76 years, Male, newly diagnosed lung cancer. Evaluate for metastases. There is a 6 mm focus of enhancement along the surface of the inferior cerebellar vermis without associated parenchymal edema or mass effect. There is susceptibility effect involving this lesion with corresponding calcification demonstrated on recent CT. There is no significant abnormal parenchymal or meningeal enhancement in the remainder of the brain. There is minimal smooth enhancement along the right frontal dura which may be related to remote subdural hemorrhage, for example. No significant extra-axial collections are present on the current study. There is global parenchymal volume loss commensurate with patient's age. No intracranial mass effect, midline shift, or herniation. No hydrocephalus.There are multiple punctate foci of susceptibility involving the left paracentral lobule, left parietal and left occipital deep white matter, as well as in the left medial temporal lobe. These are consistent with chronic microhemorrhages. There are minimal foci of T2/FLAIR hyperintensity in the bilateral subcortical and periventricular white matter, which are nonspecific, but compatible with mild senescent white matter changes.There is a small lipoma involving the left anterior frontal scalp. No destructive lesions in the calvarium. Degenerative changes in the cervical spine with partial ankylosis of the C4 and C5 vertebrae partially imaged.
1. No definite evidence of intracranial metastatic disease. There is a 6 mm enhancing nodule along the inferior cerebellar vermis which appears to demonstrate calcifications. Imaging appearance would be compatible with a subependymoma although a solitary metastasis is not excluded. 2. Scattered chronic microhemorrhages in the left cerebral hemisphere as described above which are in a nonspecific distribution. Please see additional comments above.