The “Clinical Cases” section provides selected images, along with a short relevant discussion, from patient exams, contributed by the MR expert network community. This section will with time cover the breadth of clinical MR. Important aspects of imaging technique and clinical findings will be discussed. Each case will also include a downloadable file (corresponding to each presented image), enabling the user to replicate on his/her MR system the specific imaging technique employed.

Case Report: Clinical Usability of MyoMaps in Myocardial Infarction

These case reports show that current advances in T1 and T2 mapping and ECV quantification might have the potential to improve the diagnosis of cardiovascular disease, refine myocardial risk stratification and guide patient personalized therapeutic strategies. View/Download [...]

Cardiovascular Magnetic Resonance Teaching Network

The article introduces a novel teaching approach allowing time-effective teaching as well as an ongoing quality control. The aim is to enable CMR in all settings – hospitals of different sizes as well as in outpatient departments. [...]

Pelvic schwannoma

  Clinical History: 49-year old woman with an asymptomatic pelvic mass for 10 years (an incidental finding on routine physical examination)   Diagnosis: Pelvic schwannoma   MR Technique: Pelvic MR imaging was performed on a 3T system (Skyra, Siemens). (A) Coronal T2-weighted TIRM (TR/TE 4000/78ms), (B) sagittal T2-weighted TIRM (TR/TE 4000/70), (C) axial T1-weighted TSE […] [...]

Brain abscess

Clinical History: This 5-year old boy presented with an acute headache and vomiting for 12 hours. The patient had a clinical history of cholesteatoma surgery in the recent past, involving the right mastoid.   Diagnosis: Brain abscess   MR Technique: Contrast-enhanced brain MR imaging was performed on a 3T system following an unenhanced CT scan […] [...]

Proliferative myositis

  Clinical History: A 63-year old woman presents with an asymptomatic mass inferior to the right inguinal area for 10 days   Diagnosis: Proliferative myositis   MR Technique: Imaging of the right lower extremity was performed on a 3T MR system (Siemens Skyra). (A) Coronal T2-weighted TIRM (TR/TE 3000/38ms) and (B) axial T2-weighted TSE with […] [...]

Right renal angiomyolipoma

Clinical History: 59-year old woman with right lower back pain for more than one year   Diagnosis: Right renal angiomyolipoma   MR Technique: Upper abdominal imaging was performed on a 3T MR system. (A, B) Axial T1-weighted VIBE in- and out-of-phase (TR/TE 3.88/1.27ms), and (C) axial FS T2-weighted TSE (TR/TE 5814/78ms, with respiratory triggering) scans […] [...]

Left thigh schwannoma

  Clinical History: 31-year old woman with left foot numbness and pain for 6 months   Diagnosis: Left thigh schwannoma   MR Technique: Imaging of the left lower extremity was performed on a 3T MR system. (A) Coronal T2-weighted TIRM (TR/TE 3000/38ms), (B) sagittal T2-weighted TIRM (TR/TE 3000/38), (C) axial T1-weighted TSE (TR/TE 500/11) and […] [...]

Chronic osteomyelitis of the left femur

  Clinical History: An 11-year old boy with left thigh pain for 3 days   Diagnosis: Chronic osteomyelitis of the left femur   MR Technique: Imaging of the left lower extremity was performed on a 3T (Skyra) MR system. (A) Coronal T2-weighted TIRM (TR/TE 3000/38ms), (B) sagittal T2-weighted TIRM (TR/TE 2800/38), (C) axial T1-weighted TSE […] [...]

Prostatic sarcoma

        Clinical History: 25-year old man with dysuria for 3 weeks   Diagnosis: Prostatic sarcoma   MR Technique: Prostatic imaging was performed on a 3T MR system. (A) Sagittal T2-weighted TSE (TR/TE 7500/104ms), (B) coronal T2-weighted TSE (TR/TE 7354/104ms), and (C) axial T2-weighted TSE (TR/TE 7440/101) were acquired prior to the administration […] [...]

