 pulse sequences 181–182, 182 anorectal flexure 128, 129 renal 155, 161 normal MRIappearance 183,184 anorectal line 128 adenomyoma 261 pathologic entities, MRIappearance antispasmodic agents adenomyosis, uterus 258, 260, 184–193 gastrointestinal MRI110 260–261 children/infants 356, 358–360 intra-abdominal lymph node MRI adnexa 285–299 sizes in children/adults 356 332, 333 normal anatomy 287 tuberculosis 184–185 liver MRI8 see also ovaries; uterine tubes adrenal incidentaloma 181, 184 pancreas MRI69 adrenal adenoma 181, 185, 186 adrenocortical adenoma see adrenal pelvic MRI241, 285 aldosterone-producing 185, 186 adenoma rectal/anal canal MRI127

aus: Hamm u.a., MR Imaging of the Abdomen and Pelvis (ISBN 9783131455918) © 2010 Georg Thieme Verlag KG Index 367 anus small, normal 55 see also VIBE sequence (volume-in- atresia 342 strictures/stenoses 53, 55, 55 terpolated breath-hold examina- ectopic 343, 344 biliary–enteric anastomosis 48 tion) imperforate 342 bladder (urinary) 209–217 breathing motion artifacts aortic aneurysm (abdominal aorta) benign tumors 211 gastrointestinal tract MRI111 313,313–314 carcinoma 211–214, 230 intra-abdominal lymph node MRI causes 313 lymph node metastases 336, 340 333 contrast-enhanced 3D MRA papillary 213 liver MRI 3,5–6 313–314 recurrence 212, 214, 215 minimization 1, 3, 7, 31, 49, 219 fusiform 313 seminal vesicle involvement 212, pelvic MRI241, 243,285 inflammatory 317, 317 214, 215 see also breath-holding techniques infrarenal 310,313,313 T1 to T4 stages 212, 213, 214 broad ligament, normal anatomy 287 multislice spiral CT 305, 313–314 TNM staging 212, 212, 212,214 bronze diabetes 72 saccular 313 cervical cancer invasion 268, 269, Budd–Chiari syndrome (BCS) 42, 42, treatment follow-up by 3D MRA 272, 273 324, 351 314, 314 recurrence after surgery 278, 281 Buscopan 110 true aneurysm 313 congenital anomalies 210 butylscopolamine 110, 111, 112, 121, aortic dissection 317, 318 diverticula 210, 211 127 chronic 316 hemangioma 211 contrast-enhanced 3D MRA 317 hyperintense, motion artifacts 263 C false and true lumen 316, 317 indications for MRI209 aortic intramural hematoma (IMH) inflammation 211 CA 19–980 314–316, 315 inhomogeneous signal intensity calcification, tumors 19, 257, 358 acute/subacute 315, 315 (layering) 210, 213 Candida abscess, liver 25 aortic wall thickening vs 315–316 leiomyoma 211 cannula, indwelling 1 MR angiography 315, 315 lymphoma 215 carcinoid tumors 113 aortic occlusion 317–318, 318 malignant tumors 210, 211–215 cardinal ligaments (Mackenrodt liga- aortic stenosis 317–318, 318 carcinoma see bladder, carcinoma ments) 246, 246 aortic thrombosis 313,317,318 rare 214–215 Caroli syndrome 53,348 aortitis 316,316–317 recurrent 210, 212, 214, 215 Castleman disease 363 aortocaval fistula 314 rhabdomyosarcoma (children) catecholamines, secretion by neuro- appendicitis 123, 125, 125 362, 363 blastoma 358 MRIindication 109, 109 MRIimaging technique 209 –210 cavernous transformation, portal vein appendicoliths 123 contrast media 210, 212 350 arteriovenous fistula, MR angiography imaging planes 209 CD 117 (c-kit proto-oncogene) 113, 323 pulse sequences and protocol 197 artifacts on MRIimaging 209, 210 celiac trunk 311 arms causing wraparound 143 MRI vs CT 212, 214 stenosis 319 motion see breathing motion arti- normal MRIappearance 129,210 cerebral MRI347, 359 facts; motion artifact(s) optimal filling, before MRI209, 241, ceruloplasmin, deficiency 36 ascites 72 285 cervical canal 245–246 cirrhosis with 39, 41 pathologic entities, MRIappearance in uterus didelphys 253, 254 endometrial carcinoma 265 210–216 cervical carcinoma 267–273 ovarian cancer recurrence 298 children 361–362 contrast-enhanced images 267, 268 rectouterine pouch 248 pheochromocytoma 211 extent, ligaments in evaluation 246, atherosclerosis prostate cancer invasion 231 246 aortic occlusions 317–318, 318 sarcoma 215 incidence 267 aortic wall thickening 315 wall, cancer invasion 212, 213, 231 metastatic lymph nodes 267, 273, penetrating ulcer 314 blood, T1 relaxation time, MRA 306 273 superior mesenteric artery 320 blood flow, velocity, calculation 306 MRIappearance 267–273 autoimmune hemolysis 36, 105 blood pool agents 307 parametrial invasion 271, 271, 272 autosomal dominant polycystic kid- blood transfusions, repeated, iron pulse sequences/protocol 267, 267 ney disease (ADPKD) 155, 154–156 overload 348, 348 radiotherapy, MRIafter 277, 279 autosplenectomy 103 blueberry juice, as contrast medium recurrence after surgery 278, 280, azygos vein, blood flow 325 49, 69 281 bone marrow, neuroblastoma meta- residual tumor after radiotherapy B stases 359 278, 279 bowel cleansing 109, 110, 140 stage IA and IB 268, 270, 271 Bartholin cysts 274 bowel obstruction 342 stage IIA and IIB 268,271,271, 272 basal cell nevus syndrome 343 breast cancer, metastases 20, 20,336, stage IIIA and IIIB 269,272,272 benign prostatic hyperplasia (BPH) 337 stage IV and IVA 269,272,273 225, 225 breath-holding techniques staging 267–273, 270 MR spectroscopy 223 colorectal cancer MRI121 MRIrole, vs CT 273, 273 prostate cancer with 225,226 intra-abdominal lymph node MRI vaginal invasion 271, 272, 273,275 bile ducts 47–64 332, 333 viable vs necrotic areas 267–268, anatomic variants 56 kidney and upper urinary tract MRI 269 inflammatory conditions 55 143 cervical intraepithelial neoplasia 267 MRCP see MRCP liver MRI1, 2, 3, 7, 31 cervix, uterine normal anatomy, MRI 51, 52,52–53, MRCP 48, 49 carcinoma see cervical carcinoma 55 pancreas MRI65, 66 cysts 262, 262 pathologic entities, MRI53 –63 retroperitoneum MRI196, 196 endometrial carcinoma invasion children 348 splenic MRI87 266

