Clinical question: History of small cell lung cancer S/P chemotherapy, evaluate for brain Metastasis. Signs and symptoms: None. Pre and post enhanced brain MRI:No diffusion-weighted abnormalities.Examination demonstrates no detectable abnormal parenchymal or leptomeningeal enhancement to suggest metastatic disease. Unremarkable signal intensity on calvarium and without detectable abnormal enhancement.There are moderate patchy and confluent foci of FLAIR hyperintensity in the periventricular and subcortical white matter of bilateral cerebral hemispheres and minimally in bilateral basal ganglia and pons without evidence of hemorrhagic changes and consistent with chronic small vessel ischemic strokes.Unremarkable cerebral cortex, cortical sulci, ventricular system and CSF spaces otherwise for age.Unremarkable images through the orbits and including axial fat sat post enhanced surgeries.Normal pneumatization signal pattern of all paranasal sinuses and bilateral mastoid air cells and middle ear cavities.
1.No detectable metastatic lesions.2.Negative diffusion weighted images and moderate chronic nonhemorrhagic small vessel ischemic strokes.