Female, 47 years old, with systemic sclerosis and pachymeningitis, assess for disease progression. Two adjacent lobular enhancing lesions are demonstrated along the right temporal horn showing no significant interval change in size. Likewise, a small cystic component medial and superior to these nodules is also unchanged. Of note, the degree of parenchymal T2 hyperintensity surrounding the above-mentioned nodular lesions has decreased. As before, these lesions are contiguous with enhancing choroid plexus of the right ventricular atrium. The more anterior of these nodules shows evidence of prior lateral and superior approach biopsies with internal susceptibility compatible with placement of a biopsy marker. Linear enhancement along the lateral biopsy tract is stable. Also redemonstrated is diffuse pachymeningeal thickening involving the entirety of the right cerebral dura including the interhemispheric falx and the tentorium. Involvement of the left sided dura is also seen to a lesser degree. These findings are overall not significantly changed.Scattered punctate foci of white matter T2 hyperintensity are unchanged and nonspecific. No new parenchymal lesions or new abnormal enhancement is seen. Brain parenchymal morphology is otherwise unremarkable. The ventricles are stable and normal in size.
1.Enhancing lesions along the right temporal horn, contiguous with the enhancing choroid plexus, show no significant interval change in size. Findings related to prior biopsies are also unchanged.2.Parenchymal edema surrounding the enhancing lesions has, however, decreased when compared to the prior examination.3.Diffuse pachymeningeal thickening involving the right cerebral dura and, to a lesser degree, the left cerebral dura, shows no significant interval change.4.No new intracranial abnormalities are detected.