 A lesion with high signal in the T2 and FLAIR, low signal in T1 without enhancement is seen in the right parietal region. This lesion measures 25 x 18 mm in transaxial view.There is another lesion in the left inferior and middle frontal gyrus with mixed and heterogenous high signal in T2 and FLAIR and mixed high and low signal in T1 and partial enhancement. In its largest transaxial view the lesion measures 43 x 35 mm. Note is made that the lesion abuts the anterior horn of the left lateral ventricle which is partially effaced. There are heterogenous low signal in the susceptibility sequences representing a hemorrhagic lesion.There is a lesion in the right frontal lobe with heterogenous high signal in T2 and FLAIR, mixed signal in T1, minimal surrounding edema with peripheral enhancement, measuring approximately 18 x 33 mm in transaxial view. There are foci of low signal in this region representing hemorrhage.There is a lesion located in the right supramarginal gyrus, abutting the occipital horn of the right lateral ventricle. The lesion has peripheral high signal in T2 and FLAIR with minimal surrounding edema, low signal in T1 and peripheral enhancement. This lesion measures 11 x 8 mm in transaxial view.There is a lesion in the left occipital lobe with high signal in T2 and FLAIR, low signal in T1, partial enhancement and punctate of flow signal in the susceptibility images, measuring 18 x 33 mm. The lesion is hemorrhagic.Two lesions of high signal in T2 and FLAIR with low signal in T1, peripheral enhancement and punctate low susceptibility signal are seen in the left cerebellar lobe.Ventricular size is normal. No evidence of midline shift. Basal cisterns are patent.Paranasal sinuses are normal.The orbits are normal.There is a partially empty sella.There are no convincing metastatic lesion in the calvarium.
The lesions described above in the supratentorial region and in the left cerebellar hemisphere are of high signal in T2 and FLAIR, some necrotic, some with surrounding vasogenic edema, and some hemorrhagic. These lesions most likely represent metastatic lesions.