64 years, Male, recurrent lung cancer, evaluate for CNS involvement. There is no intracranial mass or abnormal enhancement to suggest intracranial metastatic disease. Again seen are areas of encephalomalacia with adjacent FLAIR hyperintensity including the left frontal lobe and the right parietal lobe which may be related to prior infarcts or other injury. There is susceptibility effect and thickening of the right frontoparietal scalp which may be related to prior surgery or trauma. Remainder of the brain demonstrates scattered foci of T2/FLAIR hyperintensity which are nonspecific and compatible with mild chronic small vessel ischemic changes. No hydrocephalus. No extra-axial collections. Bone marrow signal is slightly heterogeneous but similar to prior without discrete enhancing or destructive lesions demonstrated.Left internal carotid artery flow-void is severely diminutive which was present previously and may be related to chronic occlusion or high-grade proximal stenosis. Small mucous retention cysts in the maxillary sinuses and minimal sphenoid sinus mucosal thickening incidentally noted.
1. No evidence of intracranial metastatic disease.2. Unchanged areas of encephalomalacia in the right parietal lobe and left frontal lobe which may be related to prior infarcts or other injury.3. Severely diminished flow-void of the intracranial left internal carotid artery similar to prior, which may be related to chronic occlusion or high-grade stenosis proximally.4. Heterogeneous bone marrow is similar to prior without discrete enhancing or destructive lesions appreciated.