Objective: Our goal was to present MR findings in venous aneurysms and
introduce the ''layered gadolinium'' sign as an ancillary diagnostic
finding. Method: Gadolinium-enhanced MR images of three patients with
retroperitoneal venous aneurysms were retrospectively reviewed. Prior
to MRI, venous aneurysm had been suspected clinically in only one pati
ent. Surgical correlation was available in one patient. A phantom was
constructed and imaged to investigate the cause of the layered gadolin
ium sign. Results: A gradation of signal intensity, the layered gadoli
nium sign, was observed in three patients with venous aneurysms on pos
tcontrast T1-weighted images. The anterior portion of the aneurysms de
monstrated high signal intensity separated by a sharp interface from t
he low signal intensity posterior region. Unenhanced time-of-flight MR
venography, color Doppler, and duplex sonography failed to demonstrat
e flow in the patient with surgical proof. Conclusion: The layered gad
olinium sign may be helpful in the diagnosis of venous aneurysm and in
differentiating these masses from solid neoplasms.