Clinical question: Evaluate for growth of GBM. Patient on TMZ. Compared to prior exam. Signs and symptoms: GBM. Pre-and post enhanced brain MRI:Examination demonstrates further interval decreased size of a focus of enhancing tumor in the left frontal lobe measuring at 5.2 x 9.2-mm compared to prior study measurement of 13.1 x 7.4 mm. surrounding flair hyperintensity consistent with edema is again identified and without appreciably change.There is also interval decrease size of a smaller focus of enhancement in right anterior frontal measuring approximately 4 mm in transaxial dimensions compared to prior study measurement of 7.2 mm. There is no associated surrounding vasogenic edema with this finding. This is a similar observation is prior study.Diffuse patchy confluent foci of flair hyperintensity in the white matter of bilateral cerebral hemispheres (left greater than right) likely secondary to treatment/radiation change however overlapping small vessel ischemic strokes cannot be excluded. This finding remains nearly identical to prior study.No evidence of any additional foci of new edema or abnormal parenchymal/ leptomeningeal enhancement since prior exam. Ventricular system remain within normal size and stable since prior study.
1.Further interval decreased size of enhancing lesions in the left and right frontal lobes as detailed/measured above.2.Diffuse patchy/confluent foci of flair hyperintensity in bilateral hemispheres white matter (left greater than right) without significant change.