Uneingeschränkter Zugang

MRI of the Morel-Lavallée lesion – a case series

Tajda Srot Volavc
Tajda Srot Volavc
 und 
Mitja Rupreht
Mitja Rupreht
   | 10. Aug. 2021
Radiology and Oncology's Cover Image
Über diesen Artikel
Vorheriger Artikel
Nächster Artikel
Zitieren
Article Category: Research Article
Online veröffentlicht: 10. Aug. 2021
Seitenbereich: 268 - 273
Eingereicht: 29. Dez. 2020
Akzeptiert: 16. Feb. 2021
DOI: https://doi.org/10.2478/raon-2021-0018
© 2021 Tajda Srot Volavc, Mitja Rupreht, published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Figure 1

Morel-Lavallee lesion type 1. A 33-years-old professional skier 2 weeks after a fall. A large fusiform collection (arrows) between the subcutaneous fat and fascia lata demonstrating low signal intensity (SI) on T1 WI (A) and high SI on proton density fat-saturated image (PDFS) (B) in coronal plane indicating clear fluid i.e. seroma.
Morel-Lavallee lesion type 1. A 33-years-old professional skier 2 weeks after a fall. A large fusiform collection (arrows) between the subcutaneous fat and fascia lata demonstrating low signal intensity (SI) on T1 WI (A) and high SI on proton density fat-saturated image (PDFS) (B) in coronal plane indicating clear fluid i.e. seroma.

Figure 2

ML lesion type 3. A 34-year-old male after a distortion. On axial protondensity fat-suppression (PDFS) MRI (A) a fusiform fluid collection with hypointense debris is demonstrated between the deep subcutaneous fat and layers of medial patelofemoral ligament (arrows). On T1 weighted sagital image (B), in moderately hypointense collection several fat globules are visible (thin arrow).
ML lesion type 3. A 34-year-old male after a distortion. On axial protondensity fat-suppression (PDFS) MRI (A) a fusiform fluid collection with hypointense debris is demonstrated between the deep subcutaneous fat and layers of medial patelofemoral ligament (arrows). On T1 weighted sagital image (B), in moderately hypointense collection several fat globules are visible (thin arrow).

Figure 3

Extension of the Morel-Lavallée (ML) lesion. Same patient as in the Figure 1. On axial proton-density fat-suppression (PDFS) images, a thin communication (thin arrows) between gluteus maximus muscle and the deep gluteal fat connects the primary lesion (thick short arrow) and another collection posteriorly (thick arrow). Note also the mild oedema signal of the gluteus maximus muscle and gluteal fat indicating contusions.
Extension of the Morel-Lavallée (ML) lesion. Same patient as in the Figure 1. On axial proton-density fat-suppression (PDFS) images, a thin communication (thin arrows) between gluteus maximus muscle and the deep gluteal fat connects the primary lesion (thick short arrow) and another collection posteriorly (thick arrow). Note also the mild oedema signal of the gluteus maximus muscle and gluteal fat indicating contusions.

Figure 4

Fat globule and concomitant injury. In this 14-year-old boy with unknown time and mechanism of injury, a small fusiform fluid collection is visible at the right side between deep subcutaneous fat and fascia lata with low T1 (A) and high proton-density fat-suppression (PDFS) (B) SI (thin arrows) on coronal images. Note also a large fat globule in the lesion (short thick arrows). In addition, on the left side (C), an small avulsion of the sartorious tendon off the anterior superior iliac spine is visible (long thick arrow).
Fat globule and concomitant injury. In this 14-year-old boy with unknown time and mechanism of injury, a small fusiform fluid collection is visible at the right side between deep subcutaneous fat and fascia lata with low T1 (A) and high proton-density fat-suppression (PDFS) (B) SI (thin arrows) on coronal images. Note also a large fat globule in the lesion (short thick arrows). In addition, on the left side (C), an small avulsion of the sartorious tendon off the anterior superior iliac spine is visible (long thick arrow).

Figure 5

Concomitant injuries. Same patient as in Figure 1 and 3. In proton-density fat-suppression (PDFS) coronal image, a mild hyperintensity of adductor muscles is visible (thick arrow) indicating mild distension without fibre disruption. In addition, note secondary cleft sign (thin arrow) at the lower right edge of the pubic symphysis indicating possible injury of the rectus/adductor aponeurosis. In such case, a dedicated MRI examination might be warranted.
Concomitant injuries. Same patient as in Figure 1 and 3. In proton-density fat-suppression (PDFS) coronal image, a mild hyperintensity of adductor muscles is visible (thick arrow) indicating mild distension without fibre disruption. In addition, note secondary cleft sign (thin arrow) at the lower right edge of the pubic symphysis indicating possible injury of the rectus/adductor aponeurosis. In such case, a dedicated MRI examination might be warranted.

MRI classification of Morel-Lavallee lesions according to Mellado-Bencardino12

Lesion type T1W T2W Morphology Other
Type 1 - Seroma Homogenously hypointense seroma Hyperintense collection Laminar No evidence of outer capsule formation
Type 2 – Subacute hematoma Homogenously hyperintense Homogenously hyperintense Oval Presence Thin capsule of methaemoglobin formation
Type 3 – Chronic organizing hematoma Hypointense Heterogeneous hypointense/ isointense Oval Thick capsule formation Capsular and internal enhacement on postcontrast sequences
Type 4-Closed laceration Hypointense Hyperintense Linear No capsule formation
Type pseudonodular 5-Small, rounded appearance Variable Variable Round Variable capsule formation
Type 6-Superimposed infection Variable Variable Variable sinus tract Thick enhancing capsule
eISSN:
1581-3207
Sprache:
Englisch
Zeitrahmen der Veröffentlichung:
4 Hefte pro Jahr
Fachgebiete der Zeitschrift:
Medizin, Klinische Medizin, Allgemeinmedizin, Innere Medizin, Hämatologie, Onkologie, Radiologie
Zeitschrift RSS Feed