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MRI 2/22/11


MRI BRAIN WITH AND WITHOUT CONTRAST: 2/22/2011

CLINICAL HISTORY: 46-year-old no with history metastatic melanoma with a left neck primary status post suboccipital craniotomy in September 2010 for left occipital metastatic disease. Patient is also status post Cyberknife in November 2010 for brain metastatic disease.

TECHNIQUE: The following MR sequences were obtained on a 1.5 Tesla scanner: Three plane localizer, axial diffusion, axial T1, axial FLAIR post gadolinium, axial T1 postgadolinium and coronal 3-D SPGR post gadolinium weighted sequences.

COMPARISON: Comparison is made to most recent prior external examination dated 12/16/2010, 11/2/2010 and priors dating back to 4/1/2010.

FINDINGS:
There has been interval increase in size of the left paramedian parietal lobe mass with intrinsic T1 shortening within the left paramedian parietal lobe focus of intrinsic T1 shortening measuring 1.8 x 1.2 cm (AP by transverse) with a rim of marked T2 hypointensity consistent with hemosiderin and no appreciable enhancement consistent with hemorrhagic metastatic disease (previously measuring 1.9 x 0.5 cm). There is surrounding FLAIR hyperintensity. Additionally, there is evidence of prior left occipital craniotomy with underlying 1.7 x 1.4 cm cavity with minimal subtle enhancement along the superior aspect (Image 15, series 6) with surrounding pericavitary FLAIR hyperintensity. There is no associated intrinsic T1 shortening. There are no new enhancing lesions identified.

IMPRESSION:
1. Interval increase in hemorrhage associated with the left paramedian parietal lobe mass now measuring 1.8 x 1.2 cm (AP x transverse). No new intracranial metastases are identified.

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