Name of the Patient : Abc Xyz lmn / M / 27 yrs.
Referred by : Dr. Abc Xyzrel.
Examination : M.R.I. of the Brain.
CLINICAL PROFILE :
H/O Posterior third ventricular ependymoma, operated on 00.00.00 followed by radiotherapy from 00.00.00 to 00.00.00. VP shunt done on 00.00.00.
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 an occipital craniectomy. A CSF signal intensity lesion on all the pulse sequences at the craniectomy site may represent a pseudomeningocele/post-operative CSF collection. Slight effacement of the cerebellar folia is noted bilaterally.
There is still seen a small, approximately 0.5 x 1.3 x 0.7 cms sized enhancing lesion in the posterior third ventricular region antero-inferior to the splenium of the corpus callosum. This lesion is of intermediate signal on the T1 Weighted images and is relatively hypointense on the T2 Weighted images.
The aqueduct does not show the normal flow signal and is probably obstructed.
There is mild fullness of both the lateral ventricles. The third and the fourth ventricles are normal. The tip of the shunt tube is noted in the body of the left lateral ventricle with the shunt tube tract traversing the right parietal lobe. A burrhole is noted in the right posterior parietal region. Minimal enhancement of the ependymal lining of the lateral ventricles is noted
The basal cisternal spaces are unremarkable. There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.
Slightly increased tentorial enhancement may be due to the previous surgery.
1. Post-operative/post-shunt status with a pseudomeningocele/ post-operative collection in the occipital region in the midline.
2. An approximately 0.5 x 1.3 x 0.7 cms sized enhancing lesion in the posterior third ventricular region may represent a residual third ventricular ependymoma.
As compared to the previous MRI dated 00.00.00, there is decrease in the size of the residual posterior third ventricular lesion. The lateral ventricular size has however increased slightly. Minimal enhancement of the ependymal lining is noted.
The occipital collection is largely unchanged.