Patient with newly diagnosed metastatic breast cancer, evaluate for brain metastasis. There is no evidence of intracranial hemorrhage, suspicious mass, or acute infarct. No abnormal enhancement is noted intracranially. Subcentimeter left frontal lobe cystic lesion is noted, demonstrating suppression on FLAIR sequence with no associated enhancement or mass effect. Differential includes enlarged perivascular space, sequela of prior injury, or other benign cystic lesions. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits, paranasal sinuses, and scalp soft tissues are grossly unremarkable. Nonspecific low T1 marrow signal of the calvarium with mild associated enhancement is noted, which can be seen with marrow conversion due to conditions such as chronic anemia. No destructive focal calvarial lesions are noted.There is a T1 hypointense lesion involving the posterior aspect of the C3 vertebral body, which may represent metastasis.
1.No evidence of intracranial metastatic disease.2.T1 hypointense lesion involving the posterior aspect of the C3 vertebral body is suspicious for osseous metastasis. Suggest correlation with bone scan or PET/CT. Dedicated spine MRI may be considered as clinically warranted.3.Diffuse low signal involving the calvarium with mild enhancement. This may be related to marrow conversion such as secondary to chronic anemia; however, this is nonspecific and may also be correlated with bone scan/PET. No focal destructive osseous calvarial lesions are appreciated.