Clinical question: History of left acoustic neuroma status post radiosurgery; please evaluate for response. Signs and symptoms: As above. Pre- and post enhanced brain MRI:Examination is performed utilizing the standard pre and post enhanced brain MRI and without dedicated by IAC images.Negative diffusion weighted series.Examination demonstrates an enhancing left-sided acoustic neuroma occupying the entire left internal auditory canal and the slight bulge into the cerebellopontine angle cistern. The lesion measures 13.3 mm in transverse axis which is identical to prior study. It measures approximately 7.7 mm in AP axis at the level of the left internal auditory meatus is similar to prior exam.Examination otherwise demonstrate normal anatomical morphology of the brain and with normal signal intensity on all MRI sequences. No detectable abnormal parenchymal or leptomeningeal enhancement. Unremarkable calvarium and soft tissues of the scalp. Unremarkable images through the orbits including axial fat sat post enhanced series. Normal signal intensity of bilateral mastoid air cells, middle ear cavities and visualized paranasal sinuses.
1.No appreciable interval change in the size, morphology or enhancement of a 13.3 x 7.7 mm left acoustic neuroma since prior exam.2.Unremarkable pre and post enhanced brain MRI otherwise. Please see above comments.