 Redemonstrated are postsurgical changes related to a left frontal craniotomy for resection of a brain metastasis. There is stable mild dural thickening and enhancement subjacent to the craniotomy. There is stableT2/FLAIR signal abnormality surrounding the resection cavity. Susceptibility artifact within the resection cavity is unchanged and likely represents old blood product. A small round 4 mm focus of apparent enhancement in the anterior temporal lobe as well as a more posteriorly located focus of curvilinear enhancement within the inferior left temporal lobe are noted on SPGR postcontrast imaging. However these cannot be confirmed on any other imaging sequence and there is no associated edema. Therefore, these findings may be artifactual but close interval follow-up is suggested. Scattered periventricular and subcortical T2 hyperintensities are nonspecific but may be related to mild chronic small vessel ischemic disease. The ventricles are within normal limits. The cisterns remain patent. Normal flow-voids are demonstrated in the major intracranial vascular structures. The midline structures and craniocervical junction are within normal limits. There are bilateral lens implants.
1.Stable postsurgical changes and T2/FLAIR signal in the left frontal lobe without evidence of tumor recurrence in the surgical bed. 2.Small round 4 mm focus of apparent enhancement in the anterior temporal lobe as well as a more posterior focus of curvilinear enhancement within the inferior left temporal lobe are noted on SPGR postcontrast imaging. However these cannot be confirmed on any other imaging sequence and there is no associated edema. Therefore, these findings may be artifactual but close interval follow-up is suggested. 3.Findings were discussed with the primary service time of this dictation.