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4.1b. Pre-contrast Axial T1 Wtd MRI4.1c. Post-contrast Axial T1 Wtd MRI4.1a. Axial T2 Wtd MRI 4.1d....
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Transcript of 4.1b. Pre-contrast Axial T1 Wtd MRI4.1c. Post-contrast Axial T1 Wtd MRI4.1a. Axial T2 Wtd MRI 4.1d....
4.1b. Pre-contrast Axial T1 Wtd MRI 4.1c. Post-contrast Axial T1 Wtd MRI4.1a. Axial T2 Wtd MRI
4.1d. Post-contrast Sagittal T1 Wtd MRI
Patient with Intra-cranial mass.
Q1. Diagnosis Please
4.2a. Post-contrast Axial T1 Wtd MRI 4.2b. Post-contrast Coronal T1 Wtd MRI
Patient with multiple Intra-cranial masses. Q2. Diagnosis Please
Abnormal MRI
Q3. Diagnosis Please
4.3b. Post-contrast Axial T1 Wtd MRI 4.3c. Post-contrast Coronal T1 Wtd MRI4.3a. Pre-contrast Axial T1 Wtd MRI
4.3d. Post-contrast Sagittal T1 Wtd MRI
4.4. Post-contrast Coronal T1 Wtd MRI
Abnormal MRI with dural masses
Q4. Diagnosis Please
4.5. Post-contrast Axial T1 Wtd MRI
Abnormal MRI
Q5. Diagnosis Please
Fig. 4.1 Fig. 4.2 Fig. 4.3
Fig. 4.4 Fig. 4.5
Cases 4.1 through 4.5 share a common diagnosis.
Name the common diagnosis.
Fig. 4.1 Fig. 4.2 Fig. 4.3
Fig. 4.4 Fig. 4.5
Cases 4.1 through 4.5 share a common diagnosis.
Name the common diagnosis.
METASTASES TO THE BRAIN
4.1b. Pre-contrast Axial T1 Wtd MRI 4.1c. Post-contrast Axial T1 Wtd MRI4.1a. Axial T2 Wtd MRI
4.1d. Post-contrast Sagittal T1 Wtd MRI
56-year old lady with a history of Breast carcinoma presented with 1-month history of increased difficulty in word finding.
Findings: A well-defined enhancing tumor (arrow) is seen within the left frontal lobe with surrounding edema (E in figure A)
Diagnosis: Solitary metastatic adenocarcinoma to the brain from breast primary.
E
40-year old lady with a history of breast carcinoma diagnosed 6 years ago, presented with headache and ataxia.
Findings: Shower of at least 30 metastatic enhancing lesions are seen closely packed together within both Cerebellar hemispheres (yellow arrows) and few lesions also seen within both posterior Fronto-parietal lobes (red arrows)
Diagnosis:Multiple metastasis to the brain from breast primary
28-year old male with melanoma presented with severe headaches, treated by chiropractor without relief, and also with blurred vision progressed to diplopia.
4.3b. Post-contrast Axial T1 Wtd MRI 4.3c. Post-contrast Coronal T1 Wtd MRI4.3a. Pre-contrast Axial T1 Wtd MRI
4.3d. Post-contrast Sagittal T1 Wtd MRI
Findings: Linear enhancement of the subarachnoid space outlining the cerebellar sulci (yellow arrows) and cortical sulci (red arrows). Note the pathology is not seen in non-contrast study (A).
Findings: Linear enhancement of the subarachnoid space outlining the cerebellar sulci (arrows in B, C, D) and cortical sulci (small arrows in C,D). Note the pathology is not seen in non-contrast study (A).
Diagnosis:Leptomeningeal/subarachnoid spread of melanoma metastasis, proven by cerebrospinal fluid cytology.
4.4. Post-contrast Coronal T1 Wtd MRI
69-year old male with prostate cancer diagnosed 7 years ago, presented with right sided hemiparesis.
Findings: Multiple enhancing dural masses involving the left frontal dura (short arrow) and left temporal dura (long arrow) with calvarial metastases (red arrows).
Diagnosis:Dural metastases from prostrate carcinoma
50-year old male with renal cell carcinoma
Diagnosis:Right temporal calvarial metastasis with a small epidural tumor (arrow head) and an intraventricular metastasis (arrows).
Fig. 4.1 Fig. 4.3
Fig. 4.4 Fig. 4.5
Common primary sites: Lung, Breast, Melanoma, Thyroid, Renal Cell Carcinoma
METASTASES TO THE BRAIN
Patten of involvement:
• Intraparenchymal (Figure 4.1)
• Leptomeningial/Subarachnoid Spread (Figure 4.3)
• Dural (Figure 4.4)
• Epidural (Figure 4.5)
• Intraventricular (Figure 4.5)
Hemorrhagic Metastases
•Renal
•Breast
•Melanoma
•Choriocracinoma
MRI is more sensitive than CT imaging to detect metastatic lesions and can detect a lesion as small as a dot (2mm).