Clinical question: Assess for brain metastases. Signs and symptoms: Known stage IV lung cancer. Pre-and post-enhanced brain MRI:Negative diffusion weighted images.Examination demonstrates no detectable foci of signal abnormality or enhancement to suggest metastatic disease. Calvarium and soft tissues of the scalp as well as images through the orbits are also unremarkable and without evidence of metastatic lesions.Few tiny foci of flair hyperintensity in the subcortical white matter of bilateral frontal lobes are identified which are nonspecific however could representing chronic microvascular ischemic strokes.Otherwise there is normal anatomical morphology and signal intensity of brain parenchyma on all MRI sequences and without abnormal parenchymal or leptomeningeal enhancement.
1.No evidence of metastatic disease.2.Negative diffusion weighted series. 3.Minimal nonspecific periventricular and subcortical bilateral frontal foci of flair hyperintensity as detailed. 4.Unremarkable pre-and post enhanced brain MRI otherwise.