What the Prenuvo scans cover

The following table lists all the common conditions that can be covered by a Prenuvo scan. Rarer conditions that are not listed in the table are also reported from time to time. In some cases, either because of the patient or the scan acquisition, not all listed conditions are covered.

Brain aneurysm

A brain aneurysm, (also cerebral or intracranial aneurysm) is an outpouching of an artery of the brain. They usually occur where an artery branches (bifurcation). The pouch of the aneurysm is weaker than the rest of the artery, which causes it to grow, and potentially rupture.

Brain

Calcification of the prostate

Calcification of the prostate gland is where dense usually round regions of signal void on MRI develop in the prostate gland. Calcification in the prostate is a relatively common, benign finding and there is a link between prostate calcifications and prostatitis.

Prostate and male reproductive organs

Bone fracture

A bone fracture, also known as a broken bone, is a partial or complete break in the continuity of the bone. It can be a single fracture line or multiple fractured pieces. Fractures can occur from trauma, stress or from another pathology.

The different types of fractures are:

  • Displaced: the bone breaks into two or more parts and moves to out of alignment
  • Non-displaced: the bone breaks either part of all the way through but maintains alignment
  • Closed: the bone breaks but no puncture or open wound in the skin
  • Open: when the bone breaks and punctures the skin; these fractures are at risk of infection

Fractures are placed into subtypes:

  • Comminuted: broken into several pieces
  • Transverse: fracture line is perpendicular to the long part of the bone
  • Oblique: fracture line is on an angle through the bone
  • Pathologic: caused by a disease that weaken the bone
  • Stress: hairline crack

Healing of the bone starts almost immediately. It can be visualized on an x-ray within 2 weeks in adults.

Bony skeleton and soft tissue

Gallbladder appearance

The gallbladder is normally well seen on a Prenuvo scan.

The gallbladder is not visualized if it has been removed, severely contracted (due to recent fatty meal) or rarely congenitally absent.

Gallbladder and biliary system

Tumor of the knee

A tumor of the knee joint can arise from the bone, cartilage, or soft tissue around the joint.

These tumors may be benign, malignant, or indeterminant. The radiologist will give a likelihood of the type of tumor it is based on its imaging characteristics.

A bone tumour, or bone cancer, is a primary cancer that starts in the bone or adjacent cartilage. The tumours can be benign or malignant. Benign nonaggressive bone tumor types include an osteoma, osteoclastoma (giant cell tumours) or osteochondroma.

In general aggressive bone tumors are more common in children, adolescents and young adults. The most common types of malignant bone tumours in young adults are chondrosarcoma and osteosarcoma. A chondrosarcoma originates in the cartilage most commonly of the longbones: femur and humerus. An osteosarcoma is the second most common bone cancer and is rarely found in the shoulders, but is more common in the knees, tibiae, and in older people around the hip or jaw. Rarer types of bone cancer are: fibrosarcoma, angiosarcoma, and undifferentiated high-grade pleomorphic sarcoma. Until the dominant tumor tissue type is known, the tumor type is generally called a sarcoma.

Soft tissue tumours common around a joint are synovial chondromatosis, pigmented villonodular synovitis, synovial sarcomas, lipomas, fibromas, desmoid tumours, leiomyoma, leiomyosarcoma, and synovial sarcoma.

Knees

Bone island of the ankle

A bone island, also known as enostosis, is a benign, very dense region of compact bone within the normal bone structure. It is generally less than 2cm in size and is usually found incidentally. A condition where multiple bone islands occur is called osteopoikilosis.

Ankles

Esophageal benign leiomyoma

A leiomyoma is the most common benign tumor of the esophagus. They are formed from an overgrowth of smooth muscle.

Esophagus

Esophageal malignancy

There are two common types of esophageal carcinoma. These are squamous cell carcinoma and adenocarcinoma. Squamous cell carcinoma arises from the epithelial cells that line the esophagus. Adenocarcinoma arises from the glandular cells in the lower third of the esophagus. Symptoms usually appear after the cancer has infiltrated over 60% of the circumference of the esophagus by which time the carcinoma is in an advanced stage.

The earliest way to detect a developing malignancy in the esophagus is by direct visualization of the tissue lining of the esophagus

Esophagus

Malrotation of kidney

Malrotation of the kidney occurs during fetal development when the kidneys do not move into their normal final position.

For some unknown reason, when the embryologic kidneys move from their start in the pelvis to their final position in the upper posterior abdomen they fail to rotate.

Kidneys

Degeneration of the knee

Degenerative joint disease or degenerative arthritis (osteoarthritis) is the most common condition to affect joints. It is a chronic condition. It is in two forms: primary and secondary. Primary is hereditary and less common but occurs without cause or injury. Secondary is the most common form and is due to abnormal mechanical forces such as obesity, previous injury/trauma or joint stress.

Degenerative joint disease occurs when the cartilage breaks down causing the bones to rub together and become misshapen with bone spurs (osteophytes). Typically it occurs in the older population.

The Prenuvo scan does not look at cartilage, thus the earliest signs of arthritis may not be seen on this study. If you are interested in cartilage imaging, discuss with your doctor about obtaining a dedicated joint MRI.

Knees

Agenesis of the liver

Agenesis of the liver is a condition where a section of the liver (called a lobe) is absent, even though other anatomical features of the liver are present. It is typically identified as an incidental finding by imaging.

Liver

Indeterminant cardiac lesion

An indeterminate lesion of the heart can potentially be a benign or a malignant lesion. Unfortunately we are unable to determine the exact nature of the lesion from this scan, as the Prenuvo scan is not designed to evaluate the heart.

Heart and great vessels

Hemorrhagic cyst of the oral pharynx

Hemorrhagic cysts are abnormal lesions of the neck which have had an episode of bleeding (hemorrhage) within the lesion. This can occur due to trauma, infection or tumor and the bleeding is often associated with an immediate onset of pain and other symptoms.

Oral pharynx

Mucous retention cyst

A mucous retention cyst is an incidental, asymptomatic fluid filled sac in one of the paranasal sinuses. They may or may not grow, but can occasionally spontaneously rupture and therefore disappear.

Sinuses and mastoids

Bladder/Ureter calculus

A calculus (plural: calculi), also known as a bladder (or rarely ureter) stone, is similar in composition to a kidney stone. Calculi are made of salts and minerals from urine which have not been excreted. In the bladder, these salts and minerals have been retained for an extended period of time causing a stone to form. The number, size and composition of bladder stones may vary.

A calculus in the ureter is usually a kidney stone that has dropped into the ureter - it is usually extremely painful and thus not new, and not seen outside of a hospital setting. A calculus in the ureter is best evaluated by CT imaging, Xray or urology specialists.

Bladder and ureters

Brain abscess

A brain abscess is a potentially life threatening condition where an infectious agent (ie bacteria, parasite etc), lodges in the brain tissue and starts to grow and destroy the normal brain tissue. A brain abscess often has a wall around the lesion which can make treatment difficult.

Brain

Mullerian duct anomaly

Mullerian duct anomalies is a type of female genital malformation resulting from abnormal development of the mullerian ducts during the embryonic development. The mullerian ducts develop to form the fallopian tubes, uterus,cervix, and the upper two-thirds of the vagina, Degree of symptoms can vary depending on the defect.

There are six classifications:

  • Class I: Mullerian agenesis (absent uterus).
  • Class II: unicornuate uterus - only one side forms and appears “banana shape” on images.
  • Class III: uterus didelphys(double uterus) - both Mullerian ducts form but fail to fuse, this results in a “double uterus”. It is also possible to have a cervix and partial double vagina.
  • Class IV: Bicornuate uterus (uterus with two horns) - this occurs when the upper part of the uterus fails to fuse. It creates a heart shaped uterus.
  • Class V: Septate uterus (uterine septum or partition) - in this case the mullerian ducts have fused, but the partition between them is still present, splitting the system in two parts. This is the most common malformation.
  • Class VI: Acurate Uterus - a mild indentation of the endometrium at the uterine fundus (some may not consider this an anomaly as there is no definitive depth to define this classification).
  • Class VII: DES uterus - the uterine cavity has a “T-shape” as the result of fetal exposure to a estrogen drug that is no longer used, diethylstilbestrol.

Uterus

Indeterminant nodule of the oral pharynx

A nodule in the oropharyngeal tissues of the neck describe a small lesion which is generally too small to be able to characterized as benign or potentially malignant. Unfortunately we are unable to determine the exact nature of the lesion from a single scan.

Oral pharynx

Indeterminant lesion of the liver

An indeterminant lesion of the liver can potentially be a benign or a malignant lesion. Unfortunately we are unable to determine the exact nature of the lesion based on its current size and tissue composition.

Liver

Indeterminant bowel lesion

An indeterminate lesion of the bowel can potentially be a benign or a malignant lesion. Unfortunately we are unable to determine the exact nature of the lesion.

Direct visualization of the bowel remains the best way to assess the colon.

Bowel

Inflammation of the thyroid

The thyroid can become inflamed and diffusely enlarged due to many causes. The most common is thyroiditis, of which there are multiple different etiologies, which need to be assessed in conjunction with blood thyroid hormone tests.

Thyroid

Inflammation in the nasal pharynx

The nasal pharynx is composed of a mucosal tissue layer that protects the underlying sensitive tissue from infection, or other injuries. However this area can get irritated and become inflamed by repetitive irritant exposure.

Nasal pharynx

Muscle atrophy with fatty replacement

Muscle atrophy is when the muscle either partially or completely wastes/decreases in mass. It can be associated with restricted movement/lack of physical activity or as the result of surgery, trauma, or other conditions/diseases affecting the person.

Muscle atrophy can be broken into three different categories: physiologic, pathologic, and neurogenic. Physiologic is when the muscle is not being used enough. This can occur when a person is confined to a bed, has broken a limb, in places where there is no gravity or have a lifestyle with decreased activity levels. Pathologic is when the a person is suffering from other conditions such as aging, starvation, cancer, HIV, or Cushing disease. Neurogenic atrophy can be the result of injury or a disease that affects the nerves stimulating the muscles. Examples of neurogenic muscle loss are: ALS, carpal tunnel syndrome, Guillain-Barre syndrome, toxins or alcohol, polio or a spinal cord injury.

Bony skeleton and soft tissue

Liver hemangioma

Hemangiomas, or more accurately, cavernous hepatic hemangiomas, are the most common liver tumor and are benign. Hemangiomas are considered to be congenital (present at birth), which means if you have no hemangiomas detected on your current scan, you should not develop any hemangiomas in the future.

Liver

Tethered cord

Tethered cord syndrome occurs when the lower part of the spinal cord is anchored (usually to the sacococcygeal region), causing it to overstretch the spinal cord and nerve roots.

Tethered cord can be primary, where it is an isolated congenital abnormality, or secondary, where it can occur with other abnormalities such as a tumor or after an injury.

Spine

Degeneration of the pelvis and hips

Degenerative joint disease or degenerative arthritis (osteoarthritis) is the most common condition to affect joints. It is a chronic condition. It is in two forms: primary and secondary. Primary is hereditary and less common but occurs without cause or injury. Secondary is the most common form and is due to abnormal mechanical forces such as obesity, previous injury/trauma or joint stress.

Degenerative joint disease occurs when the cartilage breaks down causing the bones to rub together and become misshapen with bone spurs (osteophytes). Typically it occurs in the older population.

The Prenuvo scan does not look at cartilage, thus the earliest signs of arthritis may not be seen on this study. If you are interested in cartilage imaging, discuss with your doctor about obtaining a dedicated joint MRI.

Pelvis and hips

Spinal cord infarct

A spinal cord infarct is due to a stroke which affects the spinal cord. It is quite uncommon.

A spinal cord infarct usually causes severe neurological symptoms. The prognosis is generally very poor.

Spine

Bone metastases

Bone metastases or osseous metastatic disease are cancerous lesions that result from a spread of a primary cancer(a cancer somewhere else in the body) to the bone. They are more common than primary bone cancer. Some of the most common cancers to spread to bones are: breast, prostate, lung, kidney and thyroid. Due to the blood supply in the bones of the spine, these tumor cells appear to lodge there and destroy the normal bone.

Metastatic disease disrupts the regular cycle of bone turnover (production and removal of normal bone). As a result the structure of the bone changes. There are two type of bone metastases, osteoblastic (sclerotic) metastases and osteolytic metastases.

Osteoblastic metastases occur when cancer cells invade and cause an increase in irregular bone cells to form. The bone then becomes very dense (white on Xray). Osteolytic metastases occur when the cancer breaks down too much bone resulting in it being thinned/destroyed and weakened.

Spine

Knee replacement

Knee replacement (or knee arthroplasty) is a surgical procedure that is done to relieve the pain and restore the function of a knee joint which has been severely damaged by arthritis or a knee injury. During the operation the original joint is partly or completely removed and replaced with an artificial joint made of metal, plastic, and/or ceramic parts.

Knees

Hamartoma of the lungs and mediastinum

A hamartoma is the most common benign lung tumor. A hamartoma is slow growing and usually has a smooth edge. It forms as a disorganised collection of tissues which are usually found in the lung and can include fat, connective tissue and cartilage.

Lungs and mediastinum

Brain metastases

Brain metastases are formed by the spread of cancer from other organs to the brain. Metastatic spread is the most common cause of tumors in the brain.

Brain

Tumor of the lungs and mediastinum

A lung tumor is a descriptor for a lesion that has the risk of an aggressive malignancy in the lung. Lung cancer is the leading cause of cancer deaths in North America. Smokers are not the only ones at risk of lung cancer.

Lungs and mediastinum

Breast implants

After breast implant surgery, the body produces a fibrous tissue capsule around the saline or silicone implant. The implant itself can rupture, known as implant or intracapsular rupture, and the contents of the implant are contained by the body's fibrous capsule.

Extracapsular rupture can also occur where the implant contents extend through the fibrous tissue capsule and exit into the surrounding breast tissue.

The majority of ruptures are intracapsular and account for 85% of the detected cases. Due to the thickness of silicone, it does not freely infiltrate into the surrounding tissue, whereas saline does, but this is of no issue as it is naturally resorbed by the body. Breast implant ruptures have not be associated with cancer, reproductive issues or other conditions.

Breasts

Tumor of the bony skeleton and/or soft tissue

Bone tumors, or bone cancer, is a primary cancer that starts in the bone or cartilage.

These tumors may be benign, malignant, or indeterminant. The radiologist will give a likelihood of the type of tumor it is based on its imaging characteristics.

It is more common in children, adolescents and young adults. The most common types of malignant bone tumors in young adults is chondrosarcoma and osteosarcoma. Other non-cancerous types are osteoma,osteoclastoma (giant cell tumors) and osteochondroma. Rarer types of bone cancer are: fibrosarcoma, angiosarcoma, and undifferentiated high-grade pleomorphic sarcoma. The tumor can grown into the bone as well as neighbouring tissue. Most are called sarcomas.

A chondrosarcoma is the most common in adults. It originates in the cartilage. It is typically found in the long bones - humerus and femur. It is a slow growing cancer.

Osteosarcoma is second most common bone cancer in adults. It is most often found in the knees, tibia,and long bones. It can also be found in the hips and jaw in older adults.

Soft tissue tumors can also occur. These include: lipomas, fibromas, desmoid tumors, leiomyoma, leiomyosarcoma, schwannoma, liposarcoma, synovial sarcoma, and neurosarcoma.

Bony skeleton and soft tissue

Focal nodular hyperplasia

Focal nodular hyperplasia (FNH) is a benign regenerative tumor of the liver. It is the second most common abnormal liver mass after the hemangioma. FNHs rarely cause symptom.

Liver

Prior fracture of the sacroilliac joint

If a fracture has completely healed in normal position then there should be little evidence of it on MRI imaging. However, if a fracture doesn’t heal properly, ie not in normal original position (malunion) or if healing doesn’t occur within 6-9 months (non-union or pseudoarthrosis) there may be identifiable features on MRI.

Sacroiliac joints

Transitional cell carcinoma of the kidney

Transitional cell carcinoma of the kidney occurs in the renal pelvis. The renal pelvis is the center of the kidney where urine collects before travelling down the ureters to the bladder. The tissue that lines this area has cells called transitional cells. They are able to bend and stretch without being damaged. Transitional cell carcinoma forms in these cells.

Transitional cell carcinoma can be either high grade or low grade. Low grade is less likely to spread to other areas or have a recurrence. High grade is more likely to metastasize to other parts of the body, like lymph nodes, and has a higher chance of returning after treatment. The grading is assessed by a biopsy.

Transitional cell carcinoma can affect both males and females but most commonly affects males between the ages of 60-70 years old.

Kidneys

Beaver tail liver

A beaver tail liver is a normal variant of the liver anatomy where the left lobe of the liver extends laterally to contact or surround the spleen.

Liver

Multiple sclerosis/Demyelinating disease

Multiple sclerosis is a chronic demyelinating disease which involves the brain and less often, the spinal cord. It is the second most common cause of neurological impairment in young adults, second only to trauma.

The lesions can be present without symptoms though the diagnosis of multiple sclerosis requires an event of neurological symptoms to have occurred on more than one occasion.

Brain

Brain infarct

A brain infarct is a region of dead tissue in a portion of the brain as a result of the loss of oxygen and nutrients. It is the end result of blocked or narrowed feeding arteries.

If blood flow to a certain area in the brain is disrupted (condition also known as a stroke) for a long period of time (minutes) brain cells start to die leading to an infarcted area.

Brain

Duplex kidney

A duplex kidney is a normal finding that you are born with. It is where you have two separate collecting systems in a kidney instead of one and the drainage tube from the kidney (ureter) may also be partially or completeley duplicated.

There is a slight increase in likelihood of kidney stones (best seen by ultrasound or CT), as well as reflux of urine from the bladder, back into the kidney.

Kidneys

Total size of bladder

Urine enters the bladder via the ureters and exits via the urethra. Typically the bladder can hold 300 and 500 ml of urine comfortably for two to five hours. The bladder can be stretched considerably larger and bladder volumes as large as 6000ml have been reported in literature (idiopathic giant bladder). Normally the bladder needs to be emptied 6-8 times (250-500ml of urine each time) during a 24-hour period. Usually the urinating frequency is lower during the night. In cases where the urge to empty the bladder interferes with sleep you might suffer from a condition called nocturia.

When a person gets older bladder and urethral functions deteriorate. These changes might lead to more frequent bathroom visits. The bladder capacity itself rarely decreases during aging.

