Male, 61 years old, history of stage IV lung adenocarcinoma, in need of brain MRI to complete staging. Fairly extensive patchy periventricular T2 hyperintensity seen. Notable T2 hyperintensity is also evident within the pons.Diffusion weighted images are normal. No evidence of parenchymal edema or mass effect is detected. On postcontrast images, a punctate, submillimeter focus of enhancement is seen within the right parietal white matter (image 254 series 12). Otherwise, no pathologic parenchymal or extra-axial enhancement is detected.Numerous scattered foci of susceptibility are seen, prominently clustered within the basal ganglia and thalami, but with a few scattered elsewhere including the left cerebellum. No evidence acute intracranial hemorrhage is seen. No pathologic extra-axial fluid collections are detected. The size and shape of the ventricles are within normal limits.Mucosal thickening and layering of secretions are evident in the right maxillary sinus and at the level of the right ethmoid air cells.
1.Extensive periventricular white matter signal abnormality, with scattered corresponding foci of susceptibility, likely reflect sequelae of chronic microvascular ischemic disease.2.No definite evidence of intracranial metastatic disease is seen. A punctate submillimeter focus of enhancement within the right parietal white matter is nonspecific, but given the appearance of the background parenchyma, it may reflect a resolving or subacute microvascular event. A follow up examination should be considered to verify resolution.