Female, 66 years old, history of brain metastases, assess for new lesion. Evidence of prior right parietal craniotomy and tumor resection are again seen. The resection bed is stable in size and morphology. Curvilinear enhancement within the resection bed is unchanged.Mild patchy gyriform diffusion restriction is seen along the right central sulcus and within the posterior right temporal lobe and right occipital lobe. The cortex is mildly edematous in these areas with at least one area of corresponding gyriform enhancement in the right occipital lobe.No additional new enhancing lesions are seen. Extensive confluent T2 hyperintensity within the periventricular white matter of the cerebral hemispheres, contiguous with abnormal signal surrounding the right parietal resection bed, have otherwise not significantly changed. No generalized mass effect is detected. Ventricular size and morphology are unchanged.
1.Redemonstrated are postoperative findings compatible with resection of tumor from the right parietal region. The operative bed has not significantly changed.2.Scattered areas of mild diffusion restriction and cortical edema are seen involving the parenchyma along the right central sulcus, the posterior right temporal lobe and the right occipital lobe. Mild corresponding enhancement is also seen within the right occipital lobe. The differential for these findings would include ischemic injury, probably subacute; an inflammatory or infectious etiology; or perhaps an atypical presentation of recurrent disease. A close interval follow-up can be considered to help distinguish these possibilities.