aus: Hamm u.a., MR Imaging of the Abdomen and Pelvis (ISBN 9783131455918) © 2010 Georg Thieme Verlag KG 368 Index cervix, uterine splenic infarction with 104 spiral and multislice (SCT/MSCT) fibrosis, postoperative 278, 280 splenomegaly with 104, 105 305 mucus 249 Wilson disease 347 aortic aneurysm 305, 313–314 normal anatomy 245, 245 citrate, MR spectroscopy of prostate aortic dissection 317 normal MRIappearance 248, 248, 222, 222,223,233 pancreas 65 250, 251 prostate cancer 232, 233 renal trauma 151 stenosis 261, 277 c-kit proto-oncogene 113, 197 congenital anomalies/diseases T2 w images 248, 248, 250 clear cell tumor, renal 356 bladder (urinary) 210 zonal anatomy 249, 250 coils gastrointestinal tract 342–343 chemical shift imaging (CSI) 182, 210, body, pelvic MRI 243 kidney 150, 150,352,352 292 conventional, in MR angiography 309 pancreas 71–72 3D MRS see MR spectroscopy, 3D endorectal prostate 223 children, abdominal MRI341 –365 contraindications (acute prostati- uterus see under uterus abdominal vascular malformations tis) 224 vagina 274 350–351 pelvic MRI(female) 242 congenital mesoblastic nephroma adrenal gland disease 356, prostate MRI219, 219,235 355–356 358–360, 359 rectum MRI128 contraindications for MRI241, 342 neuroblastoma 358,358–359, flexible wraparound for neonates/ contrast media 359, 359 infants 341 administration methods 9, 10 contraindications for MRI342 phased-array low rate of adverse effects 306 ganglioneuroblastoma 359 bladder MRI209 nonspecific see gadolinium-based ganglioneuroma 359, 360 intra-abdominal lymph nodes contrast media gastrointestinal tract 342–345 332 tissue-specific see iron oxide par- hepatobiliary system 345–348, 346, kidney and urinary tract 143–144 ticles; superparamagnetic iron 347, 348 liver MRI2 oxide particles (SPIO) indications for MRI341 MR angiography 306, 309 seealsospecificanatomicregions kidneys 352–356, 357 MRCP 47 (e. g. liver) MRIimaging technique 341 –342 pelvic MRI242, 243,285 copper coils and pulse sequences 341 rectum and anal canal MRI intratumoral, hepatocellular carci- contrast media 342 127–128 noma 21 positioning 341 retroperitoneum MRI195 toxicity, Wilson disease 42–43, 347 sedation 341–342 spleen MRI87 corpus luteum cysts 289 pancreatic abnormalities 348–349 surface, bile/pancreatic duct MRI47 creatine, MR spectroscopy of prostate pathologic entities, MRIappearance colon 119–125 222,223,223 342–364 adenoma 119, 131–132 prostate cancer 232, 233 pelvic conditions/MRI361 –363, 363 ascending, carcinoma 122 Crohn disease 109 retroperitoneum 352 carcinoma see colorectal cancer antrum 112 splenic abnormalities 350 Crohn disease 121, 123 children 343, 345 systemic neoplastic disease 363 diverticulitis 121, 123, 124, 124 colon 121, 123 chloral hydrate 341, 342 inflammatory disease 121, 123–125 complications 116,124 cholangiocarcinoma 11, 22, 25,63 lymphatic drainage 120 enterocutaneous fistula 117 cholangiocellular carcinoma (Klatskin MRI vs CT 124, 125 perianal fistulas 136, 137, 137, 138 tumor) 63, 64 polyp 120 rectum 136–138, 137, 138 cholangitis radiation-induced changes 121, 123 small intestine 114–115, 116 acute 76 sigmoid 122, 123, 124 ulcerative colitis vs 123 primary sclerosing (PSC) 61, 63 ulcerative colitis 121, 123, 123 Crohn Disease Activity Index (CDAI) secondary sclerosing 61 see also gastrointestinal tract 114–115 choledochal cysts 348, 349 colonography, MR see MR colonogra- cryptorchidism 361 choledochal stent 51, 53 phy (MRC) CT during arterial portography (CTAP) choledocholithiasis 58 colorectal cancer 119–121, 131–132 33 choline, MR spectroscopy of prostate “apple core” appearance 119, 119 Currarino triad 363 222,223,223 distant metastases 121 Cushing syndrome 185 prostate cancer 232, 233 liver metastases 19,19–20, 28–29, cyst(s) see individual cysts chordoma, presacral 362 121 cystadenocarcinoma choriocarcinoma 261 local recurrence 121 ovarian 295, 297,361 chromaffinoma, of adrenal gland 190, MRIrole, and vs PET/CT 121, 125 pancreatic 79 192, 192, 193 screening, MR colonography 109 cystadenofibroma, serous 294 cirrhosis 38–42 spread 119–120 cystadenoma advanced 40–42 TNM staging 119, 119, 132 mucinous 79, 81, 290, 291, 295 ascites with 39, 41 see also rectal cancer ovarian 290, 291, 295, 295 confluence fibrosis, with 39, 40 common bile duct pancreatic 77, 79, 79, 81 contrast media use 32–33, 323 diameter after cholecystectomy 55, serous 77, 79, 79,290 dysplastic nodules 40, 41 63 cystic duct first MRIsigns 38 normal MRCP 51, 52, 54 MRCP 55 indication for MRI34 stones 55, 58–59, 63 stones 58 macronodular 39, 41 common channel syndrome 348 cystic fibrosis, pancreas 71 neoplastic lesions 39–40, 41 common hepatic duct, bifurcation, cystic pancreatic neoplasms 77, 79, 79 portal vein thrombosis 40 cholangiocarcinoma 63 cystitis 211 primary biliary 55 computed tomography (CT) cystoscopy, bladder cancer 214 primary hemochromatosis and 36 intramural hematoma of aorta 315 regenerative lesions 40, 41, 42 MRIcomparison see individual con- siderotic nodules 39 ditions

aus: Hamm u.a., MR Imaging of the Abdomen and Pelvis (ISBN 9783131455918) © 2010 Georg Thieme Verlag KG Index 369

D menstrual cycle effects 247, 247, adrenal gland imaging 182, 184 248 bladder imaging 210 defecation disorders 125, 140 polyps 261, 261 children/infants MRI342 Denonvilliers fascia 221 radiotherapy effect 276–277, 277 intra-abdominal lymph nodes 333, dermoid cysts 292–293 Endorem 8, 27 334, 336 diazepam 341 endoscopic retrograde cholangiopan- kidney and upper urinary tract 146, diffusion-weighted imaging (DWI), creatography (ERCP) 47 148, 174 rectal/anal canal imaging 128 enterocutaneous fistula 117 liver imaging 8, 9, 27, 29,31–32, 34, dilatation and curettage, MRIafter Eovist, 3D MR angiography 307 91 276 esophageal squamous cell carcinoma, pancreas imaging 66, 68 diverticula metastases 112 prostate imaging 220, 238 duodenal 115 esophageal varices 323 rectal imaging 127 urinary bladder 210, 211 retroperitoneum imaging 196 diverticulitis, colon 121, 123, 124, 124 F splenic imaging 87, 91 diverticulosis 123 uterine zonal anatomy 247, 248 Dotarem (Gd-DOTA) 8–9, 34, 127, 306 fallopian tubes see uterine tubes gadolinium chelates 306, 307 DOTATOC 125 fast spin echo sequence see FSE se- gadolinium-DTPA 306, 307 doughnut sign, liver metastases 19 quence gadolinium ions (Gd3+)306 duct-penetrating sign 55, 80, 84 fat saturation techniques 66 Gadovist (gadobutrol) 8–9, 306, 307 duodenal C-loop 70 spectral/effective, liver imaging 7, 8, gallbladder duodenal diverticula 115 35 adenomyomatosis 55, 62 duodenum, pancreatic head differen- fat suppression disorders in children 348 tiation (MRI) 69, 70 adrenal gland imaging 181, 183 polyps 55, 61 dynamic contrast-enhanced MRI see for children/infants 341 stones 55, 58, 60 contrast media liver imaging 2, 3,4,7–8, 9,35 Gamna–Gandy bodies 39, 105, 106 dysgerminoma 297–298, 361 pancreas imaging 66 ganglioneuroblastoma 359 dystocia 301 pelvic MRI242 –243 ganglioneuroma 359, 360 retroperitoneum imaging 196, 196 Gartner duct, cysts 274, 275 E small intestinal MRI115 gastric cancer see stomach, adeno- splenic imaging 87 carcinoma echinococcal infection 186, 346, 346 see also short tau inversion recovery gastric leiomyoma 112 echo-planar imaging (EPI), liver 5 (STIR) sequence gastric leiomyosarcoma 112 ectocervix 249, 250 fecal incontinence 343 gastric lymphoma 112 ectopic pregnancy 288 female genitalia gastric vein, left, dilatation 323, 323 edema anomalies 360–361 gastrinoma 22,80,82 intrahepatic 37, 38 disease/tumors in children 361, 362 gastrointestinal stromal tumor (GIST) pancreatitis in children 348 seealsospecificanatomicstructures 113–114, 115,197 peritumoral (retroperitoneal fetopelvic disproportion 301 gastrointestinal tract 109–126 tumors) 200 fibroids see uterus, leiomyoma advantages of MRI, over CT 109, 121, ejaculatory ducts 221, 221 (fibroids) 125 embryonal carcinoma 361 fibromuscular dysplasia 319, 320 congenital anomalies 342–343 endocervical glands 249 fibrosarcoma functional/dynamic MRI125 endocervix, endometrial carcinoma renal 171 inadequate distention and tumor invasion 266 retroperitoneal 203, 204 mimic 111 endodermal sinus tumors 361, 362 FIGO classification indications for MRI109, 109 endometrial carcinoma 262–266 cervical carcinoma 268, 270 motion artifacts and prevention 110 epidemiology and risk factors 262 endometrial carcinoma 263, 266, MRIimaging technique 109 –112 MRIappearance 263 –266 266 abdominal imaging 110–111 myometrial invasion 262, 263, 264, FLASH 144, 196 contrast media 110, 111–112, 125 266 flow compensation (gradient moment patient preparation 109–110 pulse sequence/protocol 263, 263 nulling), liver imaging 7 pelvic imaging 111 recurrence after surgery 278, 280 flow-related signal enhancement, MR pulse sequences 110–111 residual tumor after radiotherapy angiography 305–306 pathologic conditions, MRIappear- 278, 280 flow-related signal loss (phase shifts) ance 112–125 stage Iand IA 263, 263,266 305, 306 children/infants 342–345 stage IB/IC 263, 264,266 focal nodular hyperplasia (FNH), liver PET/CT vs MRI121, 125 stage II, III and IV 265,266 see under liver see also colon; small intestine; staging/FIGO classification follicular cysts 287–288, 289 stomach 263–266, 266 Fourier space (k-space) 307 Gaucher disease, spleen 102 errors and overstaging 263 FSE sequence genitalia, anomalies 360–361 MRIrole 266 –267 for children/infants 341 germ cell tumors, testicular 361 T2 w images (high intensity) 263 liver MRI3, 5 gestational trophoblastic disease vaginal spread 262 pelvic MRI242, 252 (GTD) 261 endometrial cavity 253 retroperitoneum MRI196 ghosting/ghosts, liver imaging 6 blood clot in 247, 248 fungal infections 25,102,185 giant cell aortitis 316 endometrioma (endometriotic cysts) glucagon, rectal/anal canal imaging 290, 292, 292 G 127 endometriosis 253, 254, 290 glucagonoma 80 adenomyosis vs 258 gadobutrol see Gadovist (gadobutrol) Gorlin syndrome 343 endometriotic cyst 290, 292, 292 gadofosveset (Vasovist) 307 graafian follicles 287 endometrium 247 gadolinium-based contrast media gradient echo sequences see GRE abnormal thickening 264 3D MR angiography 306–307 sequences

