They can form multiple groups with surrounding anechoic haloes 8. On T2-weighted images the scar appears as hyperintense in 80% of patients, which is very typical. elongated paraovarian cyst; cystic ovarian neoplasm(s): identification of a separate ovary helps distinguish a hydrosalpinx from a cystic ovarian mass, an important distinction because malignancy is rare Renal oncocytomas account for approximately 5% of resected primary adult epithelial renal neoplasms. Efforts to diagnose and treat RCC at a curable stage result in many benign neoplasms and indolent cancers being resected without clear benefit. While there can be variation in appearance, tophi tend to be hyperechoic, heterogeneous, and have poorly defined contours. variable restricted diffusion; T1 C+ T1: hypointense; T2: hyperintense; T1 C+ (Gd): enhancing cyst walls; Treatment and prognosis. MRI. One of the major concerns is the potential malignant transformation to endometrial carcinoma. It is often seen as a round or oval adnexal lesion. Score: Fazekas 0: None or a single punctate WMH lesion; Fazekas 1: Multiple punctate lesions; Fazekas 2: Beginning confluency of lesions (bridging) s disease, the main differential diagnosis. Rim is T1 isointense to hyperintense relative to white matter and T2 hypointense. T1: typically homogeneously hypointense 1; T2: typically hyperintense 1-2; T1 C+ (Gd): intense wall enhancement may be seen 1; Treatment and prognosis. Differential diagnosis. Conservative treatment (use of GnRH analogs, oral contraceptives to suppress ovulation, pain medication) is the first line of treatment. Epidemiology. Renal cyst is a generic term commonly used in description of any predominantly cystic renal lesion.The majority of parenchymal cystic lesions represent benign epithelial cysts; however, malignancy such as renal cell carcinoma may also present as a cystic lesion 8.. Renal cysts are usually evaluated by complexity: a "simple" cyst is confidently diagnosed as a benign Complications. This lesion surely has the appearance of a meningioma: these tumors can be hypointense on T2 due to a fibrocollageneous matrix or calcifications and frequently produce reactive edema in the adjacent white matter of the brain. There is 2:1 male predilection 1,2.Unfortunately, these demographics are similar to renal cell carcinoma.. Clinical presentation typically hypointense owing to the presence of deoxyhemoglobin and methemoglobin (shading sign), which is very suggestive of an endometrioma 3; T2 dark spot sign is specific for chronic hemorrhage and is helpful in diagnosing endometriomas 9; old hemorrhage occasionally appears hyperintense; DWI/ADC. The T2 and post-contrast T1W images show a large lesion in the left hemisphere with alternating T2-hyperintense and isointense bands. Differential diagnosis Many factors, alone or combined, can cause CVT. For a corpus luteal cyst 3 cm, no follow up is necessary 7. Bone infarction is a term used to refer to osteonecrosis within the metaphysis or diaphysis of a bone. T1: hypointense T2: markedly hyperintense; C+ (Gd): prompt enhancement but no washout; Other general features There is a slightly low T2 signal sheet-like mass in the pancreaticoduodenal groove, with tiny cystic changes (arrow, A). biochemical testing is useful to help differentiate; adrenal cortical carcinoma; adrenal metastasis There is a quick, intense and homogeneous enhancement of the lesion in the arterial phase itself, hence the name "flash filling". Renal cell carcinomas (RCC) (historically also known as hypernephroma or Grawitz tumor) are primary malignant adenocarcinomas derived from the renal tubular epithelium and are the most common malignant renal tumor.They usually occur in 50-70-year old patients and macroscopic hematuria occurs in 60% of the cases. In the rest of the phases, it retains the contrast and remains isodense to the adjacent vascular pool. Small cysts with well defined margins showing iso to hypointense or rarely hyperintense signal relative to muscle on T1 weighted images, hyperintense on T2 weighted images (Radiographics 2003;23:425) Ultrasonography (AJR Am J Roentgenol 1982;138:927): Anechoic well defined cystic lesions near the endocervical canal An important first step in narrowing the differential diagnosis is to determine the presence or absence of complex features in cystic liver lesions. On the left a chronic hematoma known as Morel-Lavallee lesion. T2. Magnetic resonance imaging (MRI) findings are more variable, depending on the degree of mineralization, although the most common pattern (77% of cases) reveals low to intermediate signal intensity with T1 weighting and very high signal intensity with T2 weighting with hypointense calcifications (Radiographics 2007;27:1465) Papillary renal cell carcinomas (pRCC) are the second most common histological subtype of renal cell carcinoma (RCC). Although CVT can occur at any age, it most commonly affects neonates and young adults. In this review, we will show a series of cases in order to provide In the rest of the phases, it retains the contrast and remains isodense to the adjacent vascular pool. synovial chondromatosis. CT scans shows well circumscribed, hyperdense lesion in the subcutaneous tissue, sometimes intramuscular (Am J Case Rep 2020;21:e921447, Cureus 2017;9:e1124, Virchows Arch 2021;478:527) MRI: usually contains low signal internal strands, heterogeneous on contrast, commonly enhanced, isointense or hypointense to subcutaneous fat, hyperintense There is a quick, intense and homogeneous enhancement of the lesion in the arterial phase itself, hence the name "flash filling". the high water content causes an embryonal sarcoma to appear hyperintense on T2-weighted imaging and hypointense on T1-weighted imaging. [1][2] A combination of medical history, Prostatitis is a clinical diagnosis and imaging is useful to evaluate abscess formation. T2: hypointense; T1 C+ (Gd): non-enhancing; If tightly packed, they may be hard to differentiate especially if isointense to joint effusion. Bone infarction is a result of ischemia, This lesion was assigned to PI-RADS