Glioblastoma status post biopsy, assess tumor. There are interval left transparietal biopsy findings in the heterogeneously enhancing mass, with diffuse susceptibility effect and areas of restricted diffuse, centered in the left parietal lobe with extension across the splenium of the corpus callosum. There is a new intermediate T1 and low T2 signal hematoma within the mass that measures up to 19 mm. Overall, the lesion measures up to 60 mm on the axial sections, previously 55 mm, and there appears to be expansion of the necrotic components. There is mass effect and effacement of the left occipital horn has slightly increased. However, the surrounding confluent T2 hyperintensity is not significantly changed in the left hemisphere and has actually diminished in the right posterior cingulate region. There are few scattered punctate white matter hyperintensities, which are nonspecific, but may represent chronic small vessel ischemic disease. There is a punctate focus of T2 hyperintensity in the right cerebellum is unchanged and may represent a chronic infarct. There is no midline shift or herniation. The orbits and paranasal sinuses are grossly unremarkable.
Interval left transparietal biopsy findings in the glioblastoma that appears to have increased in size slightly due to expansion of the necrotic components and development of intratumoral hemorrhage. However, the surrounding confluent T2 hyperintensity, which may represent at least in part vasogenic edema is not significantly changed in the left hemisphere and has actually diminished in the right posterior cingulate region.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.