RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES

KARNATAKA, BENGALURU.
ANNEXURE-II
PROFORMA FOR REGISTRATION OF SUBJECTS FOR DISSERTATION

1 Name of the candidate: Dr. R SAMYUKTHA,

POST GRADUATE RESIDENT
DEPARTMENT OF RADIODIAGNOSIS
MAHADEVAPPA RAMPURE MEDICAL
COLLEGE KALABURAGI-585105
Permanent address: Dr R SAMYUKTHA
D/O R NAGENDRA PRASAD
NO-53/A WARD-16 KAMAKSHI NILAYA
OPPOSITE RADHIKA THEATRE
RAGAVACHARI ROAD
BELLARY
KARNATAKA – 583101
2. Name of the Institution H. K. E. SOCIETY’S MAHADEVAPPA
RAMPURE MEDICAL COLLEGE
KALABURAGI-585105
3. Course of study and subject POST GRADUATION
M.D. RADIODIAGNOSIS

4. Date of Admission to the course 16 OCTOBER 2023

5. Title of topic “A STUDY TO CORRELATE MAGNETIC

RESONANCE IMAGING OF BRAIN IN
INHERITED NEUROMETABOLIC AND
GENETIC DISORDERS WITH CLINICAL
FINDINGS IN PAEDIATRIC AGE GROUP”

Brief Resume of the intended work:

6. 6.1. Need for study:

Many inborn errors of metabolism and genetic disorders affect the brain. Magnetic resonance

imaging has proven to be a valuable tool to evaluate the brain structure, biochemistry, blood

flow and function. Its non-invasive nature allows for longitudinal assessments and follow-up. It

has a great potential for investigation and management of IEM and other genetic conditions 1.

Developmental delay is the most common neurological form encountered in patients with IEM 2.

It is defined as significant functional delay in two or more developmental domains. A quarter to

half cases of identified causes are genetic in origin. Genetic etiologies are multiple and include

chromosomal anomalies, submicroscopic deletions/duplications/rearrangements and monogenic

disorders3. Most IEM are inherited in autosomal recessive pattern, few are inherited in an X-

linked pattern2.

Inborn errors of metabolism in children can be challenging to interpret because of the similarity

of their appearances on imaging. There are important clues to diagnosis based on geographical

distribution of lesions (e.g., subcortical vs deep white matter or frontal vs parietooccipital), other

imaging features (e.g., contrast enhancement, calcification, cysts, cortical dysplasia), clinical

history, head circumference (e.g., macrocephaly). A systematic approach of synthesizing the

clinical information along with salient imaging features can help in arriving at an appropriate

diagnosis2.

Very few studies have been done in this region on this topic and hence the study is taken.

6.2. Review of Literature:

In Deccan College of Medical Sciences, Hyderabad study of MRI of Brain in 81 pediatric

patients (46 Males and 35 Females) presenting with developmental delay was conducted. It was

seen that only 11% patients presented with only developmental delay, rest 89% presented with

additional features such as epilepsy, neurological deficits, abnormalities of head size, facial

dysmorphism, visual and auditory disturbances and gait disturbances. Normal MRI findings

were seen in 32% (26 cases), abnormal morphological appearance was seen in the remaining

68% (55 cases).Abnormalities of ventricles and white matter mainly the corpus callosum were
found to be most common as seen in 62% and 58% cases respectively. Nonspecific

abnormalities were found in 22% of children; like Prominent Virchow-Robin spaces in six

cases, abnormal basal ganglia in four cases and abnormal sulcation in two cases. Traumatic/

Neurovascular Diseases was the most consistent etiology. Proportion of children with

Congenital & Developmental, Metabolic and Degenerative, neoplastic and non specific were

17%, 10%, 2.5% and 7.5% respectively4.

Retrospective observational study was performed in Radiology Department at Hospital in

Dhahran, from January 2013 to January 2020. Out of 133 cases, 72 (49 males, 90% AR) were

found to have neurometabolic disorders. Sensitivity, specificity, positive and negative predictive

values were calculated as 81.94% )CI, 71.11-90.02(, 67.21% )CI, 54.00-78.69(, 74.68% )CI,

66.96 81.11( and 75.93% )CI, 65.16-84.17( respectively. Findings were found significant5.

