Diagnosis: Examination of participant in clinical trialClinical question: metastatic breast cancer - r/o brain mets prior to starting on a clinical trial The CSF spaces are appropriate for the patient's stated age with no midline shift. There is a 5 mm enhancing lesion present in the right parietal lobe in the subcortical white matter of the precuneus. There is associated susceptibility effect and T2 and FLAIR abnormality.There is a 3 x 4 mm enhancing focus in the subcortical white matter of the right frontal lobe. There is a 3 mm enhancing focus in the right periventricular white matter at the posterior aspect of the body of the right lateral ventricle. There is a 4 mm enhancing focus in the periventricular white matter adjacent to the trigone of the right lateral ventricle. There is a punctate focus of enhancement present in the left cerebellar hemisphereOn susceptibility imagingNormal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
There are multiple small enhancing lesions within the brain parenchyma is detailed above which are suspicious for a metastatic disease. One of these lesions in the right precuneus is associated with blood products.