sb/ke
Date : 00.00.00

Name of the Patient : Abc XyzRodrilmn / M / 35 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O seizures since 6 months.

EXAMINATION :

M.R.I of the brain was performed using the following parameters :

5 mm thick T1 Weighted, proton and T2 Weighted axial images.

4 mm thick FLAIR coronal images.

After administration of contrast, 5 mm thick T1 Weighted axial images with magnetization transfer, 4 mm thick T1 Weighted coronal images with magnetization transfer, 5 mm thick T1 Weighted sagittal images were obtained.

OBSERVATION :

There is seen a fairly large, ill-defined, mass lesion in the right fronto-temporal region. This lesion is seen to involve the grey and white matter and is predominantly isointense to normal grey matter on the T1 Weighted images and appears hyperintense on the T2 Weighted images. In the subcortical white matter, there are hypointense areas on the T1 Weighted images which turn hyperintense on the T2 Weighted images and may represent areas of necrosis. Altered signal is also noted in the head of the right caudate nucleus and in the external capsule and anterior limb of the internal capsule. Involvement of the genu of the corpus callosum on the right is also noted. There is effacement of the sulcal spaces in the right fronto-temporal region and mild indentation on the frontal horn of the right lateral ventricle. Slight bulge of the anterior interhemispheric fissure to the left is noted. There is also slight medial and inferior displacement of the right medial temporal pole.



There is a focal, hypointense lesion on the T1 Weighted images in the left frontal cortex which appears hyperintense on the T2 Weighted and FLAIR images.

The left lateral, third and the fourth ventricles are normal. The basal cisternal spaces are unremarkable. No obvious vascular anomaly is identified on this study.

After administration of contrast, there is patchy enhancement of the lesion in the right fronto-temporal region. There is no enhancement of the lesion in the left frontal cortex.

IMPRESSION :

A fairly large, ill-defined, patchily enhancing mass lesion in the right fronto-temporal region with signal characteristics and extensions as described, most likely represents a glial cell tumor. Focal, non-enhancing lesion in the left frontal cortex is not specific for a single etiology. This lesion may either represent another focus of a glial cell tumor (multicentric origin) or may represent metastasis from the right fronto-temporal lesion. The possibility of an ischemic lesion may also be considered as a differential diagnosis, though less likely.