72 years, Male, metastatic lung cancer, brain metastases, status post SRS to right frontal lesion. There appears to be little contrast within the brain on the post gadolinium sequences although full dose was administered. As such this examination is limited. There is however a cystic appearing lesion in the left inferior frontal lobe measuring up to 15 x 13 mm in the craniocaudal and transverse dimensions, coronal T2 image 13, and approximately 13 mm in the AP dimension. There is surrounding edema and mild local mass effect.There is also a 7 mm lesion involving the left anterior frontal subcortical white matter. There are additional scattered foci of T2/FLAIR hyperintensity in the bilateral subcortical and periventricular white matter which are nonspecific but compatible with chronic small vessel ischemic and/or posttreatment-related changes. Note underlying small metastases cannot be excluded due to the relative lack of contrast. There is no midline shift or herniation. No hydrocephalus. Calvarium and extracranial soft tissues are grossly unremarkable.
1. This examination is limited due to insufficient contrast within the brain on the postcontrast sequences although full dose was administered. This may be related to partial contrast extravasation. Would suggest patient returning for repeat postcontrast imaging.2. There are least two left frontal lobe metastatic lesions, as described above. There is mild local mass effect without midline shift or herniation. There may be additional smaller lesions which cannot be appreciated without contrast. Prior study is not available for comparison.