History of glioblastoma. Follow-up exam. Stable postoperative findings from right temporal and frontal craniotomy related to prior subtotal resection of tumor. Redemonstration of a centrally necrotic residual tumor mass in the right temporal lobe measuring 5.3 x 4.3 cm, previously 4.8 x 4.0 cm. Overall there is slight interval increase in associated edema particularly within the anterior aspect of the temporal lobe. There is associated local mass effect with local sulcal effacement.Additional centrally necrotic tumor in the right frontal lobe is not significantly changed measuring 2.9 x 1.8 cm, previously 3.0 x 1.8 cm. 2 adjacent cavities with high T1 and T2 signal and peripheral rims of susceptibility compatible with intraparenchymal hemorrhage appear similar to prior. The degree of vasogenic edema surrounding this tumor is not significantly changed from prior.There is stable 5 mm leftward midline shift and partial effacement of the left ambient cistern.Perfusion imaging again shows increased relative cerebral blood volume along the anteromedial aspect of the frontal lobe lesion and surrounding the temporal lobe lesion suggestive of viable tumor within the enlarging mass.Scattered foci of periventricular and subcortical white matter T2 hyperintensity appear similar to prior and may reflect a combination of small vessel ischemic changes and possibly postradiation effect. The ventricles are stable in size. The basal cisterns are preserved. The expected intracranial vascular flow voids are present. The paranasal sinuses and mastoid air cells are clear. Effacement of the left ambient cistern
1.Slight interval increase in size and adjacent vasogenic edema associated with the right temporal lobe tumor.2.No significant interval change in size or edema associated with the right frontal lobe tumor.3.No significant interval change in 2 intraparenchymal hemorrhagic collections adjacent to the right frontal lobe tumor.4.Perfusion imaging again shows increased relative cerebral blood volume along the anteromedial aspect of the frontal lobe lesion and surrounding the temporal lobe lesion suggestive of viable tumor within the enlarging mass.