Complete Heart Block with Diastolic Heart Failure and Pulmonary Edema Secondary to Enlarging Previously Diagnosed Thrombosed Aneurysm of Sinus of Valsalva in a Patient with History of Autosomal Dominant Polycystic Kidney Disease

Figure 1

MRI of the abdomen with/without contrast (04-01-2011). (a) A heterogeneous mass is again seen adjacent to the left heart border, measuring approximately 8.5 × 8.0 cm which is partially visualized. Again, a vascular lesion is not excluded. (b) Multiple hepatic cysts are again demonstrated. A large mixed signal mass is again identified in the right lobe of the liver, which in the current study measures 13.0 × 11.7 cm. This measured 19 × 15 cm in the prior study and appears smaller in the current study. Multiple cystic lesions are again noted in the spleen. There is a mass within the spleen anteriorly which again demonstrates a peripheral rim of hypointensity, measuring approximately 3.5 × 3.6 cm. Multiple splenic cysts are noted. (c) Multiple renal cysts are present. There is a new well-circumscribed lesion in the mid pole of the left kidney measuring 1.7 × 1.6 cm which is T1 hyperintense and vaguely T2 hypointense. The subtraction image demonstrated no significant enhancement in this region. This likely represents a hyperdense cyst. There are several T1 hyperintense lesions within the kidneys bilaterally, which are too small to characterize. There are several nonenhancing T2 hyperintensities identified that appear to be within the pancreas; however, these are difficult to evaluate due to overlapping soft tissue structures in this region.

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