Following an incidental findings, I've recently done a detailed MRI study. Having a family with young children, I'm obviously very stressed. Will appreciate any advice on what is it and how to proceed.
Multiplanar T1-weighted and T2-weighted scans were obtained.
Intravenous contrast: 10ml of Magnevist.
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.
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.
If it was me, I would schedule an appointment with a neurologist who treats brain tumors.
The MRI shows that you have a smallish lesion - about a hazelnut - in there. The MRI does show , to my layman read, that it is non-aggressive - which I take to mean that it is not appearing malignant to his view. But he is sending you for follow up as it is hard to determine the type of lesion and you have to know what it is to determine treatment.
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