Patient with adenocarcinoma of the lung and multiple known bony metastases and 3 possible brain metastases shown on outside MRI, but only visible on once axial slice each. Need MRI with thin cuts to evaluate for brain metastases. No focal neurologic deficits. High functioning. There are multiple, at least 15, supratentorial and infratentorial subcentimeter lesions. For example, the largest supratentorial lesion is located in the right precentral gyrus and lateral to the right posterior cingulate gyrus and measure 4 mm in diameter, while the largest infratentorial lesion is located in the left cerebellar hemisphere and measures 6 mm in diameter. There are also multiple enhancing lesions in the skull, including within the clivus, as well as within the mandible. There is no evidence of intracranial hemorrhage or acute infarct. 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. The orbits, paranasal sinuses, and scalp soft tissues are grossly unremarkable.
1. Multiple, at least 15, supratentorial and infratentorial subcentimeter lesions are compatible with metastases.2. Multiple bone lesions are also compatible with metastases.