Orbital Cavernous Hemangioma MRI

Note well defined strongly enhancing mass located medially in the right orbit. This extraconal mass has high signal on T2. It has not changed over time. This is Orbital Cavernous Hemangioma. If we would perform dynamic contrast scan it would show graduate enhancement. Here is the mass nicely depicted on T2, T1 FS with contrast and on CT. Case is complementary to my previous case.

Paraganglioma - Glomus Jugulare

Note intensively enhancing tumour in the foramen jugulare that expands the foramen and with characteristic "salt & pepper" appearance. It extends along the jugular vein and has irregular border. Finding represents Glomus Jugulare Paraganglioma.

Neurocentral Synchondrosis

MRI of the 11 years old child showing symmetric low signal intensity lines on T2 sequences in all vertebrae (arrows). Those are normal growth plates called Neurocentral Synchondrosis that ossify later in life and are no longer visible in the adult spine.

See drawing from Gray's Anatomy figure 102.

Spondylolysis

When you see spondylolisthesis (minimal in our patient) you might suspect (usually bilateral) spondylolysis. This is often not the case as spondylolisthesis can also be due to displacement in the facet joints. However it is wise not to miss the spondylolysis. It is rather easy finding on CT - as you can see above. There is no problem judging spondylolysis from normal facet joints. However nowadays we mainly perform MRI for spinal problems.

On MRI it is not that easy to find spondylolysis. This is mostly due to more horizontal angle of the fractures compared to vertical angle of the normal facet joints as seen on transversal images. The sagittals are not always that helpful as well. The clue is that spondylolysis looks like 'additional joint' that should not be there. Note on the images above spondylolysis as well as normal facet joint with cartilage seen on the last image (long arrow). This is the same patient as shown on CT therefore it is good to compare those two diagnostic methods.

Epidermoid Cyst DWI

CT (not shown) has revealed a cystic structure in the left cerebellopontine angle with mass effect on the pons and cerebrellar peduncle. MR has shown that the structure has inhomogeneous slightly increased signal on FLAIR, cystic high signal on T2 and what is most characteristic has high signal on diffusion weighted (DWI) sequence. On ADC signal was very close to that of brain parenchyma. Also note the expansion of the mass into the Meckel cave seen on FLAIR (first image). This finding represents a classic Epidermoid Cyst.

You might also check another case of Epidermoid Cyst in this most common location.