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ke/hs/nl/rg.

Name of the Patient : Abc Xyzakant Polmn / M / 62 yrs.
Referred by : Dr. Abc Xyzhtekar.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O diplopia since 00.00.00.
H/O FESS (right) done on 00.00.00. Anterior and posterior ethmoidectomy done. H/O transnasal excision of sphenoid sinus lesion on 00.00.00.
EXAMINATION :

M.R.I of the brain was performed using the following parameters :

5 mm thick T1 Weighted, proton and T2 Weighted axial images.

3 mm thick STIR and T1 Weighted coronal images.

3 mm thick T1 Weighted and T2 Weighted sagittal images.

OBSERVATION :

There is no focal area of altered signal intensity in the brain parenchyma (hyperintense signal posterior to the vermis on the T2 Weighted images [se/im 102/5] is due to partial voluming with CSF).
There is still seen a well-defined, approximately 2.0 x 1.8 x 1.8 cms sized lesion in the sphenoid sinus, posteriorly and more to the right of the midline. The posterior half of this lesion appears predominantly hyperintense on the T1 Weighted images but is relatively hypointense on the T2 Weighted images. The anterior half of this lesion appears relatively hypointense on the T1 Weighted images and is hyperintense on the T2 Weighted images.
Thinning of the posterior and right lateral margin of the sphenoid sinus is noted. The lesion is in close relation to the right cavernous sinus. The cavernous segment of the right internal carotid artery however shows normal flow void signal.

There is mild fullness of both the lateral and the third ventricles. The fourth ventricle is minimally effaced. The basal cisternal spaces are unremarkable. There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.Mucosal thickening is noted in the region of the ethmoidal air cells bilaterally. The right middle nasal turbinate is not visualized. Evidence of surgical intervention in the nasal cavity is noted.
IMPRESSION :1. Post-operative status.2. An approximately 2.0 x 1.8 x 1.8 cms sized lesion in the sphenoid sinus, posteriorly and more to the right of the midline represents a residual mucocele. 3. Mucosal thickening is noted in the region of the ethmoidal air cells bilaterally.As compared to the previous MRI (Study No.0000) dated 00.00.00, there is no significant change in the size of the mucocele.

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