Bladder and ureters

Atrophied kidney

Atrophic kidney is when the kidney has shrunk to an abnormal size most likely due to chronic kidney disease/renal failure. This could be the result of other diseases that affect the body such as longstanding poorly controlled diabetes, chronic urinary tract infections, high blood pressure, heart disease, glomerulonephritis, or polycystic kidney disease.

Kidney athrophy can start to be seen by imaging if the kidney has been poorly functioning or been damaged for 3 consecutive month or more.

Atrophic kidney tends to affect the left kidney more often than right.

Kidneys

Congenital spinal canal narrowing

Congenital narrow spinal canal is where the front to back (or anteroposterior AP) dimension of the canal in the vertebral bone where the spinal cord is situated is narrow.

Spine

Prostatitis

Prostatitis is the inflammation of the prostate gland. It is usually occurs as a response to an infection. This inflammation causes swelling of the prostate gland which in turn can affect urination.

Prostate and male reproductive organs

Indeterminant lesion of the spinal cord

An indeterminant tumor of the spinal cord can potentially be a benign or a malignant lesion. Unfortunately we are unable to determine the exact nature of the lesion from this scan.

Spine

Ovary appearance

Absent or not visible ovaries could be due to a few different conditions:

  • As females age and progress through menopause the ovaries shrink and become hard to visualize. In a postmenopausal woman this non-visualization of the ovary is common as the ovaries shrink to the size of a raisin.
  • A congenital malformation where the ovary and fallopian tube never developed, this a rare condition.
  • The ovary or ovaries were surgically removed.

Ovaries

Lymphoma in the nasal pharynx

Lymphoma is a cancer which arises in the lymphocytes or lymphoblasts. Lymphoma can arise from, or spread to any of the glands and organs throughout the nasopharyngeal tissues (nasal passages) of the skull base and neck (and many other locations within the body).

Nasal pharynx

Bone marrow edema of the spine

Bone marrow is a semi-solid tissue which is found within the spongy or cancellous portions of bone. It is responsible for the production of new blood cells. Bone marrow edema is the term used when there is a fluid collection within the bone marrow. It is usually present when there is an underlying condition affecting the bone. Conditions can include: trauma, fracture, arthropathy, hypoperfusion, infection, post-operative changes, chemotherapy, bone metastases, or arthritis.

Spine

Knee hemangioma

A bony hemangioma can often be referred to as a few other names, primary intraosseous hemangioma or vascular hamartoma. A hemangioma is a benign vascular malformation that occurs when blood vessels multiply at an abnormal rate. They most commonly occur in the skull and the spine but they can form in any body part. Capillary and cavernous hemangiomas are the most common type of hemangioma to affect bones. The can occur on the surface of the bone or deeper. Often hemangiomas are asymptomatic and are found incidentally on an xray or MRI.

Knees

Muscle tear of the shoulder

A muscle tear is an acute or chronic soft tissue injury that occurs to muscle. The muscle becomes overstretched and receives more physical stress than it can handle. The tears can occur partially or completely. Acute tears tend to happen with recent trauma or injury whereas chronic tears are related to repetitive movement over a long period of time.

Muscle tears are classified by degree of severity: first degree (mildest - some tearing still with full range of motion), second degree (moderate - torn, painful with limited motion) and third degree (severe - torn with limited or no movement).

In the shoulder there are multiple muscles that can be torn: supraspinatus, infraspinatus, subscapularis, teres minor, and deltoid.

Shoulders

Uterine fibroid

Uterine fibroids are also known as uterine leiomyomas. They are benign smooth muscle(myometrial origin) tumours of the uterus. They are the most common solid benign uterine neoplasm. Rarely do fibroids turn into a malignant tumour.

Fibroids are commonly found incidentally on examinations for other reasons, occur during childbearing years. The size of fibroids can range from millimeters to large bulky masses. In some cases, they can grow large enough to extend up into the upper abdominal cavity.

There are different types of fibroids depending on whether the location is in or on the uterus. The different types are:

  • Intramural: most common type. They are located within the muscular wall of the uterus
  • Subserosal: these are formed outside the uterus
  • Pedunculated: a subserosal fibroid that has a stem that supports the fibroid
  • Submucosal: least common. These develop in the middle muscle layer (myometrium)

Uterus

Splenic cyst

Splenic cysts are benign, most often congenital (from birth) organized clusters of cells which create a fluid filled pouch. They typically grow slowly if at all.

Spleen

Renal leiomyoma

A renal leiomyoma is a benign tumour of the kidney. It is made of smooth muscle tissue. They can occur both in the renal cortex (outer part) and medulla (inner part) of the kidney. They usually have a distinct capsule and rarely have cystic or calcified portions. They can grow in size anywhere from 0.5cm up to 57cm.

Most people experience no symptoms of a renal leiomyoma and it is discovered incidentally during examinations for another reason.

Kidneys

Solid thyroid mass

A solid thyroid mass has a high risk of being malignant, based on the irregular features of the thyroid gland. This will require further evaluation and workup as unfortunately we are unable to determine the exact nature of a thyroid lesion from a single scan.

Thyroid

Indeterminant cystic lesion of the kidney

An indeterminate cystic kidney lesion is a fluid containing lesion with uncharacterized tissue that we cannot evaluate because it has properties such as size (too small), or other features that we cannot classify. Unfortunately at this time we are unable to determine the exact nature of the lesion from this scan. Prior imaging or history is valuable to assess stability or interval change.

The causes of cystic kidney lesions is broad but does include malignant potential, thus it is important to follow these lesions to determine if the tissue evolves into a concerning lesion.

Kidneys

Cyst of the oral pharynx

Simple cysts are fluid-filled sacs that can form in any of the soft tissues of the neck. Simple cysts usually do not cause symptoms or harm the function of the tissue. Treatment is not needed for simple cysts that do not cause any symptoms.

Oral pharynx

Adrenal hemorrhage/calcification

Adrenal hemorrhage can be caused by both traumatic and non-traumatic causes. It can affect one or both adrenal glands.

Trauma most commonly affects just one adrenal gland. Usually, when just one adrenal is affected, there are no clinical or biochemical signs of adrenal hormone disfunction as the other normal gland is able to compensate. Therefore, it is commonly diagnosed incidentally. Most commonly the findings of an old adrenal hemorrhage are detected and appear as coarse calcification from the hemorrhagic incident. MRI does not directly see calcification well, thus the findings of an old adrenal hemorrhage is only seen when calcification is coarse and bulky.

When both adrenal glands are affected, symptoms are often severe, leading to coma and death if steroid replacement therapy is not administered almost immediately. The most common cause of bilateral adrenal hemorrhage is inferior vena cava and bilateral adrenal vein thrombosis.

Adrenals

Shrunken liver

Shrunken liver is the reduction in size of the liver with the liver tissue being fibrotic and scarred (cirrhosis). This is an indicator that the liver has lost its ability to regenerate. This is usually due to chronic liver disease which leaads to cirrhosis.

The normal liver size is 10-12cm x 20-23cm.

Liver

Bone cyst of the spine

Simple bone cysts are cavities that form in the bone which are filled with fluid. The cysts are usually small and asymptomatic.

Spine

Hepatic adenoma

A hepatic adenoma, also known as a hepatocellular adenoma, is a rare, benign liver lesion. They have been linked to increased estrogen levels, which includes women who take estrogen containing oral contraceptives. They have also been linked to metabolic syndrome (including diabetes) as well as steroid use.

Hepatic adenomas are usually asymptomatic. If they rupture (hemorrhagic) then there is a greater likelihood for abdominal pain and internal bleeding.

Large hepatic adenomas are also at risk for degeneration into hepatocellular carcinoma, and thus changing causation factors and monitoring is important.

Liver

Indeterminant nodule of the nasal pharynx

A nodule in the soft tissues of the nasal passages (nasopharynx) describe a lesion which cannot be adequately described by imaging as it is generally too small to be able to be characterized as benign or potentially malignant. Unfortunately we are unable to determine the exact nature of the lesion from a single MRI scan. A clear medical history may provide valuable insight into the lesion.

Nasal pharynx

Hemangioma of the bony skeleton

A hemangioma is a benign vascular malformation that occurs when blood vessels multiply at an abnormal rate. They most commonly occur in the skull and the spine but they can form in any body part.

A bony hemangioma can often be referred to by a few other names, primary intraosseous hemangioma or vascular hamartoma.

Capillary and cavernous hemangiomas are the most common type of hemangioma to affect bones. They can occur on the surface of the bone or deeper, or in the soft tissues. Often hemangiomas are asymptomatic and are found incidentally on an xray or MRI.

Bony skeleton and soft tissue

Atelectasis

Atelectasis is the partial or complete collapse of part or all of a lung. Atelectasis occurs when the tiny air sacs within the lung become deflated or filled with fluid. It occurs secondary to either something within the lung, or external to the lung compressing the structures. Atelectasis causes decreased blood flowing through the segment of the affected lung.

Lungs and mediastinum

Indeterminant cystic lesion of the nasal pharynx

A cystic lesion of the soft tissues of the neck may be benign or could potentially be malignant. Statistically, cystic lesions are less likely to be malignant than solid tumors. Unfortunately it is not possible to determine the exact nature of the lesion from a single MRI scan.

Nasal pharynx

Marburg variant of multiple sclerosis

Multiple sclerosis is a chronic demyelinating disease which involves the brain and less often, the spinal cord. It is the second most common cause of neurological impairment in young adults, second only to trauma.

The Marburg variant is characterized by a sudden onset of severe symptoms. For this reason, it is highly likely you are aware you have this condition.

Brain

Rheumatoid arthritis

Rheumatoid arthritis (RA) is an inflammatory disease that can affect multiple joints in the body. The immune system fails to function properly and attacks the linings of joints. RA can affect other parts of the body, including the nerves, skin, lungs, eyes and heart. It can have a gradual progression or come on abruptly. Diagnosis of rheumatoid arthritis requires a combination of multiple blood tests, imaging and physical examination.

Sacroiliac joints

Mucosal thickening

Mucosal thickening is a nonspecific finding. It describes the appearance of an asymmetry of the bowel wall where a focal area appears thicker than the remaining bowel. Mucosal thickening is potentially due to a benign or a malignant process. Imaging obtained without distending the bowel can show these asymmetric regions of thickening, which can be exacerbated by underlying conditions such as diverticular disease, an inflammatory bowl disease (Crohn's, ulcerative colitis) etc. This thickening can mimic an underlying colon cancer. This is why direct visualization of the colon (ie colonoscopy) remains the best method to evaluate the bowel, and most importantly exclude the presence of colon cancer.

Bowel

Ovarian tumor

Ovarian cancer is the fifth most common cancer affecting women. It accounts for approximately 6% of female malignancies. There are numerous types of tumours that can affect the ovaries.

The cancer can start in the ovary’s germ cells, stromal cells or epithelial cells. Germ cells are the cells inside the ovary that develop into eggs, stromal cells make up the inner part of the ovary and the epithelial cells are the outer layer. Epithelial cell carcinoma is the most common type of ovarian cancer. It accounts for approximately 85-89% of ovarian cancers.

Ovaries

Polycystic liver disease

Polycystic liver disease (PLD) describes the presence of multiple cysts scattered throughout the liver. There are two genetic variants of PLD. One is genetically linked to polycystic kidney disease and Caroli disease. The other is isolated polycystic liver disease, in which there is no association with polycystic disease of other organs.

Liver

Lymphoma in the thyroid

Lymphoma is a cancer which arises in the lymphocytes or lymphoblasts. Lymphoma can arise from, or spread to any of the glands and organs throughout the soft tissues of the neck (and many other locations within the body).

Thyroid

Hemorrhagic cyst of the thyroid

Hemorrhagic cysts are lesions which have had an episode of bleeding (hemorrhage) within the tissue. This is a finding that is often associated with the thyroid, but can occur in other soft tissues of the neck. When the hemorrhage occurs, it is often associated with an immediate onset of pain and other symptoms.

Thyroid

Reactive or inflammatory lymph nodes of the neck

Reactive or inflammatory lymph nodes are a relatively common finding in the neck. These may be present due to something as benign as a recent cold, or can be due to local infection such as tonsillitis, or a systemic autoimmune disorder such as lupus.

Cervical lymph node chain

Adenomyomatosis

Adenomyomatosis is benign thickening of the gallbladder wall which can occur normally or as residua of an inflamed gallbladder (cholecystitis).

Gallbladder and biliary system

Lung metastases

Lung metastases are formed by the spread of cancer from other organs to the lung(s). The lung receives and oxygenates the blood flow from the body via the right side of the heart, and as a result of this, there is risk of tumor from the body spreading via the blood (hematogenous) to the lungs.

Lungs and mediastinum

Cyst in the hypopharynx

Simple cysts are abnormal, fluid-filled sacs that can form in any of the soft tissues of the neck. Simple cysts usually do not cause symptoms or harm the function of the tissue.

Hypopharynx

Enterocele

An enterocele is when the small intestine herniates down into the vaginal passage, usually between the posterior wall of the vagina and the rectum.

Uterus

Enteritis

Enteritis is the general term used for inflammation of the small bowel. If the stomach is also involved, then the term gastroenteritis is used. This is most commonly the result of a transient infection. In its simple form it is commonly referred to as “a gastro bug” or the “stomach flu” (though it is not related to the flu). Common causes are infection, inflammatory bowel disease and radiation.

Bowel

Narrowed Airway

A narrowed airway is a mostly benign condition where the distance behind the tongue and soft palate is narrowed. This occurs more commonly when in the supine position (laying on back). Therefore the Prenuvo scan can diagnose this condition. A narrowed airway can be associated with snoring and sleep apnea (OSA).

Oral pharynx

Urachal remnant

Urachal remnant anomalies are a range of anomalies that occur when the fetal urachus does not disappear after birth. The urachus is a hollow structure that connects the top of the bladder to the umbilicus (belly button) during fetal development. By the time birth occurs it changes from the urachus to the median umbilical ligament and should close off, sometimes leaving a remnant or it just completeley disappears.

If the urachal remnant doesn’t completely close then the urachus can be left open giving a urachal anomaly.

There are four types of anomalies: patent urachus (fistula), urachal cyst, umbilical-urachal sinus, and vesicourachal diverticulum. The most common (approx. 50%), patent urachus, is when the path between the bladder and umbilicus has not completely closed. The second most common (approx 30%), urachal cyst, is a dilatation of the mid urachus filled with fluid. Third most common (approx. 15%), umbilical-urachal sinus, is a dilatation/outpouching at the umbilical end of the urachus. Finally, the least common (approx. 5%), vesicourachal diverticulum, is a dilatation/pouch at the bladder end of the urachus.

There is an increased risk of developing an adenocarcinoma from a urachal remnant.

Bladder and ureters

Uterine cystocele

Uterus

Diminutive Thyroid

”Diminutive” is the word used instead of “small” in medicine. A small thyroid is not an imaging based abnormality, but is a possible indicator of an underlying pathology, with thyroid gland function best checked by blood tests.

Thyroid

Indeterminant solid mass of the oral pharynx

A solid mass of the soft tissues of the neck may be benign or could potentially be malignant. As a general rule, the more solid a tumor is, the greater the probability it is malignant. Statistically, greater than 50% of solid tumors are benign. Unfortunately it is not possible to determine the exact nature of a nodule from a single MRI scan.

Oral pharynx

Effusion of the shoulder

A joint effusion is an abnormal collection of fluid located in the joint space. It is commonly referred to as a 'swollen joint'

Shoulders

Intraductal papillary mucinous neoplasm

Intraductal papillary mucinous neoplasm (IPMN) is a benign type of tumor which originates within the pancreatic duct. As their name implies, these tumors excrete mucus, which in turn can create cysts within the pancreas/pancreatic ducts.

As an IPMN can at any stage evolve to pancreatic cancer, it is known as a precancerous condition. Therefore monitoring or preemptive surgery are options with an IPMN.

Pancreas

Conus level

The conus is the level of the bottom end of the spinal cord before it separates into individual nerves.

Spine

Adrenal metastases

Adrenal metastases are most commonly associated with lung, small and large bowel, breast and pancreatic cancer. Usually when there is metastatic disease of the adrenals, it affects both adrenal glands. Occasionally metastatic disease can be one sided.

Adrenals

Developmental venous anomaly

Developmental venous anomaly (DVA) is a congenital malformation of veins which drain blood from the normal brain. They were thought to be rare before cross-sectional imaging but are now recognised as being the most common cerebral vascular malformation, accounting for ~55% of all vascular lesions.

Brain

Bone cyst of the ankle

There are three types of bone cysts: traumatic bone cyst, aneurysmal bone cyst and unicameral bone cyst. They are benign are do not spread to other parts of the body.

Traumatic bone cysts tend to occur in the jaw and facial bones after trauma.

Aneurysmal bone cysts (ABC) are typically found in children and adolescents They are composed of numerous blood-filled channels which creates an expanded lesion within the bone. The cause of these are unknown.

Unicameral bone cysts (simple bone cysts) are cysts or cavities that form in the bone and are filled with fluid. They are considered latent or active depending on their location. Active bone cysts are located near the epiphyseal (growth) plate and will continue to grow until it fills the entire diaphysis (shaft). Latent cysts are located away from the epiphyseal plate and will heal with treatment or resolve on their own.

Ankles

Enlargement of the lymph nodes in the neck

The enlargement of a gland is not always a pathology problem, but is a possible indicator of an underlying problem as the lymph nodes are filters of fluid in the head and neck region.

Cervical lymph node chain

Biliary cystadenocarcinoma

Biliary cystadenocarcinomas are when the benign biliary cysts in the liver transform into a malignant condition. Imaging and other routine tests are unable to tell when this occurs, particularly if no baseline imaging study of the liver is available.

Biliary cysts arise from cells in the bile ducts.

Liver

Gastrointestinal stromal tumor (GIST)

A gastrointestinal stromal tumor (GIST) is a tumor which develops from interstitial cells of Cajal anywhere within the gastrointestinal tract from cells which regulate movement of food through the gastrointestinal system.

They form a rounded soft tissue mass that are often large at diagnosis and have potential to metastasize.

Esophagus

Ovarian teratoma

An ovarian teratoma is a benign congenital germ cell tumour. Teratomas contain elements from all three embryological layers: endoderm, mesoderm and ectoderm. They contain different tissue types, including, fat, cystic fluid, skin, soft tissues, hair and sometimes calcification including teeth.

Ovaries

Soft tissue edema

Soft tissue edema is the accumulation of fluid within the supporting tissues around the bones of the spine.

