Case Images
Case Notes
History
27 yo male with treated ALL, now neutropenic. He presented with fever, and systemic infectious symptoms.Exam
Prior Study
MR flair1. There is a single intraaxial, early stage, brain abscess in the mesial aspect of the left occipital lobe.
MR T1-w pre and post contrast axial and post coronal
1. The post contrast features are also consistent with a single intraaxial, early stage, brain abscess in the mesial aspect of the left occipital lobe.
Dicom
Findings
| MR diffusion | Correct Answer | Your Answer |
|---|---|---|
|
There is evidence of a cortical/subcortical T2-shine through on diffusion consistent with leptomeningitis, or evidence of T2 shine through within brain parenchyma consistent with cerebritis/cerebellitis/rhombencephalitis. |
Yes | NA |
|
There is evidence of a parenchymal abscess or intraventricular infected sequestra with positive fluid restriction (i.e. positive DWI and positive ADC). |
No | NA |
|
There is evidence of an extraaxial empyema with T2 shine-through (positive DWI/negative ADC: both hyperintense). |
No | NA |
|
There is evidence of an extraaxial empyema with adjacent bone osteomyelitis having positive fluid restriction (positive DWI/positive ADC: DWI hyperintense/ADC hypointense) in both areas. |
No | NA |
|
There is evidence of secondary arterial ischemic event. |
No | NA |
|
No other significant imaging findings are present. |
Yes | NA |
Impression
Expert Answer
None of the above answers are correct.
Your Answer
Recommendations & Acuity
Recommendations
Expert Answer
Proceed with additional MR imaging sequences.
Your Answer
Acuity
Expert Answer
Emergent (Action Necessary now)
