Tuberous sclerosis

Non-fat-saturated, noncontrast T1 (A), fat-saturated postcontrast T1 (B), out-of-phase T1 (C), and fat-saturated T2 (D) magnetic resonance images in a patient with tuberous sclerosis complex showing typical features of numerous lipid-rich lesions consistent with AMLs replacing much of the kidney parenchyma bilaterally. These features include decreased signal on fat-saturated T1- and T2-weighted images, India ink artifact on out-of-phase images (black outlines of lesions, arrows), and enhancement of the soft tissue components of the AMLs.