Date : 00.00.00
Name of the Patient : Abc Xyz Chhlmn / F / 23 yrs.
Referred by : Dr. Abc Xyztel.
Examination : M.R.I. of the Brain.
CLINICAL PROFILE :
Known C/O TBM since April 0000. On AKT since then.
No complaints at present. For follow-up.
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.
After administration of contrast the following parameters were used :
5 mm thick T1 Weighted axial and coronal images with magnetization transfer.
5 mm thick T1 Weighted sagittal images.
There are multiple areas of hypointensity on the T1 Weighted images within both temporal lobes, right frontal lobe, left high frontal lobe and in the midbrain. These are isointense to hypointense to grey matter on the proton, T2 Weighted and FLAIR images. Surrounding white matter edema is seen, more so in the right fronto-temporal region with effacement of the right Sylvian cistern. Also seen is compression upon the frontal horn of the right lateral ventricle and third ventricle with shift of the midline to the left side.
Irregularly defined areas of altered signal intensity are seen in the interpeduncular cistern and suprasellar cistern.
After administration of contrast there are multiple conglomerate ring enhancing lesions in both temporal lobes, right frontal lobe, midbrain and in the interpeduncular cistern and suprasellar cistern. Disc enhancing lesions are seen in the left high frontal lobe.
The left lateral and the fourth ventricles are normal. The basal cisternal spaces are unremarkable. No obvious vascular anomaly is identified on this study.
In a known C/O intracranial tuberculosis, the MRI features are suggestive of multiple ring and disc enhancing lesions in both temporal lobes, right frontal lobe, left high frontal lobe, midbrain and in the interpeduncular cistern and suprasellar cistern as described.
As compared to the previous MRI dated 00.00.00, there is an increase in the size and distribution of the lesion with presence of white matter edema.