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US Case of the Day¹

¹ From the Department of Radiology, University of Arkansas for Medical Sciences, Slot 581, 4301 W Markham, Little Rock, AR 72205. From the 1998 RSNA scientific assembly. Received November 20, 1998; revision requested December 30 and received February 3, 1999; accepted February 4. Address reprint requests to T.L.A.

View larger version (127K): [in a new window]   Figure 1a.  (a) Axial US image of the fetal abdomen shows the fetus in breech presentation with its spine toward the mother's left side (arrow). A left paraspinal mass (arrowhead) appears predominantly solid but also demonstrates several cystic areas. (b) Longitudinal US image of the fetal chest and abdomen demonstrates that the mass is subdiaphragmatic in location but is not clearly differentiated from the surrounding organs.

View larger version (115K): [in a new window]   Figure 1b.  (a) Axial US image of the fetal abdomen shows the fetus in breech presentation with its spine toward the mother's left side (arrow). A left paraspinal mass (arrowhead) appears predominantly solid but also demonstrates several cystic areas. (b) Longitudinal US image of the fetal chest and abdomen demonstrates that the mass is subdiaphragmatic in location but is not clearly differentiated from the surrounding organs.

View larger version (113K): [in a new window]   Figure 2.  Color Doppler US image of the fetal abdomen clearly demonstrates the aorta and renal vessels (arrow). The mass does not appear to be vascular but does appear to be separate from the kidney (arrowhead).

View larger version (113K): [in a new window]   Figure 3.  Coronal US image of the fetal abdomen obtained 2 weeks after the initial visit shows the plane of separation between the mass and the left kidney (arrow).

View larger version (90K): [in a new window]   Figure 4a.  (a) Longitudinal US image of the left upper quadrant of the neonatal abdomen shows the mass (arrow) separate from the adrenal gland (arrowhead). (b) Coronal US image of the neonatal abdomen obtained just inferior to a shows the relationship between the aorta, mass, adrenal gland, and left kidney (arrow).

View larger version (105K): [in a new window]   Figure 4b.  (a) Longitudinal US image of the left upper quadrant of the neonatal abdomen shows the mass (arrow) separate from the adrenal gland (arrowhead). (b) Coronal US image of the neonatal abdomen obtained just inferior to a shows the relationship between the aorta, mass, adrenal gland, and left kidney (arrow).

View larger version (165K): [in a new window]   Figure 5a.  (a) On a coronal T1-weighted MR image of the chest and abdomen, the mass has low signal intensity with high-signal-intensity cystic areas corresponding to those seen at prenatal US, a finding that suggests the presence of hemorrhage. Both adrenal glands are visualized (arrows), with the left adrenal gland being displaced inferiorly by the mass. (b) On an axial T2-weighted MR image of the abdomen, the mass is markedly hyperintense relative to the adrenal glands (arrows).

View larger version (146K): [in a new window]   Figure 5b.  (a) On a coronal T1-weighted MR image of the chest and abdomen, the mass has low signal intensity with high-signal-intensity cystic areas corresponding to those seen at prenatal US, a finding that suggests the presence of hemorrhage. Both adrenal glands are visualized (arrows), with the left adrenal gland being displaced inferiorly by the mass. (b) On an axial T2-weighted MR image of the abdomen, the mass is markedly hyperintense relative to the adrenal glands (arrows).