74-year-old female with newly diagnosed lung cancer and neurologic deficit. No restricted diffusion to suggest acute ischemia. No intracranial hemorrhage. There is a 6 x 6 mm enhancing mass in the left parietal lobe (image 36 series 11) with minimal surrounding T2 signal abnormality. There is also a 3 mm enhancing right parietal lesion (image 66 series 11). No other abnormal parenchymal or meningeal enhancement. The ventricles are within normal limits in size and configuration. Multiple foci of T2/FLAIR hyperintensity are seen in the bilateral subcortical and periventricular white matter, which are nonspecific, but compatible with chronic small vessel ischemic changes. There are few scattered tiny foci of susceptibility including the right frontal lobe as well as the left parietal lobe, which are compatible with chronic microhemorrhages. Major flow-voids are preserved.Sella and orbits are grossly within normal limits. Paranasal sinuses and mastoid cells are clear. There is diffuse low T1 marrow signal which is nonspecific, but without focal destructive lesions.
1. A 6-mm enhancing left parietal and a 3-mm right parietal enhancing lesions are compatible with metastasis. No significant edema or mass effect.2. Chronic small vessel ischemic changes.3. Several foci of chronic microhemorrhage in a nonspecific distribution. 