hs/sb/rg/nl

Name of the Patient : Abc Xyzakar Hlmn / M / 51 yrs.
Referred by : Dr. Abc Xyzstak / Dr. Abc Xyztty.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

H/O sudden staring episodes for 1-2 seconds since 6 months.

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 coronal and sagittal images.

After administration of contrast the following parameters were used :

5 mm thick T1 Weighted coronal images with magnetization transfer and fat saturation and 5 mm thick T1 Weighted axial images with magnetization transfer.

5 mm thick T1 Weighted sagittal images.

OBSERVATION :

There is evidence of a fairly well-defined extra-axial mass lesion in the inferior frontal region, in the midline, measuring approximately 6.0 x 5.4 x 6.5 cms.

This lesion is hypointense on the T1 Weighted images with a few areas of hyperintensity within it (which get suppressed on the fat saturation images and may represent fat/marrow). It is predominantly hyperintense on the proton, T2 Weighted and Flair images. Multiple punctate and curvilinear areas are seen within this lesion on all the pulse sequences which may represent calcium/fibrous tissue. After contrast administration the lesion shows heterogeneous but fairly intense enhancement, more so at its periphery.



This lesion is seen to splay both the inferior frontal lobes and extend into the ethmoidal air cells, right frontal sinus and upper nasal cavity with destruction of the cribriform plate of the ethmoid bone. There is no obvious extension of this lesion into the orbits.

There is no focal area of abnormal signal intensity within the brain parenchyma per se.

Both the lateral, third and the fourth ventricles are normal. The basal cisternal spaces are unremarkable. No obvious vascular anomaly is identified on this study.

IMPRESSION :

The MRI features are suggestive of a fairly well-defined, extra-axial mass lesion measuring approximately 6.0 x 5.4 x 6.5 cms., located in the inferior frontal region, in the midline. The differential diagnosis would include :

1. Meningioma.

2. Esthesioneuroblastoma.

3. Chondrosarcoma.

4. Other neoplastic processes like secondaries - less likely.