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Brain MRI Reports
Brain MRI Reports
Brain MRI Reports
Item to be fulfilled:
Ventricular system
Cerebral parenchyma
OR
OR
OR
If fractures are present mention the site (frontal, parietal, ) and type
(fissure, depressed, comminuted,.). when subgalial hematoma is
present it should be mentioned.
OR
OR
High T1
Low T1
High T1
intermediate T2 [fat,...]
Early sub acute blood [high signal in T1WIs and dark signal on
T2WIs] [intracellular met HB].
OR
NB
In case you see a black line surrounding the hematoma you say a rim
of persistent low signal in all pulse sequences is seen surrounding the
hematoma denoting hemosidren formation.
NB
The lesion measures ----x ----x --- cm maximal AP, transverse and
craniocaudal diameters respectively.
The lesion exerts a mass effect in the form of effacement of the cortical
sulci compression of the ipsilateral ventricle contra lateral shift of the
midline structures.
Normal posterior fossa (if the lesion is not in the posterior fossa).
Scanned paranasal sinuses are clear.
Extra axial hemorrhage
A well defined extra axial (elliptical or cresentic shaped) hematoma is seen in
the (Mention the site of the lesion).
It showed .. Mention the signal changes in T1 and T2WIs as described
with the intra cerebral hematoma however,
Sub arachnoid hemorrhage is not assessed by MRI, if so, you can follow
the same items used for CT and remember to change the densities to
signal intensities.
Fresh blood signal is seen smearing the cortical sulci and extra axial CSF
spaces extension into the ventricular system showing dark signal in T2 WIs
NB
Also mention that the ventricular system is dilated denoting the presence of
communicating hydrocephalus which is usually seen in cases of subarachnoid
hemorrhage.
Normal posterior fossa (if the lesion is not in the posterior fossa).
Brain infarction
Not included [we do not usually measure the size of the infarct]
foci of blood signal are seen within the lesion in cases of hemorrhagic
infarction. The blood signal you will see is either
Sub acute blood [high signal in both T1 and T2WIs] [extra cellular
met HB].
Normal posterior fossa [if the lesion is not in the posterior fossa].
Scanned paranasal sinuses are clear.
Lacunar infarction
Old lacunar infarct will show low signal in T1 and FLAIR images with
high signal in T2WIs [CSF signal].
NB
OR
extra axial CSF spaces [in old patients with brain atrophic changes]
Grade II = area more than 2 cm but less than 1/2 the cerebral
hemisphere in which the lesion is present.
Grade III = area more than 1/2 the cerebral hemisphere in which
the lesion is present
Midline shift.
Meningioma
A well defined oval shaped SOL is seen in the . [Mention the site of the
Lesion]. It showed low signal in T1WIs and high signal in T2WIs.
NB
NB
Some meningiomas may contain low signal foci within the tumor mass
The lesion is surrounded by grade --- perifocal brain edema showing low
signal in T1 and high signal in T2 WIs.
The lesion and edema exert a mass effect in the form of -------, --------, -----
Normal posterior fossa (if the lesion is not in the posterior fossa).
Scanned Para nasal sinuses are clear
OR
A well defined [or an ill defined], ------[mention the shape of the lesion
oval, irregular,] shaped SOL is seen in the -----[mention the site of the
lesion]
OR
Normal posterior fossa (if the lesion is not in the posterior fossa).
Scanned Para nasal sinuses are clear
OR
The lesions range in size between -------[the smallest lesion] and -------[the
largest lesion] and showed -------- [mention the pattern of enhancement.
The largest lesion measures ----- x ----- cm in maximal diameters and is
located in ---- [mention the site of the largest lesion].
NB
Cyst
Ex.
Ex.
NB
Dermoid cysts usually contain fat, then you have to say that the lesion
contains fat signal which appeared high in T1 and intermediate in T2
WIs.
NB
exert a mass
effect, then you have to mention the manifestation of the mass effect in the
form of ------, -----, ------.
NB
NB
NB
NB
Acostic neuroma
A well defined SOL is seen in the ------- [left or right] cerebello- pontine
angle region extending inside the adjacent internal auditory canal which is
widened [or not]
A well defined partly cystic and partly solid SOL is seen in the supra sellar
area with it's main bulk exactly in the midline plane [or slightly to the left or
right of the midline]
The cystic component showed low signal in T1 and high signal in T2 WIs
while the solid component showed intermediate signal in both T1 and T2
WIs with homogenous or heterogenous pattern of contrast enhancement.
