Benign neoplasm of cerebral meninges [D32.0], Reason for Study: ^Reason: recurrent meningioma, s/p RT (2014), s/p resection (7/2015); surveillance History: recurrent meningioma Post right fronto-parietal craniotomy status for frontoparietal meningioma resection.There are a couple of crescent shape enhancements as well as thick linear enhancements on the tumor bed. The largest one was measured as 7mm (RL) x 14mm (AP) x 9mm (CC). There is localized extra-axial fluid collection overlying the lesion with thick but smooth dural enhancement.There is linear susceptibility lesion on the right pre central gyrus indicate postsurgical changes.Comparing to prior scan which showed multifocal scattered enhancement over the right pre central gyrus, those enhancing lesions are now more conspicuous and relatively better defined. This configuration change could be related to the overlying extra axial fluid collection or could be related to reduction of postoperative edema.In addition, overlying dural and bone flap also show more enhancement on today's scan which could represent postoperative changes.Constellation of above findings could represent focal either local residual mass or localized inflammatory lesions. Underlying brain shows multifocal scattered high signal intensity lesions on FLAIR images indicating non specific small vessel ischemic disease, no change since prior scan.The ventricles, sulci and cisterns are symmetric and unremarkable. There is no evidence of acute ischemic or hemorrhagic lesion.The midline structures and cranial-cervical junction are normal. Normal flow voids are identified in the major intracranial vessels. The paranasal sinuses and mastoid air cells are clear.
1. Interval configuration change of operation site enhancing lesion as well as more confined extra axial fluid collection overlying the tumor bed as described above. More conspicuous and discrete looking enhancing lesions on prior tumor bed may indicate possible residual tumor but cannot completely exclude focal residual postoperative inflammatory reaction. Follow up MR imaging is recommended.2. No evidence of acute ischemic or hemorrhagic lesion on this scan.3. No change of non specific small vessel ischemic disease.