category 5, based on a 16 mm lesion, markedly hypointense on ADC and markedly hyperintense on DWI (score 5 - dominant sequence), correlated to markedly hypointense on T2W (score 5). Clinical presentation. Both VMCs and metastatic pancreatic adenocarcinomas can be CK7 positive and therefore CK7 does not help in this differential diagnosis. However, there is gray matter on the anteromedial and posteromedial side of the lesion (red arrow). CVT is difficult to diagnose clinically because patients can present with a wide spectrum Differential diagnosis. A: Axial T2-weighted single-shot fast spin-echo (SS-FSE) images with fat-suppression; (B) Pre- and (C, D) Post-contrast 3D-GRE T1- weighted images with fat-suppression during the late arterial and portal venous phases. Imaging is a crucial step in diagnosing these conditions as liver enzymes can be elevated in up to 9% of individuals in the USA. When located in the adrenal gland, the differential is essentially that of an adrenal tumor and includes: lipid poor adrenal adenoma: also washes out, but often <120 HU on an arterial or portal venous contrast phase. Epidemiology. Cystic renal cell carcinoma (RCC) is almost certainly overdiagnosed and overtreated. Although a benign simple cyst is usually easy to recognize, the same is not true for complex and multifocal cystic renal lesions, whose differential diagnosis includes both neoplastic and non-neoplastic conditions. Watchful waiting for patients with mild symptoms or moderate to severe symptoms with minimal impairment in quality of life (Annu Rev Med 2016;67:137) Medical treatment based on alpha blockers (nonselective; alpha-1A selective), 5-alpha-reductase inhibitors, phosphodiesterase type 5 inhibitors and combination T2: hypointense; T1 C+ (Gd): contrast enhancement tends to be less intense than in the more common clear cell RCC subtype; Benign nodular enlargement of the prostate gland . On MRI, appears as a T1 hypointense and T2 hyperintense lesion with heterogeneous contrast enhancement On MRI of a superficial neurofibroma, the signal characteristics are usually homogeneous or heterogeneous without targets (AJR Am J Roentgenol 2005;184:962) These lesions are found around the thigh and have a well-defined oval or fusiform shape. This is especially true for cystic masses, which compared with solid masses are more likely to be benign and, when PML should be considered as a differential diagnosis in any MS patient taking Tysabri presenting with neurological symptoms and/or new brain lesions in MRI. T1: hypointense marrow in adjacent vertebrae; T2: hyperintense marrow, disc, soft tissue infection; T1 C+ (Gd): marrow, subligamentous, discal, dural enhancement; The paraspinal collections are typically well-circumscribed, with fluid centers and well-defined enhancing margins 7. Prostatitis refers to an infection or inflammation of the prostate gland that presents as several syndromes with varying clinical features. General imaging differential considerations include. Patients are usually asymptomatic 6 and thus the condition is discovered incidentally on imaging or autopsy. They typically present in the 6 th to 7 th decades with a peak incidence at 55 years of age. the soft tissue swelling may be hyperdense due to the crystals, and the tophi can calcify (uncommon in the absence of renal disease) Ultrasound. Image-guided transvaginal fluid aspiration and sclerotherapy have been attempted with partial success 8. Imaging findings include ovoid lesions involving the central splenium, hyperintense lesions on T2-weighted and FLAIR images, and hypointense lesions on T1-weighted images, with restricted diffusion and no enhancement (2,8,9,54). Endometrial hyperplasia is an abnormal proliferation of the endometrial glands and stroma, defined as diffuse smooth thickening >10 mm 13. Note that the outermost band shows diffusion restriction. Necrosis is a type of cell death due to irreversible cell injury, which can be recognized microscopically by alterations in the cytoplasm (becomes eosinophilic) and in the nucleus (swelling, pyknosis, karyorrhexis, karyolysis). Liver lesions have a broad spectrum of pathologies ranging from benign liver lesions such as hemangiomas to malignant lesions such as primary hepatocellular carcinoma and metastasis. MRI will show a hypointense central scar on T1-weighted images. A Morel-Lavallee lesion is the result of separation of the skin and subcutis from the fascia, producing a cavity that is filled with fluid and debris. Classic imaging appearance for primary CNS lymphoma is of a CT hyperdense avidly enhancing mass, with T1 hypointense, T2 iso- to hypointense, vivid homogeneous gadolinium-enhancing lesion(s) with restricted diffusion on MRI, and exhibiting subependymal extension and crossing of the corpus callosum. On imaging, they have a variety of Epidemiology This subtype may account 13-20% of all renal cell cancer 1. The early (first 1 to 2 weeks) lesion, often called focal cerebritis, is poorly demarcated and is evident by acute inflammatory changes like vascular congestion and localized edema. There is a smaller, similar lesion on the right. Cases of asymptomatic PML based on MRI and positive JCV DNA in the cerebrospinal fluid have been reported. T1: hypointense T2: markedly hyperintense; C+ (Gd): prompt enhancement but no washout; Other general features It is best scored on transverse FLAIR or T2-weighted images. In some instances, lesions may be complicated by hemorrhage presenting acutely or result in hepatomegaly or liver impairment. Cerebral venous thrombosis (CVT) is uncommon, representing approximately 0.5% of all cases of cerebrovascular disease worldwide. PI-RADS (Prostate ImagingReporting and Data System) is a structured reporting scheme for multiparametric prostate MRI in the evaluation of suspected prostate cancer in treatment naive prostate glands.This article reflects version 2.1 (v2.1), published in 2019 and developed by an internationally representative group involving the American College of Treatment and prognosis. MRI. 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