The most common cause of soft tissue edema is traumatic or overuse injury. Within the spine it can occur between the bones of the spinous processes of the vertebrae (interspinous), it can occur within a muscle, or a set of muscles adjacent to the vertebrae (paraspinal), or it can occur within the subcutaneous layers of the lower back.

Spine

Gastrointestinal stromal tumor (GIST)

A gastrointestinal stromal tumor (GIST) is a tumor which develops from connective tissue cells in the stomach which regulate movement of food through the gastrointestinal system. These abnormal cells form a rounded soft tissue mass that quite often are often large at the time of diagnosis, with GIST having malignant potential.

The stomach, like all of the hollow viscous of the mouth through to anus is best assessed by direct visualization as these tissues are too mobile and flexible for imaging to be useful for early detection. The added benefit of direct visualization (gastroscopy/endoscopy), is if suspicious tissue is identified, it can be biopsied at the time of visualization.

Stomach

Uterine position

The uterus position in the pelvis can vary based on a number of known factors, mainly the degree of distention of the bladder and rectum. The most common position of the uterus is anteverted and anteflexed where the fundus (top of the uterus) is pointing towards the abdomenal wall. As the bladder fills, the uterus tilts upward because of the bladder below it lifting it up. The described uterine locations include:

Anteverted/anteflexed: cervix angles forwards and the uterus is pointing forward towards the abdominal wall (most common position)

Retroverted: uterus is tipped backwards pointing towards the spine.

Hyperanteflexion: the uterus is tipped too far forwards

Absent: The uterus is not present; usually due to surgery (hysterectomy) or rarely congenital malformation (agenesis)

Uterus

Indeterminant lesion of the bladder and ureters

An indeterminant lesion of the bladder and urethers can potentially be a benign or a malignant lesion. Unfortunately we are unable to determine the exact nature of the lesion by imaging.

Bladder and ureters

Hydronephrosis

Hydronephrosis is the swelling/enlargement of a kidney due to the backup of urine. It happens when urine cannot drain out from the kidney to the ureters down to the bladder due to a blockage or obstruction. Hydronephrosis can occur in one or both kidneys.

Hydronephrosis is not a disease itself but occurs when there is either an obstruction of the outflow of urine, or reverse flow of urine already in the bladder (called vesicoureteral reflux). It is a manifestation of a present or previous underlying cause.

Kidneys

Fatty infiltration of the pancreas

Fatty infiltration of the pancreas is most often associated with obesity and aging. Outside of the causal factors, fatty infiltration is a benign condition.

Pancreas

Pelvis and hips metastases

Bone metastases or osseous metastatic disease are cancerous lesions that result from spread of another primary cancer (a cancer somewhere else in the body). They are more common than primary bone cancer. Some of the most common cancers to spread to bones are: breast, prostate, lung, kidney and thyroid.

Metastatic disease affects the regular process of decay and growth of bone. As a result the structure of the bone changes. There are two type of bone metastases, osteoblastic metastases and osteolytic metastases. Osteoblastic (sclerotic) metastases occur when cancer cells invade and cause too many bone cells to form. The bone then becomes very dense. Osteolytic metastases occur when the cancer breaks down too much bone resulting in it being destroyed and weakened. The former is the more common type.

Pelvis and hips

Polycystic ovary

Polycystic ovaries is an abnormally high number (more than 12) of visible follicles in the ovaries. It is referred to as polycystic ovarian morphology (PCOM). This can also cause the ovaries to appear large in size

This condition is associated with polycystic ovary syndrome (PCOS) but is not the only criteria required or necessary to be diagnosed. Polycystic ovary syndrome requires two out of three criteria for diagnosis. The three criteria are: infrequent or absent periods, high levels of androgens (male hormones) or polycystic morphology. Imaging alone cannot diagnose PCOS.

Ovaries

Prostate cancer

Prostate cancer is one of the most common types of cancer in men. Prostate cancer is usually slow growing and the goal is to identify cancer confined to the prostate gland at diagnosis. Aggressive forms of prostate cancer spread outside of the prostate gland to involve the seminal vessicles, pelvic lymph nodes, paraspinal lymph nodes (Batson's plexus) and eventually bone.

Imaging is useful for identifying prostate cancer, but the aggressiveness is best identified by biopsy giving a Gleason grade. MRI can give an estimation of risk of aggresiveness by the tissue properties (single exam Pi-RADS) and with multiple exams using growth rate over time (watchful waiting) with watchful waiting performed in conjunction with serial blood testing (PSA, PCA3 etc.).

Prostate and male reproductive organs

Acoustic schwannoma

An acoustic schwannoma is a benign tumor that develops around a nerve in the inner ear. This tumor grows around and compresses either the auditory (cochlear -for hearing) or vestibular (for balance) nerves leading from your ear to the brain

The Prenuvo scan is not intended to look at individual nerves of the central nervous system, thus this finding (if present) represents a large mass lesion.

Brain

Indeterminant fat-containing kidney lesion

An indeterminant fat-containing kidney lesion is rarely related to malignancy. However if the lesion has properties such as size (too small), or you have a history of prior kidney issues, we may put a lesion in this category as to ensure appropriate characterization occurs, as there are rare conditions where the kindney contains fat and malignancy can occur. Unfortunately at this time we are unable to determine the exact nature of the lesion from this scan.

Kidneys

Indeterminant bone lesion of the spine

An indeterminant bone lesion of the spine can potentially be a benign or a malignant lesion. Unfortunately we are unable to determine the exact nature of the lesion from this scan.

Spine

Hip impingement

Impingement is the narrowed space and increased pressure of a joint which is accentuated when in motion. It is a relatively common finding which most commonly affects the shoulder and hip. Impingement occurs when inflammation causes the tendons, muscles, or bones to push into the bursa or against each other.

Pelvis and hips

Bladder polyp

Bladder polyps are abnormal, protruding tissue growths that can occur in the lining(mucous membrane) of the bladder wall. Polyps can be both benign (non-cancerous) and malignant (cancerous). Imaging cannot determine if a polyp is benign or malignant, and thus direct visualization (cystoscopy) of the polyp is needed for further characterization.

Bladder and ureters

Bladder obstruction

Bladder obstruction is a condition where the urine flow from bladder to urethra is reduced or completely blocked. In men, this is often linked to prostate hyperplasia. Other common causes include stricture, scarring, and bladder stones. If the cause is not treated the obstruction may lead to other bladder or kidney problems.

Bladder and ureters

Small vessel ischemia

Small vessel ischemia is the term used to describe the changes which occur by disrupting the small blood vessels in the brain and is a direct sign of poor cardiovascular health.

Mild or patchy small vessel ischemia is a fairly common finding in patients over the age of 60.

Brain

Bone metastases

Metastatic disease affect the regular process of decay and growth of bone. As a result the structure of the bone changes. There are two type of bone metastases, osteoblastic metastases and osteolytic metastases. Osteoblastic (sclerotic) metastases occur when cancer cells invade and cause too many bone cells to form. The bone then becomes very dense. Osteolytic metastases occur when the cancer breaks down too much bone resulting in it being destroyed and weakened. The former is the more common type.

Bone metastases or osseous metastatic disease are cancerous lesions that result from spread of another primary cancer (a cancer somewhere else in the body). They are more common than primary bone cancer. Some of the most common cancers to spread to bones are: breast, prostate, lung, kidney and thyroid.

Bony skeleton and soft tissue

Ulcerative colitis

Ulcerative colitis is a condition that results in inflammation and ulceration of the large bowel wall. This usually starts distally in the bowel wall. There is no obvious cause and no definite cure beyond surgery, however symptom management options are available.

Bowel

Mucosal thickening

Mucosal thickening is a nonspecific finding. It describes the appearance of an asymmetry of the esophagus where an area of the wall of the esophagus appears thicker than the rest of the esophagus. This can be due to repeated irritation and is a risk factor for developing cancer.

MRI is not well suited to look at the esophagus because the normal esophagus is constricted (to prevent acid/food reflux), thus identifying this region of thickening is concerning as most often as imaging (ie CT, or MRI) does not detect the earliest signs of esophageal cancer.

Esophagus

Indeterminate lesion of the lung

An indeterminant lesion of the lung can potentially be a benign or a malignant lesion. Unfortunately we are unable to determine the exact nature of the lesion from this scan.

Lungs and mediastinum

Adrenal cortical carcinoma

Adrenal cortical carcinoma is a very rare but aggressive form of cancer which originates in the outer layer (cortex) of the adrenal gland. It can be hormonally active, and then cause an increase in hormone production, or hormonally inactive, where it maintains normal hormone production.

Adrenals

Hemorrhagic ovarian cyst

A hemorrhagic ovarian cyst is a fluid filled sac within the ovary which has some blood components. Most ovarian cysts that occur during childbearing age are benign and harmless. However, only time can be used to separate benign causes from concerning pathologic causes of blood in an ovarian cyst.

Ovaries

Spondyloarthropathy of the lumbar spine

Spondyloarthropathy is the medical term for degenerative arthritis in the spine. In the lumbar spine this includes all of the bony facet joints and discs of the back.

Spine

Bowel polyp

A polyp of the bowel is a fleshy outgrowth into the bowel from the bowel wall. They can be either benign (hyperplastic), premalignant (adenoma) or malignant (adenocarcinoma). There is no way of knowing which type of polyp it is, which is why, as a general rule they are all removed on colonoscopy and assessed pathologically under the microscope.

Imaging is unable to adequately assess polyps, which is why colonoscopy for screening is important. A generalization for polyps and risk of malignancy is:

  • A polyp less than 1cm has a 1% risk of cancer.
  • A polyp that is 1-2cm has a 10% risk of cancer.
  • A polyp greater than 2cm has a 50% risk of cancer.

Bowel

Pansinusitis

Pansinusitis is the term used to describe sinusitis affecting all of the sinuses of the head at the same time.

Sinuses and mastoids

Muscle tear of the knee

A muscle tear is an acute or chronic soft tissue injury that occurs to muscle. The muscle becomes overstretched and receives more physical stress than it can handle. The tears can occur partially or completely. Acute tears tend to happen with recent trauma or injury whereas chronic tears are related to repetitive movement over a long period of time.

Muscle tears are classified by degree of severity: first degree (mildest - some tearing still with full range of motion), second degree (moderate - torn, painful with limited motion) and third degree (severe - torn with limited or no movement).

In the knee there are multiple muscles that can be torn: quadriceps femoris, biceps femoris, hamstring, gastrocnemius, tensor fasciae latae, rectus femoris, vastus lateralis, triceps surae, vastus medialis, popliteus, gluteus medius, soleus, and articularis genus.

Knees

Simple cyst of the liver

Simple liver cysts are fluid-filled sacs that form in the liver. Often cysts are single, though some people develop multiple cysts. Simple liver cysts usually do not cause symptoms or harm the function of the liver. Treatment is not needed for simple liver cysts that do not cause any symptoms.

Liver

Ankle metastases

Bone metastases or osseous metastatic disease are cancerous lesions that the result of spread from another primary cancer (a cancer somewhere else in the body). They are more common than primary bone cancer. Some of the most common cancers to spread to bones are: breast, prostate, lung, kidney and thyroid.

Metastatic disease affect the regular routine process of bone turnover. As a result, the structure of bone changes. There are two type of bone metastases, osteoblastic metastases and osteolytic metastases. Osteoblastic(sclerotic) metastases occur when cancer cells invade and cause too many bone cells to form. The bone then becomes very dense. Osteolytic metastases occur when the cancer breaks down too much bone resulting in the bone being destroyed and weakened. The former is the more common type.

Ankles

Simple cyst of kidney

Simple kidney cysts are fluid-filled sacs that form in the kidneys. Simple kidney cysts usually do not cause symptoms or harm the kidneys. Most simple kidney cysts are found during imaging tests done for other reasons. Treatment is rarely, if ever, needed for simple kidney cysts.

Extremely rarely do simple kidney cysts transform into tumors. This potential can be re-evaluated on your next Prenuvo scan.

It is quite common that kidney cysts change size over time.

Kidneys

Accessory spleen

An accessory spleen (also known as splenunculus or a splenule) is a small nodule of splenic tissue which is not connected to the rest of the spleen. They are benign and asymptomatic.

Spleen

Random white spots

These are small (less than 5mm) white spots seen in the white matter of the brain. This finding is relatively common in people over the age of 30 and the number of spots can increase slowly (if at all) with aging. These are generally asymptomatic, although in some people there is a slight correlation to migraine. The exact cause of these cannot be determined but they may relate to changes in small blood vessels in the white matter of the brain or they can be from an old injury.

Brain

Indeterminant cystic lesion of the pancreas

An indeterminant cystic lesion of the pancreas can potentially be a benign or a malignant lesion. Unfortunately we are unable to determine the exact nature of the lesion based on its current size and tissue composition.

If you have prior imaging of the abdomen available, a comparison to assess for change in the interval would be helpful.

Pancreas

Spinal cord metastases

The spinal cord (intramedullary metastasis) and CSF space (leptomeningeal metastastis) are rare, but possible locations for cancer to spread to. These locations are rarely affected early in the disease unless from a CNS cause and can be difficult to visualize by imaging unless large.

Spine

Bursitis of the pelvis and hips

A bursa is a fluid-filled sac that cushion and lubricates bones and tendons when they move. The body is comprised of over 150 bursae. Bursitis is an inflamed or swollen bursa. In the pelvis and hip region there are twenty bursae.

The bursae commonly affected are:

  • Iliopsoas bursa: largest bursa of the body and beneath iliopsoas, beside the pectineus muscle and the ASIS
  • Subgluteus bursa: also known as the greater trochanteric bursa, located between the greater trochanter and gluteus maximus tendon
  • Ischiogluteal bursa: sits between the gluteus maximus and ischial tuberosity
  • Gluteofemoral bursa: sits deep next to the iliotibial band and tensor fascia lata distal to the greater trochanteric bursa
  • Subgluteus medius bursa: sits deep to the tendon at the superior end of the lateral facet
  • Subgluteus minimus bursa: lies beneath the minimus tendon at the anterior facet
  • Ischiofemoral bursa: sits between quadratus femoris and ischium of the lesser trochanter
  • Obturator internus bursa: lies between the internus muscle and ischium
  • Obturator externus bursa: lies between the tendon and the ischiofemoral capsular ligaments

Pelvis and hips

Indeterminant solid kidney lesion

An indeterminate solid kidney lesion is a non fluid filled lesion with uncharacterized tissue that we cannot evaluate because it has properties such as size (too small), or other features that we cannot classify. Unfortunately at this time we are unable to determine the exact nature of the lesion from this scan. Prior imaging or history is valuable to assess stability or interval change.

The causes of solid kidney lesions is broad but does include malignant potential, thus it is important to follow these lesions to determine if the tissue evolves into a concerning lesion.

Kidneys

Cancer of the bladder and ureters

Transitional cell carcinoma, also known as urothelial carcinoma, is a malignant type of cancer that is found in the inside lining (the urothelium), of the bladder and or ureters. It is the most common type of bladder cancer. The earliest form of transitional cell cancer is identified by cystoscopy (a scope in the bladder), whereas the Prenuvo scan will find larger tumors projecting into the bladder.

Bladder and ureters

Iron deposition

Iron deposition, (which leads to iron overload, or hemochromatosis) is a condition in which the liver accumulates and stores a higher than normal amount of iron. The most common causes are hereditary hemochromatosis, and transfusional iron overload from repeated blood transfusions. The heart (not assessed on this Prenuvo scan) can also be affected by this condition.

Liver

Granuloma of the inner ear or mastoid air cells

Granulomas can occur in the mastoid air cells as well as the middle ear. They are a nodular inflammatory lesion which is formed from granulation tissue. On some occasions granulomas can progress to bleeding and are a common cause for bleeding into the eardrum seen by otoscopy (looking in the ear).

Sinuses and mastoids

Pre-kidney stone / proteinaceous cyst

Before kidney stones become solid, they appear as a protein and calcium filled cystic structure. This dense cyst has the potential to become either a kidney stone, or disintegrate by dilution.

Kidneys

Bone marrow edema of the knee

Bone marrow is a semi-solid tissue which is found within the spongy or cancellous portions of bone. It is responsible for the production of new blood cells. Bone marrow edema is the term used when there is a fluid collection within the bone marrow. It is usually presence when there is an underlying condition. Conditions it could be related to can include: trauma (bone bruise), microtrabecular fracture, arthropathy, decreased blood flow, infection, post-operative changes, chemotherapy, bone metastases, or arthritis.

Knees

Prostate appearance

Prostate and male reproductive organs

Indeterminant gastic lesion

We have detected a lesion in your stomach. Unfortunately we cannot determine the exact nature of the lesion. This is often due to the fact that the stomach shape and contents change based on how much liquids or solid food is present within the stomach.

Stomach

Benign prostatic hyperplasia (BPH)

Benign prostatic hyperplasia (BPH) is the benign enlargement of the prostate. It is caused by the overgrowth of cells usually in the central or transitional zone of the prostate. This causes compression of the urethra, which impacts urine flow from the bladder.

Prostate and male reproductive organs

Nabothian cyst

A nabothian cyst is a mucus-filled cyst on the surface of the cervix. The mucus, which can be pale yellow to amber in colour, is secreted from the cervical glands. Nabothian cysts are also known as cervical cysts, mucinous retention cysts, or epithelial cysts. There are a benign finding and fairly common finding. They can range from a few millimeters to as large as four centimeters in diameter.

Uterus

Osteitis condensans ilii

Osteitis condensans ilii is a benign sclerosis/increased density of the ilium adjacent to the SI joint. The ilium is the pelvic portion of the SI joint. It typically occurs bilaterally and has a triangular shape.

Sacroiliac joints

Bowel lymphoma

Lymphoma can be found throughout the gastrointestinal tract, with the small bowel being the most common site. The bowel is usually a secondary site for lymphoma to spread to, not a primary (starting) location. However if the bowel is the primary site for lymphoma, it is usually associated with other conditions such as in patients with HIV/AIDS, celiac disease or patients who have had an organ transplant.

Bowel

Metastases of the oral pharynx

Metastatic disease of the soft tissues of the neck occurs when cancer spreads from another location in the body and seeds in the neck tissues. The seeding can occur in glands, organs, muscles or lymph nodes of the neck. It can also spread by infiltrating through tissue or through lymphatics.

Oral pharynx

Biliary cancer

There are two forms of biliary cancer which are closely related based on where the cancer originates, either in the gallbladder or the bile ducts (cholangiocarcinoma). These cancers can be difficult to diagnose due to the small initial size of the earliest imaging detectable lesions (~4mm in thickness), however there are good outcomes with early diagnosis. Unfortunately if diagnosed late, once symptomatic, outcomes are much poorer.

