 There is status post resection of of meningioma with postsurgical changes seen in the right superior frontal gyrus and anterior aspect of the falx. There is high signal on T2 and FLAIR images with subtle enhancement within the resection cavity, likely representing postop scar and fibrous tissues. Tear drop shaped anterior falx shows high signal intensity on T1, low signal intensity on T2 and significant signal drop on Fat Saturated T1 without evidence of enhancement indicating fatty tissue .On the posterior margin of the resection cavity, there is a small 15 x 5 mm lesion, which is broad based and attached to the falx with intense enhancement and low signal in T2, representing residual or separated remained meningioma.Punctate high signal foci are seen in T2 and FLAIR in the periventricular white matter, consistent with nonspecific small vessel ischemic changes.The ventricles and sulci are within normal limits. The basal cisterns remain patent. There is no midline shift or mass effect. There are no areas of abnormal signal. There is no diffusion abnormality. No extra-axial fluid collection is identified.Normal flow-voids are demonstrated in the major intracranial vascular structures. The midline structures and craniocervical junction are within normal limits.
Post surgical changes of resected meningioma in the right superior frontal gyrus. Small residual or separated meningioma attached on anterior falx, measuring 15 x 5 mm, is seen on the posterior aspect of the resection cavity.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.