NSCLC with brain metastasis. Interval MRI for evaluation. There are new enhancing lesions at the grey-white matter junctions in the superior right precentral gyrus and left superior frontal gyrus that measure up to 4 mm with minimal associated vasogenic edema. There are persistent foci of enhancement in the right precentral gyrus and left parietal lobe. There is unchanged confluent white matter T2 hyperintensity in the bilateral cerebral hemispheres, which is likely treatment-related. There is no evidence of intracranial hemorrhage or acute infarct. The ventricles and basal cisterns are unchanged in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits, skull, and scalp soft tissues are grossly unremarkable. There is scattered paranasal sinus mucosal thickening and fluid signal within the bilateral mastoid air cells, left greater than right.
1. New punctate metastases in the superior right precentral gyrus and left superior frontal gyrus. 2. Persistent punctate metastases in the right precentral gyrus and left parietal lobe.3. Findings suggestive of sinusitis and mastoiditis.