Malignant neoplasm of upper lobe, bronchus or lung [162.3] / Chemotherapy follow-up examination [V67.2] / Disseminated malignant neoplasm [199.0] / Secondary malignant neoplasm of brain and spinal cord [198.3] / Radiotherapy follow-up examination [V67.1] Redemonstration of multifocal various sized bihemispheric nodular lesions.Some of lesions are peripherally enhancing and some show nodular enhancing. All lesions show susceptibility artifacts on gradient echo images.Comparing to prior scan, the extent of enhancement on both peripherally enhancing lesions and nodular lesions appear to be decreased. In addition, most of perilesional edema seen on FLAIR images appear to be decreased.There is no evidence of acute ischemic lesion on the scan. The ventricles, sulci and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. There is no mass, mass effect, edema, midline shift, intra or extra-axial fluid collection/hemorrhage, restricted diffusion/acute ischemia, or abnormal contrast enhancement. The midline structures and cranial-cervical junction are normal. Normal flow voids are identified in the major intracranial vessels. The paranasal sinuses and mastoid air cells are clear.
1. Multifocal various sized bihemispheric metastatic nodules redemonstrated.2. Interval decrease of the degree of enhancement and surrounding edema of intra-parenchymal lesions as described above.3. No evidence of acute ischemic lesion on this scan.