Case Reports in Radiology The latest articles from Hindawi Publishing Corporation © 2016 , Hindawi Publishing Corporation . All rights reserved. Aortic Pseudoaneurysm Secondary to Mediastinitis due to Esophageal Perforation Wed, 10 Feb 2016 12:06:57 +0000 Esophageal perforation is a condition associated with high morbidity and mortality rates; it requires early diagnosis and treatment. The most common complication of esophageal rupture is mediastinitis. There are several case reports in the literature of mediastinitis secondary to esophageal perforation and development of aortic pseudoaneurysm as a complication. We report the case of a patient with an 8-day history of esophageal perforation due to foreign body (fishbone) with mediastinitis and aortic pseudoaneurysm. The diagnosis was made using Computed Tomography (CT) with intravenous and oral water-soluble contrast material. An esophagogastroduodenoscopy did not detect the perforation. Claudia Patricia Zuluaga, Felipe Aluja Jaramillo, Sergio Andrés Velásquez Castaño, Aura Lucía Rivera Bernal, Julio Cesar Granada, and Jorge Alberto Carrillo Bayona Copyright © 2016 Claudia Patricia Zuluaga et al. All rights reserved. Left Inferior Vena Cava and Right Retroaortic Renal Vein Wed, 03 Feb 2016 12:56:57 +0000 Nowadays, incidental anatomical variants are frequent findings, due to the widespread diffusion of cross-sectional imaging. This case report illustrates a fairly uncommon anatomical variant, that is, the copresence of left inferior vena cava and retroaortic right renal vein reported in a 46-year-old lady, undergoing a staging CT for breast cancer. Although the patient was asymptomatic, the authors highlight potential risks related to the above-mentioned condition and the importance of correct identification and diagnosis of the findings. Alberto Nania, Fabio Capilli, and Eugenia Longo Copyright © 2016 Alberto Nania et al. All rights reserved. Fetal MRI Characteristics of Exencephaly: A Case Report and Literature Review Wed, 03 Feb 2016 11:59:41 +0000 We present the fetal MRI characteristics of exencephaly, a rare malformation of the cranium. The fetus was initially misdiagnosed as anencephaly at 14 weeks of estimated gestational age (EGA) and later mislabeled as acrania at 20 weeks of EGA by ultrasound. A confirmatory magnetic resonance imaging (MRI) at 29 weeks of EGA demonstrated findings consistent with exencephaly, which was confirmed after birth. To our knowledge, no full fetal MRI characteristics have been described. We hope to use this case to review the key MRI findings in differentiating exencephaly from other cranial vault defects and to help early diagnosis of exencephaly as the appropriate use of correct nomenclature allows better research while giving parents the most accurate and appropriate counseling. Ali Sharif and Yihua Zhou Copyright © 2016 Ali Sharif and Yihua Zhou. All rights reserved. Imaging Manifestations of a Subependymal Giant Cell Astrocytoma in Tuberous Sclerosis Sun, 31 Jan 2016 12:19:52 +0000 Tuberous sclerosis is a rare genetic disorder resulting in benign tumor growth in various organs including the brain, heart, skin, eyes, kidney, and lung as well as systemic manifestations including seizures, cognitive impairment, and dermatologic abnormalities. This report shows the radiological findings and differentiation between a subependymal nodule and subependymal giant cell astrocytoma in a patient with tuberous sclerosis presenting with new onset seizures. Joseph R. Stein and Daniel A. Reidman Copyright © 2016 Joseph R. Stein and Daniel A. Reidman. All rights reserved. Dual-Energy CT for Evaluation of Intra- and Extracapsular Silicone Implant Rupture Thu, 28 Jan 2016 13:44:49 +0000 Silicone implants are commonly used for both breast augmentation and breast reconstruction. With aging of the implant, the silicone envelope may become weak or may rupture. The technique of choice for evaluation of implant integrity is breast MRI; however this may be contraindicated in some patients or the cost may be prohibitive. Dual-energy CT allows determination of density and atomic number of tissue and can provide material composition information. We present a case of extracapsular implant rupture with MRI and dual-energy CT imaging and surgical correlation. Katrina N. Glazebrook, Shuai Leng, Steven R. Jacobson, and Cynthia M. McCollough Copyright © 2016 Katrina N. Glazebrook et al. All rights reserved. Pulmonary Embolism Originating from a Hepatic Hydatid Cyst Ruptured