Clinical question: History of lung cancer with metastases to brain. Evaluate for edema or new metastases. Signs and symptoms: Left hand locking up and left leg heaviness. Pre-and post enhanced brain MRI:Examination demonstrate multiple new small bilateral hemispheric and cerebellar metastatic lesions since prior exam. Radiologist supratentorially no metastatic lesion measures approximately at 6-mm in transaxial dimensions and located superficially in the left posterior temporal -- parietal junction. All additional new metastatic lesions are significantly smaller in size.There is evidence of interval decreased size of few previously known metastatic lesions since prior exam. A left posterior temporal metastatic lesion measures at 5.4-mm compared to prior study measurement of approximately 8.5 mm.There is no evidence of hemorrhage or any significant surrounding vasogenic edema or mass effect. The ventricular system remain within normal size and with maintained midline.Calvarium demonstrate no metastatic lesions.Images through the orbits and including axial fat sat post enhanced series are unremarkable.
1.Multiple new supratentorial and infratentorial small metastatic lesions since prior exam as detailed/measured above.2.Several decreased size of multiple previously known metastatic lesions as detailed.3.No significant peritumoral edema, mass effect or midline shift.