Clinical question: Evaluate for brain metastases. Signs and symptoms: None. Pre-and post-enhanced brain MRI:Diffusion weighted abnormalities.Examination demonstrates moderate periventricular and minimally subcortical foci of flair hyperintensity likely representing chronic microvascular ischemic changes without evidence of hemorrhagic change.The anatomical morphology and the signal intensity of brain is otherwise within normal in all MRI sequences.There is no portable abnormal enhancement brain parenchyma, the meninges or the calvarium to suggest metastatic disease. Next unremarkable images through the orbits and including axial fat sat post enhanced series.Bilateral mastoid air cells comminuted cavities and alternatives of sinuses demonstrate normal pneumatization signal patterns.
1.No evidence of metastatic disease.2.Negative diffusion weighted images and mild chronic findings of small vessel ischemic strokes only in the periventricular and minimally in the subcortical white matter of cerebral hemispheres.