Clinical question: Metastatic lung cancer to brain. Evaluate for change. Signs and symptoms: None. Pre- and post enhanced brain MRI: A small mildly enhancing metastatic lesion in the left inferior cerebellum measuring at 11 x 10 mm in transaxial dimensions compared to prior study measurements of 9 x 9 mm. No surrounding edema or mass effect.A right posterior occipital peripheral small enhancing metastatic lesion measuring at 4.6 x 5.7 mm compared to prior study measurement of 3 x 4.6 mm. No surrounding edema or mass effect.A right high convexity posterior parietal enhancing metastatic lesion measuring 4.2 x 3 mm on sagittal post enhanced images compared to prior study measurement of 2.5 mm in transaxial dimensions. There is no surrounding edema or mass effect.There is no evidence of any new parenchymal metastatic lesion and no detectable that the meningeal enhancement.Calvarium demonstrates normal signal intensity and without metastatic lesions.Unremarkable images through the orbits and including axial fat sat post enhanced series.Paranasal sinuses and bilateral mastoid air cells and middle ear cavities demonstrate normal pneumatization signal patterns.
1.Examination demonstrate multiple previously noted metastatic lesions in supra and infratentorial brain parenchyma with evidence of minimal interval increased size as detailed/measured above. None of the lesions demonstrate any surrounding edema or mass effect.2.No evidence of any new parenchymal metastatic lesions and no detectable leptomeningeal enhancement.3.Unremarkable calvarium, orbits, paranasal sinuses and mastoid air cells.