Cystosarcoma phyllodes of the breast (CSPB)

    Clinical history: 32-year old woman with a right breast mass   Diagnosis: Cystosarcoma phyllodes of the breast (CSPB)   Imaging techniques: Non-contrast MR imaging of the bilateral breasts was performed on a 3T MR system (Skyra, Siemens). (A) Axial T1-weighted TSE (TR/TE 626/8.1), (B) axial T2-weighted TSE with Dixon fat suppression (TR/TE 3700/101ms), […] [...]

Left thigh myxofibrosarcoma

  Clinical history: 52-year old man with left thigh mass   Diagnosis: Myxofibrosarcoma   Imaging techniques: Imaging of the left thigh was performed on a 3T MR system (Skyra, Siemens) and 64-MDCT (GE). (A) Coronal T2-weighted TIRM (TR/TE 3000/38), (B) sagittal T2-weighted TIRM (TR/TE 3000/38ms), (C) axial T1-weighted TSE (TR/TE 700/11ms), and (D) T2-weighted TSE […] [...]

Multiple myeloma

  Clinical History: 56-year old woman with right leg pain for 10 months   Diagnosis: Multiple myeloma   MR Technique: Imaging of the right lower extremity was performed on a 3T MR system. (A) Coronal T2-weighted TIRM (TR/TE 3000/38ms), (B) sagittal T2-weighted TIRM (TR/TE 3000/38), (C) axial T1-weighted TSE, and (D) axial T2-weighted TSE with […] [...]

Dermatofibrosarcoma protuberans

  Clinical history: 50-year old man with progressively enlarging left upper arm mass for one year   Diagnosis: Dermatofibrosarcoma protuberans   Imaging techniques: Imaging of the left upper arm was performed on a 3T MR system (Skyra, Siemens). (A) Coronal T2-weighted TIRM (TR/TE 2734/38), (B) axial T1-weighted TSE (TR/TE 500/12ms), and (C) axial T2-weighted TSE […] [...]

Intramuscular hemangioma

  Clinical History: 2-year old boy with an asymptomatic mass in his left buttock Diagnosis: Intramuscular hemangioma MR Technique: Imaging of the pelvis was performed on a 3T MR system (Skyra, Siemens). (A) Coronal T2-weighted TIRM (TR/TE 4000/78ms), (B) axial T1-weighted TSE (TR/TE 450/18ms), (C) axial FS T2-weighted TSE (TR/TE 2500/84ms), and (D) T2-weighted TIRM […] [...]

Thoracic spine schwannoma

  Clinical History: 28-year old woman with chest and upper back pain for 3 months Diagnosis: Thoracic spine schwannoma  MR Technique: Imaging of the thoracic spine was performed on a 3T MR system. (A) Sagittal T1-weighted TSE (TR/TE 650/8.1ms), (B) sagittal T2-weighted TSE (TR/TE 2000/97), (C) sagittal T2-weighted TSE images with Dixon fat suppression (TR/TE2500/101), […] [...]

Right thigh rhabdomyosarcoma

  Clinical history: 44-year old man with progressively enlarging right thigh mass Diagnosis: Rhabdomyosarcoma Imaging techniques: Imaging of the right thigh was performed on a 3T MR system (Skyra, Siemens). (A) Coronal T2-weighted TIRM (TR/TE 3000/38), (B) sagittal T2-weighted TIRM (TR/TE 3000/38ms), (C) axial T1-weighted TSE (TR/TE 700/12ms), and (D) T2-weighted TSE images with Dixon […] [...]

Oligodendroglioma

    Clinical history: 51-year old woman with episodic seizures for 20 years Diagnosis: Oligodendroglioma (WHO grade II) Imaging techniques: (A) Sagittal T1-weighted TIRM*(TR/TE 2000/9ms), (B) axial T1-weighted TIRM (TR/TE 2000/9ms), (C) axial T2-weighted TSE (TR/TE 4800/99ms), (D) axial T2-weighted TIRM (TR/TE 8500/85ms), and (E) coronal T2-weighted TIRM (TR/TE 8500/85ms) images were acquired along with […] [...]

Giant cell tumor

  Clinical History: 40 year old man with left knee pain for three months Diagnosis: Giant cell tumor involving the proximal tibia with intratumoral hemorrhage MR Technique: Knee imaging was performed on a 3T MR system (Skyra, Siemens). (A) Axial T1-weighted TSE (TR/TE 700/12ms) images and (B) axial T2-weighted TSE images with Dixon fat suppression […] [...]

