Evaluate for leptomeningeal diseaseSigns and Symptoms: met breast cancer There is a hyperintense sulcal signal identified on FLAIR MR images located along the high convexities of the left frontal lobe at the posterior aspect of the superior frontal sulcus, the left central sulcus and the sulci of the left parietal lobe as well as some of the right central sulcus and right medial parietal lobe. Postcontrast imaging indicates that there is a mild degree of leptomeningeal enhancement associated with this. There is also some associated gyral signal hyperintensity on FLAIR and T2 MR images along the left parietal lobe.There is redemonstration of ventriculomegaly associated with mild periventricular signal hyperintensity on T2 and FLAIR MR height.There is a mild degree of periventricular and subcortical punctate hyperintense white matter lesions present identified on the FLAIR and T2 images.Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
1.There is leptomeningeal disease present. Although this is a nonspecific finding, in the context of breast cancer this is concerning for carcinomatosis.2.There is ventriculomegaly present. There is associated periventricular signal hyperintensity. The possibility of hydrocephalus cannot be excluded Please correlate with patient's clinical symptoms3.Periventricular and subcortical white matter signal changes of a mild degree are present which are nonspecific. They could be vascular related, related to demyelination, trauma, vasculitis, sarcoid. They are nonspecific. 