hs/ke
Date : 00.00.00

Name of the Patient : Abc Xyztiben Jalmn / F / 59 yrs.
Referred by : Dr. Abc Xyzh Shah.
Examination : M.R.I. of the Brain and Orbits.

CLINICAL PROFILE :

C/O headaches with vomiting and periorbital edema since 15 days.
MRI to exclude venous sinus thrombosis, meningitis, ?? SOL.

EXAMINATION :

M.R.I of the brain and orbits 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.
3 mm thick STIR coronal images.

After administration of contrast the following parameters were used :

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

OBSERVATION :

There are irregularly defined areas of hypointensity on the T1 Weighted images in the retro-orbital fat, medially, in the left orbit. These areas turn heterogeneously hyperintense on the STIR images and show patchy enhancement after contrast administration. However the optic nerves bilaterally show normal signal intensity. The intraocular lens is not well-identified bilaterally and these may be the result of previous cataract surgery.
..2/.







Few small bright foci on the FLAIR images are noted within the white matter in the frontal lobes bilaterally and these are most likely ischemic in etiology. There is mild fullness of the third and both the lateral ventricles. Also seen is mild prominence of the basal cisternal spaces, cerebral cortical sulci, cerebellar folia and Sylvian fissures bilaterally. Note is made of an empty sella.

Inflammatory changes are noted within the ethmoidal air cells, left maxillary sinus, and the sphenoid and frontal sinuses.

Soft tissue edema (hyperintense on the STIR images) is seen within the subcutaneous soft tissues in the temporal regions bilaterally and in the soft tissues around the right orbit.

The fourth ventricle is normal. There is no shift of the midline structures. No obvious vascular anomaly is identified on this study. There is no obvious thrombosis of the dural venous sinuses on this scan.

IMPRESSION :

The MRI features are suggestive of :

1. An irregularly defined lesion within the medial aspect of the left orbit as described is most likely inflammatory in etiology.

2. Inflammatory changes within the ethmoidal air cells, left maxillary sinus, and the sphenoid and frontal sinuses.