75 years, Male, Reason: history of metastatic basal cell carcinoma with new brain metastases on outside MRI (cerebellum and occipital lobe); please evaluate for radiosurgery planning Limited sequences of the brain for treatment planning protocol including post gadolinium 3-D T1 as well as susceptibility weighted sequences. There is a subtle enhancing lesion in the right occipital lobe measuring approximately 7 mm. There is also a larger enhancing lesion in the left cerebellar hemisphere measuring up to 15 mm in diameter. Please note due to the mild enhancement of the lesions and the limited available sequences, the lesions are difficult to discern. There appears to be mild surrounding edema.No evidence of hemorrhage associated with the lesions. There is a punctate focus of susceptibility in the left parietal lobe without associated enhancement evident and compatible with chronic microhemorrhage. No significant intracranial mass effect, midline shift, or herniation. There are scattered foci T1 hypointensity in the periventricular and subcortical white matter likely reflective of mild chronic small vessel ischemic disease. Vascular structures are patent. Calvarium and extracranial soft tissues are grossly unremarkable.
Prior MRI is not available for comparison, and current examination is limited to sequences per treatment planning protocol. Enhancing lesions are seen in the left cerebellar hemisphere and right occipital lobe with approximate measurements as above. Please note due to the relatively mild enhancement of these lesions, would suggest obtaining prior study to review additional sequences and better assess the size of the lesions. 