into the Inferior Vena Cava: CT and MRI Findings Thu, 21 Jan 2016 13:45:01 +0000 Pulmonary embolism due to hydatid cysts is a very rare clinical entity. Hydatid pulmonary embolism can be distinguished from other causes of pulmonary embolism with contrast-enhanced computed tomography (CECT) and magnetic resonance imaging (MRI). MRI especially displays the cystic nature of lesions better than CECT. Here we report a 45-year-old male patient with the pulmonary embolism due to ruptured hydatid liver cyst into the inferior vena cava. Necdet Poyraz, Soner Demirbaş, Celalettin Korkmaz, and Kürşat Uzun Copyright © 2016 Necdet Poyraz et al. All rights reserved. Bilateral Congenital Agenesis of the Long Head of the Biceps Tendon: The Beginning Thu, 21 Jan 2016 13:19:16 +0000 The biceps brachii muscle is prone to variants but absence of the long head of the biceps (LHB) tendon is an exceptionally rare anomaly. This report concerns the fourth case of bilateral congenital absence of the LHB tendon and presents the ultrasonography (US) and magnetic resonance (MR) findings. Our case has the peculiarity of being the first in which bilateral LHB tendon agenesis is not associated with rotator cuff or labral tears. Francisco Rego Costa, Cátia Esteves, and Lina Melão Copyright © 2016 Francisco Rego Costa et al. All rights reserved. Detection of Myofascial Herniation on Dynamic Sonography and Magnetic Resonance Imaging Thu, 14 Jan 2016 07:53:28 +0000 Muscle hernia is an uncommon cause of leg swelling. It can be detected in the early stages only if there is a high index of suspicion. It is common in lower extremity compared to the upper extremity. Tibialis anterior muscle in the leg is commonly involved. Dynamic sonography and magnetic resonance imaging (MRI) are the mainstay in their diagnosis, which demonstrate a facial defect with herniation of muscle fibers. We report a case of 23-year-old male patient who presented with a painless swelling in the anterolateral aspect of the left upper leg. Dynamic sonography done with high-resolution probe demonstrated a defect in fascia overlying tibialis anterior with herniation of outer muscle fibers which increased during dorsiflexion and reduced in the supine position at rest. MRI of the left leg confirmed the findings. Sanjay M. Khaladkar, Sushen Kumar Kondapavuluri, Anubhav Kamal, Raghav Kalra, and Vigyat Kamal Copyright © 2016 Sanjay M. Khaladkar et al. All rights reserved. Granulomatosis with Polyangiitis Presenting with Coronary Artery and Pericardial Involvement Tue, 22 Dec 2015 11:15:23 +0000 Granulomatosis with polyangiitis is a systemic disease resulting in necrotizing vasculitis of small- and medium-sized vessels. Cardiac involvement is rare and when present usually manifests with pericarditis and coronary artery vasculitis. We report here a case of granulomatosis with polyangiitis involving the native coronary arteries, bypass graft, and pericardium with interesting imaging findings on contrast-enhanced CT and MRI. A 57-year-old man with a history of chronic headaches presented to the emergency room with syncope. Contrast-enhanced CT demonstrated extensive soft tissue attenuation around the native coronary arteries and bypass graft. Contrast-enhanced MRI demonstrated enhancing nodular soft tissue surrounding the coronary arteries, bypass graft, and pericardium. Pericardial biopsy revealed a necrotizing granulomatous pericarditis with vasculitis concerning for granulomatosis with polyangiitis. The patient demonstrated MPO-positive and PR-3 negative serologies. After being discharged on rituximab and prednisone, follow-up CT 3 years later showed significant improvement of the soft tissue thickening surrounding the coronary arteries, bypass graft, and pericardium. Rohit Dewan, Humberto E. Trejo Bittar, Joan Lacomis, and Iclal Ocak Copyright © 2015 Rohit Dewan et al. All rights reserved. Late Type 3b Endoleak with an Endurant Endograft Sun, 20 Dec 2015 05:33:59 +0000 Endovascular stent grafting with different commercially available stent graft systems is widely applied for the treatment of abdominal aortic aneurysms with high success rates in the current era. Various types of endoleaks are potential complications of the procedure. They usually occur in the early period. In this report, we present type 3b endoleak occurring 14 months after a successful endovascular abdominal aortic aneurysm repair with a Medtronic Endurant stent graft. Mehmet Barburoglu, Bulent Acunas, Yilmaz Onal, Murat Ugurlucan, Omer