Secondary malignant neoplasm of brain [C79.31], Reason for Study: ^Reason: brain metastasis from lung CA, followup scan History: occasional headaches There is no evidence of acute ischemic lesion on this scan.Multiple susceptibility lesions on bilateral hemispheres are again seen, no change since prior scan in terms of size and location. There is no evidence of new susceptibility lesion indicating acute hemorrhagic lesion on this scan.Underlying brain show patchy bilateral periventricular white matter high signal intensity lesions on FLAIR/T2 indicating non specific small vessel ischemic disease, no change since prior scan.The ventricles, sulci and cisterns are symmetric and unremarkable. The midline structures and cranial-cervical junction are normal. Normal flow voids are identified in the major intracranial vessels. Bilateral mastoid air cells show opacifications, no change since prior scan.The paranasal sinuses are clear.
No evidence of acute ischemic lesion.No evidence of new hemorrhagic lesion.No change of multiple susceptibility lesions since prior scan.No change of non specific small vessel ischemic disease since prior scan.Comment: Non contrast MRI is limited for detecting small metastatic lesion, thus, if clinically indicated, Gad enhanced MRI can be considered.