ke/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc XyzNilmn / M / 70 yrs.
Referred by : Dr. Abc Xyzshar.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

H/O malignancy in the lung and mediastinal nodes and metastasis in the bone in December 0000. Received chemotherapy and radiotherapy. Relieved.
Now C/O weakness of the left hand with forgetfulness since 2 days.

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 sagittal images.

OBSERVATION :

There is a large lesion in the left temporal region which measures approximately 3.0 x 3.5 x 2.0 cms. This lesion shows a small slightly hyperintense area in the lateral aspect on the T1 Weighted images which is heterogeneously hypointense on the proton, T2 Weighted and FLAIR images. A fluid level is also noted. The medial aspect of this lesion is slightly hyperintense to CSF on all the pulse sequences. There is gross surrounding edema with mass effect and slight indentation upon the body of the left lateral ventricle and effacement of the adjacent sulci in that region.

Similar smaller lesions of varying sizes (atleast nine) are seen in the right cerebellar hemisphere, right temporal and occipital lobes, right temporal lobe, both frontal regions and the right high parietal region.


The right 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.

Incidental note is made of left maxillary polyp.

IMPRESSION :

In a known C/O small cell carcinoma of lung, the MRI features are suggestive of metastasis in the supratentorial and infratentorial regions as described.