Clinical question: Brain metastases status post SRS. Evaluate for complete tumor ablation. Signs and symptoms: None. Pre- and post enhanced brain MRI:No diffusion-weighted abnormalities.A previously known enhancing metastatic lesion in high anterior left parietal lobe is again identified and measuring at 7.8 x 7.3 mm in transaxial dimensions and without convincing evidence of interval change since prior study. A approximately 3 mm superficial located posterior temporal-occipital metastatic lesion also demonstrate no significant change in its size or pattern of enhancement since prior exam.None of the lesions demonstrate any appreciable surrounding edema or mass effect. There is also no detectable new parenchymal or meningeal enhancement to suggest additional metastases. The ventricular system remain within normal size and with maintained midline. There are several small foci of FLAIR hyperintensity in the periventricular and subcortical white matter without significant change since prior exam and likely representing mild chronic small vessel ischemic strokes. Unremarkable intracranial contents otherwise.Unremarkable images through calvarium and without abnormal enhancement.Unremarkable images through the orbits and including axial fat sat post enhanced series.Unremarkable images through the paranasal sinuses and mastoid air cells.
1.No acute intracranial process.2.Stable metastatic lesions in the left parietal (7.8 x 7.3 mm) and right posterior parietal-occipital region (approximately 3 mm) in size, morphology and pattern of enhancement.3.Unremarkable exam otherwise and without evidence of new metastatic lesions.4.Mild chronic small vessel ischemic strokes remain grossly similar to prior exam.