Brain MRI Analysis - SP Singh (11 Jul 2026)

Scanner & Technical Details

• Machine: GE Signa HDxt 1.5T (Phanphan Resonance Imaging & Diagnostic)
• Date/Time: 11 July 2026, ~06:22 PM

Image-by-Image Breakdown

Frame 1 & Frame 2 (DWI - Lower level, midbrain/temporal)

• Sequence: DWI (Diffusion-Weighted Imaging), b=1000 s/mm², SE/EPI technique
• Slice level: Low axial cut - showing the midbrain ("Mickey Mouse" shape) and surrounding temporal lobes
• Findings:
  • No focal areas of acute restricted diffusion (no bright white patches indicating acute stroke, abscess, or highly cellular tumor)
  • Some susceptibility artifact in the anterior frontal/orbitofrontal region - this is expected in EPI sequences at air-bone-tissue interfaces near the frontal sinuses; it does NOT represent a brain lesion
  • Ventricles and CSF spaces appear appropriate on this level

Frame 3 (DWI - Higher level, cerebral hemispheres)

• Sequence: DWI, b=1000 s/mm², same SE/EPI protocol
• Slice level: Higher axial cut showing the cerebral cortex and superior hemispheres
• Findings:
  • Signal intensity across both hemispheres appears symmetric
  • No obvious focal hyperintense (bright) lesion suggesting acute ischemia
  • Midline appears central, no shift
  • Sulci and gyri appear symmetric

Frame 4 (T2-Weighted - Deep brain level)

• Sequence: T2 FSE-XL/90 (Fast Spin Echo), TR 3960 ms, TE 106 ms
• Slice level: Through the basal ganglia, thalami, lateral ventricles, and internal capsules
• Findings:
  • CSF appears bright (white) in ventricles - normal for T2
  • Lateral ventricles are symmetric and normal in size - no hydrocephalus
  • Midline is straight - no mass effect or midline shift
  • Thalami, basal ganglia, and internal capsules appear symmetric and grossly intact
  • No obvious large focal lesion, hemorrhage, or significant edema on this slice

Overall Impression (Preliminary, Non-Diagnostic)

Important Caveats

1. ADC map not shown - DWI must always be correlated with the ADC (Apparent Diffusion Coefficient) map to confirm or exclude true restricted diffusion. Small acute strokes can be missed without it.
2. Only 4 frames reviewed - A full MRI brain study has 300-600+ individual images. Small lesions, lacunes, microbleeds, or white matter changes may not be visible in these 4 frames.
3. FLAIR sequence not shown - FLAIR is the most sensitive sequence for white matter lesions, cortical strokes, and leptomeningeal disease.
4. No post-contrast images shown - Enhancing lesions (tumors, infections, vascular malformations) cannot be assessed.
5. Image quality - These are photographs of a monitor, which reduces diagnostic resolution compared to DICOM workstation viewing.