Ali Sayin, and Ufuk Alpagut Copyright © 2015 Mehmet Barburoglu et al. All rights reserved. Cholangiocarcinoma Arising from a Type VI Biliary Cyst: A Case Report and Review of the Literature Tue, 15 Dec 2015 09:33:46 +0000 Cystic dilatations of the cystic duct which are suggested as type VI biliary cysts are very rare and many of them go unrecognized or are confused with other cysts until the operation although they are obvious on imaging studies. They can present with fusiform or saccular dilatations and can be accompanied by common bile duct dilatations. It is important to identify these cysts as they share the same characteristics as the other biliary cyst types and can be complicated with malignancy. We herein present a very unusual case of a cholangiocarcinoma arising from a type VI biliary cyst in a 58-year-old female patient and review the literature. The patient presented with jaundice, weight loss, and abdominal pain. On imaging, the cystic duct and common bile duct were fusiformly dilated and had a wide communication. There was a mass filling the distal parts of both ducts. The patient was urgently operated on after perforation following ERCP. Histopathology was compatible with a type VI biliary cyst and an associated cholangiocarcinoma. İlkay Çamlıdağ, Mehmet Selim Nural, Murat Danacı, İlhan Karabıçak, and Kağan Karabulut Copyright © 2015 İlkay Çamlıdağ et al. All rights reserved. Double Meniscal Ossicle, the First Description: CT and MRI Findings—Different Etiologies Tue, 15 Dec 2015 07:29:51 +0000 We present a case of 2 ossicles in the medial meniscus with emphasis on MRI and CT findings. Meniscal ossicle is a rare entity and is quite uncommon on the medial side. By showing the typical signal characteristics and intrameniscal location, MRI can be helpful in distinguishing this from other more clinically significant abnormalities. It should be kept as differential from synovial chondromatosis or sesamoid bones like fabella as management is different for all of these entities. Puneeth Kumar, Amit Kumar Dey, Kartik Mittal, Rajaram Sharma, and Priya Hira Copyright © 2015 Puneeth Kumar et al. All rights reserved. Osseous Scaphotrapezial Coalition Wed, 09 Dec 2015 14:20:02 +0000 Osseous scaphotrapezial coalition is one of the rarest forms of carpal coalition of the hand. Often discovered incidentally, pain and functional limitation have not been reported. Carpal coalitions occurring across the carpal rows are thought to occur as a result of some insult or congenital anomaly. Isolated scaphotrapezial coalition calls into question the traditional thinking that fusion between the proximal and distal carpal rows must be acquired or associated with congenital syndromes. William M. Weathers, Susanna C. Spence, and Nicholas M. Beckmann Copyright © 2015 William M. Weathers et al. All rights reserved. Pseudoaneurysm of the Common Carotid Artery in an Infant due to Swallowed Fish Bone Wed, 09 Dec 2015 07:47:27 +0000 Carotid artery pseudoaneurysm is a rare condition, particularly in the paediatric population. Only about 30 cases of carotid artery aneurysms in infants have been published until now. This paper reports the case of a giant pseudoaneurysm of the left common carotid artery due to swallowed fish bone by an 8-year-old boy. This pseudoaneurysm was 5.5 cm transverse-diameter and resulted in severe respiratory distress. It was treated by resection and end-to-end anastomosis with satisfactory outcome after one-year follow-up. To the best of our knowledge, this is the largest carotid artery pseudoaneurysm ever described in children. Moulion Tapouh Jean Roger, Fokou Marcus, Fongang Emmanuel, Moifo Boniface, and Juimo Alain Georges Copyright © 2015 Moulion Tapouh Jean Roger et al. All rights reserved. Imaging of Posterior Interosseous Neuropathy following Distal Biceps Repair: A Report of 3 Cases Mon, 07 Dec 2015 11:25:59 +0000 Three cases of PIN palsy following biceps repair are presented with clinical and imaging correlation. The imaging findings in these cases will be discussed and the orthopedic literature, as regards possible surgical approaches and technical factors believed to predispose to or prevent this complication, will be reviewed. It is important for radiologists to serve as consultants in these uncommon but sometimes devastating complications, helping to quickly and accurately recognize the imaging findings corresponding to the clinical symptoms and aiding the surgeon in diagnosis and treatment by identifying the possible