 Study is limited due to patient motionMRI BRAIN:Multiple parenchymal brain metastases are overall minimally decreased. A 5-mm left cerebellar lesion is unchanged in size (3001/6). A 5-mm right vermian lesion is unchanged (3001/10). A left frontal lobe lesion measures 1.7 x 1.3 cm (3001/15), previously 2.2 to 1.8 cm. There is susceptibility and hemorrhage within this lesion, which is bright on T1 and T2 sequences, compatible with late subacute hemorrhage. Increased diffusion restriction adjacent to this region of hemorrhage is likely secondary to artifact. Edema surrounding this lesion is slightly decreased. A right inferior frontal gyrus lesion measures 10 x 8 mm (3001/15), previously 10 x 10 mm. Right superior frontal lobe lesion measures 11 x 10 mm (3001/20), previously 14 x 13 mm. Left occipital lobe lesions are decreased in size with decreased associated edema (3001/11). Focus of susceptibility along the peripheral right frontal lobe likely represents old hemorrhage. There is new leptomeningeal enhancement with associated T2 abnormality within the cerebrum, right greater than left, particularly along the frontal lobes.The ventricles and sulci are within normal limits. The cisterns remain patent. There is no midline shift or mass effect. No extra-axial fluid collection is identified. Normal flow-voids are demonstrated in the major intracranial vascular structures. The midline structures and craniocervical junction are within normal limits. Mild mucosal thickening within the maxillary sinuses.MRI COMPLETE SPINE:There are superior endplate depressions at T4 and T5 and inferior endplate depressions at T7 and T9 which appears similar to prior exam. There is a superior endplate depression at L4 with associated STIR hyperintensity which is new from the prior CT. Alignment is anatomic. There is no abnormal signal within the cord or conus. There is multilevel disk desiccation. No significant central canal narrowing. Broad-based disk bulges at L3-L4, L4-L5 and L5-S1.
1.Multiple parenchymal brain metastases are slightly decreased.2.New leptomeningeal enhancement is nonspecific but may be related to leptomeningeal carcinomatosis or meningoencephalitis.3.New subacute hemorrhage within a left frontal lobe lesion.4.No acute cord compression.5.New endplate compression deformity at L4.