Due to the subtle imaging changes that develop early on when asymptomatic and with normal blood tests, it is important to monitor the bile ducts routinely to see if or how they change over time, as the speed of this type of cancer development is unknown.

Gallbladder and biliary system

Breast cancer

Breast cancer is the most common type of cancer to affect women. It can also occur in men.

Breast cancer starts within abnormal cells that multiply uncontrollably. Breast cancer can also spread (metastasize) to other parts of the body. There are different types of cancer which can be categorized based on where they occur.

  • Ductal carcinoma: occurs in the lining of the ducts which carry milk from the glands to the nipples.
  • Lobular carcinoma: occurs in the lobules, glands where the milk is made.
  • Some less common types of cancer are: inflammatory breast cancer, Paget disease and triple negative breast cancer.

The earliest stage of breast cancer is called 'in situ' which means the cancer is still located in its original location and has not grown into surrounding tissue. This earliest form can be identified by microcalcifications seen on mammography. Invasive is the term that is used when the cancer has spread into its surrounding tissues.

MRI does not detect calcification which is why mammography is an important standardized tool to use in addition to the Prenuvo scan to screen for calcifications and tissue distortion associated with breast cancer.

Breasts

Absent kidney

Absent kidney can be due to surgical removal (nephrectomy), or it can also occur genetically and is then called renal agenesis.

Renal agenesis is a condition when the kidney never formed during fetal development. Agenesis is usually unilateral and is not a major health concern as long as the other kidney is healthy. It is usually detected during prenatal ultrasounds. Bilateral agenesis is rare and would be detected prenatally or at birth.

Kidneys

C section scar

There are two incisions made when having a c section. The first is a vertical or horizontal incision at the front of the pelvis centred below the navel. The other is an incision into the uterus to remove the baby. It is the healed appearance of the uterine incision which the report is referring to.

Uterus

Enlarged heart

An enlarged heart is a result of an underlying medical condition. Certain conditions can cause the heart muscle to abnormally stretch or thicken resulting in the size of one or more of the heart chambers to grow. The Prenuvo scan is not designed to evaluate the detail of the heart.

Heart and great vessels

Lymphangioma of the liver

A hepatic lymphangioma is an area of dilated lymphatic drainage regions in the liver. They are rare and benign.

Liver

Schmorl's node

Schmorl’s nodes are protrusions of the intervertebral discs through the vertebral body endplates. These protrusions may contact the marrow of the vertebrae, leading to inflammation of the vertebrae.

Spine

Hemangioma of the adrenal gland

An adrenal hemangioma is a rare, benign tumor of the adrenal gland. This is usually an incidental finding.

Adrenals

Mastoiditis

Mastoiditis is the inflammation or infection of the mastoid air cells, which are located in the skull, behind the ears. It often develops as a result of a middle ear infection. If infection is left untreated, mastoiditis can lead to an infection in the brain.

Sinuses and mastoids

Adrenal cyst

Adrenal cysts are rare, the majority of which are benign incidental findings of no consequence. Adrenal cysts may be classified as simple cysts, pseudocysts, or hydatid cysts depending on their cause.

Adrenals

Gallstones

Gallstones (cholecystolithiasis) are stones which are formed and located in the gallbladder. They are formed by the hardening of bile products. About 80% of people with gallstones never have symptoms.

Gallbladder and biliary system

Muscle atrophy with fatty replacement

Muscle atrophy is when the muscle either partially or completely wastes/decreases in mass. It can be associated with restricted movement/lack of physical activity or as the result of other conditions or diseases affecting the person.

Muscle atrophy can be broken into three different categories: physiologic, pathologic, and neurogenic. Physiologic is when the muscle is not being used enough. This can occur when a person is confined to a bed, has broken a limb, in places where there is no gravity or have a lifestyle with decreased activity levels. Pathologic is when the a person is suffering from other conditions such as aging, starvation, cancer, HIV, or Cushing disease. Neurogenic atrophy can be the result of injury or a disease that affects the nerves stimulating the muscles. Examples of these are: ALS, carpal tunnel syndrome, Guillain-Barre syndrome, toxins or alcohol, polio or a spinal cord injury.

Pelvis and hips

Total size of prostate

The prostate volume is usually 30ml or less which equals roughly about the size of a ping pong ball. During aging the prostate enlarges and may compress the base of the bladder or constrict the urethra, which is why many prostate issues are related to urination.

Prostate and male reproductive organs

Renal cell carcinoma

Renal cell carcinoma is the most common type of kidney cancer. It originates in the lining of the proximal convoluted tubules which are the very small tubes in the kidney that transport urine. Quite often renal cell carcinoma develops without symptoms and this results in the disease being found late when it has spread to other parts of the body.

Renal cell carcinoma is also associated with a number of paraneoplastic syndromes which are conditions caused by either the hormones produced by the tumour or the by the body’s attack on the tumour. They are present in about 20% of people with renal cell carcinoma.

If renal cell carcinoma is found in the early stages, and it not spread to other areas of the body (metastasized), the five year survival rate is 65-90%. The survival rate becomes significantly lower when the cancer has spread.

Kidneys

Gallbladder septation

A septation, is like a partial fold through the gallbladder causing it to be partially divided into multiple compartments. It is a congenital anomaly which is very rare and considered an incidental finding.

Gallbladder and biliary system

Phrygian cap

A Phrygian cap is the folding of the fundus of the gallbladder back onto the gallbladder body. This is the most common normal anatomical variant of the gallbladder. It is benign and does not cause symptoms.

Gallbladder and biliary system

Sacroiliitis

Sacroiliitis is when inflammation occurs in one or both of the SI joints.

Sacroiliac joints

Bone cyst of the shoulder

There are three types of bone cysts: traumatic bone cyst, aneurysmal bone cyst and unicameral bone cyst. They are benign are do not spread to other parts of the body.

Traumatic bone cysts tend to occur in the jaw and facial bones after trauma.

Aneurysmal bone cysts (ABC) are typically found in children and adolescents They are composed of numerous blood-filled channels which creates an expanded lesion within the bone. The cause of these are unknown.

Unicameral bone cysts (simple bone cysts) are cysts or cavities that form in the bone and are filled with fluid. They are considered latent or active depending on their location. Active bone cysts are located near the epiphyseal (growth) plate and will continue to grow until it fills the entire diaphysis (shaft). Latent cysts are located away from the epiphyseal plate and will heal with treatment or resolve on their own.

Shoulders

Spondyloarthropathy of the thoracic spine

Spondyloarthropathy is the medical term for degenerative arthritis in the spine. In the thoracic spine this includes all of the bony facet joints and discs of the mid and upper back. Additionally arthritis can also affect the area where the ribs attach to the spine

Spine

Pancreatitis

Pancreatitis is characterized by inflammation of the pancreas. It can be acute or chronic (from repetitive episodes).

Pancreas

Ductal adenocarcinoma

Ductal adenocarcinoma is the most common form of pancreatic cancer. It is an aggressive form of pancreatic cancer which has a poor prognosis.

Pancreas

Indeterminant thyroid nodule

A nodule of the thyroid may be benign or could potentially be malignant. As a general rule, the more irregular features and growth a nodule has, the greater the probability it is malignant. Statistically, greater than 50% of nodules are benign. Multiple nodules have a lower risk of cancer and are commonly associated with goitre. Unfortunately it is not possible to determine the exact nature of a nodule from a single MRI scan. There is a risk assessment categorization procedure that has been developed for ultrasound called TI-RADS which is the best way to evaluate the risk of an indeterminant nodule being malignant.

Thyroid

Acute disseminated encephalomyelitis (ADEM)

Acute disseminated encephalomyelitis (ADEM) is an autoimmune disease where a brief, but widespread inflammatory event occurs which damages the protective coating of nerves (myelin). ADEM often occurs after a viral or bacterial infection. It has also been shown to occur rarely after certain vaccinations.

Spine

Rectocele

Rectocele is also known as prolapsed rectum. This is the result of the muscles and connective tissue between the rectum and vaginal wall becoming weak and stretched. The rectum then bulges into the back of the vagina.

Uterus

Hernia of the bladder

A hernia is when tissue or an organ bulges or projects into a cavity where it doesn’t normally sit. In the case of bladder hernia it is when a portion of the bladder bulges into the scrotal sac, inguinal canal or femoral canal. Bladder herniation into the scrotum is also called scrotal cystocele.

Bladder and ureters

Partially resected liver

A partial liver resection is the surgical removal of a portion of the liver.

The cause for this should be provided in your medical history.

Liver

Glioma

A glioma is a brain tumor which arises from any of the glial cells of the brain. There are many tissue subtypes that can categorize these brain tumors further, but tissue is required for that level of categorization.

Glioma tumors are either diffuse, which tend to have a worse prognosis, or localized, which have a better prognosis.

Brain

Thyroid appearance

The thyroid gland does not have normal appearance. This can be due to surgery, or in rare causes congenital abnormalities such as a lingual thyroid.

Thyroid

Xanthogranulomatous pyelonephritis

Xanthogranulomatous pyelonephritis (XGP) is rare type of chronic inflammation that occurs in the kidneys. It is commonly associated with proteus or E.Coli type infections. It results in the destruction of the renal parenchyma (functional tissue) by forming granulomatous tissue. This tissue is made of abscess formation and dead cells which causes severe kidney destruction.

A common finding with XGP is Staghorn calculus. This is a renal calcification, like a kidney stone, that gets its name from the shape it forms in the area of the renal pelvis. It happens with recurrent urinary tract infections and causes blockages of the kidney.

Anyone can get xanthogranulomatous pyelonephritis but typically affects middle age to elderly people. Women are twice as likely to be affected due to increased frequency of urinary tract infections. There is also an increased number of cases found in people with diabetes.

Kidneys

Syrinx

A syrinx is defined by the dilation of the central canal of the spinal cord, or a cystic dissection of the central canal which forms a collection of cerebrospinal fluid (CSF). These two entities are not easily differentiated on imaging, and clinically there is no difference between the two types, nor a difference in the severity of symptoms between them.

Spine

Bone marrow edema of the bony skeleton

Bone marrow is a semi-solid tissue which is found within the spongy or cancellous portions of bone. It is responsible for the production of new blood cells. Bone marrow edema is the term used when there is a fluid collection within the bone marrow. It is usually present when there is an underlying condition. Conditions causing bone marrow edema can include: trauma (bone bruise), microtrabecular fracture, arthropathy, decreased blood flow, infection, post-operative changes, chemotherapy, or bone metastases

Bony skeleton and soft tissue

Muscle atrophy with fatty replacement of the knee

Muscle atrophy is when the muscle either partially or completely wastes/decreases in mass. It can be associated with restricted movement/lack of physical activity or as the result of other conditions or diseases affecting the person.

Muscle atrophy can be divided into three different categories: physiologic, pathologic, and neurogenic. Physiologic is when the muscle is not being used enough. This can occur when a person is confined to a bed, has broken a limb, in places where there is no gravity or have a lifestyle with decreased activity levels. Pathologic is when the a person is suffering from other conditions such as aging, starvation, cancer, HIV, or Cushing disease. Neurogenic atrophy can be the result of injury or a disease that affects the nerves stimulating the muscles. Examples of these are: ALS, carpal tunnel syndrome, Guillain-Barre syndrome, toxins or alcohol, polio or a spinal cord injury.

Knees

Hemorrhagic cyst of the nasal pharynx

Hemorrhagic cysts are abnormal lesions of the neck which have had an episode of bleeding (hemorrhage) within the lesion. This is a finding that is often associated with the thyroid, but can occur in other soft tissues of the neck, particularly if there has been trauma or an infection. This is why a good medical history is important. When the hemorrhage occurs, it is often associated with an immediate onset of pain and other symptoms.

Nasal pharynx

Bowel adenocarcinoma

Adenocarcinomas are the most common type of cancer in both the large and small bowel. As with other cancers, it occurs due to a mutation of a gene. The tumor usually starts out as a polyp, and if untreated, can evolve into adenocarcinoma of the bowel. It is estimated that half of all bowel cancers are related to lifestyle, with a quarter of all bowel cancers being preventable.

Polyps which are considered pre-cancerous are not well seen by imaging, including the Prenuvo scan. Therefore colonoscopy is important for screening, as it is the only method to remove polyps and thus prevent colon cancer.

Bowel

Pheochromocytoma

Pheochromocytoma (PCC) is a tumor of the adrenal glands or sympathetic nervous system. Most cases arises from the inner part (also known as the medulla) of the adrenal gland and can have an effect on the epinephrine/adrenalin hormone secretion of the gland. It is often benign with a low risk of metastatic spread. However, due to the impact of the adrenalin hormone secretion on the cardiovascular system of the body, it can result in a life threatening condition if not treated properly.

Adrenals

Cholecystitis

Cholecystitis is inflammation of the gallbladder. 90% of cases are due to a gallstone blocking the gallbladder at the cystic duct. A “gallbladder attack” usually precedes cholecystitis. Gallbladder attack refers to blocked flow of bile which leads to accumulation and bile stasis in the gallbladder which can lead to gallbladder inflammation and then infection.

Gallbladder and biliary system

Arteriovenous malformation

An arteriovenous malformation (AVM) is an abnormal collection of arteries and veins in the brain. Instead of having a capillary bed in between the artery and the vein, an AVM is a direct connection between arteries and veins.

Small vascular malformations will not be identified on a Prenuvo scan, as the most sensitive sequence for tiny blood vessel imaging is not performed due to the length of time required for that type of imaging.

Brain

Lymphoma of the oral pharynx

Lymphoma is a cancer which arises in the lymphocytes or lymphoblasts. Lymphoma can arise from, or spread to any of the glands and organs throughout the soft tissues of the neck (and many other locations within the body).

Oral pharynx

Pineal Cyst

Brain

Riedel lobe

A Riedel lobe is a common, normal anatomical variant of the liver. It is a downward projection of the right lobe of the liver toward the pelvis. The Riedel lobe contains normal liver tissue.

Liver

Muscle tear of the ankle

A muscle tear is an acute or chronic soft tissue injury that occurs to muscle. The muscle becomes overstretched and receives more physical stress than it can handle. The tears can occur partially or completely. Acute tears tend to happen with recent trauma or injury whereas chronic tears are related to repetitive movement over a long period of time.

Muscle tears are classified by degree of severity: first degree (mildest - some tearing still with full range of motion), second degree (moderate - torn, painful with limited motion) and third degree (severe - torn with limited or no movement).

In the ankle there are multiple muscles that can be torn: peroneus longus, peroneus brevis, gastrocnemius, soleus, posterior tibialis, and anterior tibialis. The tendons of these muscles become very small at the anke and foot, and if there is a concern at that level, dedicated imaging would be required.

Ankles

Pericardial fat

Pericardial fat refers to a thicker than usual layer of fat surrounding the outside of the heart. It is usually present adjacent to the bottom of the heart (resting on the diaphragm) and is commonly seen in overweight individuals who have or are developing metabolic syndrome (diabetes).

Heart and great vessels

Bowel mass

A concerning mass is seen in the bowel. The characteristics by MRI cannot classify what its cause may be, and therefore further investigation is necessary.

The large bowel is best evaluated with direct visualization by colonoscopy.

Bowel

Tumor of the pelvis and hips

A tumor of the hip joint or pelvis can arise from the bone, cartilage, or soft tissue around the joint.

These tumors may be benign, malignant, or indeterminant. The radiologist will give a likelihood of the type of tumor it is based on its imaging characteristics.

A bone tumour, or bone cancer, is a primary cancer that starts in the bone or adjacent cartilage. The tumours can be benign or malignant. Benign nonaggressive bone tumor types include an osteoma, osteoclastoma (giant cell tumours) or osteochondroma.

In general aggressive bone tumors are more common in children, adolescents and young adults. The most common types of malignant bone tumours in young adults are chondrosarcoma and osteosarcoma. A chondrosarcoma originates in the cartilage most commonly of the longbones: femur and humerus. An osteosarcoma is the second most common bone cancer and is rarely found in the shoulders, but is more common in the knees, tibiae, and in older people around the hip or jaw. Rarer types of bone cancer are: fibrosarcoma, angiosarcoma, and undifferentiated high-grade pleomorphic sarcoma. Until the dominant tumor tissue type is known, the tumor type is generally called a sarcoma.

Soft tissue tumours common around a joint are synovial chondromatosis, pigmented villonodular synovitis, synovial sarcomas, lipomas, fibromas, desmoid tumours, leiomyoma, leiomyosarcoma, and synovial sarcoma.

Pelvis and hips

Hemangioma of the spleen

A splenic hemangioma, while rare, is the second most common splenic tumor. It is a benign cluster of enlarged blood vessels. They are thought to be congenital (existing from birth). Hemangiomas usually do not cause symptoms or harm the function of the spleen.

Spleen

Septation in the bladder and ureters

Septation of the bladder is when the bladder has a fibrous tissue band which separates the bladder either partially or completely into multiple compartments.

There are two categories of bladder septation: congenital and pathological. Congenital septation is a rare occurrence that occurs during fetal development. Pathological septation can occur due to scarring from surgeries, chronic infections or other conditions. To separate these different causes, your medical history is important.

Bladder and ureters

Liver abscess

A liver abscess is a pus filled benign lesion of the liver. The abscess usually accumulates secondary to an acute infections from other origins such as an inflamed gallbladder (cholecystitis), appendicitis or diverticulitis. The infective pus migrates from the initial infection site via the portal vein into the liver.

Liver

Degeneration of the ankle

Degenerative joint disease or degenerative arthritis (osteoarthritis) is the most common condition to affect joints. It is a chronic condition. It is in two forms: primary and secondary. Primary is hereditary and less common but occurs without cause or injury. Secondary is the most common form and is due to abnormal mechanical forces such as obesity, previous injury/trauma or joint stress.

Degenerative joint disease occurs when the cartilage breaks down causing the bones to rub together and become misshapen with bone spurs (osteophytes). Typically it occurs in the older population.

The Prenuvo scan does not look at cartilage, thus the earliest signs of arthritis may not be seen on this study. If you are interested in cartilage imaging, discuss with your doctor about obtaining a dedicated joint MRI.

Ankles

Pleural effusion

Pleural effusion means abnormal accumulation of fluid in the pleural cavity between the chest wall and lungs. Excess fluid presses the lung and can make breathing harder. The causes of a pleural effusion are varied. It can for example be caused by the heart’s decreased ability to pump blood, a lung infection, liver or kidney disease, or even some medications. The reason for a pleural effusion is not necessarily obvious from your scan.

