 There are no definite new foci of enhancement. Numerous previously seen bilateral cerebral and cerebellar intra-axial foci of enhancement are stable to questionably minimally smaller. For example, there is a lesion in the anterior left temporal lobe on series 13 image 76 which measures 3 mm today compared to 4 mm previously. There is a lesion in the right medial temporal lobe on series 13 image 93 which measures 4 mm compared to 5 mm previously. There is no significant edema surrounding any of these lesions. There is apparent increased enhancement in the bilateral internal auditory canals which is likely related to normal vascular enhancement.There is no acute infarct, mass effect, midline shift or herniation. There are multiple scattered small to punctate foci of susceptibility effect associated with the lesions in the bilateral cerebral hemispheres which are overall stable, likely representing a combination of mineralization, chronic microhemorrhages and/or post treatment changes.
Overall interval stability in numerous intra-axial enhancing lesions most consistent with metastases. A few lesions may be questionably minimally smaller as described above.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.