Cross-sectional study conducted in department of Pediatrics, All India Institute of Medical

Sciences, Rishikesh, Uttarakhand, 50 children with the developmental delay between 6 months

to 6 years of age were present. The mean age was 31.32 ± 20.56 months. The sensitivity of MRI

was 72%. 81.3% of the children with microcephaly had abnormal MRI. The most common

underlying etiology was hypoxic-ischemic encephalopathy (42%), followed by

congenital/developmental defects and metabolic diseases (10% each). The most commonly

involved region of the cerebral cortex was the occipital lobe (44%)6.

A prospective study conducted at Sultan Qaboos University on 110 children with global

developmental delay. Magnetic resonance imaging and metabolic screening were the most

frequently ordered investigations. Abnormal MRI and metabolic screening were significantly

associated with detection of etiology. Etiology was detected in 71.8% of the children. It was

concluded that MRI was the most significant investigation to detect the abnormality7.
 A prospective & descriptive study in Ethiopia on 65 children concluded MRI findings

divided into six categories: Normal: 12 patients (18.5%), Metabolic and degenerative

disorders: 27 patients (41.5%). Congenital and developmental disorders: 17 patients

(26.2%), Infection: 3 patient (4.6%), Neoplastic diseases: Only one patient (1.5%),

Nonspecific findings-includes enlarged subarachnoid spaces and arachnoid cysts, etc : 5

patient (7.7%)8

A hospital based retrospective observational study was carried out in Kamineni institute

of medical sciences, Narketpally among 40 children aged between 6 months to 12 years,

with features of developmental delay. Normal morphological MRI findings were seen in

only 12.5% of children with developmental delay. Abnormal morphological findings in

MRI were seen in 87.5%, out of which 40% showed metabolic and degenerative

disorders, 37.5% of the findings depicted congenital malformations, 10% of them were

of infectious aetiology. The white matter was the most commonly involved anatomical

structures i.e., (52.5%), followed by ventricles (20%)9.

6.3. Objectives of the Study:

1. To study magnetic resonance imaging of brain findings in children with genetic and

metabolic causes of developmental delay.

2. To correlate MRI findings with clinical features, metabolic evaluation and genetic testing.

7. Materials and Methods:

 7.1. Source of data:

The present study will be conducted on patients coming to radiology department of

Basaveshwara Teaching and General Hospital and Sangameshwar hospital attached to

Mahadevappa Rampure Medical College, Kalaburagi-585105

7.2. Method of collection of data (including sampling procedure if any):

i. Study Design: Observational study.

ii. Study Setting: Department of Radiodiagnosis, Basaveshwara Teaching and General

Hospital and Sangameshwar hospital attached to Mahadevappa Rampure Medical

College, Kalaburagi-585105

iii. Duration of study: 1st June, 2024 to 30th November, 2025 (18 months)

iv. Sample size: 40

Prevalence of inborn errors of metabolism in India= 1/2500

Reference: Clinical spectrum of inborn errors of metabolism in children by Jayashree K.R et al 10.

P = 0.04% = 0.0004 q = 1-P = 0.9996

Sample size(S) = (Zα/2 + Z1-β)2 p q / d2

Where α = 0.025, Zα/2 = 1.96

Β = 0.20, Z1-β = 0.842, d = 0.9 % = 0.009

So, Sample size (n) = (1.96 + 0.842)2 0.0004 X 0.9996/ (0.009)2

= (2.802)2 X 0.0004 X 0.9996/ 0.000081

= 7.854 X 0.000399/0.000081

= 0.0031/0.000081
 = 38.27

Sample size round figure (n) = 40 cases

v. Sampling Procedure: By using simple random sampling, study subjects will be selected

after applying inclusion-exclusion criteria. Information will be collected through

prepared proforma from each patient.

vi. Inclusion criteria:

1. All clinically diagnosed patients with inborn errors of metabolism and genetic disorders in

paediatric age group.

2. Children of both genders aged between 0 months to 18 years.

Exclusion Criteria:

1. Children diagnosed with traumatic brain injury.

2. Children who are claustrophobic or have any other common contraindication of magnetic

resonance imaging.

vii. Informed consent:

After approval from institutional ethical committee written informed consent will be

obtained from the parents/guardian in their own vernacular language and patient details

will be kept confidential.

viii. Study methods:

Study will be conducted with prestructured and preevaluated proforma on the patients

referred for MRI of brain to department of radio diagnosis, after explaining them about

the procedure and taking their consent.

