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KATYA POLISHCHUK's EIGHTH MRI REPORT

OREGON IMAGING CENTERS

POLISHCHUK, Katherine
DOB 12/15/2000
Date of Service: 7/10/2006 11:44 AM     

(OIC) - MR BRAIN WO&W CONTRAST

SIGNS AND SYMPTOMS: Follow up brain tumor.

MRI BRAIN - WITH AND WITHOUT CONTRAST

IMPRESSION:
1. When compared to the prior exam of 4/14/06, there is increased enhancement and edema surrounding the mass centered on the left pons. Findings suggest progression of disease.
2. Interval development of an enhancing mass within the subependymal region of the frontal horn of the right lateral ventricle most likely represents metastatic disease, possibly from subependymal spread of tumor.
3. There is no evidence of hydrocephalus. The right ventricular shunt catheter is again noted.


INDICATION: Brain tumor.

TECHNIQUE: A magnetic resonance imager was used to obtain multiplanar T1, T2 and spin density-weighted images before contrast. Multiplanar T1-weighted images following the injection of IV Magnevist, 3cc, were also acquired. No sedation was used during this exam. The exam is technically adequate.

COMPARISON: 4/14/06, 3/3/06, 12/20/05, and 8/11/05.

FINDINGS: There is a 2.9 x 2.7 x 1.9 cm heterogeneously enhancing mass identified within the left pons. There is abnormal increased T2 signal intensity surrounding the enhancement consistent with vasogenic edema and tumor. Both the enhancement and T2 hyperintensity surrounding the enhancement have progressed during the interval. There is more mass effect on the 4th ventricle on the current study. The mass surrounds the basal artery as well. There is effacement of the prepontine cistern as well as the CSF spaces around the foramen magnum.

A ventricular shunt from a right frontal approach is again identified. There is no evidence of hydrocephalus.

There is a 1.2 x 1.2 x 1.2 cm enhancing mass identified within the subependymal region of the frontal horn of the right lateral ventricle. This lesion is a new finding when compared to the prior exam and this likely represents metastatic disease. No significant extra-axial fluid is seen. The paranasal sinuses are well aerated.

The bones demonstrate surgical changes from the shunt placement.


Interpreted by GUPTA, AKSHAY, S MD, Radiology Assoc.

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