Clinical question: History of NSCLC brain metastases. Status post surgery and multiple arteries. Signs and symptoms: As above. Nonenhanced brain MRI:Examination is performed without intravenous contrast as is requested by the clinical services.Large focus of FLAIR hyperintensity surrounding a right posterior temporal-parietal surgical cavity containing CSF signal intensity and without evidence of mass effect remains identical to prior exam. Findings representing post operative changes and surrounding gliosis. There is resultant mild ex vacuo dilatation of right trigone and temporal horn of lateral ventricle similar to prior study.Patchy and confluent foci of FLAIR hyperintensity in the periventricular white matter of bilateral cerebral hemispheres and more localized in the right posterior parietal similar to prior exam and representing posttreatment changes. Slight prominence of cortical sulci similar to prior study. Mildly prominent supratentorial ventricular system with maintained midline identical to prior exam.Stable focus of encephalomalacia under a right suboccipital craniectomy demonstrate no interval change and unremarkable images through posterior fossa otherwise.Unremarkable images through the orbits, paranasal sinuses and mastoid air cells.
1.Within the limitation of this nonenhanced exam there is no convincing evidence of any acute or new finding since prior study.2.Stable postoperative changes of right posterior temporal-parietal tumor resection with residual gliosis as detailed.3.Stable findings of a right suboccipital craniectomy since prior exam.4.Stable mildly dilated supratentorial ventricular system and with maintained midline.