aus: Hamm u.a., MR Imaging of the Abdomen and Pelvis (ISBN 9783131455918) © 2010 Georg Thieme Verlag KG 370 Index gradient moment nulling (flow com- hematoma human chorionic gonadotropin pensation), liver 7 acute adrenal 356, 358 (β-hCG) 261 gradient moment rephrasing (GMR) hepatic 22 hydatidiform mole 261 306 intramural, aortic see aortic intra- hydrometrocolpos 361 graft rejection, renal 175, 177 mural hematoma (IMH) hydronephrosis, vascular origin 356, granuloma, hepatic 43, 345 perirenal 151, 152 356 granulosa cell tumors 293, 361 renal see kidney, hematoma hyperaldosteronism, primary 185, 186 GRE sequences splenic 102 hypercortisolism 185 3D hematometra 278, 278 hypospadias 360 adrenal gland 182, 182 hematometrocolpos 253 gastrointestinal tract 110–111 hematosalpinx 278, 278,290,361, I intra-abdominal lymph nodes 361 336 hemochromatosis ileus 110 kidney and upper urinary tract pancreatic MRIimaging 66 iliac arteries, left external, stenosis 144 primary (hereditary) 322 liver lesions 3, 5 children 348 iliac crest imaging 196 MR angiography using 307 liver 36, 37, 106,348 imatinab 113–114, 197 pancreas 66 pancreas71,71–72 implants, cardiac 342 retroperitoneum 196 spleen 105, 106 infants see children, abdominal MRI see also VIBE sequence (volume- secondary 36, 37, 72,348 inferior mesenteric artery 305, 312 interpolated breath-hold ex- hemoglobinuria, paroxysmal noctur- inferior mesenteric vein 312, 312 amination) nal 36, 105, 105 inferior phrenic arteries 311 adnexa imaging 286 hemorrhage inferior vena cava 312 intra-abdominal lymph nodes 332, adrenal 356, 357 anomalies, MRA 325–326 332, 333 after biopsy for prostate cancer 227, compression 326 MR pelvimetry 301, 303, 303 227, 228 obstruction, renal cell carcinoma pelvic MRI243 intratumoral, liver metastases 19, 326, 326 portal venous MRI323 21, 22 occlusion 42, 42 in pregnancy 301 uterine leiomyoma 258, 257 renal tumor invasion 166,326,327 retroperitoneum imaging 196 hemorrhagic lesions, liver 22 inflammatory bowel disease hemosiderin 292, 348 children 343, 345 H hemospermia 224–225 MRIcriteria for assessment 117,343 hepatic arteries see also colon; Crohn disease; rec- hamartoma MR angiography, protocol 308 tum; ulcerative colitis liver, children 345 right, aberrant 319 inflammatory ovarian disease 361 splenic 96 stenosis, and thrombosis 324 inflammatory pseudotumor HASTE, imaging of hepatic duct, right bowel obstruction, children 342, adnexa 286 aberrant 53 344 adrenal glands 181, 182, 183 normal MRCP 51 splenic 96, 98, 99 bile/pancreatic duct 48, 49, 50 hepatic steatosis 26, 26, 27 in-phase (IP) imaging gastrointestinal tract 109,110–111, hepatic veins, MR angiography 324 adrenal glands 181, 181,182,183, 111,115 hepatic venous outflow obstruction 193 colorectal cancer 120,121,122 42, 42,324 liver 3, 5, 6, 6, 7, 12 inflammatory disease 124 children 351 insulinoma 80, 349–350 kidney and upper urinary tract 144, hepatitis, acute 37, 38 internal iliac artery, normal MRA 312 146 hepatobiliary contrast media 27, 30, intersphincteric fistula 138 liver 3, 5, 5 30 intestinal duplication 342 rectal/anal canal 128 hepatobiliary system, children/infants intra-abdominal lymph nodes retroperitoneum 196, 196 345–348 331–340 splenic 89 hepatoblastoma 346 asymmetry, in metastases 336 hemangioendotheliomatosis, children hepatocellular adenoma 14, 18,346 benign vs malignant enlargement 345 hepatocellular carcinoma (HCC) 11, 331, 336 hemangioma 21–22, 23, 24 conglomerate 336, 337 adrenal 188, 190 children/infants 346–347, 347 contrast media 333–334, 336, 338 bladder 211 contrast media use 32–33 non-specific (gadolinium-based) capillary, splenic 93 focal, in adenomatous hyperplasia 333, 334, 336 cavernous, splenic 93 42 oral 333 liver 12, 13,13–14, 15 focal lesion in cirrhosis 39–40, 41 tissue-specific 334 centripetal enhancement 30, 31 hepatocellular adenoma vs 14 indications for MRI331 –332, 332 children 345, 346 metastases vs 27, 34 malignancy criteria 334, 336 cysts vs 12, 13, 13 pseudocapsule 21, 22, 23, 24 metastases 331, 335,336 dynamic contrast-enhanced MRI hepatocellular nodules 39,40–41 melanotic 336, 337, 338 13,14,15, 32 hepatocytes, iron uptake 36 MRIadvantages over CT 331 iron oxide particle injection 27, hepatopathy, congestive 351 MRIappearance of abnormal nodes 29 hermaphroditism 360 336, 337, 338, 339 metastases vs 13, 30, 31 Hodgkin lymphoma MRIimaging technique 332 –334 retroperitoneal 200 lymph node metastases 331, 336, imaging planes 332, 332 spleen 93, 95,95–96 338 pulse sequences 332,332–333, hemangiomatosis spleen involvement/MRI 90,99 333 liver, children 345, 346 see also lymphoma MRIse nsitivity 331, 334, 338, 339 splenic 93, 95, 96 hormone therapy, prostate cancer multiple enlarged, in malignancy hematocolpos 274, 274 232–233 336, 337

aus: Hamm u.a., MR Imaging of the Abdomen and Pelvis (ISBN 9783131455918) © 2010 Georg Thieme Verlag KG Index 371

