Known breast cancer brain metastasis follow-up. Interval increase the extent of high signal intensities around metastatic nodules on FLAIR images especially on the left parietal lobe inferior parietal lobule lesions and superior parietal lobule on the left postcentral gyrus.The left inferior parietal lobule, supramarginal gyrus enhancing lesion shows subtle interval increase in size (7.7mm x 15mm from 6.4mm x 11.1mm) and increased extent of susceptibility artifacts on gradient echo images. Another left parietal lobe metastatic lesion just adjacent to the left parieto-occipital sulcus shows more prominent susceptibility artifacts indicating possible increased extent of intralesional hemorrhages.Other multiple scattered bihemispheric metastatic nodules appear to be stable in terms of size and enhancement pattern as well as other MR characteristics.Multiple patch high signal intensities around periventricular white matter indicating nonspecific small vessel ischemic disease, no change since prior scan.The ventricles, sulci and cisterns are symmetric and unremarkable. The midline structures and cranial-cervical junction are normal. Normal flow voids are identified in the major intracranial vessels. The paranasal sinuses and mastoid air cells are clear.
1. Interval increase in size of metastatic nodules, development of intralesional hemorrhages with increased extent of surrounding edema on the left parietal lobe lesions on both superior and inferior parietal lobule as described above.2. Other metastatic lesions appear to be stable in terms of size and MR characteristics.3. No change of non specific small vessel disease.