Interpretation of Brain MRI Results

[lucas100]

I received the results of an MRI of my brain today and have questions regarding it, I really hope that someone can help me understand whether I should get even more worried, what can it be and what should I do next.

"MRI of the brain was performed with axial T2,DWI,GRE, coronal FLAIR and sagittal T1sequences.
A 15 x 10 mm well defined trapezoid area of T2 prolongation is seen in the right sublentiform region. No significant mass effect is seen.
There is no established infraction, mass effect or acute intracranial haemorrhage. The grey-white interphase is preserved. The ventricles and CSF spaces are unremarkable. Flow voids of the vessels around the circle of Willis and major dural venous are preserved. Mucosal thickening of the maxillary and frontoethmoidal sinuses us seens."

Thank you in advance!

[Daniel M Prevedello, MD]

Dear Lucas100

All this part is normal: 'No significant mass effect is seen. There is no established infraction, mass effect or acute intracranial haemorrhage. The grey-white interphase is preserved. The ventricles and CSF spaces are unremarkable. Flow voids of the vessels around the circle of Willis and major dural venous are preserved. Mucosal thickening of the maxillary and frontoethmoidal sinuses us seens."

The T2 prolongation 1.5 x 1 cm: means edema (swelling) in that area. I would need to see the MRI to understand what it is.

This MRI should be repeated with contrast.

Thank you

[lucas100]

Thank you for the prompt reply. As suggested, I've done another MRI scan, with the following results:

"
TECHNIQUE
Multiplanar T1-weighted and T2-weighted scans were obtained.
Intravenous contrast: 10ml of Magnevist.

REPORT

CEMRI BRAIN, DYNAMIC MR PERFUSION AND MR SPECTROSCOPY
There are no comparison studies.
There is a 14 x 6 x 6 mm non enhancing signal abnormality lying just inferior to the basal ganglia, and specifically inferolateral to the putamen with possible contiguity with the claustrum antero-inferiorfly.
It demonstrates mild T2 hyperintensity and T1 hypointensity, almost identical to that of a normal gray matter. It does no show restricted diffusion nor significant susceptibility artefacts.  There is no significant vasogenic edema or other focal lesions elsewhere in the brain save perivascular spaces over the left basal ganglia and right cerebral peduncle and anterior frontal subcortex. There is no hydrocephalus, extra-axial fluid collection or shift of the midline structures.

There is no associated high rCBV in the lesion on the rCBV map.
On a single voxel MRS at TE 135ms, the lesion demonstrated a mildly elevated choline/N-acety-asparate ratio of 1.3. There is a slightly prominent myoinositol peak at TE 30ms, but not to the level that is often found in low grade astrocytomas.

CONCLUSION
Small, non-enhancing signal abnormality just inferolateral to the right putamen with nonspecific but non aggressive features in MRS and perfusion MR. Differential diagnosis include a focal gray matter heterotopia or low grade primary brain tumor. Please correlate with clinical findings.
May need further action.
"

Will appreciate any advice on how to proceed.
Thank you!