hs/sb/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyznd lmn / M / 10 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

Known C/O Non-Hodgkins lymphoma detected 1 1/2 years back. Received radiotherapy and Chemotherapy.
C/O seizures since the age of 4 years.

EXAMINATION :

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.

OBSERVATION :

There is evidence of an extra-axial mass lesion in the left fronto-parietal region, parafalcine region with its broad base towards the falx and measuring approximately 3.2 x 2.2 x 2.8 cms. This lesion is iso to hyperintense to gray matter on the T1 Weighted images and is hypointense on the proton and T2 Weighted images. It has a hypointense rim on the proton and T2 Weighted images and which is hyperintense on the T1 Weighted images (? calcified lesion). After contrast administration, there is slight peripheral enhancement of this lesion.
Scan-00006


Areas which are isointense to CSF on all the pulse sequences are seen within the left fronto-parietal lobes adjacent to the aforementioned lesion. These are surrounded by areas of hypointensity on the T1 Weighted images which turn hyperintense on the proton, T2 Weighted and FLAIR images and would represent gliotic changes. These would represent areas of cystic encephalomalacia. Small areas with similar signal characterstics are seen within both frontal lobes and right cerebellar hemisphere (may be ischemic in etiology).

There is mild fullness of the third and both the lateral ventricles. There is mild prominence of the cerebellar folia bilaterally.

The fourth ventricle is normal. The basal cisternal spaces are unremarkable. There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.

IMPRESSION :

The MRI features are suggestive of :

1. An extra-axial mass lesion in the left fronto-parietal region measuring approximately 3.2 x 2.2 x 2.8 cms with signal characteristics as described. This most likely represents a meningioma, probably a calcified meningioma. The possibility of a lymphoma seems less likely.

2. Areas of cystic encephalomalacia within the left fronto-parietal lobes, both frontal lobes and in the right cerebellar hemisphere.