Diagnosis: Hemangioma of intracranial structuresClinical question: multiple ccm brain please do on 3t SCANNER WITH CCM PROTOCOL-qsm and permeability studySigns and Symptoms: yearly surveillanceComments: CCM PROTOCOL ON 3T WITH QSM/PERMEABILITY STUDY PLEASE | Patient had been on metformin but last dose was in 2014. She denies being diabetic and stated she used metformin for another purpose | The CSF spaces are appropriate for the patient's stated age with no midline shift. On susceptibility there are multiple small foci of susceptibility effect scattered in both hemispheres of the brain as well as in the brainstem and cerebellum. These are also identified on the prior exam and have not changed in number. On T2-weighted imaging there is a left frontal lobe periventricular white matter lesion with a popcorn-like appearance which currently measures 5x4mm axial dimensions. On the prior exam it measured the same.On T2-weighted imaging, in the left superior parietal lobule there is a 4 mm x 14 mm similar appearing lesion which previously measured the same. On T2-weighted imaging in the left occipital pole there is a 5 mm x 4 mm lesion.In the right temporal lobe adjacent to the temporal horn of the right lateral ventricle there is a lesion with a popcorn-like appearance on T2WI measuring 7 x 4 mm axial dimensions. It measured the same on the prior exam from July 2014.In the pons there is a lesion with a popcorn-like appearance on T2WI measuring 5x5 mm axial dimensions. It measured the same on the prior exam from July 2014.In the right inferior parietal lobule there is a lesion with a popcorn-like appearance on T2WI measuring 3x3 mm axial dimensions. It measured the same on the prior exam from July 2014.In the left caudate nucleus there is a lesion with a popcorn-like appearance on T2WI measuring 2.5x2.5 mm axial dimensions. It measured the same on the prior exam from July 2014.Other lesions identified on susceptibility weighted imaging are present which are under 2 mm in size or readily identified.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 demonstrate mucosal thickening in the right maxillary sinus. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
1.Compared to prior examination from 7/14/2014 there is no interval change in the number or size of the patient's multiple cerebral cavernous malformations.