41-year-old male with altered mental status. Evaluate for worsening edema. The patient is status post right frontal craniotomy for known anaplastic oligodendroglioma. There is a CSF filled cavity in the right frontal lobe communicating with the right lateral ventricle. This resection site appears stable.As seen on the brain MRI exam from 11/6/2016, there is heterogeneous T1 and T2 hyperintense lesion crossing from the posterior aspect of the tumor bed across the corpus callosum and into the left frontal lobe. There is associated vasogenic pattern of edema which is appears grossly stable to the prior exam allowing for motion degradation on the current and prior studies. On T1-weighted imaging it has heterogeneous signal with some mixed increased and decreased foci of signal. On susceptibility weighted imaging there are multiple punctate foci of signal loss within the lesion. Areas of mineralization were better appreciated on recent CT. There is extensive associated restricted diffusion. There is no midline shift or herniation. No hydrocephalus.
Note examination was performed without contrast. Post-treatment changes in the right frontal lobe with a large heterogeneous lesion along the posterior aspect of the tumor bed which crosses the corpus callosum into the left frontal lobe is not significantly changed since 11/6/2016 but remains suspicious for tumor. No significant interval change in extent of surrounding edema as questioned.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.