PMC3785362_01
A (Double inversion recovery T1 pre-contrast), B (Double inversion recovery T2 fat-suppressed pre-contrast). The lesion is closely associated with multiple vascular structures in the mediastinum. Note the internal tubular areas of signal void (see text).
ccrep-1-2008-127f1.jpg
PMC3785362_01_ccrep-1-2008-127f1.jpg
f1-ccrep-1-2008-127
This appeared homogenous and of slightly higher signal than skeletal muscle on T1 weighted images, with moderate signal intensity on fat-suppressed T2 weighted images (Figs. 1a/b).
A-E Dynamic first pass perfusion sequence (FGRET) from time = 0 to time = 12 secs after gadolinium injection. The position of the nodal mass (M) is shown relative to the left atrium (LA) on this coronal acquisition.
ccrep-1-2008-127f2.jpg
PMC3785362_01_ccrep-1-2008-127f2.jpg
f2-ccrep-1-2008-127
During this acquisition dramatic enhancement of the mass was seen to occur, with peak signal intensities only slightly less than those of the surrounding vascular structures and peak enhancement occurring 1-2 heartbeats after contrast appeared in the thoracic aorta (Figs. 2a-e images/movie).
A, B T1 weighted double inversion recovery pre and post gadolinium images (image B additionally acquired with fat saturation). The second image was acquired approximately 3 minutes after contrast administration. Increase in signal is seen compared to the pre-contrast image A) but is much less intense than that seen during the dynamic acquisition (Fig. 2).
ccrep-1-2008-127f3.jpg
PMC3785362_01_ccrep-1-2008-127f3.jpg
f3-ccrep-1-2008-127
Post-contrast T1 weighted imaging confirmed a persistent increase in signal intensity within the mass (Fig. 3).