hs/bv
Date : 00.00.00

Name of the Patient : Abc Xyzali Dlmn / F / 6 yrs.
Referred by : Dr. Abc Xyzwant.
Examination : M.R.I. of the Brain and Intracranial M.R.A.

CLINICAL PROFILE :

C/O headaches and vomiting.
Operated for right parietal SOL in October 0000.
Recurrent symptoms in January 0000.
H/P s/o ? choroid plexus Ca, ? hemangiopericytoma with focal papillary areas.

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.

Intracranial MRA was performed with 3D TOF sequence.

OBSERVATION :

BRAIN :

There is evidence of an ill-defined, variegated mass lesion in the right parieto-occipital region. There is resultant bulging of this lesion into the craniotomy flap in the right posterior parietal region.

This mass lesion is predominantly hypointense on the T1 Weighted images and turns heterogeneously hyperintense on the proton, T2 Weighted and FLAIR images. Areas which are iso to hyperintense to CSF are seen within this lesion and these would represent cystic/necrotic changes. Note is made of perilesional edema in the right parieto-temporo-occipital lobes with compression upon the occipital horn and atrium of the right lateral ventricle and the splenium and posterior body of the corpus callosum.

The rest of the ventricular system and basal cisternal spaces are unremarkable. There is no shift of the midline structures.
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INTRACRANIAL MRA :

The posterior Sylvian branches of the right middle cerebral artery are displaced slightly anteriorly.

The petrous, cavernous and supraclinoid segments of the internal carotid arteries bilaterally show normal signal and calibre. The visualized anterior cerebral, left middle cerebral, basilar, vertebral and posterior cerebral arteries also show normal signal, calibre and wall margins. No obvious aneurysm or vascular malformation is identified. No obvious abnormal vascularity is noted around the lesion.

The superior sagittal sinus shows normal flow-void signal on the spin-echo and FSE sequences, though it is in close relation of the tumor.

IMPRESSION :

The MRI features are suggestive of a mass lesion in the right parieto-occipital region with mass effect as described. Such features may be seen with astrocytoma, PNETs, supratentorial ependymoma or hemangiopericytoma or choroid plexus carcinoma. This may be a residual or a recurrent lesion (The patient is status post-operative). The right posterior Sylvian branches are displaced slightly anteriorly. No abnormal vascularity is noted around the lesion.

No previous scans were available for comparison.