Date : 00.00.00
Name of the Patient : Abc Xyznt Bhlmn / M / 57 yrs.
Referred by : Dr. Abc Xyzmat.
Examination : M.R.I. of the Brain.
CLINICAL PROFILE :
H/O fever (on & off) since 1 1/2 months.
C/O altered behaviour with bladder/bowel incontinence since 00.00.00.
Known diabetic/hypertensive. On Rx.
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 an ill-defined mass lesion in the left frontal lobe which is hypointense to the gray matter on the T1 Weighted images. This is seen to turn heterogeneously hyperintense on the proton, T2 Weighted and FLAIR images. A streak of hyperintense signal on the T1 Weighted images is seen at the periphery of the lesion, anteriorly, (scan 104.14) which is seen to remain so on the proton and T2 Weighted images and may represent altered blood/paramagnetic substances. There is surrounding edema with mass effect and effacement of the adjacent sulci. There is slight encroachment into the genu of the corpus callosum on the left side. Mild indentation upon the frontal horn of the left lateral ventricle is noted with slight shift of the anterior falx to the right.
Prominent perivascular spaces are seen in the lentiform nuclei and the thalamus bilaterally.
A ill-defined, hyperintense signal on the proton, T2 Weighted and FLAIR images is seen in the right high posterior parietal region and in the left frontal region, superior to the left Sylvian fissure which is hypointense to white matter on the T1 Weighted images.
A hyperintense speck on FLAIR images is seen in the subcortical white matter in the right occipital region.
There is mild fullness of the ventricular system with slight prominence of the cerebral cortical sulci and cerebellar folia bilaterally.
No obvious vascular anomaly is identified on this study.
The MRI features are suggestive of :
1. A mass lesion in the left frontal lobe with signal characteristics as described is not specific for a single etiology. The differential diagnosis would include,
a. Tuberculoma/Tubercular abscess.
b. Neoplasm like a glial cell tumor.
2. Altered signal in the right high posterior parietal region and in the left frontal region, superior to the left Sylvian fissure may represent another lesion of same pathology (multicentric distribution).
Patient refused contrast enhanced study.