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Date : 00.00.00

Name of the Patient : Abc XyzShlmn / M / 31 yrs.
Referred by : Dr. Abc Xyzporia.
Examination : M.R.I. of the Brain.


C/O headaches with nausea since 2 years.


M.R.I of the brain was performed using the following parameters :

5 mm thick T1 Weighted, proton and T2 Weighted axial images.

5 mm thick FLAIR coronal images.

4 mm T1 Weighted sagittal images and 3 mm thick T1 Weighted coronal images.

An MR Cisternogram was obtained in the sagittal plane.


There is still seen a well-marginated, approximately 2.0 x 1.0 x 2.2 cms sized hypointense mass lesion on the T1 Weighted images involving the clivus, more in the midline. This lesion appears hyperintense on the proton and T2 Weighted images. The mass lesion appears slightly expansile with extension into the prepontine cistern with minimal indentation on the basilar artery. Extension of the lesion into the dorsum sella and floor of the sphenoid sinus, posteriorly is noted. It is difficult to estimate the erosion of the cortical margins of the clivus.

There is no focal area of abnormal signal in the brain parenchyma per se.

Both the lateral, third and the fourth ventricles are normal. The rest of the basal cisternal spaces are unremarkable. There is no shift of the midline structures.
- 2 - scan-00003

Inflammatory changes are noted in the mastoid air cells bilaterally.

Screening, T1 Weighted sagittal images of the cervical spine reveal replacement of the normal fatty marrow of the cervical vertebrae by a predominantly haematopoietic marrow.


1. A well-marginated, approximately 2.0 x 1.0 x 2.2 cms sized expansile mass lesion involving the clivus, more in the midline as described is not specific for a single etiology.

The differential diagnosis would include,

a. Tuberculous osteitis.

b. Small cell tumors.

c. Metastasis.

d. Fibrous dysplasia.

As compared to the previous MRI dated 00.00.00 (scan no.00001), there is no significant change in the size of the lesion.

2. Altered marrow signal of the visualized cervical vertebrae may suggests preponderance of the haematopoietic marrow.

A contrast enhanced scan would be worthwhile.
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