Clinical question: Assess for growth of AA. Signs and symptoms:AA. Pre and post enhanced brain MRI :Negative diffusion-weighted images.Postoperative and treatment changes of a right frontal tumor evident by increased FLAIR/T2 hyperintensity and an irregular surgical cavity demonstrate no evidence of interval change in its signal pattern or extent. There is subtle underlying parenchymal volume loss similar to prior study. There is thin linear mineralization of the cortex in the surrounding region similar to prior exam. Post enhanced images demonstrate very thin linear and minimally nodular enhancement along the surgical cavity wall without appreciable change since prior study.New since prior exam however is interval increased size of 2 foci of subtle FLAIR hyperintensity however with distinct enhancement in the right anterior temporal and right basal ganglia. The focus of enhancement in the right anterior temporal measures approximately at 10 x 4.5 mm in transaxial dimensions (axial post enhanced series 1/3/2001 image 14) compared to prior study measurement of 3.5 mm. The second nodular focus of enhancement under the right insular cortex posteriorly has increased in size since prior exam and measures at 10 mm in AP and 5 mm in transverse dimensions compared to prior study measurement of approximately 4 mm in AP. Findings likely representing posttreatment change however further follow-up is recommended to exclude tumor progression.
1.Post surgical/treatment changes of a right frontal tumor with evidence of adjacent cortical mineralization and a thin and minimally irregular rim of enhancement suggestive of post posttreatment changes. Findings demonstrate no convincing evidence of interval change since prior study.2.Interval increased size of 2 remote small foci of Flair hyperintensity and enhancement since prior exam in the right anterior temporal (superior temporal gyrus) and right basal ganglia under right external capsule as detailed/measured above. Findings although suggestive of posttreatment change follow up with imaging is recommended to exclude possibility of tumor progression.