Date : 00.00.00
Name of the Patient : Abc XyzDallmn / F / 36 yrs.
Referred by : Dr. Abc Xyzrani.
Examination : M.R.I. of the Brain.
CLINICAL PROFILE :
H/O being operated for a left sided C. P. angle meningioma in September 0000.
C/O vision loss on the left side in 0000 and diminished vision on the right side.
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.
4 mm thick FLAIR coronal images.
After administration of contrast the following parameters were used :
5 mm thick T1 Weighted axial and 4 mm thick T1 Weighted coronal images with magnetization transfer.
5 mm thick T1 Weighted sagittal images.
There is evidence of a right occipital craniectomy.
There is still seen a well marginated, extraaxial, intermediate signal intensity mass lesion on the T1 Weighted images in the right cerebello-pontine angle cistern. This lesion appears hypointense on the T2 Weighted and FLAIR images and has its broad base towards the right petrous temporal bone. The lesion measures approximately 2.0 (B) x 3.8 (H) x 3.0 (L) cms. After administration of contrast, there is intense uniform enhancement of the above described lesion. A dural tail is also identified along the broad base of the lesion.
There is an ill-defined, hyperintense signal on the proton, T2 Weighted and FLAIR images in the right cerebellar hemisphere. This lesion appears hypointense on the T1 Weighted images. Slight reduction in volume of the right cerebellar hemisphere is noted. These changes represent gliotic changes and are the sequelae of previous surgery.
A shunt tube is seen to traverse the left temporo-parietal region and its tip is seen to lie in the right thalamus. Mild fullness of the left lateral ventricle is noted as compared to the right. The third ventricle is normal. The fourth ventricle is mildly dilated.
There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.
Slight increased enhancement of the right tentorial leaflet is also noted after contrast administration.
A polyp is noted in the left maxillary antrum.
In a known C/O meningioma, the MRI features are suggestive of :
1. Post-operative and post-shunt status.
2. An approximately 2.0 x 3.8 x 3.0 cms well marginated, extraaxial, uniformly enhancing mass lesion in the right cerebello-pontine angle cistern, with its broad base towards the petrous bone, as described, most likely represents a residual meningioma.
No preoperative investigations were available for comparison. As compared to the previous CT Scan dated January 0000 and September 0000, the lesion appears unchanged in size.