Clinical question: History of grade 2 oligodendroglioma status post resection and RT. Signs and symptoms: Surveillance scan. Pre-and post-enhanced brain MRI:Examination demonstrate interval complete resolution of previously noted blood/fluid level in the dependent/posterior aspect of left frontal surgical cavity.There is also slight interval decreased size of surgical cavity in the left frontal lobe with entirely CSF signal intensity and measuring approximately 26 x 24 mm in transaxial dimensions.There is decreased peri-surgical cavity flair hyperintensity representing post operative and edema and gliosis.The anatomic morphology and signal intensity of brain parenchyma is otherwise within normal on all MRI sequences and is stable since prior study.Post-enhanced images demonstrate interval increased linear and minimally nodular enhancement along the surgical cavity wall as well as adjacent falx since prior study. Findings likely representing post treatment/surgical change however further follow up is needed to exclude less likely possibility tumor recurrence. Stable expected postoperative changes of left frontal craniotomy and including adjacent dural thickening and enhancement which also appears a slightly more prominent compared to prior exam.
1.Interval improvement with evidence of resolution of blood products from left frontal surgical cavity, decreased surgical cavity size and decreased peri-surgical cavity flair hyperintensity since prior exam.2.Interval increased enhancement along the surgical cavity wall and adjacent falx which is suggestive of postoperative change however less likely possibility of tumor should also be considered and further follow-up is needed.3.Postoperative changes of left frontal craniotomy with evidence of interval increased epidural enhancement along the inner table of craniotomy flap is within expected postsurgical finding.