Reason: history of metastatic breast cancer with brain mets s/p whole brain RT History: surveillance MRI. No significant residual abnormal parenchymal or leptomeningeal enhancement. Multiple treated intracranial metastases are again seen including small lesions in the right frontal, right paramedian parietal, left temporooccipital and cerebellum. A right paramedian parietal lesion is unchanged measuring 1.1 x 0.8 cm (10/13) with minimal if any residual enhancement. Intrinsic T1 shortening associated with the right cerebellar lesion, left temporooccipital and right paramedian parietal lesions has decreased. Susceptibility associated with these lesions indicative of chronic blood products is unchanged. No new enhancing lesions are present.Slightly prominent ventricles and sulci is unchanged from the prior exam. Scattered punctate periventricular and subcortical T2 hyperintensities are nonspecific and may be related to gluteal cyst from prior metastases and/or chronic small vessel ischemic disease.. No areas of diffusion restriction. No midline shift or herniation. The major cerebral flow voids are intact. There is mild opacification of the left anterior ethmoid and sphenoid sinuses. The orbits are intact.Increased T1 signal within the clivus and skull base osseous structures is unchanged and consistent with radiation therapy. Enhancement of the left parietal calvarium is unchanged and likely represents a metastases. Enhancement of the left occipital condyle is unchanged.
1.Evidence of multiple treated metastases without significant residual enhancement. No new lesions identified.2.Stable appearance of calvarial metastases.