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ke/sb/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzh Srivalmn / M / 27 yrs.
Referred by : Dr. Abc Xyzdar.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

H/O craniotomy done on 00.00.00 for an astrocytoma.
C/O weakness of the LUE and LLE since then.
For follow-up.

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 and 6 mm thick T1 Weighted coronal images.

5 mm thick T1 Weighted sagittal images.

OBSERVATION :

There is seen reduction in the volume of the right fronto-temporal lobes. This volume loss is replaced by CSF. This CSF intensity is seen to extend in the region of the right corona radiata.

There is seen a well-defined, approximately 1.8 cms diameter sized rounded nodule along the medial margin of the residual right temporal lobe (scans no.104.9). This lesion is of intermediate signal on the T1 Weighted images and appears relatively hyperintense on the proton, T2 Weighted and FLAIR images (scans 103.9, 102.9 & 105.8). The anterior tip of the residual right temporal lobe and the residual right inferior frontal lobe also show an intermediate signal on the T1 Weighted images which appears relatively hyperintense on the proton and T2 Weighted images.

Ill-defined hyperintense signal on proton, T2 Weighted and FLAIR images is also noted along the superior and posterior margins of the previously described operative site which may represent ? recurrent tumor along the margin of the operative site, ?? gliotic changes.
..2/.




There is evidence of a right fronto-temporo-parietal craniotomy.

There is atrophy of the right cerebral peduncle and the pons on the right, anteriorly (Wallerian degeneration).

There is mild dilatation of the right lateral ventricle (as compared to the left) and the third ventricle.

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

IMPRESSION :

1. Post-operative status.

2. Reduction in the volume of the right fronto-temporal lobes replaced by the CSF in that region is the sequelae of previous surgery.

3. An approximately 1.8 cms diameter sized rounded nodule along the medial margin of the residual right temporal lobe with altered signal in the anterior tip of the residual right temporal lobe and the residual right inferior frontal lobe
most likely represents a recurrent tumor.

4. Altered signal along the superior and posterior margins of the previously described operative site may represent ? recurrent tumor along the margin of the operative site, ?? gliotic changes.

5. Atrophy of the right cerebral peduncle and the pons on the right, anteriorly may be due to Wallerian degeneration).

As compared to the previous MRI (study no:0000) dated 00.00.00, there is evidence of a recurrent lesion in the residual right temporal lobe as described.

A contrast enhanced study may be worthwhile.
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