History of meningioma s/p xrt. There is no significant change in extra-axial enhancing mass in the right paraclinoid region and partially encasing the right prechiasmatic optic nerve in its inferior aspect. The mass measures 16 x 18 x 16 mm in the AP, transverse, and craniocaudal dimensions, and not significantly changed since prior. No other areas of abnormal post contrast enhancement identified.Coronal T2 fat sat sequence of the orbit demonstrates an abnormal T2 hyperintensity within the right prechiasmatic optic nerve and was not well assessed on prior study. Posteriorly the mass abuts the right A1 anterior cerebral artery segment and the cavernous internal carotid artery in its inferior aspect without occlusion. The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. There is a small varix involving the left superior ophthalmic vein. The calvarium is diffusely thick as seen before. There is a 11 x 6 mm enhancing lesion involving the right frontotemporal calvarium, which is slightly larger compared to 3/4/2014 when it measured 7 x 5 mm and not seen on 7/10/2012.
1. Compared to 3/4/2014, there is no significant change in size and appearance of the right paraclinoid meningioma partially encasing the right prechiasmatic optic nerve. There is T2 hyperintensity within the right optic nerve which was not well assessed on priors as dedicated MRI orbit sequences were not obtained.2. Small right frontotemporal calvarial enhancing lesion (series 16 Ax T1 FS postgad image 16/23) demonstrates gradual enlargement compared to 3/4/2014 and not seen on 7/10/2012. No obvious destructive changes or epidural extension. Appearance is nonspecific however neoplastic osseous lesion cannot entirely be excluded. CT may be helpful to further assess the osseous changes. 