Reason: brain metastasis, status post whole brain radiotherapy. There are several subcentimeter foci of abnormal supratentorial and infratentorial enhancement, which appear to be leptomeningeal in nature, perhaps with associated intraparenchymal extension with at least some of the lesions. The largest is located along the right prefrontal gyrus measuring approximately up to 9 mm. Additional subcentimeter foci of abnormal enhancement are present along the inferior right temporal lobe, anterior left temporal lobe, posterior left parietal lobe, and bilateral cerebellar hemispheres. There is no evidence of intracranial hemorrhage or acute infarct. There is confluent abnormal increased T2 signal within the periventricular white matter with additional focal areas of abnormal high T2 signal within the right frontal subcortical white matter, as well as the right posterior capsular region and corona radiata. There is also patchy high T2 signal within the pons, greater on the right. There are nonspecific punctate foci of susceptibility effect along the left sylvian fissure. There is mild cerebral parenchymal volume loss. The major cerebral flow voids are intact. There appears to be a small right sigmoid diverticulum. The orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable.
Multiple intracranial enhancing lesions suspicious for leptomeningeal metastases.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.