Reason: 7-year-old female with treatment related ALL, s/p bone marrow transplant. Having fevers as well as apneic/breath holding episodes. Please assess for fungal infection of brain. The ventricles and sulci are within normal limits. The basal cisterns remain patent. There is no midline shift or mass effect. There is diffusely increased T2 signal within the white matter, sparing the subcortical white matter, which is nonspecific but favored to reflect treatment effect. There is no associated diffusion abnormality. No pathological enhancement is identified. No extra-axial fluid collection is identified. Normal flow-voids are demonstrated in the major intracranial vascular structures. The midline structures and craniocervical junction are within normal limits. The partially developed frontal, ethmoid, sphenoid, and maxillary sinuses as well as the bilateral mastoid air cells remain partially opacified. There is also persistent partial opacification of the bilateral middle ears. An endotracheal tube is partially visualized.
1.Increased T2 signal within the periventricular white matter which is nonspecific but favored to reflect treatment effect.2.No evidence of acute ischemic infarction, hemorrhage, or abnormal meningeal enhancement.3.Persistent opacification of the paranasal sinuses, mastoid air cells, and middle ears.