Dylan's MRI Report

 
Department of Radiology
MRN:   Billing Number:  			CPT CODE:
Name:   DYLAN	Age: 18M Sex: M	DOB: 07/ /2002
Acc:  Exam: MR BRAIN WITH & WITHOUT CONTR
Completed on: 0l/22/2004 at 5:52 PM
Pt. Loc. at Completion:  			Pt. Loc. ;	  Order No:  
Attending MD:  				Requesting MD:  

Diagnosis: NONE ENTERED
History; ***rt 6th & 7th nerve palsy, r/o pseudopontine angle 1esion***
HISTORY: 6th and 7th cranial nerve palsies

TECHNIQUE: MR examination of the brain was performed utilizing a 1.5 Tesla magnet. The following sequences were obtained:
Ti-weighted images in the sagittal and axial planes, T2-weighted images in the axial and sagittal planes, FLAIR axial and coronal. Postgadolinium images were obtained in the sagittal, axial and coronal planes. Diffusion weighted imaging could not be performed of the patient awakened from maximal safe sedation.
COMPARISON: None
FINDINGS:
Centered the eccentrically to the right within the pons, and extending into the medulla (right more than left.), is a intrinsic mass, measuring 2.5 cm (TR) by 2.9 cm (AP) by 4.8 cm (CC). There is significant local mass effect with acquired cerebellar torisillar ectopia and flattening of the inferior cerebellum. The local mass effect causes mild supratentorial ventriculomegaly, but. no interstitial flow of CSF. The lesion is hyperintense on T2 weighted imaging. There is no intrinsic T1 shortening or T2 hypointensity to suggest intralesional hemorrhage. Following gadolinium administration, there is no significant enhancement. Imaging findings strongly favor an intrinsic pontine glioma.
The lesion causes some displacement of the distal right vertebral, AICA and basilar arteries, but these vessels remain patent. The remainder of the major intracranial vessels demonstrate normal flow.
The supratentorial brain is unremarkable. There is no abnorma1 enhancement within the supratentorial compartment to suggest leptomeningea1 spread of tumor at this time.
The paranasal sinuses, middle ear cavities and mastoid air cells are clear. The orbits are grossly unremarkable.



IMPRESSION;
Intrinsic pontine neoplasm, most likely glioma, as detailed. This causes cerebellar tonsillar ectopia and some mass effect on the fourth ventricle with supratentorial ventriculomegaly but no overt hydrocephalus at this time. There is no interstitial flow of CFS.
 
FINAL REPORT