61-year-old female with follicular lymphoma MRI brain:Again seen is a right transfrontal ventriculostomy/Ommaya catheter terminating in the right frontal horn laterally. There is a 15x24 mm focus of CSF intensity collection surrounding the catheter with extensive surrounding vasogenic edema, appearing similar in extent to recent CT study. This results in effacement of the adjacent cortical sulci and mild mass effect on the right frontal horn and mild midline shift to the left similar to prior study. The ventricular system caliber is not significantly changed from prior study, with transverse diameter of the left frontal horn of the lateral ventricle measuring 12 mm in caliber, unchanged, and the transverse diameter of the anterior third ventricle measuring approximately 10 mm, also unchanged. No evidence of infarct. No intracranial hemorrhage is identified. There is nonsuppression of CSF involving the bilateral frontoparietal sulci on the FLAIR sequence. No intracranial mass or mass effect. Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.Left maxillary mucous retention cyst. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.MRI orbits:The images are degraded by motion artifact. No intraconal or extraconal space mass is identified. The globes and extraocular muscles are intact. Evidence of left lens replacement.Cervical spine:Marked suboptimal evaluation of the cervical spine due to motion artifact. Within these limitations there is no obvious mass effect or compression of the spinal cord. No cord signal abnormality. Minimal degenerative changes are seen without significant spinal canal stenosis.
1. Please note examination is limited due to absence of intravenous contrast and limited sequences obtained of the brain, orbits, and cervical spine. Patient could not tolerate further imaging and examination was terminated prematurely. 2. No obvious intracranial mass or diffusion abnormality to suggest lymphoma. There is nonsuppression of CSF on the FLAIR sequence involving the bilateral frontoparietal sulci which may be artifactual, but can be seen with leptomeningeal disease; postcontrast sequences would be helpful for differentiation. Again seen is 15x24 mm CSF collection surrounding the Ommaya catheter with extensive surrounding vasogenic edema and associated mass effect, similar to recent CT from 5/30/15. 3. No obvious orbital mass or cervical cord signal abnormality on the limited sequences.