causes and sites of nerve compression. Darren Fitzpatrick, Catherine Petchprapa, and Leon Rybak Copyright © 2015 Darren Fitzpatrick et al. All rights reserved. Cervical Spinal Meningeal Melanocytoma Presenting as Intracranial Superficial Siderosis Mon, 07 Dec 2015 07:03:52 +0000 Meningeal melanocytoma is a rare pigmented tumor of the leptomeningeal melanocytes. This rare entity results in diagnostic difficulty in imaging unless clinical and histopathology correlation is performed. In this case report, we describe a case of meningeal melanocytoma of the cervical region presenting with superficial siderosis. Extensive neuroradiological examination is necessary to locate the source of the bleeding in such patients. Usually, the patient will be cured by the complete surgical excision of the lesion. Savitha Srirama Jayamma, Seema Sud, TBS Buxi, VS Madan, Ashish Goyal, and Shashi Dhawan Copyright © 2015 Savitha Srirama Jayamma et al. All rights reserved. Single Stage Endovascular Treatment of a Type 2 Abernethy Malformation: Successful Nonsurgical Outcome in a Case Report Sun, 06 Dec 2015 09:36:39 +0000 Abernethy malformations are a rare collection of congenital hepatic portosystemic shunts. Our 19-year-old patient is with a type 2 Abernethy malformation elected permanent shunt closure following worsening dyspnea. This report details a single stage endovascular technique wherein shunt closure was achieved immediately by placement of an aortic endograft. At 5-month follow-up, the patient reported decreased shortness of breath. Furthermore, ultrasound investigation demonstrated a patent portal vein and right heart catheterization 6 months after procedure revealed decreased pulmonary hypertension relative to preprocedure values. This one step method may serve as an alternative treatment strategy to multistage endovascular closure techniques of type 2 Abernethy malformations. Carl Kraus, Vladimir Sheynzon, Robert Hanna, and Joshua Weintraub Copyright © 2015 Carl Kraus et al. All rights reserved. Progressive Diffuse Osteonecrosis in a Patient with Secondary Hemophagocytic Lymphohistiocytosis Sun, 29 Nov 2015 12:25:22 +0000 This is a case report with serial imaging showing progression of diffuse osteonecrosis in a patient after a diagnosis of secondary hemophagocytic lymphohistiocytosis (HLH). While bone marrow involvement in HLH has been long noted at histological evaluation and is itself one of the diagnosis criteria, to the best of our knowledge, there has been no previous publication addressing osseous image findings in a patient with HLH. Takashi Takahashi and Jeffrey Rykken Copyright © 2015 Takashi Takahashi and Jeffrey Rykken. All rights reserved. The Clinical Impact of Accurate Cystine Calculi Characterization Using Dual-Energy Computed Tomography Wed, 25 Nov 2015 09:37:19 +0000 Dual-energy computed tomography (DECT) has recently been suggested as the imaging modality of choice for kidney stones due to its ability to provide information on stone composition. Standard postprocessing of the dual-energy images accurately identifies uric acid stones, but not other types. Cystine stones can be identified from DECT images when analyzed with advanced postprocessing. This case report describes clinical implications of accurate diagnosis of cystine stones using DECT. William E. Haley, El-Sayed H. Ibrahim, Mingliang Qu, Joseph G. Cernigliaro, David S. Goldfarb, and Cynthia H. McCollough Copyright © 2015 William E. Haley et al. All rights reserved. Torsion of Fatty Appendage of Falciform Ligament: Acute Abdomen in a Child Wed, 18 Nov 2015 09:00:17 +0000 Torsion of the fatty appendage of the falciform ligament is an extremely rare condition that leads to severe abdominal pain and raised inflammatory markers. It can be recognised on ultrasound or CT scan. The pathophysiology is the same as that involved in the more common torsion and/or infarction of the greater omentum or epiploic appendages. The condition is best managed conservatively with anti-inflammatory analgesia, and the early recognition of this type of torsion may prevent unnecessary operative intervention to look for a source of abdominal pain. There have been five reported adult cases of a torted fatty appendage of the falciform ligament identified on ultrasound and CT scan, but no paediatric cases. We report a case of torsion of the fatty appendage of the falciform ligament in a ten-year-old boy and describe its imaging characteristics on CT scan. Caroline Maccallum, Sarah Eaton, Daniel