Clinical question: Initial staging. Signs and symptoms: Initial staging. Pre-and post-enhanced brain MRI:No diffusion weighted abnormalities.In the periventricular and subcortical white matter of bilateral cerebral hemispheres there are few tiny foci of flair/T2 hyperintensity which are nonspecific and not enhancing. Proper clinical setting this finding could represent minimal chronic small vessel ischemic strokes.The anatomical morphology and the signal intensity of brain parenchyma is otherwise within normal all MRI sequences. Unremarkable C. cortex, cortical sulci, ventricular system, CSF spaces and brain margination. Post-enhanced images are negative for any abnormal parenchymal or leptomeningeal enhancement.Unremarkable images through the orbits and calvarium without abnormal enhancement.The signal intensity of paranasal sinuses and mastoid air cells are within normal.
1.Negative diffusion weighted images.2.Negative exam for metastatic disease.3.Few tiny foci of flair hyperintensity only in the subcortical and periventricular white matter which are nonspecific however in the proper clinical setting could represent minimal chronic small vessel ischemic strokes.