Lungs and mediastinum

Mucinous cystadenoma

A mucinous cystadenoma is a benign tumor of the pancreas. When discovered, they are usually large (larger than 4cm). They are considered a premalignant lesion.

Pancreas

Pancreatic pseudocyst

A pseudocyst is the most common cystic lesion of the pancreas. It is a common result of acute or chronic pancreatitis. A pseudocyst is a walled off (encapsulated) collection of pancreatic juices, that have collected. It is considered to be a result of the pancreatic duct being damaged from an episode of pancreatitis which then results in pancreatic juices leaking into tissue and causing hemorrhagic fat necrosis. The cysts can grow quite large (over 10cm).

Pancreas

Mucocele

A mucocele of the sinuses is the formation of a cyst within the sinuses which contains mucus. A mucocele can expand through the walls of adjacent bone, making them potentially problematic when they grow. They have the potential to press on the optic nerves and even brain tissue if the expansion progresses.

Sinuses and mastoids

Dermoid

A dermoid cyst, also known as a mature cystic ovarian teratoma, is a common type of ovarian condition. They can be present from birth but slow growing (1-2mm per year). It may take many years before it is visible or found on examinations. It is growth that is formed of different types of primitive embryologic tissue, most commonly skin sebaceous or fatty tissue. This presence of fat in an ovarian lesion is typical for an ovarian dermoid.

Complications of a dermoid while rare, can occur. The most common complication is torsion (twisting) of the ovary due to the dermoid lesion.

Ovaries

Scar of the lung

Lung scarring usually occurs as a result of lung tissue inflammation. This scarring reduces the elasticity of the lung tissue. A small amount of scarring (commonly seen in patients with prior pneumonia) will have little effect on lung function, but a large amount of scarring can make oxygen transfer difficult, leading to shortness of breath and lack of oxygen to the body.

Lungs and mediastinum

Serous cystadenoma

A serous cystadenoma is a benign tumor of the pancreas. They are often clustered. Most people with a serous cystadenoma are asymptomatic. It is extremely rare for it to undergo a malignant transformation. Small serous cystadenomas are very slow growing (1mm per year).

Pancreas

Metastases in the neck lymph nodes

Metastatic disease of the lymph nodes of the neck occurs when cancer spreads from another location in the body and seeds the lymph nodes in the neck. The lymph nodes behave as filters of the interstital fluid between soft tissues, and tumor cells can collect and cause the lymph nodes to enlarge.

Cervical lymph node chain

Hemorrhagic cyst of the hypopharynx

Hemorrhagic cysts are abnormal lesions of the neck (hypopharynx) which have had an episode of bleeding (hemorrhage) within the lesion. This is a finding that is often associated trauma, but can be due to other causes including tumor. When the hemorrhage occurs, it is often associated with an immediate onset of pain and other symptoms.

Hypopharynx

Tumor of the shoulder

A tumor of the shoulder joint can arise from the bone, cartilage, or soft tissue around the joint.

These tumors may be benign, malignant, or indeterminant. The radiologist will give a likelihood of the type of tumor it is based on its imaging characteristics.

A bone tumour, or bone cancer, is a primary cancer that starts in the bone or adjacent cartilage. The tumours can be benign or malignant. Benign nonaggressive bone tumor types include an osteoma, osteoclastoma (giant cell tumours) or osteochondroma.

In general aggressive bone tumors are more common in children, adolescents and young adults. The most common types of malignant bone tumours in young adults are chondrosarcoma and osteosarcoma. A chondrosarcoma originates in the cartilage most commonly of the longbones: femur and humerus. An osteosarcoma is the second most common bone cancer and is rarely found in the shoulders, but is more common in the knees, tibiae, and in older people around the hip or jaw. Rarer types of bone cancer are: fibrosarcoma, angiosarcoma, and undifferentiated high-grade pleomorphic sarcoma. Until the dominant tumor tissue type is known, the tumor type is generally called a sarcoma.

Soft tissue tumours common around a joint are synovial chondromatosis, pigmented villonodular synovitis, synovial sarcomas, lipomas, fibromas, desmoid tumours, leiomyoma, leiomyosarcoma, and synovial sarcoma.

Shoulders

Endocrine pancreatic tumor

Endocrine tumors of the pancreas are a range of tumors which arise from hormone producing cells of the pancreas.

Pancreas

Anomalous number of ribs

An anomalous number of ribs is defined as variant anatomy. Most commonly people have 12 rib bearing thoracic vertebrae. Some people are born with either fewer or more than 12 ribs attached to the vertebral bones of the spine.

Extra ribs, also called accessory ribs, can occur above the rib cage and at this location are called cervical ribs because they attach to the cervical spine of the neck. Accessory ribs can also occur at the bottom of the rib cage giving 13 or more rib bearing thoracic type vertebra.

Occasionally incomplete tiny ribs can occur, most commonly at the bottom of the rib cage, and these are called 'rudimentary' or 'vestigeal' ribs and they are assigned to the lumbar type vertebrae of the lower back.

Fewer than 12 thoracic vertebrae can also occur, with the 'missing' rib(s) being at the lower part of the ribcage. This can result in the most common rib count variant of 11 thoracic type vertebrae.

The number of thoracic (rib bearing) vertebrae is important to know, because in medicine landmarks for the lumbar spine levels are often (erroneously) counted based on the number of ribs seen, with the first lumbar vertebra assigned as the one without a bony rib even if it has a rudimentary rib. This erroneous counting usually occurs because only a part of the spine is imaged.

Knowing the presence of this variant anatomy is essential if any surgery is planned, as X-rays easily see the ribs and thus the counting of the ribs and vertebrae is used for surgical planning.

Pateints with an anomalous number of ribs usually remain entirely asymptomatic, however in some people accesory (extra) ribs can become problematic by causing pain, lack of mobility, soft tissue irritation, or nerve compression anytime now or in the future. Understanding your medical history and preventing irritation to these potentially susceptible areas is important to know if and when symptoms occur.

Spine

Appendicitis

Appendicitis is most commonly caused by a hard collection (usually of feces) which obstructs the entrance to the appendix. This causes the appendix to swell and as mucus or pus is produced, pressure within the appendix increases and causes pain. This pressure compresses the blood vessels of the appendix walls which then start to die. This loss of appendix wall integrity can lead to the appendix bursting.

Bowel

Hernia

A hernia is when tissue or an organ bulges/moves into a cavity where it doesn’t normally sit. In the case of a groin hernia it is when the intra-abdominal fat or bowel moves into the scrotal sac, inguinal canal or femoral canal.

Bowel

Sacroiliac joint bone marrow edema

Bone marrow is a semi-solid tissue which is found within the spongy or cancellous portions of bone. It is responsible for the production of new blood cells. Bone marrow edema is the term used when there is a fluid collection within the bone marrow. It is usually presence when there is an underlying condition which stresses the bone.

Sacroiliac joints

Spondyloarthropathy of the cervical spine

Spondyloarthropathy is the medical term for degenerative arthritis in the spine. In the cervical spine this includes all of the bony facet as well as uncovertebral joints and discs of the neck.

Spine

Biliary cystadenoma

Biliary cystadenomas are benign cystic lesions of the liver. They arise from cells in the bile ducts. While benign, biliary cystadenomas can evolve to a malignancy called biliary cystadenocarcinoma. Imaging alone cannot distinguish the exact time point that this evolution occurs.

Liver

Myxoma

A myxoma is the most common benign tumor of the heart, Myxomas account for 50% of all benign heart tumors. The majority of myomas originate in the left atrium (almost 90%).

Heart and great vessels

Cystocele

A cystocele can occur in females when the muscles and connective tissue between the bladder and vaginal wall become weak and stretched. This causes the bladder to then bulge into the vagina. It is often identified during a Papp test or during an exam when the bladder is full.

Quite often the cystocele occurs with prolapsing of the urethra. Together this condition is called cystourethrocele.

Bladder and ureters

Bone marrow edema of the ankle

Bone marrow is a semi-solid tissue which is found within the spongy or cancellous portions of bone. It is responsible for the production of new blood cells. Bone marrow edema is the term used when there is a fluid collection within the bone marrow. It is usually presence when there is an underlying condition. Conditions it could be related to can include: trauma (bone bruise), microtrabecular fracture, arthropathy, decreased blood flow, infection, post-operative changes, chemotherapy, bone metastases, or arthritis.

Ankles

Esophageal polyp

An esophageal polyp is a benign submucosal tumor. It can grow significantly and cause difficulty swallowing. They are most common in the upper third of the esophagus.

The esophagus is best assessed by direct visualization as small polyps cannot be seen by imaging unless there is distention of the esophagus.

Esophagus

Renal papillary adenoma

Renal papillary adenoma is a benign kidney tumor. They are tumors made of epithelial tissue and typically measure less than 5mm. When they increase beyond 15mm in size they become a concern for being renal cell carcinoma.

Kidneys

Ankle hemangioma

A bony hemangioma can often be referred to as a few other names, primary intraosseous hemangioma or vascular hamartoma. A hemangioma is a benign vascular malformation that occurs when blood vessels multiply at an abnormal rate. They most commonly occur in the skull and the spine but they can form in any body part. Capillary and cavernous hemangiomas are the most common type of hemangioma to affect bones. The can occur on the surface of the bone or deeper. Often hemangiomas are asymptomatic and are found incidentally on an xray or MRI.

Ankles

Ovarian cyst

An ovarian cyst is a fluid filled sac within the ovary. It is a common finding on gynecological pelvis exams. Most ovarian cysts are benign in nature and harmless. On occasion they can twist the ovary (torsion) or burst. This can result in acute, severe pain.

The ovaries during childbearing years are maturing eggs and thus creating follicular cysts, which depending on the menstrual cycle stage can be of different sizes. This is why if you are symptomatic then often for evaluation of the ovaries which have cysts repeat imaging is necessary to determine which cysts are functional versus non-functional. Some non-functional cysts are concerning and will continue to enlarge, whereas functional cysts will often resolve with time. Unfortunately, no test other than time can separate concerning cysts from normal functional cysts.

Ovaries

Bursitis of the ankle

A bursa is a fluid-filled sac that cushions and lubricates bones and tendons when they move. The body is comprised of over 150 bursae. Bursitis is an inflamed or swollen bursa.

  • The ankle has three main bursas.
  • The retrocalcaneal bursa: located at the back of the ankle between the calcaneus (heel) and achilles tendon.
  • The subcutaneous calcaneal bursa (achilles bursa): located in the lower heel between the calcaneus and the skin.
  • The subcutaneous bursa of the medial malleolus: located between the skin and the medial malleolus.
  • Ankles

    Metastases in the nasal pharynx

    Metastatic disease of the soft tissues of the nasopharynx occurs when cancer spreads from another location in the body and seeds in the neck tissues. The seeding can occur in glands, organs, muscles or lymph nodes of the head and neck.

    Nasal pharynx

    Indeterminant nodule of the hypopharynx

    A nodule in the soft tissues of the neck describe a small lesion which is generally too small to be able to be characterized as benign or potentially malignant. Unfortunately we are unable to determine the exact nature of the lesion from a single scan.

    Hypopharynx

    Fibromatosis of the ovary

    Ovarian fibromatosis is a rare condition where mass-like enlargement occurs due to ovarian fibrosis (fibrosis is thickened scar like tissue). Ovarian fibrosis is the result of depletion of ovarian follicles and loss of ovarian function. This could be the result of damage or injury to the ovary (ie.surgery, chronic inflammation, other ovarian conditions). This is a benign finding.

    Ovaries

    Kidney stone

    Kidney stones, also know as nephrolithiasis, are solid pieces of material that typically form in the kidney. They usually pass through the kidney, into the ureter, through the bladder, and exit when passing urine. Small kidney stones can occur and pass without symptoms.

    Kidny stones typically are made of calcium based material, which does not give off signal on a MRI, and thus may be missed on any MRI scan. Ultrasound and CT scan (CTKUB) are the best modalities for looking at kidney stones, with urinalysis also helping to assess if signs of kidney stones are present.

    A kidney stone can develop when chemicals in your body crystallize together. Stones are typically made of calcium oxalate, occasionally made of uric acid or cystine. The stones can range in size from less than 5mm (grain size) to larger than 4cm (golf ball size).

    Kidneys

    Kyphosis / Lordosis

    Kyphosis or lordosis is a spine condition where there is loss of the normal curvature of the spine. It can affect the cervical (neck), thoracic (midback), or lumbar (lower back) areas of the spine. Depending on the direction of the curvature (forward or backward), it can have different effects. For example, increased kyphosis (forward flexion curve) of the thoracic spine can result in abnormal rounding of the back and is sometimes known as "roundback" or in the case of a severe curve is called "hunchback."

    Spine

    Shoulder Impingement

    Impingement is the narrowed space and increased pressure of a joint which is accentuated when in motion. It is a relatively common finding which most commonly affects the shoulder and hip. Impingement occurs when inflammation causes the tendons, muscles, or bones to push into the bursa or against each other.

    Shoulders

    Diverticular disease

    Diverticulosis also known as diverticular disease is a condition where there are numerous outpouches (diverticula) in the colon. These outpouchings occur due to weakened muscle layers of the bowel wall. When these diverticula become inflamed, they are known as diverticulitis.

    The sigmoid colon is the most common location for diverticulosis due to the increased pressure exerted in this area, particularly when defecating.

    This is often an asymptomatic, incidental finding, however extensive diverticula makes assessment for colon cancer more difficult.

    Bowel

    Hepatic biloma

    A biloma is a benign collection of bile outside of the gallbladder and bile ducts. These are often found within the liver but can also be found elsewhere in the abdominal cavity. Small spontaneous bilomas are often asymptomatic. Post surgical and traumatic biloma formation can have non-specific symptoms such as abdominal pain, nausea, weight loss, jaundice, fever and abdominal tenderness.

    Liver

    Bursitis of the shoulder

    A bursa is a fluid-filled sac that cushion and lubricates bones and tendons when they move. The body is comprised of over 150 bursae. Bursitis is an inflamed or swollen bursa. There are 5 main bursae in the shoulder:

    • Subacromial-deltoid bursa - located between the joint capsule and the deltoid muscle
    • Subscapular recess - located between the joint capsule and the subscapularis muscle
    • Subcoracoid bursa - located below the coracoid
    • Coracoclavicular bursa - located between the coracoid and the clavicle
    • Supra-acromial bursa - located above the acromion

    Bursitis in the shoulder can occur in any of the bursae but the most common location is the subacromial-deltoid bursa. It is the largest bursa which is usually related to impingement between the rotator cuff and the acromion.

    Shoulders

    Breast cyst

    A breast cyst is a fluid filled sac within the breast tissue. It is typically benign in nature. It is possible to have one or multiple breast cysts as well as affect one or both breasts. Breast cysts are usually round or oval in shape with a distinct capsule. On palpation a breast cyst feels like a grape or water filled balloon, they can also feel firm. Breast cysts can move easily, with touch, within the tissue. The cysts can change with the menstrual cycle, changing in size and tenderness.

    This is a common finding in women between 35-50 years old, but not limited to that age range.

    Breasts

    Bile duct stricture

    A bile duct stricture is a condition where the duct is narrower than it should normally be. The cause of the stricture can be due to many different causes both benign and malignant.

    Gallbladder and biliary system

    Uterine adenomyosis

    Adenomyosis is a condition where endometrial tissue(the inner layer of the uterus) is present in the myometrium (the thick, muscular layer of the uterus). The junctional zone (transition between endometrium and myometrium) thickens abnormally, however with menstruation, this tissue cannot normally be sloughed and it causes pain. It is a condition similar to endometriosis (where endometrial tissue is present outside of the uterus). In up to 20% of the time, both adenomyosis and endometriosis are found together, and it is associated with increased estrogen levels. Typically adenomyosis resolves after menopause.

    Uterus

    Baker's cyst

    A Baker's cyst (aka popliteal cyst) is a type of fluid collection behind the knee.

    Knees

    Enlargement of the thyroid

    The enlarged thyroid is not an imaging based abnormality, but is a possible indicator of an underlying pathology, with thyroid gland function best checked by blood tests.

    Thyroid

    Muscle tear of the pelvis and hips

    A muscle tear is an acute or chronic soft tissue injury that occurs to muscle. The muscle becomes overstretched and receives more physical stress than it can handle. The tears can occur partially or completely. Acute tears tend to happen with recent trauma or injury whereas chronic tears are related to repetitive movement over a long period of time.

    Muscle tears are classified by degree of severity: first degree (mildest - some tearing still with full range of motion), second degree (moderate - torn, painful with limited motion) and third degree (severe - torn with limited or no movement).

    Pelvis and hips

    Arachnoid cyst

    Arachnoid cysts are benign, usually asymptomatic cerebrospinal (CSF) fluid collections which usually occur around the brain, but may also appear around the spinal cord.

    Brain

    Number of vertebrae

    Most people have 7 cervical, 12 thoracic and 5 lumbar type vertebrae. However there are some congenital changes to this where some people can be born with more or less vertebrae. These variances become important for counting the nerve roots if you develop low back, leg or foot pain, and surgery is contemplated.

    The spaces between the vertebrae called neural foramen are where the nerve roots exit from the spinal cord to the body, and each nerve is specifially named based on 8 cervical, 12 thoracic and 5 lumbar nerve roots.

    Spine

    Lymphoma in the lymph nodes of the neck

    Lymphoma is a cancer which arises in the lymphocytes or lymphoblasts. Lymphoma can arise from, or spread to any of the glands and organs throughout the soft tissues of the neck (and many other locations within the body).

    Cervical lymph node chain

    Soft tissue abnormality

    A soft tissue abnormality is an issue which involves any of the connective tissue of the body, or tissue surrounding the organs. Please note that skin lesions are best assessed by direct visualization, and MRI is only useful for nonvascular abnormalities below the skin surface.

    Bony skeleton and soft tissue

    Bone island of the spine

    A bone island, also known as enostosis, is a benign, very dense region of compact bone within the normal bone structure. It is generally less than 2cm in size and is usually found incidentally. It is usually found incidentally. A condition where multiple bone islands occur is called osteopoikilosis.

    Spine

    Lung nodule

    A lung nodule is a descriptor for a lesion of the lung which is generally small (approximately 1cm in size). A lung nodule has the potential to be benign or malignant, and as lung cancer is the leading cause of cancer deaths in the developed world, a nodule must be followed up to ensure stability over time. Stability over time ensures that the nodule is not an aggressive lung cancer and that the findings favor a benign cause.

