 There are interval postsurgical changes of a left frontotemporal craniotomy. There appears to be a partial resection primarily involving the left anterior temporal lobe, when compared to the outside postoperative CT. There are expected postoperative changes including a small left extra-axial collection and fluid filled resection cavity primarily in the left anterior temporal lobe. There is T1 shortening on postcontrast T1 sequences centered in the basal ganglia, which is suspected to represent residual enhancing tumor rather than only T1 shortening related to postoperative blood products. There is improvement in mass effect with persistent effacement of the left lateral ventricle. There is interval decrease in rightward midline shift measuring 5 mm, previously 13 mm. Previously seen uncal herniation is no longer evident. There is interval decrease in surrounding T2/FLAIR hyperintensity, which still extends superiorly into the left centrum semiovale and corona radiata. Nonspecific focus of T2 hyperintensity in the left pons is unchanged.
Examination limited to sequences for treatment planning and an immediate postoperative MRI is not available. Based on outside postoperative CT, there appears to have been resection of primarily the left anterior temporal component of the tumor and without significant tumor resection in the left basal ganglia; would suggest correlation with operative history. The T1 shortening on the postcontrast sequence in the basal ganglia is therefore favored to represent enhancing residual tumor rather than intrinsic T1 shortening from blood products. 