79 years, Male, metastatic melanoma. Evaluate for brain metastases. Multiple sequences are motion degraded. There is however no intracranial mass or abnormal enhancement to suggest metastatic disease. No restricted diffusion to suggest acute ischemia. No intracranial hemorrhage. Ventricles and sulci are prominent related to global parenchymal volume loss but appropriate for age. No hydrocephalus. Similar to prior, there are foci of T2/FLAIR hyperintensity in the bilateral subcortical and periventricular white matter, which are nonspecific, but compatible with mild chronic small vessel ischemic changes. Brain parenchyma is otherwise unremarkable for age. Major flow-voids are preserved.Sella and orbits are grossly within normal limits. There is partial opacification involving the bilateral ethmoid air cells as well as mild opacification involving the maxillary sinuses. Calvarium and extracranial soft tissues are grossly unremarkable.There is abnormal marrow signal involving the C4 vertebral body which is partially imaged and suspicious for osseous metastasis. This finding was also present on prior PET from 7/15/2016.
1. No evidence of intracranial metastatic disease although suboptimally evaluated due to motion degradation.2. Osseous metastasis involving the C4 vertebral body is partially imaged and was also present on prior PET from 7/15/2016.