sb/ke/nl/rg.
/452 Date : 04/00.00.00

Name of the Patient : Abc Xyzti Palmn / F / 72 yrs.
Referred by : Dr. Abc Xyz Shah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

H/O progressive left hemiparesis since 15-20 days.
Known hypertensive.
H/O vaginal hysterectomy with bilateral salpingo-oophrectomy done in July 0000 for well differentiated Ca uterus (Grade I).

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

OBSERVATION :

There is seen a fairly large, approximately 4.5 x 3.5 x 3.5 cms sized predominantly hypointense mass lesion on the T1 Weighted images in the right deep temporo-parietal region. This lesion appears predominantly hyperintense on the proton, T2 Weighted and FLAIR images. There is mild perilesional edema with effacement of the right Sylvian cistern and mild indentation of the right lateral and third ventricles. On the Fast Scan (T2 *) images, there are focal areas which seem to bloom, peripherally, which may suggest calcification/hemosiderin deposit within the lesion. After contrast administration, there is uniform enhancement of the lesion except for some non-enhancing cystic/necrotic areas within it.
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There are small bright foci on the proton and T2 Weighted images in the left external capsular region and in the pons which may represent ischemic changes.

The left lateral and the fourth ventricles are normal. The basal cisternal spaces are unremarkable. There is slight prominence of the cerebral cortical sulci and the cerebellar folia bilaterally. There is mild bulge of the midline structures to the left. No obvious vascular anomaly is identified on this study.

There is no other focal area of abnormal enhancement within the brain parenchyma or the meninges.

IMPRESSION :

An approximately 4.5 x 3.5 x 3.5 cms sized enhancing mass lesion in the right deep temporo-parietal region as described is not specific for a single etiology.

A metastatic lesion, glial cell tumor or a lymphoma may be considered as differential diagnosis.