normal MRIappearance 334, 334, contrastmedia148,174,352,353 cirrhosis see cirrhosis 335, 339 precontrast imaging 144, 146 contrast-enhanced MRI27 –30 pelvic see pelvic lymph nodes protocol for graft recipients 175 diffuse liver disease 34, 39 size 331, 334 pulse sequences 144, 144, 145 focal lesion characterization 34 malignancy diagnosis 334, 335, for specific indications 144, 144 focal lesion diagnosis 30–33, 31, 336 MRI vs CT 143 32, 33 spherical transformation 336 normal MRIappearance 146,148 hepatobiliary contrast media 8, 9, T1 w hyperintensity in melanoma pathologic entities, MRIappearance 27, 28–29,30,30 336, 337, 338 150–177 late postcontrast images 31–32 T1 w hypointensity and T2 w hy- children 352–356 nonspecific contrast media perintensity 334, 334,336 polycystic disease 154, 155–156, 31–32 upper abdomen, pulse sequences 352 SPIO (iron oxide particles) 8–9, 332, 332, 333 stones 154, 154 27, 28, 29, 30 intracervical mucus 249 trauma 151, 152 contrast inflow, temporal course 10, intraductal papillary mucinous tumor tumors see renal tumors 10 (IPMT) 77, 79 vascular anatomy 174, 174 cysts 12, 12, 13, 91 intrahepatic block 351 see also entries beginning renal children 345, 346, 346 intramural hematoma (IMH) of aorta Kinsbourne syndrome 359 diffuse disease 34–43, 35 see aortic intramural hematoma Klatskin tumor 63, 64 acute infections/inflammatory (IMH) Klippel–Trenaunay–Weber syndrome 37, 38 intraperitoneal abscess, children 350 93 vascular 42, 42 intrathoracic lymph nodes 336 Krukenberg tumor 112, 297, 297 edema (intrahepatic) 37, 38 intrauterine device (IUD) 241 k-space (Fourier space) 307 eggshell calcification 12 iodine-based X-ray contrast media Kupffer cells 8, 42 fatty infiltration 3, 6 8–9 diffuse/generalized 35, 36 iron L focal lesions 26, 26, 27 chelation therapy 348 fibrosis 38–42 deposition/storage 36, 102, 105, 106 labor, protracted 301 confluent, cirrhosis with 39, 40 liver 35–36, 106 lactate dehydrogenase (LDH), elevated see also cirrhosis pancreas 71,71–72 358 focal lesions 1–34 splenic 102, 103–104, 104, 105 Larmor frequency 306, 307 benign 12–18 iron gluconate 286 left common iliac veins 327 characterization 34 iron overload leiomyoma detection (contrast media use) liver 35–36, 348, 348 bladder 211 30–33, 31, 32, 33 pancreas 71,71–72 gastric 112 fatty 26, 26, 27 iron oxide particles small intestine 113 hemorrhagic 22 bile/pancreatic ducts contrast 48, uterine see uterus, leiomyoma malignant 19–22 48–49, 51 (fibroids) role of MRI30 –34 pancreas imaging 69 leiomyosarcoma focal nodular hyperplasia (FNH) 11, see also superparamagnetic iron epithelioid, myxoid/granular cell 14, 16,27 oxide particles (SPIO) types 203 dynamic MRI30, 33 iron storage disease 35–36, 71,71–72 gastric 112 pedunculated 14, 17 ischiorectal abscess 138, 139 prostate 237, 238 granuloma 43, 345 islet cell tumors 80, 82, 83 renal 171 hemangioma see hemangioma, liver liver metastases 28–29 retroperitoneal 197, 202–203 hilum, enlarged lymph nodes 43 leiosarcoma, small intestine 113 incidentally detected lesions, MRI K Leriche syndrome 317 for 1 leukemia, MRIof children 363 indeterminate lesions, MRItechni- kidney 143–179 levator ani muscle 128–129, 130 ques 2 advantages of MRI143 lipoma indications for MRI1, 2,34 artifacts (wraparound) 143 presacral 362 intraparenchymal hemorrhage 42 atrophy 151, 154 retroperitoneal 202, 202 iron deposition 35–36, 106 benign conditions 150–161 small intestine 119, 119 malignant tumors 11, 12,27 congenital anomalies 150, 150,352, liposarcoma children 346–347 352 perirenal fatty tissue 160 see also hepatocellular carcinoma cysts see renal cysts renal 160, 171 (HCC) duplex 352, 352 retroperitoneal 200, 201,202 metastases 1, 2, 7,11,19–21 ectopic 150 littoralcellangioma96,97 from breast cancer 20, 20, 101 functional imaging 174 liver 1–45 calcification 19 hematoma 151, 152 abscess 25, 26, 345 children 347 in graft recipient 175, 176 adenoma 11, 14, 18,346 from colorectal cancer 19,19–20, horseshoe 150, 150 adenomatous hyperplasia, focal 28–29,121,125 indications for MRI143 HCC in 42 dynamic contrast-enhanced MRI inflammation/abscess 151, 152 advantages/benefits of MRI1 12,19,27,31 living donor evaluation 174, 174 atrophy 25, 38, 39 fatty lesions resembling 26, 27 lymphoma 171, 172, 173 in cirrhosis 38, 39, 41 from gastrinoma 22 metastases in 171, 172, 173 benign focal lesions 12–18 HCC vs 27, 34 MRIimaging technique 143 –148 benign tumors 1, 12,34 hemangioma vs 13, 30, 31 children/infants 352 children/infants 345–346 hemorrhage in 19, 21, 22 coils 143–144 see also hemangioma, liver hypervascular 12,20,21,32 contrast-enhanced imaging 144, biopsy, children 347 hypovascular 19, 19,19–20, 30, 31 147 caudate lobe hypertrophy 43 from islet cell carcinoma 28–29

aus: Hamm u.a., MR Imaging of the Abdomen and Pelvis (ISBN 9783131455918) © 2010 Georg Thieme Verlag KG 372 Index liver hilum of liver 43 middle suprarenal arteries 311 metastases intra-abdominal see intra-abdomi- milk, whole, as contrast agent 342 melanotic (melanoma) 12, 20–21, nal lymph nodes mononuclear phagocytic system 22, 101–102 pelvic see pelvic lymph nodes (MPS), magnetite uptake 8, 27 neuroblastoma 358, 359 perirectal, metastases 133 motion artifact(s) 3,5–8 nonspecific contrast media sizes, normal vs metastases 334, bowel movement 3,5–6, 49, 110, 31–32, 91 335,336 219, 241 from pancreatic carcinoma 77, 78 lymphoma causes 3,5–6 from rectal cancer 31,132 adrenal 190 ghosting/ghosts 6 from renal cell carcinoma 20, 21 bladder 215 minimization 6–8, 9 tissue-specific contrast media 27, children, MRI350, 363 gastrointestinal MRI110, 111 28–29,30,31 gastric 112 pancreatic MRI66 MRItechnique see liver, MRItech- mesenteric 113 prostate MRI219 nique ovarian 298, 298 respiratory triggering 8, 9, 28–29 nodule-in-nodule 42 renal 171, 172, 173 see also breath-holding techni- nodules see hepatocellular nodules small intestine 113, 119, 119 ques; fat suppression; presatu- normal MRIappearance 11, 11 spleen involvement 90,99,99, 100 ration band parasitic infections 37 see also Hodgkin lymphoma; non- pelvic MRI241 pathology, MRIappearance Hodgkin lymphoma pulsation artifacts 3,6,7 diffuse liver disease 35–43 lymphoproliferative disease 356 respiratory see breathing motion focal lesions 11–26 benign atypical 363 artifacts sarcoidosis 43 urinary bladder, endometrial carci- siderotic nodules 39,40–41 M noma MRI 263 transplantation 324,324–325, 325 MP-RAGE (magnetization-prepared trauma, children 348 Mackenrodt ligaments (cardinal liga- rapid acquisition gradient echo) vascular disease 42, 42 ments) 246, 246 323, 336 Wilson disease 42–43 magnetic resonance cholangiopan- MR angiography (MRA) 305–330 liver, MRItechnique 1– 11, 2, 5 creatography (MRCP) see MRCP contrast-enhanced 3D 305, 306–310 coils 2 magnetic resonance elastography automatic injectors and rates 307 contrast media 1, 8–9 (MRE) 34, 38 coils 309 administration methods 9 magnetites see superparamagnetic contrast media 306–307 nonspecific (gadolinium) 8, 9, 27, iron oxide particles (SPIO) k-space and timing 307 29,31–32, 34 Magnevist (Gd-DTPA) 34, 66, 68, 127, parallel imaging techniques 308 tissue-specific see below 306 patient examination 309, fat suppression 2, 3, 4,7,35 male genitalia, anomalies 361 309–310 imaging planes 1–2 malignant fibrous histiocytoma (MFH) postprocessing techniques 308, motion artifacts and reduction of 204, 205 308, 310, 311, 322 5–8 maximum intensity projection (MIP), protocol 309–310 see also motion artifact(s) MRA 308, 322 pulse sequences 307–308, 308 patient positioning/preparation 1 Mayer–Rokitansky–Küster–Hauser flow-related signal enhancement protocols 9–11 syndrome 253, 360 (inflow effects) 305–306 dynamic 9–10, 10, 13,14,15,34 Meigs syndrome 293 flow-related signal loss (phase multiphasic 10 melanoma, malignant shifts) 305, 306 static using tissue-specific con- amelanotic, metastases 336 imaging technique 305–310 trast media 10–11 liver metastases 12, 20–21, 22 indications 305 unenhanced 9 lymph node metastases 336, 337, kidney and upper urinary tract 143, pulse sequences 2–8, 4, 5 338 144, 147, 147 3D GRE sequence 2–3, 5 splenic metastases 100, 101 liver transplantation evaluation in-phase and opposed-phase 3, 5, Ménétrier disease 112 324, 324, 325 6, 6, 7, 12 meningomyelocele 362, 363 normal anatomy, appearance intermediate field strength T1 w menstrual cycle 311–312, 312 3 endometrium thickness 247, 247, pancreas 66, 83 T1 w imaging 2–3, 5, 6, 7,11,12 248 pathologic entities, MRIappearance T2 w imaging 3, 5, 5,7,12,12 ovarian changes 288 313–328 turbo/fast SE (TSE, FSE) 3, 5 vaginal changes 249 children/infants 341, 350, 351, tissue-specific contrast media 8–9, mesenchymal tumors 197 351 10–11, 31 granulosa cell 361 pelvic inflammatory disease 288 hepatobiliary (low-molecular- hemangioma of liver 13,13–14 phase-contrast (PC) 306 weight)8,9,27,30,30,37 hepatic sarcoma 347 renal transplantation evaluation SPIO (iron oxide particles) 8–9, retroperitoneal see retroperitoneal 321, 322, 323 27, 28, 29, 30, 34, 39 soft-tissue tumors time-of-flight (TOF) 305–306, 327, lumbar arteries 311 mesenteric ischemia 319, 319, 320 327 lumbar lymph nodes 334 mesenteric lymphoma 113 unenhanced 305–306 Lumirem 342 mesorectal fascia 128, 131 see also individual arteries/veins lung metastases 121, 132 mesorectum 130,132 MR colonography (MRC) 109, 109 lymphadenopathy, retroperitoneal metastases see specific cancers and colorectal cancer 120,121,122 326 anatomic structures inflammatory disease of colon lymphangioma methemoglobin 292 123–125 abdominal, children 343 MIBG scintigraphy, pheochromocy- waterenemaorairinsufflation110 splenic 96 toma 192 MRCP 47–64, 65 lymph-hemangiomatosis 350, 351 microabscesses, splenic 102 advantages and cost-benefits 47 lymph nodes middle sacral artery 311 children 348, 349

