A request arrives from General Practitioner (GP) which reads “MRI brain”.  Clinical indications: 20 year old female complaining of chronic headaches, dizziness, nausea and hormonal disturbances. Patient underwent CT scan three months earlier and showed no abnormality. After reviewing the first sequence (attached image), you noticed an abnormality. 1500 words)

 

1.This is an MP2RAGE (Magnetization Prepared 2 Rapid Gradient Echo). MPRAGE and MP2RAGE sequences are utilized on high field scanners (≥3T). Discuss the clinical value of this sequence and the advantages of using it on high field

2.Identify the abnormality and discuss possible pathologies.

3.How would you tailor this exam in light of this finding?

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