The patient will be sedated if needed and subjected to PHILLIPS Achieva 1.5 Tesla MRI

machine. Following Sequences will be taken: AXIAL T1 TSE , AXIAL T2 TSE, AXIAL

T2 FLAIR,AXIAL T2 FFE, CORONAL T1 TSE, CORONAL T2 TSE, THIN

CORONAL T2 FLAIR, DWI , ADC , SWI, SAGITTAL T1 TSE, T1 3D ISO, T1

 INVERSION RECOVERY, POST CONTRAST T1WI and Single VOXEL MR

SPECTROSCOPY

viii. Statistical Analysis:

The data collected will be analysed statistically using IBM SPSS Software version 20.0.

For quantitative data analysis mean, standard deviation and t test will be applied. For

qualitative data analysis percentages & chi-square test will be applied for test of

significance. p value of <0.05 will be considered as significant.

7.3. Does the study require any investigation or interventions to be conducted in patients or

animals? If so describe briefly.

Yes, Magnetic Resonance imaging of Brain.

7.4. Has ethical clearance been obtained from your institution in case of 7.3?

The study has been applied for approval from the “Institutional Ethics Committee”

Mahadevappa Rampure Medical College, Kalaburagi. Approval is awaited.

8. LIST OF REFERENCES:

1. Gropman AL, Anderson A. Novel imaging technologies for genetic diagnoses in the

inborn errors of metabolism. J Transl Genet Genom. 2020;4:429-445.

2. Mohannad Ibrahim, Hemant A. Parmar, Nickoleta Hoefling, and Ashok Srinivasan,

Inborn Errors of Metabolism: Combining Clinical and Radiologic Clues to Solve the

Mystery. AJR. 2014 Aug;203(3):W315-W327.

3. Srour M, Shevell M. Genetics and the investigation of developmental delay/intellectual

disability. Arch Dis Child. 2014 Apr;99(4):386-9.

4. Ali AS, Syed NP, Murthy GS, Nori M, Abkari A, Pooja BK, Venkateswarlu J. Magnetic

resonance imaging (MRI) evaluation of developmental delay in pediatric patients. J Clin

Diagn Res. 2015 Jan;9(1):TC21-4.

5. Ali Al Orf, Khawaja B. Waheed, Elsayed M. Ali, Abdulrahim K. Muhammad, Faisal M.

Al Zahrani et al, Inherited paediatric neurometabolic disorders, can brain magnetic

resonance imaging predict?. Neurosciences Journal. 2020 Oct;25(5):392-398.

6. Nikhil Rajvanshi, Swathi Chacham, Aswanth KS, Pooja Semwal, Khanak

K. Nandolia, Jitendra Rohilla et al. Magnetic resonance imaging brain yield in

developmental delay: A developing country perspective. Research in Developmental

Disabilities. 2023 Jul;138:0891-4222.

7. Roshan Koul, Mohammed Al-Yahmedy, Amna Al-Futaisi. Evaluation of children with

global developmental delay: A prospective Study at Sultan Qaboos university, Oman.

Oman Medical Journal. 2012;27(4):310-313.

8. Tewodros Endale Balcha, Abebe Mekonnen Woldeyohannes, Getachew Assefa

Neknek. Brain Magnetic Resonance Imaging Findings in Patients with

Developmental Delay in Addis Ababa, Ethiopia. Ethiopia Journal of Health

Sciences.2022;32(4):773-780.

9. L. V Padma Priyanka Dittakavi, Shreya Tanneru, Prasad Thanda, Suresh R. J. Thomas.

 Role of magnetic resonance imaging brain in children with developmental delay.

International Journal of Contemporary Pediatrics.2023;10(3):305-310.

10. Jayashree K. R, Madhivanan S, Kumarasamy K, Karthick A. R. Clinical spectrum of

inborn errors of metabolism in children in a tertiary care hospital. International Journal of

Contemporary Pediatrics.2020 Mar;7(3):495-499.

