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What Does My MRI Report Indicate About The Brain Tumor?
Question: I am getting ready for brain surgery on 6/19. The detailed reading of the MRI is:
1. Intensely enhancing, oval extra-axial- mass lesion near the right clinoid processes visually appears slightly larger; however, the maximum A.-P. dimension is quite similar to prior study (3.0 - 3.2 cm). The amount of adjacent brain reaction/edema may have slightly increased since prior study. The mass lesion and accompanying edema result in some local mass effect on inferior right frontal lobe and some attenuation involving the inferior aspect of the anterior right lateral ventricle. This extra-axial lesion may in case/around adjacent segment of intracranial right internal carotid artery. There is slight leftward shift of interhemispheric fissure inferiorly.
2. Similar brain volume/mild intracranial atrophy.
3. On FLARR and T2-weighted images, there are a few punctate high signal intensity within frontal lobe white matter bilaterally, of uncertain etiology and clinical significance.
4. No abnormal intracranial contrast enhancement is suggested.
5. There is suggestion of calcification/mineralization involving the falx, without adjacent brain reaction/edema.
6. No convincing MR evidence of intracranial blood products.
7. No evidence of restricted water diffusion or other suggestion of acute infarction.
8. Mild mucosal thickening within paranasal sinuses.
9. Minimal mucosal thickening/retained fluid within mastoid air cells bilaterally.
My questions:
1. What are the implications of the following phrases:
(a) "Intensely enhancing, oval extra-axial- mass lesion near the right clinoid processes visually appears slightly larger".
(b) "The amount of adjacent brain reaction/edema may have slightly increased since prior study".
(c) The mass lesion and accompanying edema result in some local mass effect on inferior right frontal lobe and some attenuation involving the inferior aspect of the anterior right lateral ventricle
(d) "This extra-axial lesion may in case/around adjacent segment of intracranial right internal carotid artery."
(e) "There is slight leftward shift of interhemispheric fissure inferiorly."
(f) "Similar brain volume/mild intracranial atrophy."
(g) "On FLARR and T2-weighted images, there are a few punctate high signal intensity within frontal lobe white matter bilaterally, of uncertain etiology and clinical significance."
(h) "There is suggestion of calcification/mineralization involving the falx, without adjacent brain reaction/edema."
(i) "Mild mucosal thickening within paranasal sinuses."
(j). "Minimal mucosal thickening/retained fluid within mastoid air cells bilaterally."
2. Do you think I should have the surgery and why? If not, why not?
Thanks.
1. Intensely enhancing, oval extra-axial- mass lesion near the right clinoid processes visually appears slightly larger; however, the maximum A.-P. dimension is quite similar to prior study (3.0 - 3.2 cm). The amount of adjacent brain reaction/edema may have slightly increased since prior study. The mass lesion and accompanying edema result in some local mass effect on inferior right frontal lobe and some attenuation involving the inferior aspect of the anterior right lateral ventricle. This extra-axial lesion may in case/around adjacent segment of intracranial right internal carotid artery. There is slight leftward shift of interhemispheric fissure inferiorly.
2. Similar brain volume/mild intracranial atrophy.
3. On FLARR and T2-weighted images, there are a few punctate high signal intensity within frontal lobe white matter bilaterally, of uncertain etiology and clinical significance.
4. No abnormal intracranial contrast enhancement is suggested.
5. There is suggestion of calcification/mineralization involving the falx, without adjacent brain reaction/edema.
6. No convincing MR evidence of intracranial blood products.
7. No evidence of restricted water diffusion or other suggestion of acute infarction.
8. Mild mucosal thickening within paranasal sinuses.
9. Minimal mucosal thickening/retained fluid within mastoid air cells bilaterally.
My questions:
1. What are the implications of the following phrases:
(a) "Intensely enhancing, oval extra-axial- mass lesion near the right clinoid processes visually appears slightly larger".