aus: Hamm u.a., MR Imaging of the Abdomen and Pelvis (ISBN 9783131455918) © 2010 Georg Thieme Verlag KG Index 373

indications for 47 nephroblastoma see Wilms tumor fibroma see ovarian fibroma maximum intensity projection (nephroblastoma) follicular cysts 287–288, 289 (MIP) algorithm 48, 49, 52 nephroblastomatosis 355, 355 functional cysts 289, 290,361 normal 51, 52, 55 nephrogenic systemic fibrosis (NSF) functioning tumors 293, 294 oral contrast media 48–49 148 hemorrhagic cysts 289, 290 negative (iron oxide) 48,48–49, nephroma indications for MRI285 51 congenital mesoblastic 355–356 inflammatory disease in children in pancreas MRIprotocol 66 multilocular cystic 160, 356 361 patient preparation 48–49 neuroblastoma 192–193, 358, lymphatic drainage 287 recommended protocol 49, 50,51, 358–359, 359 lymphoma 298, 298 51, 52 staging 359 malignant tumors 294–296 technique 47–51 neuroendocrine tumors 79, 80,125 children 361 coils 47 neurofibroma, and neurofibromatosis metastases 295, 297 pulse sequences 48, 49, 50 204, 205 primary see ovarian cancer MR defecography 140, 140 neurovascular bundle, prostate base menstrual cycle effects 288 MR enteroclysis 109, 109,110 see prostate MRIimaging technique 285 –286 MR hysterosalpingography 288, 289 Niemann–Pick disease 102 contrast media 286 MR pelvimetry 301–304 non-Hodgkin lymphoma imaging planes 285 advantages and indications 301 adrenal 190 pulse sequences/protocol imaging technique and findings inflammatory bowel disease vs 345 285–286, 286 303 lymph node metastases 331, 336 normal anatomy 287 pelvic measures 302,302–303 mesenteric 113 normal MRIappearance 287, postpartum 301, 302,302–303 ovarian 298, 298 287–288 prenatal 301, 303 spleen involvement/MRI99, 99, 100 pathologic entities, MRIappearance pulse sequences 303, 303 see also lymphoma 288–298, 361 reference values 303 polycystic ovary syndrome MR spectroscopy, 3D 222–223 O 289–290, 361, 362 free induction decay (FID) signal torsion 289, 292, 361 223 omentum, endometrial carcinoma in- zonal anatomy 287, 288 frequency spectrum 222, 223 vasion 265 prostate see prostate; prostate Omniscan 8–9, 66, 68, 306 P cancer oncocytoma 155, 158, 159 MR urography (MRU) 143, 144, 147, opposed-phase (OP) imaging pacemakers 342 148 adrenal glands 181, 181,182,183, PACE technique, bile/pancreatic duct 3D MR angiography with 305 193 imaging 48 renal graft recipients 175 liver 3, 5, 6, 7 pancreas 65–86 T1 w excretory, and T2 w static 148, opsoclonus 359 anatomy 65, 65,70 149 Optimark (gadoversetamide) 8–9 annular 66,71 mucoviscidosis (cystic fibrosis) 71 oral contraceptives 14, 248, 249 atrophy 74 müllerian duct, anomalies 252–255, Ormond disease (retroperitoneal fib- calcification 74, 76 360 rosis) 204, 206 chronic 75 agenesis 360 ovarian cancer 285, 294–295 congenital anomalies/diseases cysts 223 borderline 295, 296, 298 71–72 incomplete/absent (unicornuate criteria of malignancy 295, 296, 297 see also pancreas divisum uterus) 252,254,254 FIGO/UICC stages 297 cystadenoma, children 350 partial nonfusion 252, 254, 254 histologic classes 294–295 cystic fibrosis 71 multicystic renal dysplasia 352, 353 lymph node metastases 331 cysts 71 Multihance (Gd-BOPTA) 8, 9, 31, 306, recurrence 298, 298 endocrine/exocrine secretions 49, 307 serous papillary 296 65 multilocular cystic nephroma 160 staging laparotomy 295 outflow obstruction 52 multiplanar reconstruction (MPR) ovarian fibroma 293, 294 fibrosis 74 308, 322 malignant transformation 293, 294, focal enlargement 80 multiple endocrine neoplasia type 1 295 functions 65 (MEN 1) 80 uterine leiomyoma vs 256 head 69, 70, 70 multiple endocrine neoplasia type ovarian follicles 287–288, 288 carcinoma 76,76–77 2A/2B 192 ovarian fossae 287 enlargement 71, 72, 75 myelolipoma, adrenal 188, 189 ovarian ligament 245,287 pseudocyst 73 myometrium ovarian teratomas 361, 362 indications for MRI65, 66 invasion by endometrial carcinoma ovarian veins 287, 326–328 inflammatory disease see pancrea- 262, 263, 264,266 2D TOF MRA 327, 327 titis invasion by endometrial tissue thrombosis, septic puerperal 328 lipomatosis 70, 70 (adenomyosis) 258, 260,260–261 ovaries 285–299 lymphatic drainage 65,70,77 normal MRIappearance 247, 247, benign tumors 289–293 mass(es) 57,61,63 248 cystic 289–293, 361, 362 MRIimaging technique 66 –69, 67 benign vs malignant masses 286, contrast media 66, 68–69 N 295 dynamic 66, 68, 69,83 blood supply and venous drainage imaging planes 66 Nabothian cysts 246,249,262,262 287 pulse sequences 66, 67, 68, 69 navigator echo technique 8, 9,48 cortex, and medulla 287, 288 MRI vs CT65,72,74,77 neonates and infants, MRIimaging 92, cystadenoma 290, 291, 295, 295 neoplasms 76–80 341 dermoid cysts 292–293, 293 ampullary cancer 77, 77 see also children, abdominal MRI endometriotic cysts 290, 292, 292

