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sb/bv/rg.
Date : 00.00.00

Name of the Patient : Abc Xyz lmn / F / 26 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

Known C/O Kochs in the midbrain. On AKT.
For follow-up.

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 FLAIR coronal images.
4 mm thick T1 Weighted and T2 Weighted sagittal 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.

OBSERVATION :

There is still seen a small bright focus on the proton, T2 Weighted and FLAIR images in the midbrain, centrally and more to the left of the midline (scans 102.9, 105.10). This lesion appears iso to hypointense on the T1 Weighted images.

Small bright foci on proton, T2 Weighted and FLAIR images are also noted in the posterior parietal deep white matter, bilaterally (scans 105.5/7).

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

After administration of contrast, faint focal enhancement of the lesion in the midbrain is noted (scans 107.9). No enhancement of the lesions in the posterior parietal deep white matter is noted. There is no other area of abnormal enhancement in the brain parenchyma or along the meninges.

IMPRESSION :
Very small focal enhancing lesion in the midbrain, centrally and more to the left of the midline may either represent a residual/resolving granuloma or may represent a gliotic focus due to the resolved granuloma.

Focal very small non-enhancing lesions in the posterior parietal deep white matter, bilaterally may represent gliotic changes, the sequelae of previous granulomas.
As compared to the previous MRI (study no:00003) dated 00.00.00, there is significant to near complete resolution of the lesion in the midbrain.


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