 Examination is limited by motion artifact.Right frontal craniotomy changes related to resection of right frontal lobe mass are again demonstrated. Subtle micronodular areas of enhancement with extensive restricted diffusion involving the posterior margin of the cavity in the right frontal lobe as well as the anterior body of the corpus callosum appear similar to prior examination and again do not demonstrate elevated relative cerebral blood volume. However, compared to prior examinations, the body of the corpus callosum appears slightly more thickened, with subtle gradual increased enhancement and heterogeneous signal extending to the left of midline.In addition, there is new restricted diffusion with subtle enhancement extending along the lateral margin of the left lateral ventricular body. This area demonstrates questionable increased relative cerebral blood volume which may be related to an adjacent blood vessel. Overall, there is subtle increase in FLAIR signal extending posteriorly and cranially along the posterior aspect of the right frontal lobe, compared to multiple prior exam. Gradient susceptibility likely related to hemosiderin deposition along the surgical cavity is again demonstrated with 2-3 new scattered punctate foci of susceptibility, for example in the left frontal centrum semiovale.
Comparing to older exams, there has been gradual subtle increased expansion of the corpus callosal body with subtle progression of speckled enhancement and abnormal heterogeneous signal extending across midline, including extension now along the lateral margin of the left lateral ventricular body with associated diffusion restriction. Overall, the areas of abnormal signal/speckled enhancement now demonstrate any significant hyperperfusion and appear to demonstrate decreased rCBV. Linear hyperperfusion along the left lateral ventricular body is noted, possibly relating to an adjacent blood vessel. Continued follow-up is recommended, as findings may in large part relate to post treatment changes although a component of tumor is not entirely excluded.