78 years, Female, left upper lobe lung mass, adenocarcinoma. Evaluate for brain metastasis.. No evidence of intracranial metastatic disease. No intracranial mass or mass-effect. No abnormal parenchymal or meningeal enhancement. No restricted diffusion to suggest acute ischemia. No intracranial hemorrhage. There is prominent dural calcification along the left anterior frontal parietal convexity which is nonspecific. Several foci of T2/FLAIR hyperintensity are seen in the bilateral subcortical and periventricular white matter, which are nonspecific, but compatible with mild chronic small vessel ischemic changes. There is global parenchymal and loss, with particularly prominent volume loss involving the anterior and medial temporal lobes. No hydrocephalus. Major flow-voids are preserved.There is a partially empty sella which can be a normal variant at this age group. There is mild patchy opacification of the paranasal sinuses with small fluid levels in the bilateral maxillary sinuses, which can be seen with acute sinusitis in the appropriate clinical setting. Bone marrow signal and extracranial soft tissues are grossly unremarkable.
1. No evidence of intracranial metastatic disease.2. Prominent volume loss involving the anterior and medial temporal lobes which may be related to a neurodegenerative process and can be correlated with clinical findings.