Follow-up after radiation and chemotherapy. Evaluate for progression of the astrocytoma. A rim-enhancing lesion centered in the right frontal corona radiata is unchanged in size compared to the prior examination, measuring 45 x 41 mm. The degree of surrounding parenchymal T2 signal abnormality and local mass effect has decreased significantly in size compared to the previous MRI with a decrease in the mass effect on the body of the right lateral ventricle and a reduction in the leftward midline shift from 7 mm down to 3 mm. A second rim-enhancing lesion centered on the right paracentral lobule has also similar in size measuring 21 x 25 mm compared to 19 x 28 mm previously. An additional punctate focus of enhancement more superiorly positioned in the right frontal lobe is somewhat more conspicuous compared to the previous exam (series 1/2/2001, image 270). A second focus of enhancement with more curvilinear morphology is seen along the superior frontal gyrus on the right appears conspicuous compared to the previous exam (series 1/2/2001, image 277).Sequela of prior right parietal vertex craniotomy are again seen. There is no evidence of intracranial hemorrhage. The ventricles and basal cisterns are normal in size and configuration. The major cerebral flow voids are intact. The orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable.
1.Stable right middle frontal gyrus mass with a significant decrease in amount of adjacent vasogenic edema with reduction in the mass effect on the right lateral ventricle and decrease in the midline shift from 7 mm on the 3 mm.2.The second smaller mass located in the right parietal paracentral lobule is also stable in size.3.Two small areas of enhancement separated from the two larger lesions were present previously but are slightly more conspicuous on today's exam and are suspicious for possible additional non-contiguous disease.