68 years, Female, with metastatic small cell lung carcinoma. No restricted diffusion to suggest acute ischemia. No intracranial hemorrhage. There are numerous small foci of enhancement within the supratentorial brain, measuring up to 5 mm. Most of these are well seen on the axial 3-D T1 postcontrast images (series 1200) including; lesions in the right frontal lobe (image 113), left frontal lobe (image 94), right basal ganglia (image 80) left basal ganglia (image 71), left temporal lobe (image 65), left temporal lobe (image 60), left temporal lobe (image 47), left frontal lobe (image 102). A tiny lesion in the left gyrus rectus is best seen on sagittal 3-D postcontrast T1 (series 11 image 14). There is also a tiny ill-defined focus of enhancement in the pons just to the right of the midline (series 1200 image 50), possibly an additional lesion. No significant surrounding edema or mass-effect. The ventricles are within normal limits in size and configuration. Several foci of T2/FLAIR hyperintensity are seen in the bilateral subcortical and periventricular white matter, which are nonspecific, but compatible with chronic small vessel ischemic changes. Sella and orbits are grossly within normal limits. Mild mucosal thickening is present in the anterior ethmoid air cells. Paranasal sinuses and mastoid cells are otherwise clear. There is nonspecific heterogeneous enhancement of the calvarium without large discrete destructive osseous lesions. Extracranial soft tissues are within normal limits.
1. Approximately 10 small enhancing lesions in the brain most consistent metastatic disease. No significant mass effect. 2. Heterogeneous enhancement of the calvarium with a large discrete destructive osseous lesions. Finding may be treatment-related but suggest correlation with prior PET or bone scan.