Ectopic lesions in the abdomen and pelvis: a multimodality pictorial review

MR Imaging for Ectopic Pregnancy

Ectopic pregnancy (EP) is diagnosed based on laboratory values and ultrasonography (US) findings. Evaluation for suspected EP should begin with a quantitative measurement of the serum β-human chorionic gonadotropin levels and transvaginal US. MR imaging is not preferentially performed in the evaluation of EP; however, if the findings of transvaginal US are uncertain, MR imaging can be used, as it has the advantages of superior soft-tissue contrast resolution and a wide scanning range. Identifying the exact location of implantation transfer using MR imaging can help in the diagnosis and establishment of treatment strategies for ectopic pregnancies, including laparoscopy. In particular, as the incidence of heterotopic pregnancy has increased with the recent increase in use of assisted reproductive technology, the scope of application of MR imaging is expected to expand further. This pictorial essay describes the various manifestations of EP and related conditions on MR imaging and US. Familiarity with the clinical setting and the US and MR imaging features of EP and associated conditions can lead to a more accurate diagnosis and treatment.

Two Ectopic Liver Lobes Discovered Incidentally at an Autopsy: A Case Report

The ectopic liver lobe is a rare anomaly and is most frequently reported as a solitary mass. Herein, we report a case of multiple (two) ectopic liver lobes detected at an autopsy. A Japanese man in his 70s died of an infectious disease associated with acquired immunodeficiency syndrome (AIDS). Autopsy revealed the incidental finding of two 1-cm masses, located anterior to the inferior vena cava. Both masses were composed of liver tissue and had internal microscopic structures resembling the porta hepatis, consisting of an outflow bile duct and blood vessels. The outflow bile duct appeared to be continuous with the common bile duct, but the connection point of the outflow vessel was unclear. The liver tissue showed fibrous thickening of the central veins and portal venopathy, including fibrosis in the portal area as well as narrowing and loss of the portal veins. There was no evidence of congestion, fibrosis, biliary stasis, or neoplasm. The incidence of hepatocellular carcinoma is higher in the ectopic liver lobe than in the proper liver, presumably due to the abnormal circulation and bile excretion pathways. The patient also presented with portal venopathy; this suggests the presence of abnormal circulatory dynamics.