Male, 48 years old, with multiple myeloma of the CNS. On limited visualization of the brain, a right frontal approach ventricular catheter is in place with its tip in the right frontal horn. There appears to be a small amount of enhancement along the catheter tract. Patchy enhancement is also seen along the left superior frontal sulcus which is difficult to compare to the immediate prior noncontrast examination. However, there was similar patchy enhancement in this area on the older study from 4/16. The previously demonstrated large nodule of enhancement seen in the posterior left frontal lobe does not appear to be present on the current study. Ventricular size remains within normal limits. Susceptibility effect and minimal enhancement in the pineal region may reflect treatment effect from the prior lesion in that location. The globes, optic nerves and extraocular muscles are within normal limits. No intraorbital masses are seen. No pathologic orbital enhancement is detected. Note is made of generalized paranasal sinus mucosal inflammation with fluid levels in the maxillary sinuses.
1.Please note that this examination only partially assesses the brain as it was ordered and protocoled as an MRI of the orbits.2.Mild enhancement along the right frontal catheter tract, and patchy enhancement along the left superior frontal sulcus, are nonspecific findings which could represent mild residual disease or treated disease.3.The previously seen large lesions in the left posterior frontal lobe and in the pineal region are not appreciated on this examination.