Reason: breast cancer with history of brain metastases s/p SRS. Please evaluate with interval MRI History: breast cancer with history of brain metastases s/p SRS. Please evaluate with interval MRI The CSF spaces are appropriate for the patient's stated age with no midline shift. A 3mm nodule is present in the left middle frontal gyrus which previously measured 2 mm.A punctate focus of susceptibility effect associated with contrast enhancement present along the right precentral gyrus medially which is also present on the prior exam and has not changed substantially.Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
1.Since the prior exam there is no change in a right medial precentral gyrus lesion, however, a left middle frontal gyrus lesion appears to be slightly larger. These most likely represent metastatic foci.