Eosinophilic granuloma

Clinical History: 12 year old boy with back pain limiting activities of daily living Diagnosis: Thoracic vertebral eosinophilic granuloma MR Technique: Thoracic spine imaging was performed on a 3T MR system (Skyra, Siemens). (A) Sagittal T1-weighted TSE (TR/TE 650/8.1ms) and (B) T2-weighted TSE (TR/TE 2000/97ms) images were acquired. Contrast-enhanced sagittal T1-weighted (C) and coronal T1-weighted […] [...]

Intermuscular Lipoma

Clinical History: 46 year old woman with a progressively enlarging right thigh mass Diagnosis: Intermuscular lipoma of the anterior right thigh MR Technique: Imaging of the right thigh was performed on a 3T MR system (Skyra, Siemens). (A) Axial T1-weighted TSE (TR/TE 700/11ms) and (B, C) axial T2-weighted TSE water/fat-images obtained with the Dixon fat […] [...]

Burkitt lymphoma

An eight year old boy [...]

Colloid cyst

A 27-year-old woman who began to have headaches over the past 2 months, and then presented with significant nausea, vomiting, and lethargy [...]

Dandy-Walker variant

A 29 year old man with Down’s syndrome, and no acute clinical symptomatology relevant to the imaging findings. [...]

Degeneration (Lumbar)

A 76 year old man with advanced degenerative spine disease [...]

Lipoma

A 53-year-old woman complaining of severe left leg pain for several months [...]

Metastasis (carcinoma of prostate)

This 64 year old man is status post prostatectomy with positive margins and subsequent local regional recurrence, treated with external beam radiation therapy, with further recurrence and subsequent development of disseminated disease. [...]

Multiple chronic compression deformities

An unfortunate 83-year-old lady with severe degenerative spine disease, a history of multiple compression fractures and prior vertebroplasty of L2, presenting once again with intractable back pain [...]

Retinoblastoma

A 15 month old female infant. [...]

Silicone lymphadenopathy

A 69 year old female patient with subcutaneous mastectomy and inlay-reconstruction due to invasive lobular carcinoma on the right side ten years ago, presenting now for follow up MR-mammography. The patient was free of complaints. An external rupture of the silicon-inlay was known. [...]

Invasive lobular carcinoma

A 41 year old female patient presented with a new palpable mass in the left upper lateral quadrant. In regards to the patient’s family history, her mother developed breast cancer at 40 years of age, her sister at 38 years of age and her aunt at 30 years of age. On the mammogram, extensive dense breast parenchyma was noted on both sides, corresponding to an ACR4 classification, and thus a limited evaluation. On the basis of this exam alone, no tumor or architectural disorder could be detected. Due to the patient’s family history additional MR-Mammography was performed for further evaluation. [...]

Intraductal papillary carcinoma

A 69 year old female patient with hemorrhagic nipple discharge on the left side. Clinical assessment revealed no palpable mass, and no signs of inflammation. Mammography and ultrasound were within normal limits. [...]

Intraductal papilloma

A 52 year old female patient with right sided nipple discharge. The mammogram was classified as ACR4 without any abnormal findings. [...]

Burkitt lymphoma

Burkitt lymphoma is a type of non-Hodgkin lymphoma. It is highly aggressive, rare, and has a strong male preponderance. The human immunodeficiency virus (HIV), which causes AIDS, has also been linked to the development of Burkitt lymphoma. The immunodeficiency-associated variant of this tumor is most common in HIV positive patients, but can also be seen in any immunosuppressed patient. It accounts for 30-40% of NHL in HIV patients, and is one of the AIDS defining diseases, being associated with the initial disease presentation. [...]

Acute and chronic vertebral compression fractures

An 83 year old woman with back pain. [...]

C3 burst fracture

A 77 year-old woman seen in the emergency room, following trauma, with cervical pain but no neurologic deficit. [...]

Oligodendroglioma (WHO grade II)

A 30 year old man referred to Neurosurgery for a mass lesion (of the brain) revealed by imaging at an outside hospital. [...]

Medulloblastoma (posterior fossa PNET)

A 7 year-old boy who presents with nausea and vomiting. [...]

