Name of the Patient : Abc Xyzndas Milmn / M / 60 yrs.
Referred by : Dr. Abc Xyzla.
Examination : M.R.I. of the Brain.
CLINICAL PROFILE :
H/O being operated for multicentric intracranial malignant ependymoma on 00.00.0000.
For follow up.
No complaints at present.
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.
There is evidence of a right parieto-occipital craniectomy.
Slight herniation of the brain parenchyma in that region through the craniectomy site is noted. Susceptibility artifacts are also seen at the operative site.
There is a CSF signal intensity lesion on all the pulse sequences in the right parieto-occipital lobe which represents an area of cystic encephalomalacia, the sequelae of previous surgery. Ill-defined, hyperintense signal on the proton, T2 Weighted and FLAIR images is also noted in the white matter in the right temporo-parieto-occipital region. This signal appears hypointense to normal white matter on the T1 Weighted images.
Similar altered signal is noted in the left posterior parietal periventricular white matter.
There is mild dilatation of both the lateral and the third ventricles. The fourth ventricle is normal. There is slight prominence of the cerebral cortical sulci and the basal cisternal spaces bilaterally. There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.
After administration of contrast, there is enhancement along the margins of the brain parenchyma at the operative site (along the margins of the encephalomalacic area).
There is no other focal area of abnormal enhancement in the brain parenchyma or along the meninges.
1. Post-operative status.
2. An area of cystic encephalomalacia in the right parieto-occipital lobe, the sequelae of previous surgery.
Enhancement along the margins of the encephalomalacic area
may either be due to post-operative changes or may be due to
recurrent/residual tumor along the margins of the operative site.
3. Diffuse altered signal in the white matter in the right temporo-parieto-occipital region is not specific for a single etiology. This may represent gliotic changes/tumor infiltration/edema.
- 3 - Scan-00001
4. Altered signal in the left posterior parietal periventricular white matter may also represent a multicentric/metastatic tumor focus.
As compared to the previous MRI dated 00.00.0000, the patient is now status post-operative. There is near complete excision of the enhancing lesion identified previously in the right temporo-parieto-occipital region. The disc enhancing lesion in the left posterior parietal region is not identified on the present study. There is also slight increase in size of the ventricles as compared to the previous study.