Metastatic pulmonary adenocarcinoma, evaluate for metastasis. Please examination is obtained for MRI brain fusion protocol for treatment planning limited to 3-D T2 and 3-D post gadolinium T1-weighted sequences. No abnormal parenchymal or meningeal enhancement is appreciated to suggest metastatic disease. There are scattered foci of T2 hyperintensity in the bilateral subcortical and periventricular white matter, which are nonspecific, but compatible with mild chronic small vessel ischemic changes. No intracranial mass or mass effect. No hydrocephalus. No midline shift or herniation. No extra-axial collections. Extracranial soft tissues are grossly unremarkable.
Please note examination was obtained with limited sequences prior MRI brain fusion protocol, which is suboptimal. Nevertheless there is no evidence of intracranial metastatic disease. No abnormal parenchymal or meningeal enhancement, intracranial mass, or mass effect.