GBM. There is redemonstration of postoperative changes from previous resection of the right anterior temporal lobe, portion of the right insula, and right inferior frontal lobe. Compared to the more recent 7/1/2016 exam, there is apparent increased conspicuity of slightly nodular appearing enhancement along the medial margin of the resection cavity, now extending minimally along the anterior body the right lateral ventricle. There is also apparent increased conspicuity of nodular ependymal enhancement along the medial margins of the anterior body of the lateral ventricles. However, previous exam was performed 1.5T on the current exam is at 3T. A more comparable comparison is made with the 5/6/2016 exam which is of the same scanner, where overall there is no significant interval change in appearance of the scattered areas of nodular enhancement. Subtle enhancement is now again seen along the lateral aspect of the right ventricular atrium. Although there remains slight deformity along the lateral aspect of the anterior body the left lateral ventricle, the degree of associated nodular enhancement has decreased compared to 5/6/2016.Extent of surrounding T2/FLAIR hyperintensity along the cavity margins extending posteriorly remains unchanged, with ex vacuo dilatation of the right lateral ventricle. Ill-defined T2/FLAIR hyperintensity along the left lateral ventricular margins is also unchanged and remains nonspecific.There is mild mucosal thickening in the right maxillary sinus with a mucosal retention cyst in the left. There is trace fluid in the right mastoid air cells.
1.Allowing for differences in technique, stable appearance of the resection cavity.2.No significant change in scattered areas of nodular ependymal enhancement along the lateral ventricular margins when compared to 5/6/2016 exam, except for decreased degree of of nodular enhancement along the lateral margin of the anterior body of the left lateral ventricle. Previous apparent diminished ependymal enhancement may have been technical in nature.