Clinical question: Evaluate for new metastases. Signs and symptoms: New neurological findings with history of lymphoma. Pre-and post-enhanced brain MRI:Diffusion-weighted images are unremarkable.Examination fails to demonstrate any parenchymal, leptomeningeal or calvarial metastatic lesions.Small focus of T2 hyperintensity along the superior aspect of the left cerebellum is a nonspecific finding and demonstrate no interval change since prior study. Possibility of a tiny chronic ischemic stroke should be considered. Few additional tiny foci of T2 hyperintensity in the subcortical and periventricular white matter similar to prior exam from 2013 and suspicious for mild chronic small vessel ischemic strokes.Unremarkable cerebral cortex and cortical sulci as well as the ventricular system of the CSF spaces and brain myelination otherwise. No abnormal enhancement. Signal voids of major intracranial arterial branches are identified. Signal intensity of intracranial venous sinuses are within normal and normal pattern of enhancement.
1.No evidence of metastatic disease.2.Negative diffusion weighted images and stable findings suggestive of mild chronic small vessel ischemic strokes.