ke/sb/nl/rg.
/195 Date : 17/00.00.00

Name of the Patient : Abc Xyzti Almn / F / 66 yrs.
Referred by : Dr. Abc Xyzmpat.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O left sided weakness with slurred speech since 4 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 and Fast Scan (T2 *) coronal images.

5 mm thick T1 Weighted sagittal images.

After administration of contrast the following parameters were used :

5 mm thick T1 Weighted axial images and 3 mm thick T1 Weighted coronal images with magnetization transfer.

5 mm thick T1 Weighted sagittal images.

OBSERVATION :

There are ill-defined, hypointense areas on the T1 Weighted images in the right lentiform nucleus extending into the right corona radiata. These lesions are seen to turn heterogeneously hyperintense on the proton, T2 Weighted and FLAIR images with a small lesion posteriorly turning homogeneously hyperintense. There is surrounding edema with mass effect and compression upon the body of the right lateral ventricle and third ventricle with slight shift of the midline structures to the left. On administration of contrast, there is fairly thick peripheral enhancement of the lesion with multiple smaller lesions of varying sizes around. The largest lesion measures approximately 1.8 x 1.5 x 1.7 cms.
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There is no area of abnormal enhancement along the meninges.

The left lateral 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 altered signal intensity, rim-enhancing lesions in the right lentiform nucleus extending into the right corona radiata. These are not specific for a single etiology.

The differentials to be considered are :

1. Metastasis.

2. Infective granuloma.

3. Lymphoma.

4. Less likely to represent an ischemic lesion.