    Lungs and mediastinum

    Enlarged liver

    An enlarged liver (hepatomegaly) is a non-specific finding which has various causes. These include but are not limited to infection, tumors, metabolic disorders (commonly diabetes) and alcoholism. The presentation of an enlarged liver is due to vascular swelling of the liver and inflammation.

    Normal liver size in axial dimensions is 10-12cm(front to back) x 20-23cm.

    Liver

    Choledochal cyst

    Choledochal cysts are rare cystic dilations of the bile ducts They are believed to be congenital (from birth) and are associated with biliary obstructions in infants. Remaining asymptomatic into adulthood is rare, but not unheard of. Choledochal cysts lead to an increased risk of biliary cancer and are considered pre-malignant. The risk of cancer developing is dependent on age from 2% at age 20, to 75% at age 70.

    There are 5 different types of choledochal cysts.

    • Type I - the most common, which relates to dilatation of the extrahepatic common bile duct.
    • Type II - a diverticulum arising from the extrahepatic bile duct.
    • Type III - dilatation of the extrahepatic duct within the duodenal wall.
    • Type IV - Second most common with dilatations and cysts of intra and/or extrahepatic ducts.
    • Type V - Multiple dilatations and/or cysts of intrahepatic ducts only. This is also known as Caroli disease.

    Gallbladder and biliary system

    Effusion of the pelvis and hips

    A joint effusion is an abnormal collection of fluid located in the joint space. It is commonly referred to as a 'swollen joint'

    In the hip, these joint effusions are difficult to identify due to the fact that the joint is deep in the body and thus the fluid cannot be felt with a physical exam.

    Pelvis and hips

    Uterine prolapse

    A uterine prolapse is a condition where uterus is slipping down to vaginal passage. This happens when the ligaments of the uterus are stretched due to weakness in the pelvic floor.

    The staging of prolapse is classified by the position of the cervix and uterus:

  • Grade 0: cervix at normal position
  • Grade I: cervix halfway to the introitus/hymen
  • Grade II: cervix at the introitus/hymen
  • Grade III: cervix extends outside of the vaginal introitus with straining
  • Grade IV: cervix extends outside of the vaginal introitus all the time. This is also known as procidentia.
  • Uterus

    Sinus nasal polyp

    Polyps are benign growths which can occur in the nasal passages or sinuses. They most commonly occur due to chronic inflammation due to asthma, infection and allergies. They may be entirely asymptomatic, or may cause symptoms. They occur in the mucous membrane of the nasal passages and sinuses.

    Imaging is not the best way to assess the nasal mucosal tissue for polyps, the best way is direct visualization of the nasal passages.

    Sinuses and mastoids

    Pericardial effusion

    The pericardium is the collective name for the layers of tissue surrounding the heart. A pericardial effusion refers to an abnormal amount of fluid between the heart muscle and the pericardium. This increase in fluid leads to an increase in the pressure on the beating heart.

    Heart and great vessels

    Duplex ureter

    Duplex ureter also known as duplicated collecting system, is when two ureters are coming from one kidney and connect to the bladder. Normally each kidney has one ureter that leads to the bladder, and a duplex ureter is a congenital (born with) condition that is discovered incidentally or in the past if there was a problem with the ureters or kidney. Normally the ureters are collapsed and not well seen by imaging, however when there is a problem, the ureters distend with urine and become easily seen by imaging. A duplex ureter can also join to one ureter before connecting with the bladder.

    Having duplex ureters is associated with vesicoureteral reflux (backflow of urine from the bladder), ectopic ureter (where the ureter drains into somewhere other the bladder - this would be detected at an early age), or a ureterocele (where there is ballooning at the end of the ureter that connects to the bladder).

    Bladder and ureters

    Spinal fracture

    A fracture of a vertebra can be due to trauma, osteoporosis or a tumor invading the bone.

    The compressive force of a traumatic injury is able to immediately fracture the vertebra (usually causing a “burst” or a “compression” fracture).

    Osteoporosis and tumors destroy the bone matrix, eventually weakening the bone to the point of collapse under normal body weight or by a fall from standing height.

    Spine

    Ankle tumor

    A tumor of the ankle joint can arise from the bone, cartilage, or soft tissue around the joint and is extremely rare.

    These tumors may be benign, malignant, or indeterminant. The radiologist will give a likelihood of the type of tumor it is based on its imaging characteristics.

    A bone tumour, or bone cancer, is a primary cancer that starts in the bone or adjacent cartilage. The tumours can be benign or malignant. Benign nonaggressive bone tumor types include an osteoma, osteoclastoma (giant cell tumours) or osteochondroma.

    In general, aggressive bone tumors are more common in children, adolescents and young adults. The most common types of malignant bone tumours in young adults are chondrosarcoma and osteosarcoma. A chondrosarcoma originates in the cartilage most commonly of the longbones: femur and humerus. An osteosarcoma is the second most common bone cancer and is rarely found in the shoulders, but is more common in the knees, tibiae, and in older people around the hip or jaw. Rarer types of bone cancer are: fibrosarcoma, angiosarcoma, and undifferentiated high-grade pleomorphic sarcoma. Until the dominant tumor tissue type is known, the tumor type is generally called a sarcoma.

    Soft tissue tumours common around a joint are synovial chondromatosis, pigmented villonodular synovitis, synovial sarcomas, lipomas, fibromas, desmoid tumours, leiomyoma, leiomyosarcoma, and synovial sarcoma.

    Ankles

    White matter disease

    White matter disease is damage or loss of tissue that covers nerve axons in the largest and deepest part of your brain. This covering is made of fatty material called myelin that protects the nerve fibers and gives white matter its color. Myelin is also responsible for enabling rapid nerve signal transmission. When the white matter of the brain is lost, it does not recover.

    White matter brain tissue helps you think fast, walk straight, and keeps you from falling. When it becomes diseased, the myelin breaks down and the nerve signals no longer get through efficiently or sometimes at all.

    Brain

    Variant anatomy of hepatic vessels

    Variant hepatic arterial anatomy:

    Usually the common hepatic artery arises from celiac artery. Variant hepatic arterial anatomy refers to variations of this. This includes the hepatic artery arising directly from the aorta or the superior mesenteric artery (SMA), the right hepatic artery arising from the SMA, or the left gastric artery arising from the left gastric artery.

    Variant hepatic venous anatomy:

    This refers to a variation in the venous anatomy of your liver. The most common variation is an accessory right inferior hepatic vein. This vein drains the posterior portion of the right liver lobe directly into the inferior vena cava (IVC).

    Liver

    Polysplenia

    Polysplenia is characterised by the formation of multiple accessory spleens without a full sized parent spleen. Polysplenia sometimes occurs in isolation, though it is often accompanied by other congenital abnormalities which affect cardiac formation.

    Spleen

    Bladder wall thickening

    Bladder wall thickening is a reactive action that happens when the bladder is working harder to expel urine, has become chronically irritated/inflamed or has been scarred. This is usually caused by another condition such as urinary tract infections, abnormal tissue growth, cancer, cystitis, amyloidosis or bladder obstruction.

    Bladder and ureters

    Muscle atrophy with fatty replacement of the ankle

    Muscle atrophy is when the muscle either partially or completely wastes/decreases in mass. It can be associated with restricted movement/lack of physical activity or as the result of other conditions or diseases affecting the person.

    Muscle atrophy can be divided into three different categories: physiologic, pathologic, and neurogenic. Physiologic is when the muscle is not being used enough. This can occur when a person is confined to a bed, has broken a limb, in places where there is no gravity or have a lifestyle with decreased activity levels. Pathologic is when the a person is suffering from other conditions such as aging, starvation, cancer, HIV, or Cushing disease. Neurogenic atrophy can be the result of injury or a disease that affects the nerves stimulating the muscles. Examples of these are: ALS, carpal tunnel syndrome, Guillain-Barre syndrome, toxins or alcohol, polio or a spinal cord injury.

    Ankles

    Breast tissue density

    Breast tissue is comprised mainly of glandular and fat tissue, with the ratio varying from woman to woman. The denser the breast, the more glandular tissue it has compared with fat tissue.

    Dense glandular tissue is a normal finding particularly in women of childbearing age. Usually as females age the breast tissue becomes less glandular and the glandular tissue gets replaced with fat.

    Dense tissue is becoming more recognized as requiring additional screening tests, such as MRI or ultrasound. Having dense breast tissue makes breast screening with mammography challenging.

    Breasts

    Mucinous cystadenocarcinoma

    A mucinous cystadenocarcinoma is the malignant transformation of a mucinous cystadenoma. Mucinous cystadenocarcinoma of the pancreas tend to be a low grade tumor. Therefore they grow slower than other cancers and metastasize less often.

    Pancreas

    Effusion of the knee

    A joint effusion is an abnormal collection of fluid located in the joint space. It is commonly referred to as a 'swollen joint'

    Knees

    Indeterminant biliary lesion

    An indeterminant lesion of the biliary system can potentially be a benign or a malignant lesion. Unfortunately we are unable to determine the exact nature of the lesion based on its current size and tissue composition.

    If you have prior imaging of the abdomen available, a comparison to assess for change in the interval would be helpful.

    Gallbladder and biliary system

    Hiatus hernia

    A hiatus hernia describes the occurrence of a portion of the stomach projecting into the thoracic cavity through the esophageal hiatus of the diaphragm. When the stomach completely projects through the esophageal hiatus it is described as an intrathoracic stomach. Having a portion of the stomach above the diaphragm can result in stomach acid refluxing up into the esophagus exposing the esophageal tissues to highly acidic fluid and is know as gastroesophageal reflux disease (GERD).

    Stomach

    Sarcoidosis

    Sarcoidosis is an autoimmune disorder which involves a collection of inflammatory cells that form lumps, which are known as granulomas. Sarcoidosis can affect the lungs, skin, lymph nodes, liver, heart, brain and eyes. The most common site of presentation of sarcoid is within the lungs.

    Lungs and mediastinum

    Perivascular space

    A perivascular space, is a benign fluid filled space in the brain. They are simply a folding of the layering structures that surround a small blood vessel in the brain. These perivascular spaces are usually very small (smaller than 5mm). They are more commonly seen in elderly patients due to their enlargement with age and hypertension.

    Brain

    Lung consolidation

    Consolidation occurs when the normal air within a segment of the lung is replaced by fluid, blood, pus, tumor or another substance. Once consolidation is identified, the underlying cause needs to be found. The lungs are often best assessed by a CT scan because the fine lace like detail is better seen by CT, and thus CT is used for treatment planning.

    Lungs and mediastinum

    Intrauterine Device (IUD)

    An intrauterine device (IUD) is a device which is inserted into the uterus as a form of birth control. Once removed, fertility usually returns to normal quickly.

    Uterus

    Ankylosing spondylitis

    Ankylosing spondylitis is a type of arthritis in which there is long term inflammation. It can occur in other parts of the body, particularly the spine where over time the bones fuse together and create a rigid spine. It can range from mild to severe and possible result in changes in posture. Early diagnosis may help progression, reduce symptoms or prevent deformity. Ankylosis refers to the bony fusion, which is typically best seen on Xrays.

    Sacroiliac joints

    Circle of Willis Variant Anatomy

    The Circle of Willis is a ring like configuration of arteries that feed the brain. It is fed by the two carotid arteries and the basilar artery, with normally 6 arteries (3 per side) extending from the Circle of Willis to supply the cerebrum of the brain.

    In some people a complete circle, or all 6 brain supplying arteries do not develop, and this is called variant anatomy of the Circle of Willis.

    Brain

    Splenic artery aneurysm

    Splenic artery aneurysms are the third most common abdominal aneurysm. The are usually saccular (bulging out one side of the artery) in shape. The majority of splenic artery aneurysms are incidental findings. There is a risk of the aneurysm spontaneously rupturing, particularly with people who undergo a liver transplant, have portal hypertension or are pregnant. If a splenic artery aneurysm ruptures, there is a 1 in 3 mortality rate.

    Spleen

    Adrenal lymphoma

    The adrenal glands are a common site for lymphoma to spread to. However it is a rare site for lymphoma to originate from. When lymphoma involves the adrenal glands, the function of the adrenals may be affected, potentially causing adrenal insufficiency.

    Adrenals

    Indeterminant bone lesion

    An indeterminant lesion of the bony skeleton can potentially be a benign or a malignant lesion. Unfortunately we are unable to determine the exact nature of the lesion from this scan.

    Bony skeleton and soft tissue

    Demyelinating plaque

    Many nerves in the brain and spine are coated in myelin. Myelin is an insulating material which allows nerve signals to travel 100 times faster than they would without the myelin. When the myelin around the nerves are damaged, these nerve signals are slowed. This damage is called demyelination. A demyelinating plaque is a localized region of demyelination. New myelin can grow in areas of damage, but the new myelin is thinner and not as effective.

    Spine

    Splenomegaly

    Splenomegaly is an enlargement of the spleen. Massive splenomegaly is used to describe a spleen which weighs more than one kilogram. The spleen being a curved organ is somewhat tricky to measure in XYZ (cartesian) planes, thus imaging features of enlargement are employed by the radiologist.

    Splenomegaly is usually associated with increased workload on the spleen, which suggests that it is a response to something that is causing the spleen to work harder than normal. Other conditions increasing the risk of splenomegaly include blood disorders, infection, metabolic disorders, cancers, trauma and connective tissue disorders. The range of conditions that could cause this is broad and so a finding often requires follow-up and additional testing.

    Spleen

    Pituitary mass

    A pituitary mass (sometims called pituitary tumor) is an abnormal growth which arises from the pituitary gland, which is located at the center of the skull near the middle of the brain. The pituitary gland is responsible for producing many important hormones which are responsible for growth, blood pressure/fluid regulation and reproduction.

    The majority of pituitary masses are benign and are called pituitary adenomas. The important characteristic is to determine if the pituitary mass is over or underproducing hormones, and this is assessed by blood testing. A pituitary mass that is overproducing hormones is called a 'functioning pituitary adenoma'.

    Rarely are pituitary masses caused by metastatic disease, or other malignant cancers.

    Brain

    Horseshoe kidney

    Horseshoe kidney is a congenital disorder that occurs during fetal development where the kidneys fuse together to form a horseshoe shape. The area that is joined together is called the isthmus. This is the most common renal fusion anomaly and does not normally impair renal function.

    Kidneys

    Liver metastases

    A hepatic metastasis (plural: metastases) is a malignant tumor of the liver which has spread from another organ which has cancer. Metastases are referred to as secondary cancers (the originating organ is referred to as the primary).

    The liver is a common location for metastatic disease due to the dual blood supply from the hepatic artery and the portal vein (drains the gastrointestinal tract).

    Metastases to the liver are 20 times more common than a primary cancer originating in the liver. In 50% of all cases of hepatic metastases, the primary tumor is in the gastrointestinal tract.

    Liver

    Indeterminant cystic lesion of the neck lymph nodes

    A cystic lesion of the soft tissues of the neck may be benign or could potentially be malignant. Statistically, cystic tumors are less likely to be malignant than solid tumors. Unfortunately we are unable to determine the exact nature of the lesion from a single scan.

    Cervical lymph node chain

    Enlargement of the oral pharynx

    The enlargement of an organ or a gland is not a pathology, but is a possible indicator of an underlying pathology, or could be a normal variant.

    Oral pharynx

    Colitis

    Colitis the general term used for inflammation of the large bowel. This can be from an inflammatory, viral, bacterial, fungal or parasitic infection. It could be a simple cause that will pass in a few days, or could be something that requires further treatment, and your medical history and symptoms may be helpful.

    Colonoscopy remains the best way to assess for inflammation of the large bowel, as the tissue layer (mucosa), will provide the best clue as to the underlying cause.

    Bowel

    Uterine cancers

    A uterine neoplasm or cancer is a malignant tumour that can metastasize to other parts of the body and are classified based on location: cervical, vaginal, and endometrial carcinomas. A uterine cancer typically affects younger women with an average age of 45 years old. These can be detected earliest by direct visualization which is why the Papp test is critical for prevention of late stage disease. Also abnormal bleeding can be an important sign of an uterine abnormality and should always be discussed with your doctor.

    Endometrial carcinoma is the most common gynaecological malignancy, of which the most common abnormal tissue type is adenocarcinoma. Endometrial carcinoma is then divided into subtypes: Type I and Type II. Type I, which accounts for 80% of cases, are linked to excess estrogen in the body. Type II, accounts for 20%, are not linked to estrogen levels and involve endometrial atrophy.

    Cervical carcinoma is the third most common gynaecological malignancy. The tissue type is classified by biopsy. Squamous cell carcinoma (SCC) and adenocarcinomas are the most common tumours found in the cervix. Other less common types of cervical cancer are neuroendocrine tumours and adenosquamous cell carcinoma.

    Vaginal carcinoma is rare, especially as primary cancer. However, it is the fifth most common gynaecological malignancy. Squamous cell carcinoma (SCC) and adenocarcinomas are the most common tumours found in the vagina. Other less common types of vaginal cancer are primary vaginal melanoma and vaginal sarcoma.

    Uterus

    Spondylolisthesis

    Spondylolisthesis is the term which is used to describe the slippage of one vertebra in relation to the adjacent vertebrae. Spondylolisthesis occurs most commonly in the lumbar spine, but can occur anywhere in the spine.

    Spine

    Cardiac metastases

    Cardiac metastases are formed by the spread of cancer from other organs to the heart. Cardiac metastases are 40 times more likely to occur than a primary tumor of the heart. The most common cancers to spread to the heart are lung, breast, lymphoma, melanoma, mesothelioma, kidney, ovary, and stomach cancer.

    Please recall that the Prenuvo scan is not designed to evaluate the heart.

    Heart and great vessels

    Enlargement in the nasal pharynx

    The enlargement is not always a concerning problem, but in certain conditions it may be a possible indicator of an underlying pathology, or it may be a result of prior treatment.

    Nasal pharynx

    Bone cyst of the pelvis and hips

    Bone cysts are benign are do not spread to other parts of the body.

    Simple bone cysts are cavities that form in the bone and are filled with fluid. They are considered latent or active depending on their location. Active bone cysts are located near the epiphyseal (growth) plate and will continue to grow until it fills the entire diaphysis (shaft). Latent cysts are located away from the epiphyseal plate and will heal with treatment or resolve on their own.

    Around the femur, bone cysts can develop from the synovial joint material impressing upon and over time eroding the bone.

