Female, 52 years old, with history of low-grade glioma with CSF dissemination status post cranial spinal radiation. Brain:A subcentimeter nodule is redemonstrated within the left frontal horn showing susceptibility effect and intrinsic T1 hyperintensity likely reflecting calcification. The nodule enhances mildly on postcontrast images. No significant interval change is seen in the size of this lesion.Ependymal and subependymal enhancement centered on the left frontal horn is again seen. The geographic extent of this enhancement is similar to prior though in some areas the thickness of this enhancement has increased by 1 or 2 mm. No entirely new enhancing lesions are seen.The lateral ventricles remain prominent which likely reflects volume loss of the surrounding white matter, slightly progressed from prior. T2 hyperintensity surrounding the lateral ventricles is similar in pattern and extent. Numerous scattered foci of susceptibility are seen indicating sites of chronic microhemorrhage, particularly around the left frontal horn but also elsewhere in the brain. Susceptibility effect is also seen in the brain stem and along the fissures of the vermis. These findings have also likely progressed and are probably related to therapy.No new lesions are seen. No local or generalized mass effect is seen. The right mastoid air cells remain chronically opacified.C-spine:Within the limitations of motion degraded images, the following observations are made.Spinal alignment is anatomic. Vertebral body height and morphology are within normal limits. No evidence of marrow edema or marrow replacement is seen. However, the marrow does demonstrate conspicuous fatty signal characteristics which may reflect prior radiation. No pathologic marrow enhancement is seen.The spinal cord is of smaller than normal caliber, particularly beginning at the C5 level and continuing down into the thoracic region where it becomes quite atrophic. No focal cord signal abnormality is detected. No epidural abnormalities are seen. No pathologic parenchymal or leptomeningeal enhancement is seen.Minimal disc osteophyte formation is seen at C4-5 and C5-6. No significant spinal canal or foraminal stenosis is identified at any level.
1.Stable calcified and mildly enhancing nodule within the left frontal horn.2.Mild increased thickness of the ependymal and subependymal enhancement which has been seen on numerous prior examinations along the left frontal horn. This finding is nonspecific, particularly given the long imaging interval, and could in part be technical in nature. No new enhancing or nonenhancing lesions are identified.3.Progressive periventricular white matter volume loss and progressive likely treatment-related hemosiderin deposition is seen.4.Redemonstration of spinal cord atrophy particularly in the lower cervical and thoracic regions. No findings are seen to suggest active or progressive tumor in the cervical spine.