Clinical question: History of superior sagittal meningioma status post FRT. Signs and symptoms: Surveillance scan. Pre and post enhanced brain MRI:Examination redemonstrates a mass within the superior sagittal sinus in the posterior parietal region. The mass results in expansion and complete occlusion of the sinus similar to prior exam. It extends for approximately 60 mm within the sinus and with maximum expansion of sinuses of approximately 16.2mm measured on sagittal images. Although there is no significant change in transaxial dimensions of this enhancing mass there is subtle interval decrease in expansion of the sinus since prior study. It measures 16.2 mm on current exam compared to prior study measurements of approximately 19.2 mm suggesting subtle interval decreased size of tumor. Thickening of the overlapping parietal bone with a rim of enhancement remains identical to prior study. The expanded sinus demonstrate mild flattening deformity of the adjacent parietal lobe without detectable FLAIR or T2 signal abnormality to suggest edema.The signal void of superior sagittal sinus anterior to the tumor extends for approximately 30 mm and related enhancement highly suggestive of thrombosed sinus. This finding is fairly similar to prior study. The signal intensity of superior sagittal sinus posterior to the tumor in the occipital region is detected and with normal pattern of enhancement.The anatomical morphology as well as signal intensity of brain parenchyma is otherwise within normal on all MRI sequences and without detectable abnormal parenchymal or left meningeal enhancement.Unremarkable images to the orbits, paranasal sinuses and mastoid air cells.
1.Expansile enhancing mass within the posterior parietal superior sagittal sinus consistent with patient's known meningioma demonstrates subtle interval decreased size (sagittal post enhanced measuring 16.2 compared to prior study measurement of 19.2 mm) compared to prior exam and stable otherwise.2.Unremarkable and stable exam otherwise.