59-year-old female status post cervical and thoracic decompression and fusion, tumor resection. Evaluate surgical site, tumor burden. Preoperative planning for treatment of a left frontal lesion. MRI Stealth Brain:Limited stealth sequences of the brain demonstrate a well delineated mass measuring 18 x 20 mm in the posterior aspect of the superior left frontal gyrus, which for the most part enhances centrally more than peripherally. There is surrounding vasogenic edema which causes mild localized mass effect, resulting in mild sulcal effacement. However, there is no midline shift or herniation. There is also no significant change in size or configuration of the mass and surrounding edema compared to the recent prior OSH Brain MRI from 10/24/2016. There are right cerebellar and right occipital lobe developmental venous anomalies. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. There is mild left greater than right maxillary sinus mucosal thickening and right maxillary sinus mucus retention cyst. There is right greater than left mastoid air cell fluid. MRI C-Spine:There are postsurgical changes of a C7 corpectomy with vertical strut placement, which is fixed with an anterior plate and bilateral screws into the anterior inferior aspect of C6 and T1 vertebral bodies. There has also been partial resection of the posterior aspects of C6 and the whole of C7, with bilateral pedical screw placement at C5, T1 and T2, right pedicle screw placement at C6, and bilateral vertical rod placement extending from C5 through T2. Extensive motion degradation and artifact from hardware limits postcontrast evaluation for residual tumor. Although artifact limits full evaluation of the spinal canal, There appears to be no high grade spinal canal stenosis. The remainder of the vertebral body heights are maintained. There is interval disc height loss most prominently affecting the C5-6 and C7-T1 levels. The vertebral artery flow voids appear to be intact. The paraspinous soft tissue structures appear within normal limits.
1.Enhancing 18 x 20 mm mass in the left superior frontal gyrus with surrounding vasogenic edema which causes mild mass effect on the adjacent brain parenchyma but no midline shift or herniation. 2.Post-surgical changes of a C7 corpectomy with vertical strut placement, posterior spinal resection involving C6 and C7, and posterior spinal fusion elements extending from C5 through T2.3.Motion degradation and hardware susceptibility artifact limit full evaluation for residual tumor.4.Within the above limitations, there is no evident spinal canal stenosis or spinal cord compression.