Date : 00.00.00
Name of the Patient : Abc Xyzsh lmn / M / 28 yrs.
Referred by : Dr. Abc Xyzankhla.
Examination : M.R.I. of the Brain.
CLINICAL PROFILE :
H/O low grade glioma in the left frontal region for which craniotomy was done on 00.00.00.
C/O swelling over the face and headaches since 2-3 days.
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.
5 mm thick T1 Weighted sagittal images.
There is a left fronto-parietal craniotomy. A small, epidural hemorrhagic collection is noted deep to the craniotomy site, the sequelae of previous surgery. A small, left frontal subdural collection is also noted. There is also a subgaleal collection in the left fronto-temporo-parietal region extending slightly to the right of the midline. The dura at the site of surgery is not well-defined in continuity.
There is seen an approximately 2.0 x 2.8 x 2.2 cms sized well marginated, predominantly intermediate signal intensity lesion on the T1 Weighted images in the left deep fronto-parietal, parafalcine region. This lesion appears hyperintense on the proton, T2 Weighted and FLAIR images. Focal, CSF signal on all the pulse sequences is noted within this lesion, anteriorly. There is a peripheral hyperintense rim on the T1 Weighted images which appears relatively hypointense on the proton, T2 Weighted and FLAIR images. This lesion most likely is the sequelae of previous surgery, and may represent a post-operative cavity with inflammatory changes within.
Around the above described lesion there is seen a band of tissue, approximately 1.0 cm in width, predominantly along its anterior, superior and inferior margins. This lesion appears hypointense to normal white matter on the T1 Weighted images and is hyperintense on the T2 Weighted and FLAIR images. Resultant indentation and inferior displacement of the body of the left lateral ventricle is noted with mild bulge of the midline to the right. The involvement of the body of the corpus callosum cannot be entirely ruled out. The track of previous surgery is seen to extend from the mass lesion upto the dura at the operative site. The dura is not well-defined in continuity.
There is mild fullness of the left lateral ventricle as compared to the right. The third and fourth ventricles are normal. The basal cisternal spaces are unremarkable. No obvious vascular anomaly is identified on this study.
Fluid level is noted in the sphenoid sinus.
1. Left fronto-parietal craniotomy with a small epidural and subdural collection, most likely a sequelae of previous surgery.
2. A subgaleal collection in the left fronto-temporo-parietal region.
3. An approximately 2.0 x 2.8 x 2.2 cms sized cavity in the left deep fronto-parietal parafalcine region most likely is the sequelae of previous surgery. The operative track is seen to extend upto the dura at the operative site. The possibility of communication of this post-operative cavity with the subdural, epidural and subgaleal collections cannot be ruled out.
- 3 - Scan-00001
4. A band of tissue, approximately 1.0 cm in width along the anterior, inferior and superior margins of the post-operative cavity, as described above, may represent residual tumor tissue.
A follow-up scan with contrast is recommended.