9. Signature of the Candidate

10. Remarks of the guide

11. 11.1. Name & Designation of Guide DR. SHRUTI S PATIL MD

PROFESSOR,
DEPARTMENT OF RADIO DIAGNOSIS,
MAHADEVAPPA RAMPURE MEDICAL
COLLEGE, KALABURAGI-585105
11.2. Signature

11.3. Name & Designation of CO-Guide DR. ARUNDATI S PATIL MD

PROFESSOR,
DEPARTMENT OF PAEDIATRICS,
MAHADEVAPPA RAMPURE MEDICAL
COLLEGE, KALABURAGI-585105
11.4. Signature
 11.5 Head of the Department DR. NAGENDRA PATIL MD
PROFESSOR AND HEAD,
DEPARTMENT OF RADIO DIAGNOSIS,
MAHADEVAPPA RAMPURE MEDICAL
COLLEGE, KALABURAGI-585105
11.6. Signature

12. 12.1. Remarks of the Chairman &

Principal

12.2. Signature

PATIENT CONSENT FORM

Part I: Information Sheet

I Dr. R SAMYUKTHA under the guidance of Dr. SHRUTI S PATIL will be conducting a clinical

study.

The topic of the study is:

“A STUDY TO CORRELATE MAGNETIC RESONANCE IMAGING OF BRAIN IN

INHERITED NEUROMETABOLIC AND GENETIC DISORDERS WITH CLINICAL

FINDINGS IN PAEDIATRIC AGE GROUP”

Part II: Certificate of Consent

I have been briefed on the foregoing research being conducted by Dr. R SAMYUKTHA and it has been

conveyed to me in my own language. I have had the opportunity to ask questions about it & all

questions that I have asked have been answered to my satisfaction. I consent voluntarily to participate as

a participant in this research & understand that I have the right to withdraw from the research at any

time without in any way affecting my medical care.

Name of the participant: ………………………………………………………

Signature of the participant: ……………………………………………………

Date: (dd/mm/yyyy)………………
Illiterate participant

I have read and witnessed the accurate reading of the consent form to the potential participant and the

individual has had the opportunity to ask questions, I confirm that the individual has given consent

freely.

Name of the witness: ………………................................

Signature of the witness: …………………………………...

Date: (dd/mm/yyyy)……………

Thumb impression of participant

Statement by the Researcher

I have accurately read out the information sheet to the potential participant and to the best of my ability

made sure that the participant understands the nature, purpose and expected effects of the study. I

confirm that the participant was given an opportunity to ask questions about the study and all

the questions asked by the participant have been answered correctly and to the best of my ability. I

confirm that the individual has not been coerced into giving consent and the consent has been given

freely and voluntarily. In case of any doubt I have been asked to contact,

Dr. R SAMYUKTHA

PG. DEPT OF RADIOIDAGNOSIS

M.R. MEDICAL COLLEGE, KALABURAGI

CONTACT NO: 8861111024

Name of Researcher: ……………………………………………

Signature of Researcher: ………………………………………

Date: (dd/mm/yyyy)……………
 ರೋಗಿಗಳ ಒಪ್ಪಿಗೆ ಪತ್ರ

ಶ್ರೀ/ಶ್ರೀಮತಿ_________________________________________________ ಆದನಾನು ಈ ಮೂಲಕ ನನ್ನ

ವಿಷಯವಾಗಿನಡೆಸುವ “ಆನುವಂಶಿಕವಾಗಿ ಪಡೆದ ನ್ಯೂರೋಮೆಟಾಬಾಲಿಕ್ ಮತ್ತು ಜೆನೆಟಿಕ್ ಡಿಸಾರ್ಡರ್‌ಗಳಲ್ಲಿ ಮೆದುಳಿನ

ಮ್ಯಾಗ್ನೆಟಿಕ್ ರೆಸೋನೆನ್ಸ್ ಇಮೇಜಿಂಗ್ ಅನ್ನು ಮಕ್ಕಳ ವಯಸ್ಸಿನ ಗುಂಪಿನಲ್ಲಿ ಕ್ಲಿನಿಕಲ್ ಸಂಶೋಧನೆಗಳೊಂದಿಗೆ ಪರಸ್ಪರ

ಸಂಬಂಧಿಸಲು ಒಂದು ಅಧ್ಯಯನ” ಎಂಬ ಅಧ್ಯಯನಕ್ಕೆ ನನ್ನ ಸಂಪೂರ್ಣ ಒಪ್ಪಿಗೆಯನ್ನು ನೀಡಿರುತ್ತೇನೆ. ಈ ಅಧ್ಯಯನವನ್ನು

