Clinical question: Metastatic lung cancer, status post 2 cycles of chemotherapy. Please compare with previous study to evaluate meningioma. Signs and symptoms: Meningioma. Pre and post enhanced brain MRI:No diffusion-weighted abnormalities.Examination redemonstrates a small dural based homogeneously enhancing mass along the inner table of the skull in the right posterior temporal without interval change since prior exam. There is no associated adjacent parenchymal signal abnormality/edema. There is no interval change in size or pattern of enhancement since prior exam. It measures approximately at 9 x 8 mm in size. Finding likely representing a small meningioma however less likely possibility of a metastatic lesion cannot be entirely excluded considering patient's history. Lack of any appreciable interval change is more suggestive of a meningioma also.There is no detectable abnormal parenchymal or meningeal enhancement to suggest metastatic disease.Scattered foci of FLAIR and T2 hyperintensity in bilateral subcortical and periventricular white matter grossly similar to prior exam from April 2015 and suggestive of moderate chronic small vessel ischemic strokes.Unremarkable calvarium and images through the orbits including post enhanced series. All paranasal sinuses and bilateral mastoid air cells and middle ear cavities demonstrate normal pneumatization signal patterns.
.1.Negative diffusion weighted images.2.Findings moderate chronic nonhemorrhagic small vessel ischemic strokes grossly similar to prior study.3.Stable small dural base right posterior temporal enhancing focus without associated adjacent parenchymal signal abnormality highly suggestive of a meningioma.