70 year-old male with metastatic lung cancer and known metastasis, please do violate for progression. No evidence of acute intracranial hemorrhage. There is a 5-mm focus of high attenuation in the peripheral cortex of the right frontal lobe (image 22/30, series 2) which may correlate with a previously seen metastatic lesion at this site on the previous brain MRI. Other metastasis there were previously demonstrated and not well seen given the lack of intravenous contrast on this examination.There are a few foci of subtle low attenuation in a periventricular distribution compatible with small vessel ischemic disease of indeterminate age.The ventricles and basal cisterns are normal in size and configuration. No abnormal extra-axial fluid collection.The calvaria and skull base are radiographically normal. The left frontal sinuses are completely opacified. There is partial opacification of the ethmoid air cells and sphenoid sinuses. There is slight erosion of bone of the posterior right lamina papyracea near the orbital apex. The soft tissue density previously seen in the ethmoid air cells in this region has partially resolved. Please see recent MRI for further detail. The mastoid air cells are appropriately pneumatized. The maxillary antra are not visualized on the current exam.
1. Stable noncontrast CT of the head without new acute abnormality. Please note that the lack of intravenous contrast limits the sensitivity of this examination for metastatic disease.