ಡಾ.ಆರ್.ಸಂಯುಕ್ತಾ ರವರು ಡಾ.ಶೃತಿ ಎಸ್.ಪಾಟೀಲ್ ರವರ ಮಾರ್ಗದರ್ಶನದಲ್ಲಿನಡೆಸುತ್ತಿದ್ದಾರೆ. ನನ್ನನ್ನು ಪರೀಕ್ಷಿಸುತ್ತಿರುವ

ವೈದ್ಯರುಗಳು ನನಗೆ ತೃಪ್ತಿಕರವಾಗಿ ಈ ವಿಷಯ ಮತ್ತುಇದರ ಅಗತ್ಯತೆಯ ಬಗ್ಗೆ ನಮ್ಮದೇ ಭಾಷೆಯಲ್ಲಿ ತಿಳಿಸಿರುತ್ತಾರೆ.

ನನಗೆ ಈ ಅಧ್ಯಯನದವೇಳೆಯಲ್ಲಿ ಯಾವುದೇ ತೊಂದರೆಗಳು ಆದಲ್ಲಿ ಪರೀಕ್ಷಿಸುವ ವೈದ್ಯರುಗಳನ್ನು

ಹೂಣೆಗಾರರನ್ನಾಗಿಮಾಡುವುದಿಲ್ಲವೆಂದು ಒಪ್ಪಿಕೊಂಡಿರುತ್ತೇನೆ ಹಾಗೂ ನಾನು ಯಾವುದೇ ಸಮಯದಲ್ಲಿ ಈ ಅಧ್ಯಯನದಿಂದ

ಹೊರಹೋಗಲು ಇಚ್ಛಿಸಿದಲ್ಲಿ ಹೂಗಬಹುದಾಗಿರುತ್ತದೆ ಎಂಬ ವಿಷಯವನ್ನು ವೈದ್ಯರು ನಮಗೆ ತಿಳಿಸಿರುತ್ತಾರೆ.

ರೋಗಿಯಸಹಿ: ಸಾಕ್ಷಿಗಳಸಹಿ:

ವೈದ್ಯರಸಹಿ: ತಾರೀಖು:

INFORMED PARENT/ GUARDIAN CONSENT FORM

I, ____________________________, parent/guardian of ___________________, have been explained

in a language well understood by us to our satisfaction about the study being carried out. I hereby give

my valid consent for the patient to be as an object in the study “A STUDY TO CORRELATE

MAGNETIC RESONANCE IMAGING OF BRAIN IN INHERITED NEUROMETABOLIC

AND GENETIC DISORDERS WITH CLINICAL FINDINGS IN PAEDIATRIC AGE GROUP”

conducted by Dr.R SAMYUKTHA under the guidance of Dr.SHRUTI S PATIL in the Department of

Radio-Diagnosis in BASAWESHWARA TEACHING AND GENERAL HOSPITAL,

MAHADEVAPPA RAMPURE MEDICAL COLLEGE, KALABURAGI.

Doctors examining my son/daughter have satisfactorily informed me about this matter and its

necessity in our language.

The attending doctors have informed me to my satisfaction and in the language best understood by

me, the purpose of this study, the materials to be used during the course of this study as well as the

side effects/ complications associated with the methods/tools to be used. I shall not hold the doctors

or the staff responsible for any untoward consequences.

I am also aware of our right to opt out of the study without prejudice to further treatment at any time

during the course of the study without having to give any reasons to do so

SIGNATURE OF THE ATTENDING DOCTOR:

DATE:

SIGNATURE OF THE WITNESS:

DATE:

SIGNATURE/ LEFT THUMB

IMPRESSION OF THE PARENT/GUARDIAN

ರೋಗಿಗಳ ಒಪ್ಪಿಗೆ ಪತ್ರ

ಶ್ರೀ/ಶ್ರೀಮತಿ_________________________ಇವರತಂದೆ/ತಾಯಿ/

ಪೋಷಕರುಆದನಾನುಈಮೂಲಕಇವರವಿಷಯವಾಗಿನಡೆಸುವ‘ವಿಷಯವಾಗಿನಡೆಸುವ “ಆನುವಂಶಿಕವಾಗಿ ಪಡೆದ

ನ್ಯೂರೋಮೆಟಾಬಾಲಿಕ್ ಮತ್ತು ಜೆನೆಟಿಕ್ ಡಿಸಾರ್ಡರ್‌ಗಳಲ್ಲಿ ಮೆದುಳಿನ ಮ್ಯಾಗ್ನೆಟಿಕ್ ರೆಸೋನೆನ್ಸ್ ಇಮೇಜಿಂಗ್ ಅನ್ನು ಮಕ್ಕಳ

