AJR 2008; 190:W382 0361–803X/08/1906–W382 © American Roentgen Ray Society Diagnosis of Gossypiboma of the Abdomen and Pelvis We read with interest the excellent report by Kim et al. [1] in which the authors describe their experience with MRI in the diagnosis of gossypiboma in the abdomen and pelvis in four patients. We found their report informative and well written and agree with the authors that MRI is an excellent technique in the imaging of patients with gossypiboma, despite its rare occurrence. The authors describe in detail the characteristic MRI features of gossypiboma in the abdomen and pelvis, which include the delineation of a well-defined mass with a peripheral wall of low signal intensity on T1and T2-weighted imaging, with whorled stripes seen in the central portion and peripheral wall enhancement after IV gadolinium administration on T1-weighted imaging [1]. We recently encountered a similar case in our institution, which was initially imaged on CT. Our patient was a 66-year-old woman who presented with left flank pain and high-grade pyrexia. She had a history of total abdominal hysterectomy and bilateral salpingo-oophorectomy 10 years previously for endometrial carcinoma. Urine culture grew Escherichia coli and a presumed diagnosis of left-sided pyelonephritis was made. However, despite 72 hours of treatment, her symptoms failed to improve and IV contrast-enhanced CT of the abdomen was performed. CT showed a 5 × 4 cm soft-tissue mass in the region of the left psoas muscle (Fig. 1A). In our case, there was no enhancement of the lesion on CT, making the diagnosis difficult. However, on MRI, a well-defined mass with a serrated contour in its inner border showing peripheral enhancement after IV gadolinium administration (Fig. 1B) was present in a similar fashion as that described by Kim et al. [1]. This combined with the presence of a whorled, striped (Figs. 1C and 1D) appearance suggested the diagnosis of a gossypiboma, which was confirmed at surgery. We therefore think that this case adds further credence to the series by Kim et al. in showing the utility of MRI in the evaluation of patients with retained intraabdominal surgical gauze or textiloma. In summary, we congratulate Kim et al. [1] on their excellent report in which they describe the characteristic MRI findings in four patients with gossypiboma of the abdomen and pelvis. We think that our case further adds to those described by the authors in highlighting the advantages of MRI over other cross-sectional techniques such as CT in making a diagnosis. Colm F. Murphy Helen Stunell William C. Torreggiani Adelaide & Meath Hospitals Incorporating the National Children’s Hospital Tallaght, Dublin, Ireland