Female, 50 years old, with high-grade astrocytic neoplasm, follow-up examination. A rim-enhancing mass within the posterior aspect of the right frontal lobe is again seen with evidence of prior biopsy. The overall size of the lesion has increased from the immediate prior examination, now measuring 36 x 35 mm, previously 34 x 30 mm, when measured in the axial plane. The enhancing rim has become thicker. The degree of T2 hyperintensity surrounding this lesion has also increased. More anteriorly, patchy foci of enhancement have become larger within the right operculum, along with associated T2 signal abnormality. Likewise, foci of enhancement within the corpus callosum and the left centrum semiovale white matter have become larger.rCBV mapping shows elevated blood volume correlating with both the dominant right frontal lesion and the scattered additional areas of patchy enhancement.Ill-defined nonenhancing T2 hyperintensity within the bilateral frontal white matter is not significantly changed. Likewise, nonenhancing T2 hyperintense cortical and subcortical thickening involving the anterior right temporal lobe, amygdala and hippocampal head are not significantly changed.No significant generalized mass effect or brain herniation is seen. The ventricles maintain a relatively normal morphology and configuration.
1.Mild interval increase in the size of a dominant right posterior frontal mass with associated increased edema.2.Scattered additional foci of enhancement within the right opercular tissues, the corpus callosum and the left centrum semiovale white matter have also increased.3.Other areas of nonenhancing signal abnormality remain relatively stable.4.The overall impression, in conjunction with rCBV mapping, is that of slowly progressing disease including within the contralateral hemisphere.