MRI of the brain 13.01.2023 — second expert reading
Diagnostic center
04073, Ukraine, Kyiv,
Stepan Bandera avenue, 17/1
phone: (044) 392 33 93
License of the Ministry of Health of Ukraine
decision No. 1296 dated 01.12.2016
"Medistar" LLC
Consultation on the provided MRI of the brain with intravenous contrast dated January 13, 2023
Patient's name: Zherlitsyna Anastasia Stanislavivna
Date of birth: 25.04.1976
Date of examination: 13.01.2023
Date of consultation: 17.01.2023
No. PMDA1068
From the anamnesis - leiomyosarcoma of the uterus T2NxM1. Condition after 4 cycles of chemotherapy according to the Gemcitabine+Docetaxel+Avastin protocol with progression in the liver (oncologist's advisory opinion dated January 4, 2023).
On a series of MR tomograms of the brain in parietal-temporal-occipital areas cortical-subcorticaly are visualized without clear contours of the zone of hyperintense MR signal on T2WI and T2blade dark-fl, on a larger interval without signs of diffusion limitation, however, with inclusions of hypointense MR - signal on SWI with a diameter of up to 3-3.5 mm (may indicate small hemorrhagic cells); after intravenous contrast, non-intense accumulation of the contrast agent according to the "gyriform pattern". Similar cells without clear contours on native and post-contrast images are determined in the cortex of the frontal and parietal regions. Along the course of the subarachnoid spaces in the frontal regions, there are areas of hypointense MR signal on SWI, increased on T2WI and DWI, with separate contrast loci (perhaps signs of local SAH or hemorrhagic impregnation). All identified changes were not identified on MRI dated 20.09.2022.
Middle structures without lateral displacement. The lateral ventricles of the brain are symmetrical, unchanged in size, the IV ventricle is located along the midline. The demarcation of gray and white matter is clear.
Periventricular zones of leukoaraiosis with a width of up to 2 mm.
The corpus callosum, basal ganglia, mesencephalic structures, structures of the posterior cranial fossa, brain stem areas do not contain pathological changes in the MR signal.
Craniovertebral junction: cerebellar tonsils without signs of prolapse into the large occipital foramen.
Sella turcica: located typically, conventional configuration. The walls are even, the contours are smooth, clear. The funnel of the pituitary gland is located clearly in the center. The pituitary gland is bean-shaped, the upper edge is symmetrical.
Chiasm, optic nerves without features.
Pneumatization of the paranasal sinuses is not disturbed.
Conclusion: The detected MR picture of pathological changes in the brain, taking into account the history, localization and MR characteristics, may more likely correspond to posterior reversible encephalopathy syndrome (PRES); should be differentiated with manifestations of cerebral vasculitis.
Appropriate clinical and tomographic comparison, MR control in dynamics.
Doctor: Skorokhoda Anna Orestivna
Dear patient! These research data are not a clinical diagnosis.
You need to give them to your attending physician, who will explain the results of the examination and establish a final diagnosis.
For dynamic observation, notify our staff and provide a disc with a previous study conducted at our institution.
01/17/2023 11:06:39 Protocol prepared by: Kutsenko Viktoria Stanislavivna No 01-20/128 В04 08/05/2020