aus: Hamm u.a., MR Imaging of the Abdomen and Pelvis (ISBN 9783131455918) © 2010 Georg Thieme Verlag KG 374 Index pancreas paracolpium (paravaginal tissues) peripancreatic fluid 70,72,75 neoplasms 248,249,251 perirectal abscess 127 carcinoma see pancreatic carci- paraesophageal varices 323 perirectal fat 131, 132, 133, 135 noma paraganglioma 192 perirectal lymph nodes, metastases children 349–350 parallel imaging 2, 128, 143 132, 133 cystic 77, 79, 79 paramagnetic low-molecular-weight perirenal hematoma 151, 152 islet cell tumors 28–29,80,82, 83 compounds 8, 9, 68 peristalsis, motion artifact 3,5–6, 49, pseudotumors vs 80, 83, 84 3D MR angiography 306, 307 110, 219, 241 normal MRI70 parametrium 246, 270 peritoneal carcinosis, gelatinous 121 normal parenchyma 68, 69,70 cervical cancer involvement 271, peritoneal cyst 298 pathologic conditions, MRIappear- 271, 272 peritoneum, covering uterus 246, 246 ance 71–83 normal MRIappearance 249, 251 phase contrast (PC), MR angiography children/infants 348–349 parapelvic cysts 154, 156 306 primary hemochromatosis 71, parasitic cysts, adrenal 186 phased-array coils see coils, phased- 71–72 parasitic infections, liver 37 array pseudocysts see pancreatic pseudo- paraumbilical veins 324 phase-encoding gradient 307 cysts paravaginal tissues 248,249,251 phase-ordering technique (ROPE) 8, 9 pseudotumors, vs neoplasms 80, 83, parovarian cyst 290, 290 phase shifts, MR angiography 305, 84 paroxysmal nocturnal hemoglobinuria 306 string of pearls appearance 73,74 36, 105, 105 pheochromocytoma 190, 192, 192, transplant 83 pelvic abscess 345, 345 193 pancreas divisum 52–53, 54, 58,71 pelvic arteries bladder 211 MRIindication 66 normal MRA 311–312, 312 children 359–360 pancreatic carcinoma 76–77 pathologic conditions, MRA polycystic kidney disease 154, absence of duct-penetrating sign 83 313–321, 318 155–156,352 benign lesions vs 65 pelvic floor, functional disorders 140 polycystic ovary syndrome 289–290, children 350 pelvic inflammatory disease (PID) 361, 362 classification 77 288, 289 polyethylene glycol electrolyte solu- head of pancreas 76,76–77 pelvic inlet, measures 302,302–303 tion (PEG–ES) 109, 110, 343 metastases and spread 77, 78 pelvic lymph nodes polyps MRIindication 66 contrast media for MRI333, 334 colon 120 neuroendocrine 21,79,80 metastatic, MRIappearance 336 endometrium 261, 261 portal vein invasion 324 MRIpulse sequences 128, 332, gallbladder 55, 61 signal intensity 77, 78 332–333, 333 porphyria cutanea tarda 36 tail of pancreas 76, 78 normal 334, 334, 335 portal hypertension 34, 184, 323,324 vascular encasement 77, 83 size for malignancy diagnosis 336 children 360 pancreatic duct 47–64 pelvic MRI(female) 241 –244, MR angiography 321, 323–324 accessory 52, 71 285–286 retroperitoneal collaterals 324, 324 anatomic variants 52–53, 55, 56, artifacts 241 portal veins 71 congenital uterine anomalies invasion by pancreatic tumor 324 carcinoma 76 252–253, 253 normal MRA 312, 312 dilatation 73, 75,77 contraindications 241 pathological MRA 308, 312, 312, gradual narrowing vs abrupt ob- contrast media 244 321, 323–324 struction 83 imaging planes 242, 285 children 350–351 inflammatory conditions 55 imaging strategy/protocol 242, 244, stagnant blood in 350 MRCP protocol 49, 50,51,51,65 244 stenosis 324 see also MRCP menstrual status 285 thrombosis 40, 91,350–351 normal anatomy, MRI 51, 52,52–53, patient preparation/position 241, portal venous system 55 285 contrast-enhanced 3D MRA 323, normal MRCP 51, 52 pulse sequences 242, 285 323 pathologic entities, MRIappearance adnexa imaging 285–286, 286 normal MRA 312, 312 53–63 congenital anomalies 253, 253 pathologic entities, MRA 321–325 small, normal 55 uterus and vagina imaging intraluminal dephasing phenom- stones 55, 56, 58–59,74 242–243, 244 ena 323 children 348, 349 pelvic outlet, measures 302,303 portosystemic collaterals, MRA 321, strictures/stenoses 53, 55, 55 pelvic veins 323–324 children 349 2D TOF MRA 327, 327 portosystemic shunts 325 vs malignancy 55 normal MRA 312 positron emission tomography (PET), pancreatic pseudocysts 55, 64,72,73, pathologic entities, MRA 326–328 MRI vs,colorectalcancer121 74, 75–76 thrombosis 326–328, 327 posthepatic block see hepatic venous children 348 pelvimetry 301–304 outflow hemorrhagic 74 MR see MR pelvimetry postmenopausal bleeding 262 pancreatitis 66,72–76 penetrating atherosclerotic ulcer postmenopausal women acute 54, 56,72,74 (PAU) 314 ovaries 288 complications 72, 73,74 Pepper syndrome 359 uterus 248, 249,277 edematous 72, 72 perfluorooctyl bromide, as contrast vagina 249 children 348, 349 agent 342 pregnancy 261, 301 chronic 52, 55, 65, 70, 73,74–75 perfusion-weighted imaging (PWI), ectopic 288 recurrent 48, 80, 348, 349 rectal/anal canal imaging 128 MRIduring first trimester 301 papilla of Vater 52, 55 perianal abscess 136, 137–138 MR pelvimetry see MR pelvimetry papillary sclerosis 57 perianal fistula 127, 128, 136, 137, ovarian veins 326 para-anal horseshoe abscess 139 137 prehepatic block 350

aus: Hamm u.a., MR Imaging of the Abdomen and Pelvis (ISBN 9783131455918) © 2010 Georg Thieme Verlag KG Index 375 presacral teratoma 362–363, 364 dynamic contrast-enhanced 230, vaginal MRIappearance after 277, presacral tumors, children 362–363, 232, 232 277–278 363 endorectal coil MR imaging readout gradient 307 presaturation band 241, 242, 243 226–232 rectal ampulla 128 liver imaging 6–7 extent assessment 227–228, 232 rectal cancer 131, 132 pancreas imaging 66 extracapsular 227–228, 228, 229 circumferential resection margin presaturation pulses 242, 242, 243 lymph node involvement 235, 236, 132 PRESS (point-resolved spectroscopy) 336 distant metastasis 132 222 MRI/MR spectroscopy combined lymph node metastases 132, 133 primary biliary cirrhosis (PBC) 55 232, 233, 234 MRIpulse sequences/parameters primary sclerosing cholangitis (PSC) MRI vs CT or ultrasound 235 129,132 61, 63 MR spectroscopy 232–234, 233 MRIrole/appearance 132 –133, 133, Primovist (Gd-EOB-DTPA) 8, 9, 31, 31, neovascularization 226 134 33 peripheral/transitional zone 226, recurrence 121, 135, 135–136 Prohance (gadoteridol) 8–9 227 spread 120–121, 127 prostate 219–240 radiologist's experience importance staging 132, 132 abscess 224 230, 232 T1, T2 and T3 132, 133 anatomy 220–221, 221 radiotherapy, MR spectroscopy after T4 133, 134 benign hyperplasia see benign pro- 233, 235 total mesorectal excision 128, 132 static hyperplasia (BPH) recurrent 219, 235, 235, 236 see also colorectal cancer cancer see prostate cancer (below) routes of spread 228, 229, 230 rectocele 140, 140 congenital anomalies 223 seminal vesicle invasion 228, 229, rectouterine pouch (pouch of Douglas) cysts 223, 224 230, 230 248,287,288,298 indications for MRI219 small solitary tumors 228 rectum 127–141 inflammatory conditions 224–225 stage T1 and T2 226 anatomy 128–129, 129, 130 malignant tumors 226–238, 237 stage T2A 222 anterior displacement, children adenocarcinoma see prostate stage T3 and T3 b 226, 229, 230 343 cancer stage T4 226, 228, 230, 231 blood supply 129 atypical carcinomas 236, 237 staging/TNM classification 219, 226, cervical cancer invasion 272, 273, mucinous carcinoma 236–237 226 278, 281 rhabdomyosarcoma 362 prostatectomy, prostate cancer recur- Crohn disease 136–138, 137, 138 sarcoma 237,237–238, 238 rence after 235, 235, 236 functional disorders 140 transitional cell carcinoma 237 prostate-specific antigen (PSA) 219, indications for MRI127 MRIimaging technique 219 –220 230, 233, 235 inflammatory bowel disease 127, contrast media 220, 238 prostatic capsule 222,227 128, 136–138 dynamic imaging 220 prostatic utricle 360 lymphatic drainage 120, 132 endorectal coil 219, 221, 235 prostatitis 224 MRIimaging technique 127 –128 imaging planes 219–220 proton density (PD) sequence 90, 332, MRI vs CT 127 pulse sequences and protocol 341 normal, MRIappearance 128 –131, 220, 220 proton motion 305 129, 130 MRI/MR spectroscopy combined pseudocapsule pathologic entities, MRIappearance 222,232,233 hepatocellular carcinoma 21, 22, 23, 131–140 MR spectroscopy (3D) 222, 24 pelvic (rectal ampulla) 128 222–223, 223 prostate 225, 225 perineal see anal canal citrate, choline and creatine soft-tissue sarcoma 200 venous drainage 132 222–223, 232, 233 uterine leiomyoma 256, 257, 260 wall, layers 129, 130, 131 neurovascular bundle at base 221, Wilms tumor 353, 354–355 relaxation enhancement (RARE) 221, 222 pseudocysts technique, MRCP 48 cancer involvement 228, 229 adrenal 186 renal adenoma 155, 161 nodules 225, 225 pancreatic see pancreatic pseudo- renal angiosarcoma 171 normal MRIappearance 129, cysts renal arteries 220–223 splenic 93, 102 aneurysm 322 pathologic entities, MRIappearance pseudodiverticula, urinary bladder contrast-enhanced MRA 311, 320, 223–238 210 320–321 pseudocapsule 225, 225 pseudomyxoma peritonei 121 evaluation in living kidney donors scar formation 224 pubic symphysis, normal MRIappear- 320, 321, 322 sensitivity of MRI219 ance 129 evaluation in transplant recipients T1 w image homogeneity 221 pubococcygeal line 140 321, 322, 323 T2wimages221,226,235,238 pulmonary sequester 351 normal MR angiography 311 zonal subdivision 221, 221,226 pyosalpinx 288 occlusion, children 356, 356 transitional zone 221, 221,223, PTA and stenting 320–321 225 R stenosis 320, 320, 321, 323 prostate cancer 226–235, 235, 236 children 356, 357 accuracy of MRI230 radiation cystitis 211 variants 320, 321, 322 benign prostatic hyperplasia with radiation enteritis 115, 121, 123 renalcellcarcinoma(RCC)161–163, 225,226 radiation-induced hepatitis 37 162 biopsy 226 radiotherapy 3D MRA 163, 168 hemorrhage after 227, 227, 228 cervical carcinoma 277,278,279, cystic 168 MR-guided 234, 234 280 extent determination by MRI161, capsular penetration criteria prostate cancer 233, 235 163, 164–168 227–228, 228 uterus MRIappearance after inferior vena cava invasion 166, 276–277, 277, 280 326, 326, 327

