Normal MRI brain report template
A normal MRI brain report without contrast, and a version with gadolinium. Edit the technique line to match your protocol. Placeholders in [ ] are the parts to confirm on every study.
MRI BRAIN WITHOUT IV CONTRAST
INDICATION: [ ]
COMPARISON: None.
TECHNIQUE: Multisequential and multiplanar images of the brain were submitted for review without contrast.
FINDINGS:
The brain shows normal morphology, signal intensity, and volume for age. No focal parenchymal lesions are seen.
No intracranial hemorrhage, mass effect, midline shift, extra-axial collection, or hydrocephalus is identified.
Ventricles, sulci, and basal cisterns are symmetric and normal in size and configuration.
Diffusion-weighted sequences show no evidence of acute ischemic infarction.
Midline structures including the pituitary gland, corpus callosum, pineal region, and brainstem are unremarkable.
The craniovertebral junction is within normal limits.
No calvarial abnormalities are identified.
The paranasal sinuses and mastoid air cells are clear.
Orbital structures are unremarkable.
Appropriate flow voids are present in the visualized intracranial vessels.
IMPRESSION:
1. No acute ischemia, space occupying mass, or other acute intracranial pathology is demonstrated.MRI BRAIN WITH IV CONTRAST
INDICATION: [ ]
COMPARISON: None.
TECHNIQUE: Multisequential and multiplanar images of the brain were submitted for review with contrast.
FINDINGS:
The brain shows normal morphology, signal intensity, and volume for age. No focal parenchymal lesions are seen.
No pathological enhancement is noted on the postcontrast sequences.
No intracranial hemorrhage, mass effect, midline shift, extra-axial collection, or hydrocephalus is identified.
Ventricles, sulci, and basal cisterns are symmetric and normal in size and configuration.
Diffusion-weighted sequences show no evidence of acute ischemic infarction.
Midline structures including the pituitary gland, corpus callosum, pineal region, and brainstem are unremarkable.
The craniovertebral junction is within normal limits.
No calvarial abnormalities are identified.
The paranasal sinuses and mastoid air cells are clear.
Orbital structures are unremarkable.
Appropriate flow voids are present in the visualized intracranial vessels.
IMPRESSION:
1. No acute intracranial pathology, space occupying mass, or pathological enhancement is demonstrated.Plain text. Pastes cleanly into PACS, RIS, PowerScribe, Word, or a browser. Fields in [ ] need your input. Add it to your collection to keep your own edited copy and share it with colleagues.
What to check before you sign a normal MRI brain
A normal template is only safe if you have looked at everything it mentions.
- DWI and ADC together. Bright on DWI alone can be T2 shine-through. Confirm low ADC before calling restricted diffusion, and confirm its absence before calling the study normal.
- SWI or gradient echo. Microhemorrhages, cavernomas, and calcification only show here. A normal report should mean you looked.
- FLAIR for white matter and the cortex. Small white matter lesions and subtle cortical signal change are easy to scroll past on T2 alone.
- Midline structures. Pituitary, corpus callosum, and the craniocervical junction on the sagittal T1 are often outside the area the referral is asking about.
- Flow voids. Loss of a normal flow void can be the first sign of occlusion or sinus thrombosis on a non-angiographic study.
Common mistakes with this template
A protocol line that does not match the study
The template lists SWI or a coronal sequence that was not acquired. Edit the technique to match what was done.
Contrast template on a non-contrast study
'No abnormal enhancement' on a study with no contrast is a false statement in a signed report.
'Normal for age' without stating what is present
A few white matter hyperintensities in a 70 year old are common. Name them so the next reader knows they were seen.
Questions
What does a normal MRI brain report say?
It lists the sequences performed, then states that the brain parenchyma, ventricles, extra-axial spaces, posterior fossa, midline structures, vessels, and skull base are normal, with no restricted diffusion, hemorrhage, or mass. The impression is usually 'Normal MRI brain'.
Which sequences should a routine MRI brain include?
Most routine protocols include sagittal T1, axial T2, axial FLAIR, DWI with ADC, and SWI or gradient echo. Coronal imaging and contrast are added for specific questions. Use your department's protocol.
Who wrote this template
Written by Dr Gayathri Priyadharshinee, radiologist, from the normal templates she uses in her own reporting. You are free to copy it and adapt the wording to your department's style.
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