Q. Is the bright mark inside the red circle on my brain MRI a mass?
Hi doctor,
I had complaints of loss of balance and nystagmus. Is the bright mark inside the red circle of the coronal image of the fourth ventricle a mass, or is it normal? Is it enhancing or normal? Please comment. I have attached all coronal sagittal and axial pictures for your review.
Hello,
Welcome to icliniq.com.
I thoroughly read your query and understand your concern.
So to answer your specific query, the linear tissue seen within the fourth ventricle in your brain MRI (magnetic resonance imaging) (attachments removed to protect the patient's identity) is part of the cerebellar vermis, called uvula and nodule of vermis. It is non-enhancing. This is a normal finding. It is not a mass. A mass would usually cause a mass effect in and around the structures from where it arises. The fourth ventricular mass, in particular, would mostly distort the shape of the ventricle, cause ventricular enlargement, and lead to obstruction to the normal flow of CSF (cerebrospinal fluid), causing secondary hydrocephalous. A post-contrast enhancement would also be a finding in such masses. None of this is seen on this MRI.
Note: There are other sequences on MRI, such as diffusion, FLAIR (fluid-attenuated inversion recovery), etc., that help to characterize ventricular masses.
I hope this helps.
Take care.
Hi doctor,
Thanks for the reply.
Do you see this coronal image and the small bright spot on the fourth ventricle, which is reddish and encircled? Please comment in respect of that. Is the spot normal? That is my last question to you.
Hello,
Welcome back to icliniq.com.
I understand your concern.
I have seen the red circle and the spot you are mentioning. It is part of the normal vermis, as I have already mentioned in my previous reply to you. Vermis is a normal part of our cerebellum.
I hope this has answered your query.
Kind regards.
Hello doctor,
Does every brain tumor have three sections coronal, sagittal, and axial? Suppose there is a contrast-enhancing mass lesion in the axial; then the enhancing mass will definitely remain in the sagittal and coronal section in the same place as in the axial. Is it correct?
Hello,
Welcome back to icliniq.com.
To answer your specific query - yes, a lesion that is seen in one section should be seen in the same region in other sections as well. In addition different sections give extra information about the extent of the mass lesion. For example anterior-posterior extent of the lesion from sagittal sections, superior-inferior extent from the coronal sections, and medial-lateral extent from the axial sections. I hope this helps you.
Thank you.
Hello doctor,
Can you once again confirm, based on the coronal and axial image, that the bright arrow marked dot is mass or nothing?
Hello,
Welcome back to icliniq.com.
My previous observation is based on all the images and sections provided by you.
Thank you.
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