 There are foci of high T2 signal in the subcortical white matter of the left superior frontal gyrus and a focus in the mid left cerebellar hemisphere. There are a few scattered periventricular white matter foci that are nonspecific and likely represent small vessel ischemic disease. The ventricles and sulci are within normal limits in size. There is no midline shift or significant mass effect. There is no evidence of acute cerebral infarction or intracranial hemorrhage. The orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable.
Subcentimeter foci of signal abnormality in the left superior frontal gyrus and left cerebellar hemisphere are incompletely characterized. Further evaluation via a brain MRI with contrast is recommended for evaluation for metastatic disease. This was discussed with Livia Szeto, who will order the brain MRI with contrast and have the patient return for the imaging.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.