NB
The cystic component may show high signal in T1 and T2 WIs due to
its high protein content [this finding can help in the diagnosis of
carniopharyngioma]
NB
Usually there is no edema, but mass effect is may be present in the form
of compression of the 3rd ventricle with consequent obstructive
hydrocephalic changes of both lateral ventricles.
NB
The lesion may extend inside the sella [best seen in coronal images]or
may extend into the para sellar area or even into the posterior fossa via
the pre pontine cistern (rare) These extensions should be mentioned
Normal posterior fossa. If the lesion has extended into the posterior fossa
then you can say : No evidence of cerebellar or brain stem parenchymal
lesions
A well defined intrasellar SOL is seen extending (or not) into the supra
sellar cistern.
The lesion measures ----x ----x ---- cm in maximal diameters and shows
intermediate signal in T1 and T2 WIs with homogenous or heterogenous
pattern of enhancement [mention the type of enhancement].
NB
the supra sellar extension with obliteration of the suprasellar cistern [if present
best seen in the coronal images], compression of the hypothalamus [also
seen in the coronal images better than CT scan] Extension into the
suprasellar area may also compress and streach the optic chiasm. These
findings should be mentioned in the report.
Parasellar extension into the cavernous sinuses and affection of the internal
carotid arteries should be mentioned
NB
NB
Also mention that the internal carotid artery is patent showing normal
signal void [usual finding].
NB
Infrasellar extension with erosion of the sellar floor and invasion of the
sphenoid sinus indicate that the adenoma is invasive then you mention
in the conclusion of the report that the adenoma is invasive and do not
say malignant .
Usually there is no edema, but mass effect may be present in the form of
compression of the 3rd ventricle with consequent obstructive hydrocephalic
changes of both lateral ventricles.
OR
A well defined small focal lesion is seen within the ----- (left or right) aspect
of the pituitary gland.
Mention that the cerebral parenchyma and ventricles appear normal with
no midline shift, also mention that the posterior fossa
structures are normal
OR
Aneurysm
The lesion showed signal void in all pulse sequences denoting patent
lumen.
NB
Normal posterior fossa (if no lesions are present in the posterior fossa ).
Scanned Para nasal sinuses are clear
OR
Aneurysm rupture
The ventricles are usually dilated and may contain fresh blood signal then
you can say: mild or moderate symmetrical dilatation of the supra and
infratentorial cerebral ventricles periventricular edema due to retrograde
If blood is present in the 4th ventricle then you can say : normal
appearance of the brain stem and cerebellum, but do not write the usual
statement.
Arteriovenous malformation
A well defined area of abnormal vascularity is seen ----- [mention the site of
the lesion] showing serpigenous signal void vascular channels.
Perifocal brain edema may present and a mild mass effect may be also
seen then you should mention these findings.
NB
Ischemic areas in the region of the AVM will appear of low signal in T1
and high signal in T2 WIs due to direct shunting of blood from the
arterial to the venous side.
Normal posterior fossa (if no lesions are present in the posterior fossa ).
Scanned Para nasal sinuses are clear
OR
Cavernous hemangioma
The lesion showed high signal in all pulse sequences with a well defined
margin of marked hypointensity specially noted in T2 WIs.
The lesion measures -------X ----- cm in maximal diameters and showed no
appreciable post contrast enhancement.
NB
Minimal perifocal brain edema may be present around the lesion, then
mention it and say showing low signal in T1 and high signal in T2 WIs.
NB
No mass effect exerted by the lesion, if present you can say that the
lesion exerts minimal mass effect on the adjacent structures.
NB
In case of multiple lesions, you start to described the largest one [as
mentioned above], then you say multiple similar lesions are seen in ---[mention the site of each lesion]
Normal posterior fossa (if no lesions are present in the posterior fossa ).
Scanned Para nasal sinuses are clear
OR
A well defined --------- shaped (mention the shape of the lesion) is seen ----(mention the site of the lesion).
Possible sites include:
Within the body or frontal horn of the lateral ventricle (left / right).
The lesion showed intermediate signal in T1 WIs with high signal in T2 WIs
and homogenous/ heterogenous pattern of post contrast enhancement
with foci of matrix calcifications. The surface of lesion appeared smooth
or lobulated.
NB
If the tumor has penetrated the wall of the ventricle it will initiate brain
edema around, then maliganent transformation is suspected.
Normal posterior fossa (if no lesions are present in the posterior fossa ).
Scanned Para nasal sinuses are clear
OR