    Pelvis and hips

    Bone island of the shoulder

    A bone island, also known as enostosis, is a benign, very dense region of compact bone within the normal bone structure. It is generally less than 2cm in size and is usually found incidentally. A condition where multiple bone islands occur is called osteopoikilosis.

    Shoulders

    Wandering spleen

    Wandering spleen is, as its name describes, a condition in which the spleen is not located in its usual position. It most commonly migrates to the lower abdomen or pelvis. It is more common in women who have had multiple pregnancies, as the suspensory ligaments of the spleen may be damaged with the growing fetus, allowing it to move.

    Spleen

    Solid lesion of the hypopharynx

    A solid lesion of the soft tissues of the neck (throat area) may be benign or could potentially be malignant. As a general rule, the more solid a lesion is, the greater the probability it is malignant. Statistically, greater than 50%of solid tumors are benign. Unfortunately we are unable to determine the exact nature of the lesion from a single scan.

    Hypopharynx

    Bursitis of the knee

    A bursa is a fluid-filled sac that cushions and lubricates bones and tendons when they move. The body is comprised of over 150 bursae. Bursitis is an inflamed or swollen bursa. There are 14 bursae in the knee:

    • suprapatellar bursa - between the lower femur and the quadriceps femoris
    • Prepatellar bursa - between the patella and the skin
    • Deep infrapatellar bursa - between the upper part of the tibia and the patellar ligament
    • Subcutaneous infrapatellar bursa - between the patellar ligament and skin
    • Pretibial bursa - between the tibial tuberosity and the skin
    • Lateral gastrocnemius bursa - between the lateral head of the gastrocnemius and the joint capsule
    • Fibular bursa - between the lateral collateral ligament and the tendon of the biceps femoris
    • Fibulopopliteal bursa - between the lateral collateral ligament and the tendons of the popliteus
    • Subpopliteal bursa - between the tendon of the popliteus and the lateral condyle of the femur
    • Medial gastrocnemius bursa - between the medial head of the gastrocnemius and the joint capsule
    • Pes anserinus bursa - between the medial collateral ligament and the tendons of the sartoris, gracilis, and semitendinosus
    • Bursa semimembranosa - between the medial collateral ligament and the tendon of the semimembranosus
    • There is one between the tendon of the semimembranosus and the head of the tibia
    • Occasionally there is a bursa between the tendons of the semimembranosus and semitendinosus

    Bursitis in the knee can occur in any of the bursae, but the most common ones are: suprapatellar bursa, prepatellar bursa, infrapatellar bursa and pes anserinus bursa.

    Knees

    Bone cyst of the knee

    There are three types of bone cysts: traumatic bone cyst, aneurysmal bone cyst and unicameral bone cyst. They are benign are do not spread to other parts of the body.

    Traumatic bone cysts tend to occur in the jaw and facial bones after trauma.

    Aneurysmal bone cysts (ABC) are typically found in children and adolescents They are composed of numerous blood-filled channels which creates an expanded lesion within the bone. The cause of these are unknown.

    Unicameral bone cysts (simple bone cysts) are cysts or cavities that form in the bone and are filled with fluid. They are considered latent or active depending on their location. Active bone cysts are located near the epiphyseal (growth) plate and will continue to grow until it fills the entire diaphysis (shaft). Latent cysts are located away from the epiphyseal plate and will heal with treatment or resolve on their own.

    Knees

    Spinal stenosis

    Spinal stenosis is a condition in which the spinal canal (which contains the spinal cord, spinal nerves and cerebrospinal fluid) narrows to put pressure on the spinal cord nerves.

    Spine

    Hip replacement

    Hip replacement (or hip arthroplasty) is a surgical procedure that is done to relieve the pain and restore the function of a hip joint severely damaged by arthritis or a hip fracture. During the operation the original joint is partly or completely removed and replaced with an artificial joint made of metal, plastic, and/or ceramic parts.

    Pelvis and hips

    Cyst of the nasal pharynx

    Simple cysts are abnormal, fluid-filled sacs that can form in any of the soft tissues nasal passages (nasopharynx). Simple cysts usually do not cause symptoms or harm the function of the tissue. The cause is not well assessed by a single MRI.

    Nasal pharynx

    Osteoarthritis

    Osteoarthritis (OA) is a common joint disease that results from breakdown of joint cartilage and underlying bone due to wear and tear. It is the most common type of arthritis and becomes more common with age. Osteoarthritis typically causes pain, and stiffness.

    Sacroiliac joints

    Tumefactive demyelinating lesion

    A tumefactive demyelinating lesion is a solitary large (usually over 2cm) inflammatory demyelinating lesion which can give the appearance of a tumor without tissue swelling around the lesion (unlike a tumor).

    Prognosis is generally more positive with a tumefactive demyelinating lesion compared with other forms of demyelination such as multiple sclerosis, and it is unusual for someone who presents with a solitary tumefactive lesion to develop multiple sclerosis.

    Brain

    Irregular cystic lesion of the thyroid

    Occasionally in the thyroid gland, unusual shaped fluid filled lesions are found that warrant surveillance or further investigation, as there is a chance that they may develop into a cancer.

    Thyroid

    Muscle tear of the bony skeleton

    A muscle tear is an acute or chronic soft tissue injury that occurs to muscle. It is also referred to as strain. The muscle becomes overstretched and places more physical stress than it can exert on it. The tears can occur partially or completely. Acute tears tend to happen with recent trauma or injury whereas chronic tears are related to repetitive movement over a long period of time.

    Muscle tears are classified by degree of severity: first degree (mildest - some tearing still with full range of motion), second degree (moderate - torn, painful with limited motion) and third degree (severe - torn with limited or no movement).

    Bony skeleton and soft tissue

    Renal angiomyolipoma

    Renal angiomyolipomas (AML) are the most common benign tumor found in the kidney. They are composed of vascular cells, immature smooth muscle cells and fat cells. While they are classed as benign they can still affect the function of the kidney depending on their size and location. In most cases AML occur as a single mass, but rarely it can affect both kidneys and it is possible to have more than one at a time.

    Angiomyolipoma is commonly associated with other diseases such as tuberous sclerosis (genetic disease) and lymphangioleiomyomatosis(a rare lung disease).

    Kidneys

    Effusion of the ankle

    A joint effusion is an abnormal collection of fluid located in the joint space. It is commonly referred to as a 'swollen joint'

    Ankles

    Generalized brain volume

    Your brain volume changes over your lifespan. Peak volume is usually reached around 40 years of age after which the brain volume starts decline slowly about 5% per decade. Around 70 years of age the rate of decline increases. The shrinking is observed particularly in the frontal cortex of the brain. Gray matter volume seems to decline linearly with age whereas the white matter volume stays more constant. Males have higher peak volume and they also show faster decline rates. The reasons for the decline in brain volume are not known.

    Brain

    Aortic aneurysm

    An aortic aneurysm is an abnormal enlargement (dilation) that occurs in the wall of the main blood vessel (aorta) that carries blood from your heart to your body. Aortic aneurysms can occur anywhere in your aorta and may be symmetric tube-shaped (fusiform) or round bulge like (saccular).

    Heart and great vessels

    Bone island of the bony skeleton

    A bone island, also known as enostosis, is a benign, very dense region of compact bone within the normal bone structure. It is generally less than 2cm in size and is usually found incidentally. A condition where multiple bone islands occur is called osteopoikilosis.

    Bony skeleton and soft tissue

    Prostate cyst

    Prostatic cysts are abnormal fluid filled sacs that form in the prostate. They are a relatively common, benign finding. Cysts usually do not cause symptoms or harm the function of the prostate. Treatment is not needed for simple prostate cysts that do not cause any symptoms.

    Prostate and male reproductive organs

    Spleen appearance

    Asplenia is the absence of a spleen. With asplenia, there are some serious risks associated with systemic infections. Asplenia may be congenital, developed over time, or post surgical.

    In some cases, a part of the spleen can also be removed due to trauma, surgery or infection.

    Spleen

    Solid mass of the nasal pharynx

    A solid mass of the soft tissues of the nasopharynx (nasal passages) could potentially be malignant. As a general rule, the more solid a lesion is, the greater the probability it is cancer. Statistically howver, greater than 50% of solid masses are benign. Unfortunately it is not possible to determine the exact nature of a nodule from a single MRI scan.

    Nasal pharynx

    Cortical hyperplasia

    Adrenal hyperplasia is the non-cancerous growth/enlargement of the adrenal glands.

    If the adrenal gland is producing hormones at normal levels in the blood this condition is known as adrenal hyperplasia, whereas if there is abnormal production of hormones in the blood it is known as a benign adrenal adenoma. Imaging alone is incapable of separating these two scenarios.

    The enlarged adrenal gland may or may not be actively secreting hormones into the bloodstream. The adrenal gland normally secretes 1) cortisol (steroid), 2) aldosterone (mineralocorticoid for fluid balance), 3) DHEA (the precurser of the sex hormones estrogen and testosterone) and 4) adrenalin (epinephrine and nor-epinephrine)

    Most commonly in benign adrenal adenomas, the sex hormones (testosterone and estrogen) are affected with either excessive or deficient production.

    Increased cortisol (which causes Cushing’s syndrome) causes weight gain in the upper body, stretch marks, easy bruising, mood swings and increases the likelihood of developing diabetes.

    Symptoms of increased aldosterone (which causes Conn’s syndrome) includes high blood pressure, low potassium levels, weakness and cramps in your muscles.

    Adrenals

    Biliary hamartoma of the liver

    Biliary hamartomas are rare benign lesions in the liver that are composed of small, disorganized clusters of dilated bile ducts or remnants (also known as von Meyenburg complexes). It is believed that they are congenital (from birth) and may be genetically transmitted. Biliary harmatomas have been associated with polycystic kidney disease and polycystic liver disease.

    Liver

    Bone island of the pelvis and hips

    A bone island, also known as enostosis, is a benign, very dense region of compact bone within the normal bone structure. It is generally less than 2cm in size and is usually found incidentally. A condition where multiple bone islands occur is called osteopoikilosis.

    Pelvis and hips

    Choledocholithiasis

    Choledocholithiasis refers to a gallstone which has moved from the gallbladder into the bileducts; such as the common bile duct or even the upstream into the hepatic duct (hepatolithiasis).

    If these stones are small, they will pass through the common bile duct into the duodenum without causing any issues. If the stone is larger than the diameter of the common bile duct, then it can cause an obstruction, causing choledochocystitis (inflammation commonly called gallbladder attack). If choledochocystis occurs, the location of where a gallstone is located is important for a surgeon to know as it aids in treatment planning.

    If the gallstone is in the bile duct causing an obstruction, routine blood tests will be abnormal as the bile from the liver is not able to flow freely and drain into the duodenum of the small bowel.

    Gallbladder and biliary system

    Transitional vertebra

    Transitional vertebrae and accessory vertebrae are defined as variant anatomy. While they may remain entirely asymptomatic, it is possible that they could cause pain by lack of mobility, soft tissue irritation, or nerve compression anytime now or in the future. Understanding your medical history and preventing irritation to these potentially susceptible areas is invaluable. The understanding of the variant anatomy is also important when symptoms occur and essential if surgery is planned.

    Spine

    Caroli disease

    Caroli disease is a congenital (from birth) disorder in which the bile ducts are enlarged and dilated dilatation.

    The symptoms present in childhood or young adulthood with nonspecific right upper quadrant pain, and the findings of Caroli's disease are typically not well seen on ultrasound or CT.

    Liver

    Lymphadenopathy of the chest

    Lymphadenopathy is the presence of enlarged lymph nodes. These enlarged lymph nodes may be reactive to a local autoimmune or inflammatory process (e.g. sarcoidosis) or may be due to the spread of a malignancy.

    It is possible that the underlying cause may not be determined by the Prenuvo scan and the lymph nodes return to their normal size in time.

    Lungs and mediastinum

    Muscle atrophy with fatty replacement of the shoulder

    Muscle atrophy is when the muscle either partially or completely wastes/decreases in mass. It can be associated with restricted movement/lack of physical activity or as the result of other conditions or diseases affecting the person.

    Muscle atrophy can be broken into three different categories: physiologic, pathologic, and neurogenic. Physiologic is when the muscle is not being used enough. This can occur when a person is confined to a bed, has broken a limb, in places where there is no gravity or have a lifestyle with decreased activity levels. Pathologic is when the a person is suffering from other conditions such as aging, starvation, cancer, HIV, or Cushing disease. Neurogenic atrophy can be the result of injury or a disease that affects the nerves stimulating the muscles. Examples of these are: ALS, carpal tunnel syndrome, Guillain-Barre syndrome, toxins or alcohol, polio or a spinal cord injury.

    Shoulders

    Indeterminant ovarian lesion

    An indeterminant ovarian lesion can potentially be a benign or a malignant lesion. The ovaries are a dynamic organ during childbearing age, and change with each monthly cycle. Thus in some cases from a single point in time we are unable to determine the exact nature of the lesion from this scan.

    Ovaries

    Endometriosis

    Endometriosis is a condition where endometrial tissue, which lines the uterus, grows outside the uterus. It is a painful condition that affects the pelvic area. It can affect the fallopian tubes, ovaries and adjacent tissues in the pelvis. It can rarely spread outside of the pelvic region. The abnormally located endometrium tissue, despite being located outside the uterus, continues to respond to hormones in the same way as the uterine endometrial tissue does during the menstrual cycle. It thickens, breaks down, and bleeds. However, when the tissue is located outside the uterus the blood products and tissue are unable to exit the body. This can result in scar tissue and adhesions developing in the pelvic cavity. This condition is best assessed by direct visualization at surgery because adhesions cannot be seen directly by any form of imaging, and more importantly at surgery, the endometrial deposits found in the pelvic cavity can be removed.

    Imaging usually detects endometriosis when large collections of fluid or tissue are present, and the Prenuvo scan is capable of characterizing fluid in the pelvis as either simple fluid (which is normal in females of childbearing age), fresh blood, or blood degradation products. However small collections of endometrial tissue/blood are unlikely to be detected because the body is capable of resorbing the blood degradation products. Thus if you have symptoms or concerns for endometriosis, a gynecologic opinion and assessment plan is important, as the typical delay in diagnosing endometriosis is commonly more than 6 years. However if blood is detected in the pelvis in an otherwise healthy female of reproductive age on a Prenuvo scan, it is almost definitive for endometriosis.

    Uterus

    Prostate abscess

    An abscess of the prostate is a collection of pus within the prostate gland that occurs as a result of prostatitis. An abscess is seen as a fluid filled collection within the prostate.

    Prostate and male reproductive organs

    Polyposis of the nasal airways and/or sinuses

    Polyps are benign growths which can occur in the nasal passages or sinuses. Polyps occur in the mucous membrane of the nasal passages and sinuses. The accumulation of numerous polyps is termed polyposis.

    Imaging is not the best way to assess the nasal mucosal tissue for polyps, the best way is direct visualization of the nasal passages, particularly if you have a family history of polyposis.

    Sinuses and mastoids

    Fat deposition to the liver

    A fatty liver is the build-up of fat cells in the liver. Fat is primarily metabolized from an overconsumption of sugars and alcohol in our diet. The fat is stored in various locations in our body, including the liver.

    If you have an overall liver fat percentage of below 5 percent your liver is considered normal in terms of fat content. A person has a fatty liver when fat makes up more than 5 percent the liver tissue. Fatty liver can lead to hepatitis fibrosis, scarring, and eventually cirrhosis.

    Liver

    Indeterminant cystic lesion of the liver

    An indeterminant lesion of the liver can potentially be a benign or a malignant lesion. Unfortunately we are unable to determine the exact nature of the lesion based on its current size and tissue composition.

    Liver

    Recent fracture of the sacroilliac joint

    Recent fractures are fractures that have occured within the last 2-3 months and are still in the healing process.

    A bone fracture, also known as a broken bone, is a partial or complete break in the continuity of the bone. It can be a single fracture line or multiple fractured pieces. Fractures can occur from trauma, stress or from another pathology.

    The different types of fractures are:

    • Displaced: the bone breaks into two or more parts and moves out of alignment
    • Non-displaced: the bone breaks either part of all the way through but maintains alignment
    • Closed: the bone breaks but no puncture or open wound in the skin
    • Open: when the bone breaks and punctures the skin; these fractures are at risk of infection

    Fractures are placed into subtypes:

    • Comminuted: broken into several pieces
    • Transverse: fracture line is perpendicular to the long part of the bone
    • Oblique: fracture line is on an angle through the bone
    • Pathologic: caused by a disease that weakens the bone
    • Stress: hairline crack

    Healing of the bone starts almost immediately. It can be visualized on an x-ray as early as 2 to 4 weeks in adults.

    Sacroiliac joints

    Shoulder hemangioma

    A bony hemangioma can often be referred to as a few other names, primary intraosseous hemangioma or vascular hamartoma. A hemangioma is a benign vascular malformation that occurs when blood vessels multiply at an abnormal rate. They most commonly occur in the skull and the spine but they can form in any body part. Capillary and cavernous hemangiomas are the most common type of hemangioma to affect bones. They can occur on the surface of the bone or deeper. Often hemangiomas are asymptomatic and are found incidentally on an xray or MRI.

    Shoulders

    Polycystic kidney disease

    Polycystic kidney disease (PKD, also known as polycystic kidney syndrome) is a hereditary genetic disorder in which the renal tubules’ structure becomes abnormal resulting in multiple cysts growing on the kidneys. This can happen at any time during the lifespan from fetus development through to adulthood.

    Cysts replace functioning tubules with non-functioning tubules and can be anywhere in size from microscopic to enormous.

    There are two types of polycystic kidney disease: Autosomal dominant polycystic kidney disease (most common) and autosomal recessive polycystic kidney disease. Both are hereditary with the latter affecting babies within the first few weeks of life and often associated with undeveloped kidneys.

    Kidneys

    Renal lipoma

    Renal lipomas are benign tumours found in the kidney composed of fat cells or mature adipocytes. Lipomas commonly can occur all over the body. When they affect the kidney, they typically occur in the cortex (outer edge) of the kidney

    Kidneys

    Adrenal pseudocyst

    A pseudocyst is a cyst which does not have epithelial or endothelial cells. Pseudocysts constitute approximately 40% of all adrenal cysts. The cysts can grow quite large (larger than 10cm). Pseudocysts are more likely to cause symptoms than simple cysts, often because of their size.

    Adrenals

    Balo concentric sclerosis

    Balo concentric sclerosis is a subtype of multiple sclerosis characterized by the appearance of circular layers of demyelination. With Balo concentric sclerosis, rapid progression is common, remission is possible and asymptomatic cases are rare. This type of condition is more common in Filipino and Chinese descendents.

