Male, 35 years old, with history of ependymoma and suspicious brain lesions. Surveillance exam. Brain:A punctate focus of enhancement along the left precentral sulcus has not significantly changed from the prior examination, accounting for some mild imaging artifact and differences in technique (see image 26 series 63). T2 hyperintensity spreading mildly from this lesion into the surrounding white matter seems to have lessened compared to prior.Previously seen small foci of enhancement, one each in the right and left occipital lobes, are not reliably detected on this study. No associated parenchymal signal abnormality is observed.No new areas of pathologic parenchymal signal abnormality or enhancement are detected. No restricted diffusion is seen. There is no evidence of edema or mass effect.Sequelae of prior chronic ischemia are seen in the bilateral cerebral hemispheres. Otherwise the brain morphology is within normal limits. No abnormal fluid collections are detected. The ventricles are stable and normal in size.Spine:Again seen is evidence of laminectomy from C6 through T2. The soft tissues of the paraspinal operative bed again show evidence of scarring, but no fluid collections are detected.Sequelae of tumor resection from the low cervical/upper thoracic spinal cord are again demonstrated. The cord remains thinned from C7 through T2, and also shows diffuse enhancement through this region, all similar to prior.Syringohydromyelia of the cord above the level of the lesion is stable to slightly improved. Mild syringohydromyelia below the level of the lesion, extending down to approximately T7, is probably not significantly changed, although the prior examination was motion degraded which complicates comparison.Within the limitations of mild imaging artifact, no evidence of any new pathologic intraspinal or paraspinal enhancement is seen. No new abnormalities of the spinal cord, conus or cauda equina are detected.Spinal alignment is anatomic. Vertebral body morphology is within normal limits allowing for a Schmorl's node at L1. No significant degenerative disc disease, spinal canal stenosis or neuroforaminal narrowing is detected.
1.A small focus of enhancement along the left precentral sulcus shows no significant interval change. Surrounding T2 hyperintensity does, however, seem to have improved relative to the prior examination.2.Two small foci of enhancement seen previously within the occipital lobes are no longer visualized on this study. No new intracranial lesions are detected.3.Redemonstration of postoperative findings in the spine compatible with ependymoma resection from the low cervical/upper thoracic spinal cord. The cord remains thinned and diffusely enhancing in the operative region, similar to the prior exam. No new intraspinal lesions are detected.