 This exam is degraded by motion artifact. There is a mass that measures up to 5 cm centered within the left aspect of the frontal bone that erodes through the inner table and results in mass effect upon the left frontal lobe without significant edema. There is also another subcentimeter lesion in the left squamous temporal bone. There are multiple lesions with associated vasogenic edema at the grey-white matter junctions in the bilateral cerebral hemispheres, the largest of which is in the right superior frontal gyrus, measuring up to 15 mm. There are multiple additional small patchy foci of T2 hyperintensity throughout the deep cerebral white matter that are nonspecific. There is a punctate focus of susceptibility effect within the left thalamus compatible with a chronic micro hemorrhage. There is a subcentimeter defect in the right pons, which may represent a chronic lacunar infarct. However, there is no evidence of acute cerebral infarct. There is mild diffuse cerebral volume loss. There is no midline shift or herniation. The major cerebral flow voids are intact. There is mucosal thickening within the right ethmoid and bilateral maxillary sinuses, right greater than left. There is heterogeneous signal within the C3 vertebral body.
1.A left frontal bone mass with erosion through the inner calvarial table and mild mass effect on the left frontal lobe likely represents a metastasis. Another subcentimeter left squamous temporal bone lesion also likely represents a metastasis. 2.Several bilateral cerebral hemispheric lesions likely represent metastases, although these are incompletely characterized. However, there is no evidence of associated midline shift or hemorrhage.3.An apparent lesion within the C3 vertebral body may also represent a metastasis, although incompletely characterized. 4.Numerous patchy foci of T2 hyperintensity within the supratentorial white matter are nonspecific without contrast, although many have the appearance of chronic small vessel ischemic disease.5.A small chronic microhemorrhage within the left thalamus is likely hypertensive in etiology.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.