 There is a more prominent left frontal dural based homogeneously enhancing focus measuring approximately 6 x 11 x 11 mm in the axial plane (series 1301 image 19, series 1401 image 14) which appeared on prior exams to be smaller and more like a prominent vessel. There is no significant associated mass effect and no edema within the adjacent brain parenchyma. There is no evidence of intracranial hemorrhage, mass, or acute infarct. The brain parenchyma appears unremarkable, and there are no areas of abnormal signal. The midline structures and craniocervical junction are within normal limits. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. No abnormal extra-axial fluid collection is identified. The major cerebral flow voids are intact. Diffuse low T1 signal involving the visualized osseous structures, compatible with known sickle cell disease is again noted . The paranasal sinuses and mastoid air cells are clear.MRA HEAD
1.There is a more prominent left frontal dural based homogeneously enhancing focus measuring approximately 6 x 11 x 11 mm in the axial plane (series 1301 image 19, series 1401 image 14) which appeared on prior exams to be smaller and more like a prominent vessel. The differential diagnosis most likely includes a meningioma, especially given its slow growth over the interval 13 months. Recommend follow-up imaging in 6 months to evaluate progression. Otherwise negative brain MRI.2.Normal MR angiography of the brain, without flow limiting stenosis or aneurysm identified.3.Normal MRV of the brain, without occlusion or stenosis.