Anastasia Zherlitsyna — timeline

	Diagnostic center	03186, Ukraine, Kyiv city, St. Aviakonstruktora Antonova, 13a phone: (044) 392 33 93 License of the Ministry of Health of Ukraine Series AE No. 281858 dated November 28, 2013 DC Medex" LLC

The study (magnetic resonance imaging) was performed on a 1.5T MRI system Magnetom Avanto fit manufactured by Siemens, Germany.

Patient's name: Zherlitsyna Anastasia Stanislavivna Date of birth: 25.04.1976 Date of the study: 16.06.2023 Research no.: CMDI1200 Name of the study: MRI of the brain before and after contrast
Contrast agent: Dotavist Scan protocol: performed T2WI, DWI, SWI tomograms of the brain in axial and sagittal projections, T2_spc_da-fl_iso, T1mpr, T1mpr + C with subsequent multiplanar reconstruction

Anamnestic data: uterine leiomyosarcoma T2NxM1. Condition after 4 cycles of chemotherapy according to the protocol Gemcitabine + Docetaxel + Avastin with progression in the liver. Kit mutations were detected, for which Pazopanib was recommended (according to the oncologist's advisory opinion dated January 4, 2023).

MRI in dynamics from January 20, 2023.

On a series of MR tomograms of the brain, previously described diffuse foci of hyperintense MR signal on T2WI and T2blade dark-fl are preserved in the cortical and subcortical sections of both hemispheres of the brain (mainly in the parietal regions), however, with their significant regression in the form of a decrease in size, less hyperintense MR signal on T2_spc_da-fl_iso and with regression of contrast agent accumulation in their structure. The appearance of new foci is not determined.

The focus of intracerebral hemorrhage is preserved in the left occipital region with general conventional dimensions of 11x7.5x7.5 mm (reduced in size), with signs of diffusion limitation with minimal perifocal swelling of the brain substance, up to 3 mm wide; a small focus of post-hemorrhagic changes in the right occipital region is also determined.

Along the course of the subarachnoid spaces in the frontal regions, there are areas of hypointense MR signal on SWI, increased on T2WI and T2_spc_da-fl_iso, which are not defined on DWI and do not accumulate contrast agent (perhaps the consequences of local SAH or hemorrhagic impregnation).

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 do not contain areas of pathological changes in the MR signal.

Craniovertebral junction: cerebellar tonsils without signs of prolapse into the large occipital foramen.

The sella turcica: located typically, conventional configuration. The walls are even, the contours are smooth, clear. The pituitary stalk is located clearly in the center. The pituitary gland is bean-shaped, the upper edge is symmetrical.

Chiasma, optic nerves without features.

Pneumatization of the paranasal sinuses is not disturbed.

Conclusion: the MR picture of pathological changes in the brain, which have significantly decreased in intensity and prevalence in comparison with the MRI examination from 01.20.2023, taking into account the data of the clinic and history, previous examinations, localization and MR characteristics, may correspond to the consequences of posterior reversible encephalopathy syndrome (PRES). In comparison with the previous MRI examination from January 20, 2023, a decrease in the size and transformation of the contents of the intracerebral hemorrhage in the left occipital lobe of the brain is determined.

Expedient: clinical and tomographic comparison, MR control in dynamics, observation of a neurologist.

Doctor	Sachenok Nellie Borisivna

Dear patient! These research data are not a clinical diagnosis.

You need to give them to your doctor, who will explain the results of the examination and make a final diagnosis.

For dynamic observation, notify our staff and provide a disc with a previous study conducted at our facility.

16.06.2023 19:54:23 Protocol prepared by: Matyash M.O. No. 01-20/222 B04 05.08.2020