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Name of the Patient : Abc XyzAgalmn / F / 63 yrs.
Referred by : Dr. Abc Xyzh.
Examination : M.R.I. of the Abdomen & Pelvis.

CLINICAL PROFILE :

C/O breathlessness.

EXAMINATION :

M.R.I of the abdomen and pelvis was performed using the following parameters:

8 mm thick T1 Weighted and T2 Weighted (with and without fat saturation) axial images.

6 mm thick T1 Weighted and STIR coronal images.

5 mm thick T1 Weighted and T2 Weighted (with fat saturation) sagittal images.

OBSERVATION :

There is h/o hysterectomy and cholecystectomy.

There is seen an approximately 4.5 x 6.5 x 6.0 cms sized well marginated, lobulated, hypointense lesion on the T1 Weighted images in the adnexal region in the pelvis on the left. This lesion nearly follows CSF signal on all the pulse sequences and shows multiple septae within. There is seen an approximately 2.5 x 3.2 x 2.0 cms sized solid intermediate signal intensity lesion on the T1 Weighted images along the superior margin of the above described lesion. This lesion appears relatively hypointense on the T2 Weighted and STIR images. The left ovary is not well identified separately from this lesion.

The right adnexal region is unremarkable.

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There is seen an approximately 4.0 cms sized well-defined, intermediate signal intensity lesion on the T1 Weighted images in the pelvic cavity in the midline, at the tip of the vaginal vault/cervical stump which appears relatively hypointense on the T2 Weighted images.

The liver is normal in size and signal characteristics. The gall bladder is not visualized due to previous cholecystectomy.

There is no focal or diffuse area of altered signal intensity. There is no intrahepatic biliary radicle dilatation. The intrahepatic venous architecture is normal.

The pancreas is normal in bulk and signal characteristics.

Mild splenomegaly is noted without signal change.

The right kidney appears slightly smaller than left. A fairly large, cortical renal cyst is noted in the superior pole of the left kidney.

No lymphadenopathy is detected. There is no evidence of free fluid within the abdomen or pelvis.

The urinary bladder shows normal wall thickness

The ischio-rectal fossae on either side appear normal.

No obvious vascular anomaly is noted.

A probable old fracture of the right superior pubic ramus is noted at its base.
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IMPRESSION :

1. Post-cholecystectomy/post-hysterectomy status.

2. An approximately 4.5 x 6.5 x 6.0 cms sized cystic lesion in the pelvis on the left with an approximately 2.5 x 3.2 x 2.0 cms sized solid component along the superior margin as described is not specific for a single etiology. An ovarian lesion is a likely possibility.

3. An approximately 4.0 cms sized well-defined, lesion in the pelvic cavity in the midline, is of ? etiology, probably an extrauterine fibroid (? from stump of the cervix ?? broad ligament fibroid).

4. Mild splenomegaly without signal change.

5. Slightly smaller right kidney with a fairly large, cortical renal cyst in the superior pole of the left kidney.

6. A probable old fracture of the right superior pubic ramus at its base.