These are the Final Reports from Radiology at Children's Hospital from 7/17/2012 and 8/7/2012.
MRI #1 - Brain MRI
Clinical History:
Right hemi dystonia and spasticity
Technique:
Saggital short TR/short TE, axial and coronal FLAIR, axial long TR/long TE, S1 and diffusion and coronal MP IR images were obtained. The Study is performed without intravenous contrast.
Findings:
No comparison studies are available.
The ventricles and gyri are unremarkable in appearance and gray-white matter differentation.
The corpus callosum is fully formed and myelinated and the craniocervical junction is normal. No abnormality of the pituitary hypothalmic axis is present.
On all imaging sequences but there is a small lesion abutting the left dorsal ons in the quadrageminal plate cistern which is hyperintense on the long TR and SW1 sequence. This measures approximately 4-5 mm. Tiny droplets of similar signal are seen in the superior vermis as well. In addition there appears to be a small fluid collection/arachnoid cyst abutting the right dorsal pons/tectum measuring approximately 6mm. No intra-axial foci of abnormal signal are evident. There are no discrete anomalies. Flow void does appear to be present in all the major intracranial vessels.
The middle ears and mastoids and paranasal sinuses are clear.
Impression:
1. Small 4-5 mm quadrigeminal plate lipoma and on the left and possible small 5-6 mm arachnoid cyst on the right. Tiny foci of lipomatosis signal are also seen in the vernis. When a follow-up study is obtained suggest targeted high-resolution images through the brainstem with FIESTA and SPGR sequences.
2. Otherwise unremarkable MRI of the brain.
End of Impression.
MRI #1 - Lumbar Spine
Clinical History:
Hemi Dystonia
Technique:
Saggital and axial short TR/short TE and long TR/long TE and coronal long TR/long TE images were obtained. The study is performed without intravenous contrast.
Findings:
No comparison studies are available.
By the sagittal scout, the patient has a full complement of cervical, thoracit and lumbar vertibrae.
Height and alignment of the vertibral bodies and posterior elements as well as their signal characteristics are unremarkable.
The configuration and signal characteristics of the distal cord are normal. The conus is positioned at the level of the midbody of the L2. The cauda equina is unremarkable in appearance as is the spinal canal.
Impression:
1. Unremarkable unenhanced MRI of the lower spine.
End of Impression
MRI #2 - Unspecified (Additional Sequence)
Clinical History:
Right Hemi-Dystonia and spacticity
Comparison 7/17/2012
Technique:
Multiplana multi sequence additional MRI sequences of the brin were obtained including axial T1 3mm, axial T1 3mm FTST, axial 3-D FIESTA, axial DTI, axial T1 3D FSPGR and additional tensor-weighted imaging.
Findings:
Again seen is a 5mm small rounded T2 hyperintense lesion abutting the left dorsal pons within the quadrigeminal plate cistern that is consistent with a tectal plate lipoma.
Additional punctate droplets of fat are scattered within the region of the vermis.
Overall, there is no significant interval change from the comparison study dated 7/17/2012. No intra-axial foci of abnormal signal are evident. There is no additional evidence of abnormal intrinsic signal or mass lesion. The ventricles and gyri are unremarkable in appearance. The midline structures are present. There is no evidence of hemorrahage or territorial infarction. Flow voids are appreciated in all the major intracranial vessels.
Impression:
1. 5mm quadrageminal plate lipoma, unchanged.
2. Punctuate scattered fat lobules in the region of the cerebellar vermis.
3. Otherwise unremarkable MRO appearance of the brain.
End of Impression
