Above are axial MRI images of a 30yr old female brain, one being a T2 axial and the other a T1 axial post contrast injection. The patient came into the ER this day because her husband said she had a possible seizure while she was sleeping and the patient stated her body was really sore and weak feeling. A CT of the brain was performed through the ER showing an abnormality. The patient was admitted to the ICU and given meds to prevent another seizure then came to us for her MRI. I felt so sorry for her because as I was screening her I found out her only medical background was the birth of her daughter who was now 18 months old. You could tell she was scared and nervous. I made sure I explained everything that would happen during the MRI since she had never had anything like this done in the past. The thing I thought was unique about this exam is that the area of interest was dictated as being a lesion yet it did not enhance with the contrast injection. I think every mass or lesion I have ever seen has enhanced so this was a note-worthy exam for me to share. The radiologist suggested a differential diagnosis for this finding to be neoplasms with a propensity for the temporal lobe resulting in seizure activity, such as a dysembryoplastic neuroepithelial tumor (DNET). The radiologist also gave several other possible types of lesions the area could be. You can also see in the images that the lesion was causing a mass-effect midline shift in the patients brain.
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