    Brain

    Bowel carcinoid

    Carcinoids are slow growing neuroendocrine tumors which can grow without causing symptoms for years. The small bowel is the most common location within the gastrointestinal tract for carcinoid tumor to develop (40%) although they can develop anywhere within the gastrointestinal tract. Metastasis rates increase with an increase in tumor size.

    Please note that the bowel is best assessed by endoscopy, as the Prenuvo scan will identify conditions late in the disease process.

    Bowel

    Ureterocele

    A ureterocele is a congenital abnormality found in the ureter. It is when the distal(lower) ureter is enlarged where it enters into the bladder forming a sac-like pouch. It is commonly associated with a duplex collecting system. This is when two ureters exit one kidney. However, it can occur with a normal collecting system.

    As prenatal ultrasound has become a regular exam most ureteroceles are diagnosed prenatally.

    There are six classifications of ureteroceles:

    • Intravesical: confined within the bladder
    • Ectopic: some part extends to the bladder neck or urethra
    • Stenotic: intravesical ureterocele with a narrow opening
    • Sphincteric: ectopic ureterocele with an orifice distal to the bladder neck
    • Sphincterostenotic: orifice is both stenotic and distal to te bladder neck
    • Cecoureterocele: ectopic ureterocele that extends into the urethra, but the orifice is in the bladder.

    Bladder and ureters

    Indeterminant splenic lesion

    We have detected a lesion in your spleen. Unfortunately we cannot determine the exact nature of the lesion.

    Spleen

    Adrenal adenoma

    Adrenal adenomas are benign, usually asymptomatic lesions arising from the cortex (outer component) of the adrenal gland. On imaging, the adenomas can be classified as typical or atypical. Typical adenomas are able to be confidently identified on your Prenuvo scan. They are usually less than 3cm in size. Atypical adenomas are not able to be classified and will need repeat imaging to see if they change in addition to baseline adrenal biochemical testing.

    Of the typical adenomas, they can be further classified as functional or nonfunctional based on whether the adenoma leads to an increased secretion from within the adrenal gland. Only 5% of all adenomas are functional. The symptoms of a functioning adenoma are related to the location of the adenoma within the adrenal gland, causing them to secrete higher than usual amounts of either cortisol, aldosterone or sex hormone.

    Adrenals

    Crohn's disease

    Crohn’s disease is an inflammatory bowel disease that most commonly affects the end of the small bowel (known as the terminal ileum). It can affect regions of the gastrointestinal tract anywhere from mouth to anus, and is best assessed by direct visualization (ie endoscopy or colonoscopy). In the bowel, it can cause inflammation and ulceration of the bowel wall which can lead to a fistula, where two sections of bowel can join onto each other. There is no apparent cause and no definitive cure, but there are numerous symptom management options available.

    Please note that the large bowel (colon) and the upperGI system (esophagus to duodenum) are best assessed by endoscopy or colonoscopy, as the Prenuvo scan will identify conditions late in the disease process.

    Bowel

    Neurocysticercosis

    Neurocysticercosis is caused by a tapeworm infection acquired from pork which causes small egg like lesions in the brain.

    Neurocysticercosis is more common in lower socio-economic countries where sanitary conditions are inadequate. It is the most common cause of acquired epilepsy in the world.

    Brain

    Transverse myelitis

    Acute transverse myelitis is an inflammatory process of the spinal cord which causes rapid progression of motor, sensory and autonomic nerve dysfunction.

    Spine

    Lymphoma of the sinuses

    Lymphoma is a cancer which arises in the lymphocytes or lymphoblasts. Lymphoma can arise from any of the sinuses (and many other locations within the body).

    Sinuses and mastoids

    Indeterminant cystic lesion of the hypopharynx

    A cystic lesion of the soft tissues of the lower neck may be benign or could potentially be malignant. Statistically, cystic lesions are less likely to be malignant than solid tumors. Unfortunately we are unable to determine the exact nature of the lesion from a single scan.

    Hypopharynx

    Scoliosis

    Scoliosis is a condition where a person has a sideways or rotational curve of the spine. There is usually one dominant curve and a more subtle compensatory curve.

    Spine

    Angiosarcoma of the liver

    Angiosarcoma is a form of liver cancer which originates in the lining of a blood vessel or lymphatics (the endothelium). It typically affects people in their 60s and 70s. Because angiosarcoma originates in a blood vessel, it has a risk of fast growth due to the native blood supply, and the the cancer cells are able to be carried to distant sites (most commonly lungs), where it can metastasize.

    Workers in polyvinyl chloride (PVC) polymerization plants and those in contact with arsenic containing insecticides are at a higher risk of developing angiosarcoma.

    Liver

    Hemangioma of the pelvis and hips

    A bony hemangioma can often be referred to by a few other names, primary intraosseous hemangioma or vascular hamartoma. A hemangioma is a benign vascular malformation that occurs when blood vessels multiply at an abnormal rate. They most commonly occur in the skull and the spine but they can form in any body part. Capillary and cavernous hemangiomas are the most common type of hemangioma to affect bones. They can occur on the surface of the bone or deeper. Often hemangiomas are asymptomatic and are found incidentally on an xray or MRI.

    Pelvis and hips

    Hemangioma

    A hemangioma is the most common lesion in bone. It is benign and almost always asymptomatic.

    Spine

    Bone island of the knee

    A bone island, also known as enostosis, is a benign, very dense region of compact bone within the normal bone structure. It is generally less than 2cm in size and is usually found incidentally. A condition where multiple bone islands occur is called osteopoikilosis.

    Knees

    Cystic hepatic metastases

    Cystic (viscous fluid filled) hepatic metastases are tumors that have spread from another organ primary site. The internal cystic component is associated with breakdown of the inner part of the tumor (necrosis) which occurs when the tumor outgrows its blood supply. This is also called a mucinous component tumor which derives its internal components from the primary cancer.

    Liver

    Indeterminant lesion of the sinus

    An indeterminant lesion in the sinus describes a small lesion which may be benign or could potentially be malignant. Direct visualization (if possible) or at the very least followup imaging to assess for interval change is the best way to characterize it further, as unfortunately a single timepoint of imaging is unable to determine the exact nature of the lesion.

    Sinuses and mastoids

    Deviated nasal septum

    The nasal septum is the bone and cartilage that divides the nose into a left and right nostril. A deviated nasal septum is a physical condition where, as the name describes, the inner central component of the nose is curved or offset to one side. Around 80% of people with a deviated nasal septum are completely unaware they have this condition, which also indicates its relative insignificance.

    Sinuses and mastoids

    Indeterminant breast lesion

    An indeterminant breast lesion can potentially be a benign or a malignant lesion. Unfortunately we are unable to determine the exact nature of the lesion from this scan.

    Breasts

    Urinary tract metastases

    A bladder metastasis (plural: metastases) is a malignant tumor of the bladder which has spread from another organ which has cancer. Metastases are referred to as secondary cancers. The originating organ is referred to as the primary. The metastases of the bladder are commonly from other pelvic cancers such as prostate or cervical, colorectal or from the ureters.

    Bladder and ureters

    Irregular cystic tumor of the oral pharynx

    A cystic tumor of the soft tissues of the neck may be benign or could potentially be malignant. Statistically, cystic tumors are less likely to be malignant than solid tumors. Unfortunately we are unable to determine the exact nature of the lesion from a single scan.

    Oral pharynx

    Hemorrhagic hypertensive microangiopathy

    Hemorrhagic hypertensive microangiopathy occurs as a result of long term elevated blood pressure. It is evidenced by microhemorrhages of the small blood vessels of the brain. This damages the white matter of the brain. Hypertensive microangiopathy is more commonly seen in people over the age of 60.

    Brain

    Shoulder metastases

    Bone metastases or osseous metastatic disease are cancerous lesions that the result of spread from another primary cancer (a cancer somewhere else in the body). They are more common than primary bone cancer. Some of the most common cancers to spread to bones are: breast, prostate, lung, kidney and thyroid.

    Metastatic disease affect the regular routine process of bone turnover. As a result the structure of bone changes. There are two type of bone metastases, osteoblastic metastases and osteolytic metastases. Osteoblastic(sclerotic) metastases occur when cancer cells invade and cause too many bone cells to form. The bone then becomes very dense. Osteolytic metastases occur when the cancer breaks down too much bone resulting in the bone being destroyed and weakened. The former is the more common type.

    Shoulders

    Thyroid cyst

    A simple cyst of the thyroid is a fluid-filled sac that can form in any of the soft tissues of the neck. Simple cysts usually do not cause symptoms or harm the function of the tissue. Treatment is rarely needed for simple cysts that do not cause any symptoms.

    Thyroid

    Brain mass

    A brain mass is a concerning lesion that has the possibility of being a tumor. It has imaging features which have damaged normal brain tissue adjacent to the lesion (this is termed 'mass effect'). Prior medical history and symptoms are important to determine how or if this mass needs to be evaluated further.

    Brain

    Knee metastases

    Bone metastases or osseous metastatic disease are cancerous lesions that the result of spread from another primary cancer (a cancer somewhere else in the body). They are more common than primary bone cancer. Some of the most common cancers to spread to bones are: breast, prostate, lung, kidney and thyroid.

    Metastatic disease affect the regular routine process of bone turnover. As a result the structure of bone changes. There are two type of bone metastases, osteoblastic metastases and osteolytic metastases. Osteoblastic(sclerotic) metastases occur when cancer cells invade and cause too many bone cells to form. The bone then becomes very dense. Osteolytic metastases occur when the cancer breaks down too much bone resulting in the bone being destroyed and weakened. The former is the more common type.

    Knees

    Sinusitis

    Sinusitis is mucosal inflammation or infection of one or more of the sinuses of the head. Sinusitis can be acute or chronic.

    Sinuses and mastoids

    Bone cyst of the bony skeleton

    There are three types of bone cysts: traumatic bone cyst, aneurysmal bone cyst and unicameral bone cyst. They are benign are do not spread to other parts of the body.

    Traumatic bone cysts tend to occur in the jaw and facial bones after trauma.

    Aneurysmal bone cysts (ABC) are typically found in children and adolescents They are composed of numerous blood-filled channels which creates an expanded lesion within the bone. The cause of these are unknown.

    Unicameral bone cysts (simple bone cysts) are cysts or cavities that form in the bone and are filled with fluid. They are considered latent or active depending on their location. Active bone cysts are located near the epiphyseal (growth) plate and will continue to grow until it fills the entire diaphysis (shaft). Latent cysts are located away from the epiphyseal plate and will heal with treatment or resolve on their own.

    Bony skeleton and soft tissue

    Split cord malformation

    A split cord malformation, or “diastematomyelia” is a congenital (from birth) disorder in which, as the name states, part of the spinal cord is split. This usually occurs at the upper lumbar spine level.

    The spinal cord can reunite again further down the spine, though this is not always the case. The division of the spinal cord can be caused by the presence of bone, cartilage or a fibrous septum.

    Cord malformation may be isolated, though it is more commonly found in people who have spina bifida, scoliosis or other congenital vertebral defects.

    Spine

    Bladder diverticula

    A bladder diverticulum (plural: diverticula) is an outpouching of the bladder wall, which you were born with (congenital) or it more commonly it develops later due to longstanding issues with the bladder.

    Bladder and ureters

    Gastric adenocarcinoma

    Gastric adenocarcinoma is the most common form of gastric malignancy. It arises from glandular epithelial cells in the stomach. The cancer invades the wall of the stomach. If found early, gastric adenocarcinoma is able to be treated without chemotherapy or radiation therapy.

    The stomach, like all of the hollow viscous of the mouth through to anus is best assessed by direct visualization as these tissues are too mobile and flexible for imaging to be useful for early detection. The added benefit of direct visualization (gastroscopy/endoscopy), is if suspicious tissue is identified, it can be biopsied at the time of visualization.

    Stomach

    Indeterminant prostate lesion

    An indeterminant prostate lesion can potentially be a benign or a malignant lesion. Unfortunately we are unable to determine the exact nature of the lesion from this scan.

    Prostate and male reproductive organs

    Tarlov / perineural cyst

    A Tarlov cyst (also known as a perineural cyst) is a contained outpouching of cerebrospinal fluid from the spinal canal around the normally exiting nerve between the vertebrae of the spine (at the neural foramen). These Tarlov cysts can slowly grow and erode the adjacent bony wall enlarging the neural foramen.

    Spine

    Renal oncocytoma

    Renal oncocytoma is a benign kidney mass. They are made up of oncocytes, a type of epithelial cell. As with a lot of renal masses they are typically asymptomatic and discovered on an examination for another reason.

    Renal oncocytomas typically affect males of over the age of 50. They can be a solitary mass or occur in multiples affecting one or both kidneys. People with genetic syndromes such as tuberous sclerosis complex and Birt-Hogg-Dube syndrome can be more affected by renal oncocytomas.

    Kidneys

    Brain hemorrhage

    A brain hemorrhage can occur as a result of an artery or a vein in the brain rupturing. An arterial rupture will often cause immediate severe symptoms, and without emergency treatment, coma and death, hence is unlikely to occur in the setting of a Prenuvo scan. A venous rupture can cause a slower bleed which also requires prompt medical attention to ensure it is not progressing.

    Brain

    Bone marrow edema of the shoulder

    Bone marrow is a semi-solid tissue which is found within the spongy or cancellous portions of bone. It is responsible for the production of new blood cells. Bone marrow edema is the term used when there is a fluid collection within the bone marrow. It is usually presence when there is an underlying condition. Conditions it could be related to can include: trauma (bone bruise), microtrabecular fracture, arthropathy, decreased blood flow, infection, post-operative changes, chemotherapy, bone metastases, or arthritis.

    Shoulders

    Endometrioma

    An endometrioma is a type of cyst that forms when a cluster of normal hormonally sensitive endometrial tissue grows outside the uterus. It is a benign growth and the most commonly detected form of endometriosis. Typically an endometrioma is located on or near the ovaries. Normal endometrial tissue during the menstrual cycle, thickens, breaks down, then bleeds, with these products exiting the body. However when this cluster of endometrial tissue is located outside the uterus it has no way to exit the body and forms an endometrioma. If an endometrioma grows larger than 9cm in diameter, (approximately 1% of all endometriomas) there is a possibility for the endometrioma to turn malignant.

    Endometriomas that are smaller than 5mm are considered early stage disease, and may be too small to be seen other than at surgery. Endometriomas that are larger than 15mm are considered advanced stage disease.

    Uterus

    Bone marrow edema of the pelvis and hips

    Bone marrow is a semi-solid tissue which is found within the spongy or cancellous portions of bone. It is responsible for the production of new blood cells. Bone marrow edema is the term used when there is a fluid collection within the bone marrow. It is usually presence when there is an underlying condition. Conditions it could be related to can include: trauma (bone bruise), microtrabecular fracture, arthropathy, decreased blood flow, infection, post-operative changes, chemotherapy, bone metastases, or arthritis.

    Pelvis and hips

    Indeterminant lesion of the brain

    An indeterminate lesion of the brain can potentially be a benign or a malignant lesion. Unfortunately we are unable to determine the exact nature of the lesion

    Brain

    Hepatocellular carcinoma

    Hepatocellular carcinoma (HCC) is the most common type of primary liver cancer and the 5th most common tumor type globally.

    A HCC can develop because of chronic liver inflammation, as well as genetic predisposition or infection (Hepatitis B or C).

    Liver

    Meningioma

    A meningioma the most common brain tumor. It forms from the meninges which is the membrane that covers the brain and spinal cord.

    Meningiomas are typically benign (not cancerous) and don't necessarily need treatment unless they press on the brain tissue and cause symptoms. Over time some meningiomas calcify and thus stop growing. Symptoms (if any) as well as treatment options depend on the location of the meningioma.

    The Prenuvo scan, like all non injection based imaging, may not see a small meningioma unless it presses upon the adjacent brain tissue. This finding coupled with your symptom history are important in determining the impact of a meningioma.

    Brain

    Degeneration of the shoulder

    Degenerative joint disease or degenerative arthritis (osteoarthritis) is the most common condition to affect joints. It is a chronic condition. It is in two forms: primary and secondary. Primary is hereditary and less common but occurs without cause or injury. Secondary is the most common form and is due to abnormal mechanical forces such as obesity, previous injury/trauma or joint stress.

    Degenerative joint disease occurs when the cartilage breaks down causing the bones to rub together and become misshapen with bone spurs (osteophytes). Typically it occurs in the older population.

    The Prenuvo scan does not look at cartilage, thus the earliest signs of arthritis may not be seen on this study. If you are interested in cartilage imaging, discuss with your doctor about obtaining a dedicated joint MRI.

    Shoulders

    Adrenal abscess

    An adrenal abscess is a rare pus filled benign lesion of the adrenal gland. The abscess usually accumulates secondary to an acute infection elsewhere in the body which has spread through the bloodstream to the adrenal glands.

    It would be quite unusual to detect an adrenal abscess on any imaging outside of a hospital setting, as patients with an infection that has entered into the bloodstream would be very ill.

    Adrenals

    Hydatid cyst

    Hydatid cysts are formed as a result of an infection of Echinococcus, commonly known as tapeworm. When the eggs of a tapeworm are ingested, the embryo which are released from an egg form the hydatid cyst. The egg grows 5-10cm in the first year and is able to survive for years, even decades.

    Liver
     
    Some general advice about our screening products:
    • All Prenuvo scans are effective in visualizing lesions 1.5 cm or larger in the chest, abdomen and pelvis. The comprehensive and head & torso package also evaluates the head and neck for lesions 1 cm or larger.
    • No Prenuvo scan evaluates the heart in detail, although we do see evidence of atherosclerosis in other regions of the body.
    • No Prenuvo scan evaluates the lung micro-architecture in fine detail but will assess for mediastinal/hilar adenopathy/carcinoma.
    • All Prenuvo scans are limited in the evaluation of the hollow viscus (bowel and stomach) but will detect bowel carcinoma constricting the colon.
    • No cartilage-based sequences are performed for any Prenuvo scan which limits detailed assessment of the joints.
    • As with any medical test, due to many factors including state of disease progression, body physiology, body position and body movement, there are limitations which make it impossible to detect all malignancies and conditions listed above.
    • As with any medical test, there is a chance of a false positive or differential diagnosis for any result provided by your Prenuvo scan. You should discuss your results, decide any follow-up actions and only make changes to your health management based on discussion with your primary care physician.
    • While we strive to be comprehensive, the reading radiologist will not catalog every feature that fails to meet a threshold of clinical significance.