Metastatic brain lesions. Evaluate for changes. Again seen is evidence of right frontal craniotomy and cranioplasty. Sequelae of prior tumor resection and treatment are redemonstrated within the right frontal lobe showing no significant interval change. There is no new pathologic enhancement in the treatment bed and the degree of encephalomalacia and parenchymal T2 hyperintensity is unchanged.Previously described punctate focus of enhancement within the right parietal subcortical white matter (image 66 series 14) is slightly less conspicuous. A punctate focus of enhancement within the left cerebellum (image 154 series 14) is not significantly unchanged from prior. There is a 3 mm focus of enhancement in the right frontal lobe, image 99 series 14, which also appears minimally more prominent and associated with susceptibility effect. 3 mm nodular focus of enhancement along the left inferior cerebellar surface, coronal series 1401 image 169, is slightly more prominent. Two foci of susceptibility, one in the right cerebellum and one in the left, are unchanged and likely represent a treatment related effect. A few scattered additional foci of nonspecific parenchymal T2 hyperintensity are unchanged. The ventricles are stable in size and morphology including ex vacuo dilatation of the right frontal horn.A 12 mm enhancing lesion within the left posterior parietal bone is unchanged when compared to the immediate prior examination but has increased in size when compared to older studies.
1.Punctate foci of enhancement within the right frontal lobe, right parietal lobe, and in the left cerebellum are again seen with slight differences in in appearance which may be related to technique differences (current study at 3T, prior on 1.5T). In particular, 3 mm nodular lesions along the inferior cerebellar surface and in the right frontal lobe appear more prominent in the interval and would suggest close follow-up due to possibility of enlarging metastases.2.Stable postoperative and treatment related findings in the right frontal lobe.3.Stable punctate foci of susceptibility in the cerebellar hemispheres likely related to treated lesions.4.A 12 mm enhancing lesion in the left posterior parietal bone is stable when compared to the immediate prior study but has increased in size relative to older exams and compatible with a metastatic focus.