75-year-old male with metastatic lung cancer, possible small cerebellar metastasis on the previous MRI, presenting with bilateral lower extremity weakness and falls, please evaluate for additional metastases. The exam is degraded by patient motion. There is a punctate focus of enhancement within the superior right cerebellum. There also a punctate area of high T2 signal and susceptibility effect, with possible mild enhancement in the posterior right cerebellar peduncle. There is no evidence of acute infarct. There is diffuse periventricular and subcortical deep white matter T2 abnormality. The ventricles and basal cisterns are unchanged in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits, skull, and scalp soft tissues are grossly unremarkable. There is mild scattered paranasal sinus mucosal thickening.
Redemonstration of punctate focus of enhancement in superior right cerebellum and possible metastasis in the posterior right cerebellar peduncle in a background of chronic small vessel ischemic disease.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.