Male, 62 years old, with GBM. Pretreatment. Compare to outside MRI. Please note that comparison is limited to postcontrast images as the prior examination contains only postcontrast and perfusion sequences.Findings are demonstrated compatible with left parietal craniotomy and tumor resection. An extra-axial fluid collection measuring up to 6 mm in thickness is evident subjacent to the craniotomy appearing similar to the prior examination.The left parietal lobe resection cavity also appears similar in size to that seen on the prior exam. The cavity contains a heterogeneous mixture of likely fluid and blood product. Diffusion restriction within the cavity likely represents viscous debris and/or the effect of blood product. No evidence of definite enhancement is seen above and beyond the intrinsic T1 hyperintensity of this blood product and some T1 hyperintense rimming of the surgical cavity. Ill-defined T2 hyperintensity extends into the parenchyma surrounding the resection cavity, particularly inferiorly within the periatrial region. No abnormal enhancement or mass effect is seen in this location.Within the left frontal operculum, a region of mildly T2 hyperintense, diffusion restricting, and nearly solidly enhancing tissue is evident measuring up to 31 x 23 mm in the axial plane, increased from the prior examination where it measured at most 21 x 16 mm.Minimal periatrial T2 hyperintensity is seen on the right. No other significant areas of parenchymal signal abnormal are detected. No other pathologic parenchymal or extra-axial enhancement is seen. The ventricular system is stable and within normal limits for size.
1.Stable left parietal lobe resection cavity containing a heterogeneous mixture of fluid and blood product. No clear evidence of suspicious nodular tumor or pathologic enhancement is seen within or around this cavity.2.Since the prior examination, a remote site of tumor involvement within the left frontal operculum has increased in size.