aus: Hamm u.a., MR Imaging of the Abdomen and Pelvis (ISBN 9783131455918) © 2010 Georg Thieme Verlag KG 376 Index renalcellcarcinoma(RCC) retroperitoneal lymph nodes 335 schistosoma mansoni 37 kidney contour distortion 162, 165, metastases 331 schwannoma 204, 205 166–167 normal 334 secretin 49 liver metastases 20, 21, 339 retroperitoneal soft-tissue tumors sedation, children/infants 341–342 metastatic lymph nodes 163, 168, 197, 200 seminal colliculus 221, 221 335,336 benign vs malignant 200, 201 seminal vesicle 219–240 Robson/TNM classification 162 characteristics (margination/ agenesis 223 venous invasion 163, 166,326 growth/necrosis) 200–202 anatomy 221, 221 renal collecting system, dilatation 154 classification 197, 198–199 bladder cancer involvement 212, renal columnar hypertrophy 356 enhancement patterns 200 214, 215 renal cysts 151, 152,154,155 epidemiology/incidence/staging ectopic 223 complicated 154, 156, 157 197, 199 inflammation 224–225 hemorrhagic 154, 157 fibrosarcoma 203, 204 MRI imaging 222 polycystic kidney disease 154, initial diagnostic work-up 200–206 prostate cancer invasion 228, 229, 155–156,352 invasion/spread 200, 201, 202 230, 230 simple 154, 155 leiomyosarcoma 197, 202–203 see also prostate renal dysplasia, multicystic 352, 353 lipoma 202, 202 sensitivity encoding technique renal infarction 356 liposarcoma 200, 201,202 (SENSE) 143 renal inflammation 151 malignant fibrous histiocytoma septic puerperal ovarian vein throm- renal lymphoma 171, 172, 173 204, 205 bosis (SPOVT) 328 renal oncocytoma 155, 158, 159 mixed benign 200, 201 Sertoli–Leydig cell tumors 293 renal transplant 175 MRI follow-up scheme 206 shading sign 292 3D MRA evaluation after 321, 322, patterns of spread 195 short tau inversion recovery (STIR) 323 rare tumors 204, 205 sequence complications 175, 176, 177 recurrence, MRI 206 colorectal cancer 121, 122 living donor evaluation 174, 174 sarcomas 197, 200–201 islet cell tumors 80 3D MRA 320, 321, 322 T2wandT1w sequenceintensity liver imaging 7–8 MRI imaging protocol 175 201 rectal/anal canal imaging 128, 137 normal MR angiography 322 retroperitoneal xanthofibrogranulo- sickle cell anemia 103, 350 rejection 175, 177 matosis 204, 206 siderotic nodules (Gamma–Gandy renal trauma 151, 152 retroperitoneum 195–207 bodies) 39, 105, 106 renal tumors advantages of MRI 195, 197, 206 sigmoidovesicular fistula 123, 124 benign 155, 158, 158, 159 children/infants, MRI imaging 195, signal-to-noise ratio (SNR), coils angiomyolipoma 160, 160, 161 352 improving 2, 47, 127, 143, 219, 309, multilocular cystic nephroma diffuse (nontumorous) diseases 341 160 204, 206 Sinerem8,9,334,336,339, 340 oncocytoma 155, 158, 159 indications for MRI 195, 196 single-shot technique, liver imaging 3 rare 158,160–161 metastatic disease 206 situs inversus 350 small solid tumors 161 MRI imaging technique 195–197 slice-select gradient 307 children/infants 353–356 coils 195 small intestine 113–119 malignant 161–173, 162 contrast media 196–197, 200 adenocarcinoma 113 lymphoma 171, 172, 173 imaging planes 195–196 Crohn disease 114–115, 116 metastases 171, 172, 173 pulse sequences 196, 196 diverticula 115 primary 161–171 normal anatomy 197 leiomyoma and leiosarcoma 113 rare 162,171 tumorlike lesions 197 lipoma 119, 119 transitional cell carcinoma 163, tumors see retroperitoneal soft-tis- lymphoma 113, 119, 119 169, 170 sue tumors MRI sequence 115, 117, 117–118 see also renal cell carcinoma (RCC) rhabdomyolysis 103–104 radiation enteritis 115 renal veins rhabdomyosarcoma strictures 117 compression 326 bladder 215, 362 thickening of wall 114, 115, 116, 117 diseases in children 356, 356, 357 prostate 237, 237,362 see also gastrointestinal tract left 323–324 renal 171 soft-tissue tumors 197 retroaortic left 325 vaginal 363 classification 197, 198–199 thrombosis 326, 356, 358 rheumatoid aortitis 316 epidemiology/incidence 197, 199 tumor-related obstruction 326, 326 rim enhancement 30 retroperitoneal see retroperitoneal renovascular hypertension 320 Rokitansky–Aschoff sinuses 62 soft-tissue tumors repetition time (RT), MR angiography Rokitansky protuberance 292 somatostatinoma 80, 83 306, 307 Rosai–Dorfman syndrome 363 spasmolysis see antispasmodic agents Resovist 9, 10, 27, 28–29 spatial encoding, MR angiography 307 respiratory triggering, bile/pancreatic S specific absorption rate (SAR) 301 duct imaging 48 spectral presaturation with inversion respiratory motion artifacts see sacral flexure 128, 129 recovery (SPIR) 8, 9 breathing motion artifacts salpingitis 288 spherical transformation, lymph no- respiratory triggering 8, 9, 28–29 salpinx see uterine tubes des 336 retrocrural lymph nodes 336, 339 santorinicele 52 sphingomyelin, accumulation 102 retroperitoneal collaterals 324, 324 Santorini duct 52, 71 spinal canal, neuroblastoma invasion retroperitoneal fat 184 sarcoidosis 43, 102, 103 358, 359, 359 retroperitoneal fibrosis, idiopathic sarcoma spindle cell tumors 203 204, 206 bladder 215 spin echo (SE) sequences retroperitoneal fistula 195 mesenchymal, hepatic 347 for children/infants 341 retroperitoneal lymphadenopathy prostate 237, 237, 238 in pregnancy 301 326 see also specific types of sarcoma retroperitoneum imaging 196

