 An enhancing, intrinsically T1 hyperintense treated metastatic lesion in the right superior frontal gyrus is stable. Marginal surrounding FLAIR hyperintensity is again noted. This lesion is also associated with susceptibility artifact. Small enhancing metastases in the right superior occipital and left posterior temporal occipital lobes are stable, also associated with susceptibility artifact. There are no new metastases.The ventricles and sulci are prominent, consistent with mild age-related volume loss. The basal cisterns remain patent. There is no midline shift or mass effect. There are stable scattered nonspecific punctate foci of abnormal T2/FLAIR hyperintensity within the periventricular and subcortical white matter, which most likely represent mild chronic small vessel ischemic changes in a patient of this age. A tiny anterior right parietal developmental venous anomaly is again noted. There is no diffusion abnormality. No extra-axial fluid collection is identified.Normal flow-voids are demonstrated in the major intracranial vascular structures. Incidental nonenhancing cystic structure associated with the pineal gland is again noted, unchanged in appearance. The remainder of the midline structures and craniocervical junction are within normal limits. Opacification and air-fluid levels within the paranasal sinuses have improved, with a residual small air-fluid level in the right maxillary sinus. The mastoid air cells are clear.
1.Stable small metastases as described in detail above.2.Stable mild chronic small vessel ischemic disease.3.Opacification and air-fluid levels within the paranasal sinuses have improved, with a residual small air-fluid level in the right maxillary sinus. 