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/55 Date : 00.00.00

Name of the Patient : Abc Xyzhanuben H. Ajlmn / F / 51 yrs.
Referred by : Dr. Abc Xyz Desai.
Examination : M.R.I. of the Temporal bones and Skull
base.

CLINICAL PROFILE :

C/O headaches with right ear pain, tinnitus and decreased hearing with pus discharge. Now also C/O difficulty in swallowing.
O/E VII, IX, X, XII cranial nerve palsy on the right side.
H/O DM/HT.
Patient is a known C/O malignant otitis externa on the right side.

EXAMINATION :

M.R.I of the temporal bones and skull base was performed using the following parameters :

4 mm thick T1 Weighted and T2 Weighted (with fat saturation) axial images.

4 mm thick T1 Weighted and STIR coronal images.

4 mm thick T1 Weighted sagittal images.

MR Cisternogram was obtained in the coronal plane.

The brain was screened with 5 mm thick T2 Weighted axial images.

OBSERVATION :

There is evidence of an ill-defined soft tissue lesion in the region of the external and middle ear and mastoid air cells on the right side. It is iso to hyperintense to normal muscle but hypointense to fat on the T1 Weighted images and hyperintense to both on the T2 Weighted and STIR images. It is seen to extend into the right lateral soft tissues of the neck at the C1/C2 levels. Also seen is erosion of the occipital condyle and right lateral mass of the C1 vertebra on the right side. There is
..2/.







erosion of the Styloid process on the right side. Also seen is encasement of the right carotid sheath at the C1/C2 levels and also of the petrous component of the right internal carotid artery. However flow void signal is seen in the right internal carotid artery at these levels.

The right transverse and sigmoid sinuses show an intraluminal signal which is isointense to brain parenchyma on the T1 Weighted images and hyperintense on the STIR and T2 Weighted images. This may suggest slow flow/thrombus.

The right eustachian tube appears to be filled with fluid (hyperintense on the T2 Weighted images).

Both the lateral, third and the fourth ventricles are normal. The basal cisternal spaces are unremarkable. There is no midline shift.

IMPRESSION :

In a known C/O malignant otitis externa the MRI features are suggestive of a soft tissue lesion involving the mastoid air cells, external and middle ear and the occipital condyle and lateral mass of the C1 vertebra on the right side as described.

Intraluminal signal within the right lateral and sigmoid sinuses may suggest slow/flow thrombus.

A venogram/MRV may be performed to rule out a thrombus.
]]> finance@medmantra.com (Regular User) MRI Reports Sun, 27 Dec 2015 16:48:00 +0000