Clinical question: History of metastatic ovarian cancer with brain metastases. Evaluate for radiosurgery planning. Signs and symptoms: Metastatic brain lesions. Pre and post enhanced brain MRI is performed:Examination is performed utilizing treatment planning protocol and is not a true diagnostic study. Examination demonstrate a right frontal extra-axial hematoma measuring 15.6 mm in thickness and 44 mm in length and with no convincing evidence of significant change since prior exam in its size or associated regional mass effect.Multiple enhancing metastatic lesions in bilateral cerebral hemisphere and in the right cerebellum are again noted.A left anterior frontal enhancing metastatic lesion measures approximately at 12 x 14 mm and not significantly changed since prior exam.An enhancing mass projecting immediately lateral to the trigone of right lateral ventricle with internal areas of necrosis measures at least 14 x 11 mm and appears slightly larger than prior study.A right posterior cerebellar enhancing metastatic lesion measuring get 6 x 7 mm in transaxial dimensions which is minimally larger than prior study measurements.There is a large right frontal surgical cavity with CSF internal CSF-like signal intensity and multiple petechial hemorrhage. This cavity measures approximately 22 x 33 mm in transaxial dimensions and is smaller in size compared to prior exam. There is an irregular however thin rim of enhancement surrounding the surgical cavity. This is significantly more conspicuous compared to prior exam which was of very poor quality due to extensive motion artifact. Possibility of small residual tumor along the cavity wall cannot be entirely excluded.Stable normal size of ventricular system and with maintained midline.
1.Multiple supratentorial and infratentorial metastatic lesions as detailed/measured above.2.There is suggestion of subtle interval increased size of metastatic lesions since prior exam. Please see above comments.3.A right frontal surgical cavity with interval decreased size however more conspicuous pattern of rim enhancement since prior exam.