aus: Hamm u.a., MR Imaging of the Abdomen and Pelvis (ISBN 9783131455918) © 2010 Georg Thieme Verlag KG Index 377 spleen 87–108 metastases 112 pelvic MRI242, 252 abscesses 102, 350 staging 112 rectum MRI128 angiosarcoma 100 leiomyoma, leiomyosarcoma 112 retroperitoneum MRI196 atrophy 103 lymphoma 112 tubal cancer/conditions see uterine benign tumors 93–98, 350 MRIsequences/technique 112, tubes cysts 93, 93, 94–95,350 112–113, 113, 114 tuberculosis, adrenal 184–185 children 350 signet-ring carcinoma 112, 297, 297 tubo-ovarian abscess 288 epidermoid 93 see also gastrointestinal tract turbo inversion recovery sequence diffuse disease affecting 103, string of pearls appearance, pancreas (TIR) 8 105–106 73,74 turbo spin echo sequence see TSE se- ectopic 350 subcutaneous fistula, Crohn disease quence focal lesions, contrast media 89, 138, 138 tyrosine kinase inhibitor (imatinab) 90 superior mesenteric artery 305 113–114, 197 Gaucher disease 102 atherosclerotic stenosis 320 hamartoma 96 normal MRA 312, 319 U hemangioma 93, 95,95–96 superior mesenteric vein 312, 312 hemangiomatosis 95, 96 superparamagnetic iron oxide par- ulcer, penetrating atherosclerotic 314 hematoma 102 ticles (SPIO) 27, 28, 29,30,30,31 ulcerative colitis 121, 123, 123,124 hemorrhagic lesion 96 liver imaging 8–9, 39 children 343, 345 indications for MRI87 splenic imaging 90, 91–92, 92,99 Crohn disease vs 123 infarction 103, 104,350 ultra-small see ultra-small super- ultra-small superparamagnetic iron infectious conditions 102 paramagnetic iron oxide particles oxide particles (USPIO) 9, 307, 334 inflammatory pseudotumor 96, 98, (USPIO) endometrial carcinoma staging 99 supralevator abscess 138, 139, 140 266 inhomogeneous appearance 95, 96, surface rendering, MRA 308, 322 malignant lymph nodes 331, 332, 100 syphilitic aortitis 316 334, 336, 340 iron deposition 102, 103–104, 104, normal lymph nodes 339 105 T optimal imaging time point 334 littoralcellangioma96,97 retroperitoneum imaging 196 lymphangioma 96 Takayasu aortitis/arteritis 316, 319, ultrasound lymphoma 90,99,99, 100 350 in children/infants 342 malignant tumors 88,99–100 tampon use, vaginal MRI241, 249 pelvic 241, 266–267 children 350 target sign 19, 19, 117 prostate cancer 235 metastases 100, 101, 101–102,350 teratoma transvaginal 285, 288 MRIimaging technique 87 –90, 89, mature cystic 292–293, 293 ureter 246 89 ovarian 361, 362 dilatation and obstruction 154 contrast media 87, 89–90, 91, 91, presacral 362–363, 364 ectopic insertion 150, 151 95 Teslascan (Mn-DPDP) 8, 9, 31, 34, 69 stones 154, 154 imaging planes 87, 88, 89 testicular feminization 360 see also kidney; urinary tract, upper pulse sequences 87, 89,91 testicular tumors 331, 361 urethra 221 sequence protocol 90 testicular veins 326 carcinoma 212, 215 SPIO, signal loss after 99 testis, undescended 361 diverticula 210, 211 SPIO preparation use 90, 91–92, thecomas 293, 294 urinary bladder see bladder (urinary) 92 thorotrastosis 103 urinary incontinence 150 neonatal, MRIappearance 92 time of inversion (TI) 7 urinary obstruction 154 noninfectious conditions 102 total mesorectal excision (TME) 128, urinary tract, upper 143–179 normal MRIappearance 88, 91, 132 MRIimaging technique see under 91–92 transesophageal echocardiography kidney pathologic conditions, MRIappear- (TEE), aorta 314–315 obstruction 154 ance 93–106 transitional cell carcinoma (TCC) see also ureter children/infants 350 bladder 211–214 urinoma 175, 175, 357 pseudocysts 93, 102 prostate 237 urothelial carcinoma see transitional rupture 350 renal pelvis 163, 169, 170 cell carcinoma (TCC) sarcoidosis 102, 103 transjugular intrahepatic portosyste- uterine arteries 259,287 sphingomyelin accumulation 102 mic shunt (TIPS) 325 uterine artery embolization (UAE) 255 trauma 102, 350 translevator fistula 140 uterine tubes splenic artery, pseudoaneurysm 74 transrectal prostate biopsy, MR- blockage 288 splenic vein 312 guided 234, 234 cancer 297 thrombosis 66, 74 transsphincteric fistula 138, 138 dilated 290, 291 splenomegaly 103, 104, 105, 106 transvaginal ultrasound (TVUS) 285, functioning tumors 293, 294 splenoportal venous axis 323–324 288 imaging technique 285–286 splenorenal shunt, spontaneous, con- trimethylsilyl propionate (TSP) 222 indications for MRI285 trast-enhanced MRA 308, 324 TrueFISP, gastrointestinal tract MR hysterosalpingography 288, STEAM sequences (stimulated echo 110–111 289 acquisition mode) 222 colorectal cancer 120,121,122 MRIimaging technique 285 –286 Stein–Leventhal syndrome 289–290 functional disorders of rectum 140 normal anatomy/MRI287 stenting TSE sequence uterosacral ligament 246, 246 abdominal/pelvic arteries, 3D MRA adnexa imaging 286 uterovesical ligament 246, 246 314, 314 for children/infants 341 uterus 241–283 renal artery 320–321 intra-abdominal lymph nodes 332, acquired benign disorders 255–262 stomach 112–113 332, 333,334 adenomyosis 258, 260,260–261, adenocarcinoma 112, 112, 113, 114 liver MRI3, 5 262

aus: Hamm u.a., MR Imaging of the Abdomen and Pelvis (ISBN 9783131455918) © 2010 Georg Thieme Verlag KG 378 Index uterus radiotherapy, MRIappearance after vena cava agenesis (complete/partial) 253, 276–277, 277 displacement 353, 355 253 residual tumor after 278, 280 thrombosis 358 arcuate 255 rudimentary horn 254, 254 see also inferior vena cava atrophy 277 septate 252,255,255 vena cava compression syndrome 303 benign vs malignant tumors 256 T1 w sequences 244, 246–247, 247, VIBE sequence (volume-interpolated bicornuate 252, 254,254–255, 360 253 breath-hold examination) congenital anomalies 252,252–255 T2 w sequences 244, 248, 249,253 adrenal gland MRI182, 182 pulse sequences 253, 253 unicornuate 252,254,254 gastrointestinal tract 109,110, corpus 245, 245 zonal anatomy 246–247, 247, 248 111–112, 115 dilatation and curettage, MRIafter uterus didelphys 252,253,254,360 colorectal cancer 120,121,122 276 inflammatory disease of colon double 252, 253, 254, 255,360 V 124 dynamic contrast-enhanced 244, kidney and upper urinary tract 144, 257, 259 vagina 241–283 146 gestational trophoblastic disease agenesis 254,274 liver MRI3 261 atresia 360 pancreas MRI66 hormone treatment affecting 248, cervical cancer invasion 271, 272, retroperitoneum MRI196 249 273,275 see also GRE sequences, 3D hypoplasia 253 congenital anomalies 274 VIPoma 80 indications for MRI241, 252 cysts 274 visceral arteries isthmus 245, 245 double 254,274,274,360 aneurysm 319 junctional zone 247 endometrial carcinoma invasion mesenteric ischemia 319, 319, 320 focal 260,260–261 262 MR angiography 318–319, 319 thickened, adenomyosis 260, 260 indications for MRI241 leiomyoma (fibroids) 255–257, 263, menstrual cycle effect 249 W 279 MRIimaging technique see pelvic adenomyosis with 258, 260 MRI Wilms tumor (nephroblastoma) 171, degenerative changes 258, 257 normal anatomy 245 171,353–355, 354–355 intramural 255, 256, 256 normal MRIappearance 249, 251 benign variant 160 MRIappearance 256,256–257, pathologic entities, MRI274 –276 differential diagnosis 355, 358 257 postmenopausal women 249 extrarenal 353 ovarian fibroma vs 293 radiotherapy effect 277,277–278 monitoring, MRI353, 354–355 pedunculated 256, 257, 258,293 stenosis, radiation-induced 277, subtypes and staging (SIOP) 353, pseudocapsule 256, 257, 260 277,278,278 353 pulse sequences 256, 256 T1 w images 249, 251 Wilson disease 42–43, 347 submucosal 255, 256 T2 w sequence (axial) 244, 249 subserosal 255, 256, 257,258 tumors 274–276 X ligaments supporting 246, 246 pulse sequences/protocol malignant tumor see endometrial 275–276, 276 xanthofibrogranulomatosis, retroperi- carcinoma rhabdomyosarcoma 363 toneal 204, 206 before menarche 247, 248 staging 275,275–276, 276 menstrual cycle effects 247, 247, wall, carcinoma involvement 271, Y 248 276 MRIimaging technique see pelvic vaginal bleeding 267 yolk sac tumors 361 MRI vaginal fornix, normal MRI249, 250 MRI vs CT/ultrasound 241, 266–267 vaginal septum 253–254 Z neonatal 247 vaginal stump 278, 280 normal MRIappearance 245, vaginal vault, ovarian cancer 298, 298 Zollinger–Ellison syndrome 80 245–249, 246, 247 vascular malposition 350, 351 peritoneum covering 246, 246 Vasovist (gadofosveset) 307 postmenopausal women 248, 249

aus: Hamm u.a., MR Imaging of the Abdomen and Pelvis (ISBN 9783131455918) © 2010 Georg Thieme Verlag KG