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MRI of the female pelvis: A possible pitfall in the differentiation of haemorrhagic vs. fatty lesions using fat saturated sequences with inversion recovery.

par Froehlich, Johannes M;Metens, Thierry ;Chilla, Bianka;Hauser, Nik;Hohl, Michael K;Kubik-Huch, Rahel A
Référence European journal of radiology
Publication Publié, 2011-02

Article révisé par les pairs

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Résumé :

The use of fat-saturated techniques should be an integral part of the work-up of any T1-hyperintense structure in the female pelvis for tissue characterization and for differentiation of a fat-containing ovarian mature teratoma from a haemorrhagic lesion. Two cases with haematocolpos and haematometra are presented, respectively. The haemorrhagic content showed high signal both on T1- and T2-weighted images, whereas an unexpected signal decrease in the fat-saturated T2-weighted inversion-recovery sequence was encountered. This unspecific suppression of signal in tissues with similar T1 relaxation times as fat can lead to a diagnostic pitfall both in T1- and T2-weighted STIR pulse sequences. Furthermore, a loss of signal on T2-weighting may also be due to the phenomenon of "T2-shading" in T1-bright ovarian endometrioma. Therefore, the fat-specific spectral fat-saturation of T1-weighted images is strongly recommended for tissue characterization in gynaecological disease.