File:Cerebral abscess- fungal (Radiopaedia 25792-25938 Axial DWI 15).jpg

From NC Commons
Jump to navigation Jump to search

Original file ‎(1,365 × 1,365 pixels, file size: 70 KB, MIME type: image/jpeg)

Summary:

Description
  • Radiopaedia case ID: 25792
  • Image ID: 5047903
  • Image stack position: 15/18
  • Plane projection: Axial
  • Aux modality: DWI
  • Study description: MRI brain
  • Study findings: A large area of vasogenic edema within the left occipital lobe surrounds an irregularly rounded lesion of intermediate signal intensity, measuring approximately 17 mm in diameter. T2-weighted scans indicate that the central lesion has a rim of reduced magnetic susceptibility within it, in the center of which diffusion is markedly restricted. Contrast enhancement is vivid with some loculation and several "fingers" of enhancement extending into the adjacent tissue. Relative cerebral blood volume (CBV) is increased in the peripheral enhancing portion of the lesion. Spectroscopic imaging shows large lactate/lipid peaks indicative of necrosis. Choline peaks are not prominent. Elsewhere, scattered foci of white matter abnormal signal probably indicate chronic small vessel ischemic disease. A small lateral occipital cortical signal abnormality may represent an old cortical infarct. Magnetic susceptibility effect from coils noted in relation to the terminal portion of the right internal carotid artery with the suggestion of residual aneurysmal cavity. Conclusion: The vivid contrast enhancement, extensive edema, restricted diffusion and slightly elevated relative cerebral blood volume (CBV) are most in keeping with a malignant tumor. Glioblastoma multiforme and metastasis could both produce such an appearance. The restricted diffusion and lack of prominent choline peaks means abscess cannot be entirely discarded as the diagnosis, despite the relative thickness of the enhancing walls, which can be a feature of atypical organisms in immunocompromised patients.
  • Modality: MRI
  • System: Central Nervous System
  • Findings: There is a single ring-enhancing lesion centered on the left occipital lobe, which has a maximum diameter of 13 mm. There is considerable surrounding edema within the left occipital and parietal lobes, resulting in effacement of the sulci. There is no midline shift and no effacement of the left lateral ventricle. No other parenchymal lesions are identified. The brainstem and posterior fossa have normal appearances. The ventricular system is unremarkable and the basal cisterns remain patent. The cranial vault and skull base are unremarkable. CONCLUSION: 13 mm left occipital ring-enhancing lesion, with significant surrounding cerebral edema. This most likely represents a neoplastic lesion (either primary or secondary) although the differential diagnosis includes an infective lesion.
Date Published: 8th Nov 2013
Source https://radiopaedia.org/cases/cerebral-abscess-fungal-1
Author RMH Neuropathology
Permission
(Permission-reusing-text)		 http://creativecommons.org/licenses/by-nc-sa/3.0/

Licensing:

Attribution-NonCommercial-ShareAlike 3.0 Unported (CC BY-NC-SA 3.0)

File history

Click on a date/time to view the file as it appeared at that time.

Date/TimeThumbnailDimensionsUserComment
current03:52, 18 July 2021Thumbnail for version as of 03:52, 18 July 20211,365 × 1,365 (70 KB)Fæ (talk | contribs)Radiopaedia project rID:25792 (batch #6755-93 E15)

You cannot overwrite this file.

Retrieved from "https://nccommons.org/w/index.php?title=File:Cerebral_abscess-_fungal_(Radiopaedia_25792-25938_Axial_DWI_15).jpg&oldid=1689002"