Chubb, and Stephen Franzi Copyright © 2015 Caroline Maccallum et al. All rights reserved. An Unusual Case of Laryngeal Paraganglioma in a Patient with Carotid Body Paraganglioma: Multimodality Imaging Findings Sun, 15 Nov 2015 13:16:11 +0000 Multiple paragangliomas of the head and neck are rare conditions. Carotid paragangliomas are most common multiple paragangliomas. Laryngeal paragangliomas are very rare neuroendocrine tumors and usually are seen as symptomatic solitary lesions. We present multimodality imaging findings of incidentally detected laryngeal paraganglioma in a woman with synchronous carotid body paraganglioma and positive family history. To the best of our knowledge, this is the first case of laryngeal and carotid body paragangliomas in a patient with positive family history. Radiologists should keep in mind that paragangliomas may occur in various locations as multiple tumors. Serap Dogan, Serkan Senol, Hakan Imamoglu, Ummuhan Abdulrezzak, Afra Ekinci, Imdat Yuce, and Mustafa Ozturk Copyright © 2015 Serap Dogan et al. All rights reserved. Unusual Presentations of Focal Periphyseal Edema Zones: A Report of Bilateral Symmetric Presentation and Partial Physeal Closure Thu, 12 Nov 2015 11:20:12 +0000 Focal periphyseal edema (FOPE) zones are areas of periphyseal edema seen near the time of physeal closure which are believed to be a physiologic phenomenon related to changes in distribution of forces around the physis as it closes. Since the original case series describing these areas of periphyseal edema, there has been little published in regard to FOPE zone outside of review articles. We present a set of three patients identified with focal periphyseal edema zones around the knee and compare our findings with the initial case series. We include a patient presenting with bilateral, nearly symmetric, focal periphyseal edema zones of the proximal tibia physis and a patient with partial closure of the physis at time of presentation, which were not reported in the original case series. Nicholas Beckmann and Susanna Spence Copyright © 2015 Nicholas Beckmann and Susanna Spence. All rights reserved. Tuberculous Abscess of the Chest Wall Simulate Pyogenic Abscess Thu, 05 Nov 2015 14:28:46 +0000 The chest wall tuberculosis abscesses is rare. We present a case of a 27-year-old immunocompetent male who presented chest wall abscesses. Imaging (chest radiographic, ultrasound, and computed tomography) and Ziehl-Neelsen staining demonstrated chest wall tuberculosis abscesses. Lantam Sonhaye, Abdoulatif Amadou, Faré Gnandi-Piou, Kouméabalo Assih, Mazamaesso Tchaou, Bérésa Kolou, Kokou Adambounou, Bidamin N’Timon, Lama Agoda-Koussema, Komlavi Adjenou, and Koffi N’Dakena Copyright © 2015 Lantam Sonhaye et al. All rights reserved. Malignant Peripheral Nerve Sheath Tumor: MRI and CT Findings Thu, 29 Oct 2015 12:58:06 +0000 This is a case report of a 56-year-old male with hypertension who presented with urinary retention and bowel incontinence. CT and MRI of the abdomen and pelvis showed a large complex cystic and solid enhancing mass in the right presacral space. Pathology biopsy result showed malignant peripheral nerve sheath tumor (MPNST) with extensive necrosis. The diagnosis of MPNST is extremely difficult due to the lack of (1) conclusive immunohistochemistry or unique chromosomal anomaly, (2) universal distinctive histopathology, and (3) clinical criteria. The clinical, radiologic, and histologic presentation of MPNST is important in its diagnosis. A rare case of MPNST that produced urinary retention and bowel incontinence is presented that may aid clinicians in the diagnosis of this rare clinical entity. Motor weakness, central enhancement, and immunohistochemistry may assist in the diagnosis of MPNST and differentiation between benign peripheral nerve sheath tumor (BPNST) and MPNST. K. O. Kragha Copyright © 2015 K. O. Kragha. All rights reserved. Two Unusual Aspects of Posterior Reversible Encephalopathy Syndrome Mimicking Primary and Secondary Brain Tumor Lesions Mon, 26 Oct 2015 09:43:07 +0000 The posterior reversible encephalopathy syndrome (PRES) is a rare clinical-radiological entity well described with typical clinical and radiological manifestations. Atypical presentation, especially in imaging, exists. The authors report here two cases of posterior reversible encephalopathy in which imaging aspects were atypical, mimicking, in the first case, hemorrhagic cerebral metastasis of cholangiocarcinoma and, in the second case, a