Case 5: Imaging Discussion

CASE 5: Explanation of Imaging Findings

MRI without and with contrast

CASE 5

A brain MRI without and with contrast was performed. Select images are shown.

Questions

1. What are the above sequences?

The above sequences are labelled. A and B are T2 images, which you can tell because CSF is bright. White matter is darker than grey matter.
Image C is a FLAIR sequence. CSF is supressed, which brings out areas of edema.
Image D: T1 post contrast sequence. Contrast is given to assess for areas of blood-brain barrier breakdown and vascularity of a mass.
Images E and F: Diffusion and ADC. We learned in Case 3 that diffusion is extremely helpful in assessing patients presenting with strokes. Diffusion can also be useful in evaluating patients with tumors. There are certain types of tumors which are bright on ADC-- this one is not bright.

2. Where is the abnormality located?

3. Describe the abnormality using appropriate terminology.

4. Why are the lateral ventricles enlarged?

5. What is the differential diagnosis for this abnormality?

6. Is this an example of communicating or non-communicating hydrocephalus?