Reason: hx brain lesions. Eval for growth/change History: surveillance imaging There are unchanged postoperative findings related to bifrontal and left temporal craniotomy as well as radiation therapy with extensive hemorrhagic encephalomalacia in the bilateral anterior frontal lobes. There is diffuse linear dural thickening and enhancement along the margins of the craniotomy, but no discrete nodular focus of enhancement to suggest local tumor recurrence.There is no significant interval change in size of the enhancing left parafalcine dural based mass, which measures up to 8 mm in width (1201/51). There is an unchanged dural-based enhancing lesion along the right dorsum sella/posterior clinoid, which measures up to 6 mm (1201/32). There is also an unchanged plaque-like enhancing lesion along the right posterior frontal convexity that measures up to 3 mm in thickness. The heterogeneously enhancing right frontal bone lesion appears stable when compared to the immediate prior. The ventricles are stable in size and configuration, including ex vacuo dilatation of the bilateral anterior lateral ventricles. Again seen are multiple unchanged punctate foci of susceptibility effect within the supratentorial and infratentorial brain, which likely represent a combination of cavernous malformations and chronic punctate microhemorrhages related to previous radiation. The major arterial cerebral flow voids appear to be grossly intact. There is unchanged absence of the anterior superior sagittal sinus, likely related to prior surgery. The extracranial structures are unchanged.
1.No significant interval change in size of the left parafalcine and right dorsum sella dural-based masses, likely representing meningiomas. 2.Unchanged plaque-like enhancing lesion along the right posterior frontal convexity, which likely represents scarring versus residual tumor. 3.Unchanged extensive post-treatment findings in the bilateral anterior frontal lobe regions, without definite local recurrence tumor.4.Multiple unchanged punctate foci of susceptibility effect within the supratentorial and infratentorial brain, which likely represent a combination of cavernous malformations and chronic punctate microhemorrhages related to previous radiation. 