You are here:

Radiology/Don't understand MRI/CT Report

Advertisement


Question
Please help interpret this, can you put this to Lehman's terms for me please.

MRI in 2010 reported the persistance of a left sided
cerebellar cyst.  The full report is as follows:

CLINICAL INDICATION: 15-year-old female with recent event
suspicious for seizure activity with EEG findings suggestive of a
right temporal lobe focus. The patient has a prior history of
medulloblastoma status post chemotherapy, radiation and surgical
removal at age 6 months.

TECHNIQUE: Sagittal 3D T1 gradient echo with axial reformations,
axial and coronal TSE T2, axial and coronal FLAIR, axial spin echo
T1, post-contrast sagittal 3D T1 gradient echo with axial and
coronal reformations, post-contrast axial spin echo T1 with fat
suppression, axial diffusion weighted imaging were performed on a
3.0 Tesla system. Additionally, axial arterial spin labeling was
obtained through the brain.

COMPARISON:  Sinus CT dated 4/8/2006.  Brain MRI dated 8/28/2003.

FINDINGS:
The ventricular system, including the third and possibly the
fourth ventricles, has increased in size since 8/28/2003 without
evidence of transependymal resorption of CSF and without evidence
of sulcal effacement, and with evidence of thinning of the corpus
callosum.  Given the above findings, the relatively long interval
between the current and prior MRI exams, and the history of prior
chemo-radiation therapy, ventricular enlargement is felt to likely
be the sequela post treatment related atrophy; and balanced
hydrocephalus is possible but felt to be much less likely.
There is a right occipital approach ventriculostomy catheter with
its tip again noted to be in the region of the atrium of the right
lateral ventricle. Shunt reservoirs are noted along the right
suboccipital scalp.
Mild T2-weighted signal abnormality is again noted within in the
right occipital lobe about the tip of the right occipital horn and
probably represents post treatment sequela.
There is stable mild thinning of the corpus callosum.
There is a stable, moderate-sized, 1.7 x 6.0 cm cyst along the
lateral aspect of the left cerebellar hemisphere with moderate
mass effect upon the underlying left cerebellum, and these
findings are likely reflective of an arachnoid cyst. There is a
smaller tiny arachnoid cyst along the posterior and inferior right
cerebellar hemisphere.
The cerebellar tonsils are slightly inferiorly directed and mildly
pointed in appearance, unchanged from prior examination.
There is a small stable pineal cyst.
There is moderate circumferential mucosal disease involving the
left maxillary sinus. There is also mild mucosal thickening
involving the right maxillary sinus a few left ethmoid air cells.
There is a small amount of fluid within the bilateral mastoid air
cells.
The visualized major intracranial vessels appear patent. No
definite abnormality is seen in the visualized portions of the
orbits.

IMPRESSION:
1. Mild ventricular enlargement since 8/28/2003 without evidence
of transependymal resorption of CSF and without evidence of sulcal
effacement.  Given the above findings, the relatively long
interval between the current and prior MRI exams, and the history
of prior chemoradiation therapy, ventricular enlargement is felt
to likely be the sequela post treatment related atrophy; balanced
hydrocephalus is possible but felt to be less likely. Clinical
correlation is suggested. If there is clinical concern for
ventricular shunt obstruction, a radiographic shunt series could
be obtained.


2. Right occipital approach ventriculostomy catheter with its tip
again noted to be in the region of the atrium of the right lateral
ventricle.


3. Post treatment related changes in the posterior fossa as
described above.

Answer
Nikki,

No wonder you are confused by this report. There is soo much shop talk with lots of different technical descriptions.  I am not sure it would be worth while to decode all of it for you.  It appears that there is no tumor recurrence and that in the interval since 2006 there has been some changes in the whole brain that are due to prior treatment, presumably radiation and chemo. These changes are shown as overall decrease in brain tissue. We see this often with chronic changes after such treatment, so this is expected.  There sinus inflammation but nothing too overwhelming. A catheter that is inserted into the brain appears in the stable position.

I would be happy to decipher any specific terms that you may be interested in.
Hope this helps somewhat.

MK  

Radiology

All Answers


Answers by Expert:


Ask Experts

Volunteer


Michael K.

Expertise

Almost any kind of questions regarding any types of radiology exams, procedures, meaning of radiology reports etc...

Experience

12 year experience in the field of radiology

Organizations
American Society of Neuroradiology, Senior Member Society of Pediatric Radiology, Active Member

Publications
Radiology Seminars in pediatric neurology American Journal of Roentgenology American Journal of Neuroradiology

Education/Credentials
Board Certified in Diagnostic Radiology Additional Certificate of Qualification in Neuroradiology

©2016 About.com. All rights reserved.