Demonstration of a Fluid-Fluid Level on Magnetic Resonance Imaging in a Case of Bronchogenic Cyst in the Posterior Mediastinum

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  • MRI にて Fluid-Fluid Level を呈した後縦隔気管支性嚢胞の 1 例

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We report a case of a fluid-fluid level seen on magnetic resonance (MR) images of a bronchogenic cyst. A 68-year-old man was admitted for persistent hiccup. Routine chest radiograph showed a smooth, round opacity in the left posteromedial basilar area. Although unenhanced computed tomography (CT) scans revealed a posterior mediastinal mass with homogeneous attenuation similar to that of skeletal muscle, contrast-enhanced CT scans demonstrated the nonenhancing cystic mass. Cardiac gated T1-weighted MR imaging disclosed a fluid-fluid level within the cyst. The dependent fluid layer was mildly hyperintense compared to the overlying layer. On T2-weighted MR imaging the cyst had a markedly hyperintense signal. The posterior mediastinal cyst was completely resected by video-assisted thoracic surgery and the pathological diagnosis was a bronchogenic cyst. At surgery, they cyst was ruptured with emission of nonhemorrhagic serous and mucinous fluids. The fluid-fluid level on T1-weighted MR imaging may possibly have been due to dependent layering of the proteinaceous mucinous fluid within the cyst. The present results indicate the unusual occurence of a fluid-fluid level on T1-weighted MR imaging of a nonhemorrhagic mediastinal bronchogenic cyst.

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