Postoperative assessment. Status post resection of left frontal tumor. Since the previous examination, there has been a new left frontal craniotomy with expected overlying scalp including swelling, fluid collection and foci of susceptibility. Also, there is expected underlying dural thickening. There is no perioperative infarct, significant mass-effect or significant hemorrhage.There has been resection of much of the previously described T2/FLAIR hyperintensity in the superior frontal gyrus surrounding the prior resection cavity and extending into the left frontal horn. There is focal contrast enhancement (up to 8 mm) along the anterior lateral resection margin which may represent the contrast enhancing nodule described on the previous MRI from February 2016 or may represent new postoperative contrast enhancement (coronal postgadolinium series 1203 image 78 on current study compared with coronal postgadolinium series 1102 image 86 on study from 2/18/2016). Evolution of this contrast enhancement on follow-up examinations may better characterize its significance. The deep extension of the T2 signal toward the anterior body/frontal horn of the left lateral ventricle has not changed, nor the associated ex vacuo enlargement. Otherwise, the ventricles are unchanged in size. The remainder of the brain remains unremarkable.
1.Expected postoperative changes of recent re-resection of the recurrent left frontal lobe tumor. There has been resection of much of the previously described, slowly progressive T2 signal surrounding the prior left superior frontal gyrus resection cavity extending to the left frontal horn margin.2.Focal contrast enhancement along the anterior lateral surgical margin may represent the contrast enhancing nodule described on the previous MRI from February 2016 or may represent new postoperative contrast enhancement. Evolution of this contrast enhancement on follow-up examinations may better characterize its significance. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.