ವಯಸ್ಸಿನ ಗುಂಪಿನಲ್ಲಿ ಕ್ಲಿನಿಕಲ್ ಸಂಶೋಧನೆಗಳೊಂದಿಗೆ ಪರಸ್ಪರ ಸಂಬಂಧಿಸಲು ಒಂದು ಅಧ್ಯಯನ”ಎಂಬ

ಅಧ್ಯಯನಕ್ಕೆನನ್ನಸಂಪೂರ್ಣಒಪ್ಪಿಗೆಯನ್ನುನೀಡಿರುತ್ತೇನೆ. ಈಅಧ್ಯಯನವನ್ನು ಡಾ.ಆರ್.ಸಂಯುಕ್ತಾ ರವರು ಡಾ.ಶೃತಿ

ಎಸ್.ಪಾಟೀಲ್ ರವರ ಮಾರ್ಗದರ್ಶನದಲ್ಲಿನಡೆಸುತ್ತಿದ್ದಾರೆ.

ನನ್ನಮಗ/ಮಗಳನ್ನುಪರೀಕ್ಷಿಸುತ್ತಿರುವವೈದ್ಯರುಗಳುನನಗೆತೃಪ್ತಿಕರವಾಗಿಈವಿಷಯಮತ್ತುಇದರಅಗತ್ಯತೆಯಬಗ್ಗೆನಮ್ಮದೇಭಾಷೆ

ಯಲ್ಲಿತಿಳಿಸಿರುತ್ತಾರೆ.ನಮಗೆಈಅಧ್ಯಯನದವೇಳೆಯಲ್ಲಿಯಾವುದೇತೊಂದರೆಗಳುಆದಲ್ಲಿಪರೀಕ್ಷಿಸುವವೈದ್ಯರುಗಳನ್ನುಹೂಣೆಗಾರ

ರನ್ನಾಗಿಮಾಡುವುದಿಲ್ಲವೆಂದುಒಪ್ಪಿಕೊಂಡಿರುತ್ತೇನೆಹಾಗೂನಾವುಯಾವುದೇಸಮಯದಲ್ಲಿಈಅಧ್ಯಯನದಿಂದಹೊರಹೋಗಲುಇಚ್ಛಿ

ಸಿದಲ್ಲಿಹೋಗಬಹುದಾಗಿರುತ್ತದೆಎಂಬವಿಷಯವನ್ನುವೈದ್ಯರುನಮಗೆತಿಳಿಸಿರುತ್ತಾರೆ

ರೋಗಿಯತಂದೆ/ತಾಯಿಸಹಿ: ಸಾಕ್ಷಿಗಳಸಹಿ:

ವೈದ್ಯರಸಹಿ: ತಾರೀಖು:
 PROFORMA FOR THE STUDY

Name: Ward name:

Age: IP/OP no:

Sex: D.O.A:

Occupation: D.O.D:

Address:

1) Chief complaints:

2) History of presenting illness:

3) Past history of hospital admissions:

4) Family history:

5) Birth history including pedigree chart:

6) Developmental history:

7) Immunization history:

8) General physical examination:

Pulse: Respiratory rate: Head circumference:

Blood pressure: Temperature:

9) CNS examination:

10) Investigations(if any):

-Serum CPK

-Fundoscopy

-BERA

-X-rays/skeletal surveys

-Metabolic tests

-Electroencephalography

-Genetic studies
10) MRI BRAIN FINDINGS :

1. Ventricles: Size and morphology.

2. Corpus callosum: Thickness and morphology.

3. Gray and white matter: The sulcation and gyration of the gray matter based on normal

MR brain anatomy.

4. Myelination

5. Basal ganglia, thalamus and deep grey matter nuclei: morphology

6. Brain stem: morphology

7. Cerebellum: morphology.

8. Calcifications, bleed, edema(if any):

9. MR contrast:

10. MR spectroscopy:

10) REMARKS: