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This is an MRI of the pelvis in a

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patient with an early second trimester

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pregnancy presenting with left lower

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quadrant pelvic pain and left groin pain.

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The patient had a history of neurofibromatosis

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and was being imaged to determine if a

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neurofibroma was the cause of her symptoms.

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This is an axial T2-weighted

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image of the pelvis.

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We can see the gravid uterus, which

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also has multiple uterine fibroids

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present within the uterus.

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We see the fetus here in addition to

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the early second trimester placenta.

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And what I'd like to point out for

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this patient is an asymmetry that's

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present in the common iliac veins with

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extension into the left femoral vein.

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So the left common iliac vein

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is enlarged in this patient.

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We can see that it's markedly

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asymmetric when compared with the right.

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Additionally, the wall of the vein is

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thickened, and there's surrounding T2

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hyperintensity consistent with edema.

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This extends all the way to the margin

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of our imaging plane, for the most part.

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When we look at this finding on the coronal

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T2-weighted images, we can see again that the

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left common iliac vein is distended with a

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relatively T2 heterogeneous filling defect.

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That extends all the way from the

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left common iliac vein into the left

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femoral vein with surrounding edema.

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And again, this is markedly

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asymmetric when compared with the

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right iliofemoral venous vasculature.

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So this is an acute deep venous

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thrombosis, fairly extensive in this

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patient with a second trimester pregnancy.