Clinical question: Evaluate for abnormality; history of sarcoma. Signs and symptoms: None. Pre and post enhanced brain MRI:No acute intracranial process and negative diffusion weighted series.Examination demonstrate normal anatomical morphology and signal intensity of brain parenchyma on all MRI sequences.Unremarkable cerebral cortex, cortical sulci, ventricular system, CSF spaces and brain myelination for stated age of 56.There is a well demarcated uniformly enhancing extra-axial left temporal mass measuring 19 x 12 x 15 mm. The finding results in buckling of the adjacent brain parenchyma however without evidence of vasogenic edema. The lesion demonstrate T2 and FLAIR hypointense signal and isointense on T1-weighted images. Finding is not associated with any abnormality of adjacent calvarium and is highly suggestive of a meningioma. There are no prior studies for comparison. If there are outside prior exams available and provided to radiology department and an addendum to this report will be submitted after review and comparison.There is a focus of enhancement (approximately 15 x 11 mm) at the apex of the left petrous bone abutting the left carotid canal (axial post enhanced series 1/1/2001 images 10 through 12). Considering provided clinical inflammation of malignancy possibility of an osseous metastasis lesion should be considered. Possibility of vascular/venous enhancement can cannot be entirely excluded. Follow-up with thin cut CT imaging of the skull base is recommended.There is a small well-demarcated CSF signal intensity extending medially from the right Meckel's cave and invaginating into the right aspect of the clivus (axial T2 series 501 image 11 and sagittal T1 series 301 image 21 and coronal T2-weighted series 701 image16) without enhancement. Finding is believed to represent abnormal enlargement of Meckel's cave or more likely a small meningocele.Unremarkable images through the orbits and including axial fat sat post enhanced series.There is improvement demarcated round T1 hyperintense masslike lesion without enhancement in the inferior aspect of the right inferior turbinate likely representing a benign cyst. A right maxillary sinus retention cyst is also present.
1.Normal signal intensity of brain parenchyma and without abnormal enhancement.2.Right petrous apex 15 x 11 mm focus of enhancement concerning for a bony metastasis and less likely prominent venous plexus. Follow-up with thin cut CT images is recommended for further assessment. 3.Extra-axial dural based left temporal enhancing mass highly suggestive of a meningioma measuring at 19 x 12 x 15 mm.4.Well-demarcated CSF signal intensity lesion contiguous with the right Meckel's cave and with invagination into the right aspect of clivus likely representing a meningocele.5.Please see above comments.