Benign neoplasm of cerebral meninges [D32.0], Reason for Study: ^Reason: recurrent meningioma s/p RT 2013 s/p resection 2015 History: eval for extent of disease Previously seen enhancements at tumor bed appear to be decreased in extent indicating most of enhancing lesions on prior scan could represent postoperative reactive changes. There are, however, remained two enhancing foci (both about 5mm sized, one on pre central gyrus and another on post central gyrus) on today's scan. These lesions could also represent reactive changes, however, follow up scan is recommended.Previously seen right fronto-parietal convexity extra axial fluid collection appears to be stable in size and MR characteristics.Focal encephalomalacia and susceptibility artifacts on the operation site and the right precentral gyrus are redemonstrated and unchanged.Underlying brain shows scattered FLAIR high signal intensity lesions indicating non specific small vessel ischemic disease. The ventricles, sulci and cisterns are symmetric and unremarkable. There is no mass effect, edema, midline shift, intra or extra-axial fluid collection/hemorrhage, restricted diffusion/acute ischemia. 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. Overall interval decrease in operation site enhancing lesion since prior scan. 2. Two somewhat nodular enhancing lesions at operation site as described above, follow up imaging is recommended.3. No new abnormal enhancing lesion.4. Stable extra axial operation site fluid collection since prior scan.5. Minimal non specific small vessel ischemic disease.