Clinical question: Evaluate for growth of AA status post RT/TMZ+ TMZ. Now off all treatments. Signs and symptoms: Right frontal anaplastic astrocytoma. Pre- and post enhanced brain MRI:No diffusion-weighted abnormalities.Examination demonstrates a focus of FLAIR hyperintensity with underlying parenchymal volume loss and minimal chronic hemorrhage in the right frontal lobe and extending from cortex to the right lateral ventricle. Finding consistent with postsurgical and treatment changes of a anaplastic astrocytoma which remains nearly identical to prior exam.There is no detectable abnormal enhancement at the site which is also a similar observation as prior study.Unremarkable signal intensity of brain parenchyma otherwise on all MRI sequences and without detectable abnormal enhancement of brain parenchyma or the leptomeninges.Unremarkable cerebral cortex, cortical sulci, ventricular system, CSF spaces and brain myelination otherwise.Unremarkable calvarium other than expected postoperative changes of right frontal craniotomy.Unremarkable images through the orbits including axial fat sat post enhanced series.All paranasal sinuses and bilateral mastoid air cells and middle ear cavities demonstrate normal pneumatization signal pattern.
1.Stable post surgical/treatment changes of right frontal lobe astrocytoma.2.Unremarkable pre and post enhanced brain MRI otherwise and stable since prior study.