59 years Female (DOB:5/2/1956)Reason: breast cancer with brain metastases treated with SRS; please evaluate response History: brain metastasesPROVIDER/ATTENDING NAME: STEVEN J CHMURA STEVEN J CHMURA The CSF spaces are appropriate for the patient's stated age with no midline shift. There is a 2.5 mm enhancing focus along the left parietal lobe in the superior parietal lobule which is also identified on the prior exam and not substantially changed. A couple punctate foci of enhancement present in the left middle frontal gyrus which are not clearly present on the prior exam. There is a punctate focus of enhancement in the right orbital gyrus along its medial aspect which is also present on the prior exam.On susceptibility imaging there is a punctate focus of signal loss in the left inferior parietal lobule which is not associated with contrast enhancement in those also present prior exam. An additional nodular focus of signal loss and susceptibility is present in the right precentral gyrus.Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
There is redemonstration of multiple tiny lesions in the supratentorial brain which are compatible with metastatic disease. Two of these in the left frontal lobe could represent newly MR visible metastatic foci.