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17 year old MRI - active athlete that has broken her vertibrea but no other health issues
Procedure: A combination of FLAIR, T1-, T2-, gradient-echo, diffusion and postgadolinium (10cc) T1-weighted images of the head were obtained in multiple imagine planes. Multiple coronal sequences were performed to evaluate the temporal lobe structures.
FINDINGS: There is no evidence of an acute ischemic event on diffusion imagine, Posterior fossa structures are unremarkable. 4th ventrical is midline and nondilated. No Chiari Malformation.
Supratentorial compartment: There is an area of decreased T1 and increased T2 signal without enhancement in the left parietal lobe. This appears to have a septation within it, it measures 1.5 mm in greatest diameter. There is decreased signal intensity. No other lesions are identified within the brain. Possible etiologies for this lesion include the following:
1. Ganglioglioma: These lesson are oftencystic in appearance and often peripheral within the brain. No definite enhancement which is typical.
2. Pleomorphic xanthoastrocytoma: No enhancement and no enhanced “tail”.
3. Pilocytic astrocytoma: Location uncommon – supratentorial
4. Neurocysticercosis or sequelae of neurocysticcercosis – only one lesion
5. Other posttraumatic: Patient does have a vertebrae break, Neoplastic or infections ethologies: No restricted diffusion on diffusion imaging.
From the MRI findings given to me only a differential diagnosis of a non-enhancing cystic lesion can be considered. For an extra-axial, supratentorial, non-enhancing lesion present off midline, other possibilities could be an arachnoid cyst and a hydatid cyst.
A computerised tomography scan (CT scan) of the brain would be an option to look for calcification within the lesion or on the periphery as it could be easily missed on the MRI.
Lastly, I would like to know the reasons for doing an MRI of the brain in her for a clinical correlation.
So I personally feel that with a complete clinical history and a result of the CT scan, the list of the possibilities can be narrowed down.
Please send me the list of symptoms that this person is suffering and preferably results of the CT scan as well.
I thank you again for submitting your question. I hope you find my response to be both helpful and adequate. If you have any additional concerns regarding your question I would be happy to address them.
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