(b) "The amount of adjacent brain reaction/edema may have slightly increased since prior study".
(c) The mass lesion and accompanying edema result in some local mass effect on inferior right frontal lobe and some attenuation involving the inferior aspect of the anterior right lateral ventricle
(d) "This extra-axial lesion may in case/around adjacent segment of intracranial right internal carotid artery."
(e) "There is slight leftward shift of interhemispheric fissure inferiorly."
(f) "Similar brain volume/mild intracranial atrophy."
(g) "On FLARR and T2-weighted images, there are a few punctate high signal intensity within frontal lobe white matter bilaterally, of uncertain etiology and clinical significance."
(h) "There is suggestion of calcification/mineralization involving the falx, without adjacent brain reaction/edema."
(i) "Mild mucosal thickening within paranasal sinuses."
(j). "Minimal mucosal thickening/retained fluid within mastoid air cells bilaterally."
2. Do you think I should have the surgery and why? If not, why not?
Thanks.
Brief Answer:
You should have the surgery.
Detailed Answer:
Hi,
Thank you for posting your queries. I have gone through the MRI report.
1. a) The tumor has increased in size.
b) The swelling around the tumor has also increased. Both the above points suggest that the tumor in growing.
c) The tumor and swelling are pressing on the normal brain around them, on the right side of brain. This may cause mild weakness on left side of body.
d) The tumor is also possibly pressing on the artery (blood vessel) on the right side of brain. If tumor grows and there is more pressure on the artery, it can lead to lack of blood flow to the right side of brain, resulting in left sided weakness.
e) This also shows the effect of tumor and swelling.
f) Not significant finding.
g) May be due to migraine or ischemia (lack of blood flow to brain), however, not clinically significant at this stage.
h) Normal finding.
i) Mild infection of sinuses.
j) Mild infection of mastoids. Last two points ( i and j )are minor and not related to tumor. These can be treated by ENT doctor with medications.
2. You should have the surgery to prevent any complications (such as left sided weakness, seizures, headache, etc). Also, there is no medicine to treat this condition.
I hope my answer helps. Please get back if you have any follow up queries or if you require any additional information.
Wishing you good health,
Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) XXXXXXX Consultant Neurologist
Apollo Hospitals, XXXXXXX XXXXXXX
Click on this link to ask me a DIRECT QUERY: http://bit.ly/Dr-Sudhir-kumar
My BLOG: http://bestneurodoctor.blogspot.in
You should have the surgery.
Detailed Answer:
Hi,
Thank you for posting your queries. I have gone through the MRI report.
1. a) The tumor has increased in size.
b) The swelling around the tumor has also increased. Both the above points suggest that the tumor in growing.
c) The tumor and swelling are pressing on the normal brain around them, on the right side of brain. This may cause mild weakness on left side of body.
d) The tumor is also possibly pressing on the artery (blood vessel) on the right side of brain. If tumor grows and there is more pressure on the artery, it can lead to lack of blood flow to the right side of brain, resulting in left sided weakness.
e) This also shows the effect of tumor and swelling.
f) Not significant finding.
g) May be due to migraine or ischemia (lack of blood flow to brain), however, not clinically significant at this stage.
h) Normal finding.
i) Mild infection of sinuses.
j) Mild infection of mastoids. Last two points ( i and j )are minor and not related to tumor. These can be treated by ENT doctor with medications.
2. You should have the surgery to prevent any complications (such as left sided weakness, seizures, headache, etc). Also, there is no medicine to treat this condition.
I hope my answer helps. Please get back if you have any follow up queries or if you require any additional information.
Wishing you good health,
Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) XXXXXXX Consultant Neurologist
Apollo Hospitals, XXXXXXX XXXXXXX
Click on this link to ask me a DIRECT QUERY: http://bit.ly/Dr-Sudhir-kumar
My BLOG: http://bestneurodoctor.blogspot.in
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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