Clinical question: History of lung cancer with brain metastases status post RT. Evaluate recurrence/progression. Signs and symptoms: None Pre-and post-enhanced brain MRI: Negative diffusion weighted images.Examination demonstrates no evidence of residual enhancing metastatic lesions in the supra-or infratentorial brain parenchyma. There is also no detectable abnormal enhancement of the calvarial, soft tissues of the scalp or the orbits.Diffuse bilateral hemispheric white matter flair hyperintensity with suggestion of subtle interval progression since prior study and likely representing post treatment/radiation changes.The cortical sulci and ventricular system as well as the CSF spaces remain within normal and similar to prior exam.Signal void the major intracranial arterial branches are identified.The signal intensity of intracranial venous sinuses are beginning normal and a normal pattern of enhancement.Unremarkable calvarium, paranasal sinuses and mastoid air cells.
1.No evidence of residual detectable metastatic lesion.2.Slight progression of bilateral hemispheric white matter flair hyperintensity likely treatment related since prior exam.3.Unremarkable pre-and post enhanced brain MRI otherwise there