Reason: Treatment planning MRI for SRS- metastatic NSCLC History: Treatment planning MRI for SRS- metastatic NSCLC The CSF spaces are appropriate for the patient's stated age with no midline shift. There is a small focus of enhancement present measuring 5 mm in diameter along the medial aspect of the left frontal lobe at the cingulate gyrus at the level of the genu of the corpus callosum. This previously measured 4mm. Another small focus of enhancement is present along the left inferior temporal gyrus posteriorly measuring 3 mm in diameter. This was the same on the prior exam.There is gyral enhancement present along the medial aspect of the right frontal lobe inferiorly and mediallyNo abnormal enhancing mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
1.Redemonstration of small nodules in the left cingulate gyrus and left temporal lobe are compatible with the clinical history of metastases. These appear slightly larger than on the prior exam.2.Gyral enhancement in the right medial frontal lobe is present. This could represent unusual distribution of metastases with some leptomeningeal involvement which has mildly progressed.