 The examination is limited by motion artifact and the 3-D postcontrast T1 images are degraded by technical factors. Postsurgical findings consistent with right frontal parietal craniotomy with resection of two right parietal lobe lesions are again demonstrated. Peripheral hemosiderin deposition and blood-fluid level is demonstrated in the resection cavities. Postoperative dural thickening and enhancement is demonstrated subjacent to the craniotomy. The more superolateral resection cavity demonstrates subtle increased signal on T1 post-contrast images, surrounding the resection cavity with more nodular signal along the surgical tract. This may relate to postcontrast enhancement or intrinsic signal, however intrinsic T1 signal was not present in these locations on prior postoperative imaging. Additionally, the more medial resection cavity demonstrates subtle nodular signal along the inferomedial resection margin which may also represent contrast enhancement versus intrinsic T1 signal.There is a small posterior left frontal lobe lesion measuring 5 x 8 mm (series 503, image 144). Additionally, there is a 7 x 7 mm left parietal lobe lesion (series 503, image 125). This lesion demonstrates increased surrounding vasogenic edema. A 3 mm enhancing lesion is visualized in the right cerebellum (series 401, image 36).The ventricles and sulci are within normal limits. The cisterns remain patent. There is no midline shift or mass effect. No extra-axial fluid collection is identified. Normal flow-voids are demonstrated in the major intracranial vascular structures.
1. Postsurgical findings related to resection of two large right parietal lobe metastatic lesions are demonstrated. The resection cavities demonstrate subtle nodular signal which may relate to postoperative change versus residual tumor. Limited evaluation due to lack of T1 precontrast imaging.2. There is interval slight increase in size of subcentimeter left parietal and posterior left frontal lobe lesions with increased edema surrounding the left parietal lobe lesion.3. A 3 mm metastatic lesion is also now visualized in the right cerebellum.