Disk space infection (L2-3)

A 70 year-old woman with chronic kidney disease, on IV antibiotics for osteomyelitis. [...]

Metastasis (breast carcinoma)

A 64 year-old woman with a history of breast cancer, presenting with weakness [...]

Pituitary microadenoma (prolactinoma, treated)

A 31 year-old woman with long-standing infertility, who prior to treatment presented with galactorrhea, now on cabergoline. [...]

Pituitary macroadenoma, with invasion of the left cavernous sinus

A 58 year old woman presenting with a visual field defect (bitemporal hemianopsia) [...]

Parenchymal hemorrhage, late subacute

A 68 year-old woman several weeks following a stroke. [...]

Periventricular leukomalacia

A 3 year-old girl, product of in vitro fertilization (with a normal twin), delivered by c-section at 30 weeks. She is mildly developmentally delayed, with spastic diplegic/triplegic cerebral palsy. [...]

Metastases (renal cell, lumbar)

A 56 year-old man with back pain [...]

Cavernous malformation

A 60 year-old woman with myelopathic symptoms, status/post cervical decompression, with follow-up cervical MR revealing a lesion in the pons. [...]

Toxoplasmosis

A 30 year-old woman with HIV [...]

Takotsubo Cardiomyopathy

This 70-year-old woman presented to the emergency room with acute onset of severe chest pain. No prior history of trauma. The pain started after a quarrel with her 45-year old daughter. The electrocardiogram did not reveal evidence of ischemic ST segment deviations. Creatinine kinase was of borderline value (10 U/L), but cardiac troponin T was elevated (2.15 µg/L). Coronary artery disease was ruled out by emergency coronary angiography. However, left ventricular angiography demonstrated apical ballooning with a reduced left ventricular ejection fraction. [...]

AVM (within the third ventricle)

A 21 year-old man, presenting with syncope [...]

Multiple myeloma

Back pain in a 58 year old woman [...]

Synovial cyst

Back pain in a 58 year old woman [...]

Tethered cord

Back pain in a 58 year old woman [...]

Hepatic Hemangioma

A 55 year old woman with an incidental finding on an MRI of the thoracic spine. [...]

Germinoma

A 22 year-old woman presents with a suprasellar mass on CT [...]

Oligoastrocytoma (WHO grade 2)

A 23 year old man presenting with a mass lesion on CT [...]

Posterior reversible encephalopathy syndrome (PRES), also known as acute hypertensive encephalopathy

A 25 year-old woman on chemotherapy, with hypertension and visual symptoms [...]

Carotid artery pseudoaneurysm

Trauma [...]

Septo-optic dysplasia

A five year-old boy with hydrocephalus and pituitary dysfunction [...]

Left temporal lobe arteriovenous malformation (AVM)

A 31 year old woman [...]

Glioblastoma Multiforme (left parietal)

A 57 year old man presents with a mass lesion on CT, with MR performed for differential diagnosis and better delineation of the lesion. [...]

Posterior cerebral artery infarct (early subacute)

A 79 year old man presents with symptoms of a cerebrovascular accident [...]

Lumbar vertebral metastases

A 61 year old man with small cell carcinoma of the lung [...]

Multiple sclerosis (cervical spinal cord)

A 28 year old woman [...]

Left MCA trifurcation aneurysm

A 45 year old man with end-stage renal disease and a history of polycystic kidney disease [...]

Left middle cranial fossa arachnoid cyst

An incidental finding in a 46 year old man being evaluated for possible recent cerebral infarction (the brain MR was otherwise normal) [...]

Glioblastoma (WHO grade 4 astrocytoma), recurrent

A 55 year old man, with a previous partial tumor resection [...]

Aortic Arch Arteritis

A 45 year old male with headache and mild chest pain for several months. [...]

Achilles Tendon Rupture

A 63 year old male with leg pain after fall. [...]

Endometrial polyp

A 45 year old female with newly diagnosed endometrial cancer on cervical biopsy. [...]

Jumper’s knee

A 26 year old male with left knee pain. [...]

OPLL (Ossification of the posterior longitudinal ligament)

A 57 year old male with numbness of the hands. [...]