Secondary malignant neoplasm of brain and spinal cord(198.3) [198.3] / Other malignant neoplasm without specification of site [199.1] / Malignant neoplasm of bronchus and lung, unspecified site [162.9] / Altered mental status [780.97], Reason for Study: ^ Motion artifact degraded image quality. There are multifocal ring-enhancing lesions on bilateral hemispheres including bilateral frontal lobe, left parietal lobe, left caudate nucleus, left insula cortex, left basal ganglia right temporal lobe and left occipital lobe. As well as cerebellar hemisphere indicating metastatic lesions. These lesions are associated with the surrounding edema. In particular, left occipital lobe lesion shows susceptibility artifacts on gradient echo imaging indicating hemorrhagic metastatic lesion.There is a relatively homogeneously enhancing well circumscribed mass on the sella turcica which compresses optic chiasm. The mass is measured about 24.5 mm x 34.1 mm x 32.8 mm. This masses consistent with pituitary macroadenoma.Underlying brain shows scattered high signal intensities on periventricular white matter on FLAIR imaging indicating nonspecific small vessel ischemic disease.The ventricles, sulci and cisterns are symmetric and unremarkable. The midline structures and cranial-cervical junction are normal. Normal flow voids are identified in the major intracranial vessels. The paranasal sinuses and mastoid air cells are clear.
1.Multifocal enhancing lesions indicating metastatic nodules including hemorrhagic metastatic lesion on the left occipital lobe as described above.2. Pituitary macroadenoma (24.5 mm x 34.1 mm x 32.8 mm).3. Mild to minimal nonspecific small vessel ischemic disease.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.