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hs/bv.rg.
Date : 00.00.00

Name of the Patient : Abc Xyz Jalmn / M / 25 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O headaches since 1 month with loss of vision of both eyes since 15 days.
H/O jaundice 1 month back.

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.

5 mm thick T1 Weighted sagittal images.

MR cisternogram was obtained in the sagittal plane.

Patient refused contrast enhanced study.

OBSERVATION :

There is evidence of a fairly well-defined mass lesion measuring approximately 2.8 x 3.0 x 3.0 cms in the pineal region. This lesion is hypointense on the T1 Weighted images and turns heterogeneously hyperintense on the proton and T2 Weighted images. On the FLAIR images it exhibits mixed signal characteristics (with a few cystic/necrotic areas). The tectum cannot be identified separately from this lesion. There is compression upon the aqueduct and the postero-inferior third ventricle (which is shifted to the left side). There is resultant moderate dilatation of the rest of the third and both the lateral ventricles. Also seen are periventricular hyperintensities on the proton, T2 Weighted and FLAIR images and this would represent CSF ooze. There is obliteration of the cerebral cortical sulci and this may represent an increase in the intracranial pressure.
..2/.





The lesion is seen to indent upon the superior cerebellar vermis, midbrain and the upper pons. The vein of Galen appears to be elevated with splaying of the internal cerebral veins. The posterior cerebral arteries are abutting this lesion.

There is slight inferior herniation of the cerebellar tonsils.

The fourth ventricle is normal.

IMPRESSION :

The MRI features are suggestive of a mass lesion measuring approximately 2.8 x 3.0 x 3.0 cms in the pineal region this may represents a pineal tumor (like a pineocytoma) or an exophytic glioma arising from the tectal plate.

A contrast enhanced study would be worthwhile.
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