brain tumor. The diagnosis has been retrospectively rectified due to clinical and radiological outcome. Mazamaesso Tchaou, Nicoleta Modruz, Lama K. Agoda-Koussema, Anthony Michelot, Samer Naffa, Véronique Jeudy, and Raymond Kaczmarek Copyright © 2015 Mazamaesso Tchaou et al. All rights reserved. Ileocaecal Intussusception with a Lead Point: Unusual MDCT Findings of Active Crohn’s Disease Involving the Appendix Mon, 19 Oct 2015 07:53:58 +0000 Adult intussusception is a rare entity accounting for 1% of all bowel obstructions. Unlike intussusceptions in children, which are idiopathic in 90% of cases, adult intussusceptions have an identifiable cause (lead point) in the majority of cases. Crohn’s disease (CD) may affect any part of the gastrointestinal tract, including the appendix. It was shown to be a predisposing factor for intussusception. Here, we report a rare case of adult intussusception with a lead point, emphasizing diagnostic input of multidetector computed tomography (MDCT) in a patient with active CD that involves the appendix. Ebru Ozan, Gokce Kaan Atac, Egemen Akincioglu, Mete Keskin, and Kamil Gulpinar Copyright © 2015 Ebru Ozan et al. All rights reserved. Posttraumatic Intradiploic Leptomeningeal Cyst: A Rare Complication of Head Trauma Mon, 19 Oct 2015 06:23:28 +0000 Posttraumatic intradiploic leptomeningeal cyst is an exceedingly uncommon complication of skull fracture in childhood with only about twenty-one cases described in literature till now. We report 2 such cases of intradiploic leptomeningeal cyst of occipital bone in two 17- and 21-year-old males presenting with headache with history of occipital bone fracture in childhood and briefly discuss its pathogenesis and differential diagnosis. Jernailsingh Bava, Ashank Bansal, Santosh Bhaugaunda Patil, Kiran Ashok Kale, and Anagha Rajiv Joshi Copyright © 2015 Jernailsingh Bava et al. All rights reserved. Radiographic Thrombus within the External Jugular Vein: Report of a Rare Case and Review of the Literature Tue, 13 Oct 2015 11:45:44 +0000 We are reporting a case of a 91-year-old male with a primary malignancy of the right parotid gland with radiographic thrombus extension within the right external jugular vein. He was treated with palliative radiation therapy to the right parotid mass with a marked clinical response. The rarity of this occurrence as documented in the review of the literature provides for uncertainty with regard to proper management. Radiographic evidence of thrombus in the absence of clinical manifestations, the role of anticoagulation, and the proper radiation target delineation were all challenges encountered in the care of this patient. Our case represents a rare occurrence with unique radiologic findings that has implications for management. Sayyad Yaseen Zia, Richard L. Bakst, Qiusheng Si, Mike Yao, and Peter M. Som Copyright © 2015 Sayyad Yaseen Zia et al. All rights reserved. Retrograde Transpubic Approach for Percutaneous Radiofrequency Ablation and Cementoplasty of Acetabular Metastasis Tue, 29 Sep 2015 12:35:34 +0000 We report a case of painful and disabling anterior acetabular bone metastasis treated with bipolar radiofrequency ablation and cementoplasty. Due to the high risk of complications related to the proximity of the femoral neurovascular structures with a direct approach, we successfully performed a retrograde transpubic approach under combined CT and fluoroscopic guidance. In the present report, we describe this approach detailing its indications, advantages, and the technical tips to achieve a safe and satisfactory procedure. Salem Bauones, Veronique Freire, and Thomas P. Moser Copyright © 2015 Salem Bauones et al. All rights reserved. Severe Pulmonary Arterial Hypertension: Comprehensive Evaluation by Magnetic Resonance Imaging Tue, 08 Sep 2015 07:02:58 +0000 Pulmonary arterial hypertension (PAH) is characterized by elevated pulmonary artery (PA) pressure, which negatively affects the right ventricular (RV) function. This report shows a patient with severe PAH, on whom a comprehensive MRI exam was performed to evaluate both PA and RV. New imaging sequences were implemented for obtaining additional parameters about the patient’s condition. The results show the capabilities of the developed exam of providing complete picture of the cardiovascular system in PAH, which helps the physician optimize treatment. El-Sayed H. Ibrahim and Abubakr A. Bajwa Copyright © 2015 El-Sayed H. Ibrahim and Abubakr A. Bajwa. All rights reserved.