Abstract
Objective
The purpose of this study was to assess the potential role for chemical shift magnetic
resonance imaging (MRI) in identifying lymphangiomas from other cystic mesenteric
and retroperitoneal masses.
Materials and methods
A retrospective search of radiology database identified 24 consecutive patients with
mesenteric and retroperitoneal cysts (nine men, 15 women; mean age, 41 years; age
range, 19–75 years) who had undergone MR which included in-phase and opposed-phase
chemical shift imaging. Signal intensity (SI) decrease between in-phase and opposed-phase
MR images of the cyst was evaluated qualitatively by two radiologists. Ultrasound
(US), computed tomography (CT), and MRI findings of the morphological appearances
of all the cystic lesions that demonstrated significant signal drop on chemical shift
MR were also recorded.
Results
Of mesenteric and retroperitoneal cysts, 33% (8/24) revealed qualitative decrease
in intensity on opposed-phase MR images relative to that seen on in-phase images.
On ultrasound, these cysts demonstrated anechoic simple fluid. Their mean CT attenuation
was 13 HU (range: 5–20 HU). Signal loss on fat-suppressed T1-weighted sequences was
displayed only by a single cyst. None of the lesions with qualitative SI decrease
on opposed-phase MR showed suggestion of lipid on US and CT.
Conclusion
The presence of intra cystic lipid detected by chemical shift MR may not be overt
on cross-sectional imaging such as US and CT. Chemical shift MRI provides additional
sensitivity and specificity as an imaging test for demonstration of lipid within mesenteric
and retroperitoneal cysts enabling a higher diagnostic yield for lymphangioma leading
to more appropriate patient management.
Keywords
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Article info
Publication history
Published online: April 16, 2010
Accepted:
February 20,
2010
Received:
January 20,
2010
Identification
Copyright
© 2011 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
