Case 26 - Hyper Anomenia: MRI

Dr. Yousem has provided the following report as a sample report for your reference. It does not match the case reviewed in the video.

MRI BRAIN WITH IV CONTRAST

INDICATION: 23 years old, Female, status post low segment transverse c-section complicated by uterine atony Concern for hypoxic /hypoglycemic brain injury.

TECHNIQUE: Sagittal T1 FLAIR, axial T2 FLAIR, diffusion, susceptibility weighted, and postcontrast axial fat-suppressed T2 and axial and fat-suppressed coronal T1 weighted images were acquired through the brain. ADC maps were reconstructed from the diffusion weighted data set.

COMPARISON: 10/29/2016 MRI brain.

FINDINGS:

Diffusely thickened and swollen cortex of the cerebral hemispheres seen on diffuse weighted images with associated changes on ADC map.

Scattered areas of susceptibility artifacts, new since 10/29/2016 MRI consistent with remote microbleeds (image 10 of series 9, image 14 of series 9).

Scattered nonspecific periventricular and subcortical white matter changes involving the cerebral hemispheres, slightly more prominent on current study compared to 10/29/2016 MRI.

The ventricles, cisterns and sulci are normal in size, shape and position.

No acute infarct. No acute intracranial hemorrhage. No extra-axial fluid collection. No chronic infarcts. No intracranial mass. No abnormal enhancement.

The orbits are symmetric and unremarkable. The visualized sinuses are clear. Skull base is within normal limits. There is right mastoid greater than left mastoid and middle ear cavity fluid. Basal cisterns and pituitary are normal. No abnormal enhancement.

The major intracranial flow voids are patent.

IMPRESSION:

1. Diffusely thickened and swollen cortex of the cerebral hemispheres seen on diffuse weighted images with associated changes on ADC map. Findings may represent metabolic or diffuse hypoxic anoxic ischemic changes, particularly hyperammonemia*.

2. Scattered areas of susceptibility artifacts, new since 10/29/2016 MRI consistent with remote microbleeds.

3. Nonspecific periventricular and subcortical white matter changes involving the cerebral hemispheres, slightly more prominent on current study compared to 10/29/2016 MRI.