Body MR

Question 1

AML

Answer 1

• rapid enh and washout

- signal dropout on fat-sat

Question 2

ccRCC

Answer 2

-het early enh w/o washout

Question 3

pRCC

Answer 3

-late homog enhancement

Question 4

Approach to MRCP

Answer 4

1. Thick slabs for any filling defect, dil, etc
2. Volumetric coronal thin slices for fine detail, MIPS
3. Kinematics to r/o peristalsis
4. Ax T2 to char defect and localize abnL wrt adj organs
5. Ax T1 FS will bring out certain stones

Question 4

Approach to r/o appy MR

Answer 4

1. Thick slabs for any filling defect, dil, etc
2. Volumetric coronal thin slices for fine detail of anatomy and any defects
3. Kinematics to r/o peristalsis
4. Ax T2 to char defect and localize abnL wrt adj organs
5. Ax T1 FS will bring out certain stones

Question 5

Ddx filling defect on MRCP

Answer 5

• mass
• stone
• air bubble (nondep on axials)
• clot
• stricture (benign or malig)

Question 6

Ddx diffuse beaded appearance of biliary tree on MRCP

Answer 6

• PSC (assoc w UC, r/o concurrent cholangioCA!)
• HIV ?primary or 2/2 IVDU
• ?Ascending cholangitis

Question 7

Ddx extensive intrahepatic tourtuos bil dil on MRCP

Answer 7

Intrinsic obstruction (ill-def):

• Klatskin tumor (cholangioCA @ jcn of R/L hepatic ducts)
• ?stone in proximal CBD

Extrinsic obstruction (look for mass):

• liver mass
• enlarged porta hepatis LN
• panc head mass?

Others?
Dbl check these…

Question 8

Ddx bil dil + panc dil on MRCP

Answer 8

“Dbl duct sign”

• panc head mass (adenoCA)
• ampullary CA
• CBD stone

Others??
-duodenal mass
-

Question 9

MR features of prostate CA

Answer 9

• hypo on T2 in PZ
• iso on T1 +/- hemh excl sign (= T1 bright hemorrhage spares hypo CA p-bx)
• restrict diffusion on ADC
• rapid enh & rapid washout
• us in PZ

** CAREFUL, if hypo T2 and bright T1 then consider hemorrhage

Question 10

Cystic liver lesions

Answer 10

= bright on T2

Cyst
Bile duct hamartoma

Question 11

Solid hypERvasc liver lesions

Answer 11

.