Clinical question: History of lung cancer, please compare to prior study and measure. Signs and symptoms: None. Pre and post enhanced brain MRI:No acute intracranial process and negative diffusion weighted series.Examination demonstrate stable post surgical/treatment changes of left frontal region without interval change or recurrence of disease.Findings at the site include a focus of cortical and subcortical encephalomalacia at the resection site.Additionally examination demonstrate diffuse T2/FLAIR hyperintensity of bilateral hemispheric white matter similar to prior exam and consistent with post treatment/radiation change.Ventricular system are mildly dilated similar to prior study and with maintained midline.Small focus of encephalomalacia in the right inferior frontal lobe and the surrounding gliosis and without intravenous enhancement is again noted and representing focus of treated metastatic lesion.Calvarium demonstrate postop changes and unremarkable otherwise.Unremarkable images through the orbits and including axial fat sat post enhanced series.All paranasal sinuses and bilateral mastoid air cells and middle ear cavities demonstrate normal pneumatization signal pattern.
1.No acute intracranial process or evidence of new findings since prior study.2.Stable extensive post treatment and surgical changes for treatment of metastatic lesions since prior study.3.No detectable metastatic lesion on this exam.4.Stable diffuse white matter FLAIR hyperintensity of cerebral hemispheres consistent with posttreatment/radiation change.