Clinical question: Small cell lung cancer. Status post 6 cycles of chemotherapy. Evaluate for disease status. Signs and symptoms: Small cell lung cancer. Pre and post enhanced brain MRI:Negative diffusion weighted series. Examination demonstrate scattered tiny foci of FLAIR and T2 hyperintensity along the in the periventricular and subcortical white matter of cerebral hemispheres without evidence of hemorrhagic changes or enhancement. Although nonspecific findings are highly suggestive of chronic nonhemorrhagic small vessel ischemic strokes and without significant change since prior exam from 3-5-15.Unremarkable signal intensity and overall anatomical morphology of brain otherwise and stable since prior exam.Post enhanced images are severely degraded due to motion artifact as well as extensive pulsation artifact. Within this limitation however there is no convincing evidence of abnormal parenchymal or leptomeningeal enhancement. This is a similar observation as prior study from earlier this month.Calvarium demonstrate normal signal intensity and without abnormal enhancement.Unremarkable images through the orbits including axial fat sat postcontrast enhanced series.Mild left maxillary chronic sinus disease and otherwise well pneumatized paranasal sinuses and bilateral mastoid air cells.
1.Negative diffusion weighted series.2.Findings suggestive of mild chronic nonhemorrhagic small vessel ischemic strokes only in the subcortical and periventricular white matter.3.Degraded post enhanced images due to motion and pulsation artifact however without convincing evidence of abnormal parenchymal, leptomeningeal, calvarial or orbital enhancement.