MRI BRAIN WITH AND WITHOUT CONTRAST, Dec 21, 2012 10:56:00 AM
INDICATION: Disease staging Bifrontal or frontal glioblastoma multiforme
CCOMPARISON: MRI brain from 10/29/2012.
TECHNIQUE: Multiplanar, multi-sequence MR imaging of the entire brain was performed before and after intravenous administration of gadolinium-based contrast.
Calvarium/skull base: Postsurgical changes of left frontal craniotomy for resection of a GBM.
Orbits: Grossly unremarkable.
Paranasal sinuses: Left maxillary sinus disease.
Brain: No evidence of acute abnormality. No significant white matter disease or acute ischemia. No mass effect, hemorrhage, or hydrocephalus. Grossly normal flow-related signal in the major intracranial arteries and dural sinuses.
Postsurgical changes of left frontal craniotomy for resection of GBM. Susceptibility artifact is present within the surgical bed as well as overlying dural thickening at the craniotomy site. The T2/FLAIR signal abnormality within the white matter of the left frontal lobe extending into the anterior portion of the corpus callosum is similar without evidence to suggest disease progression. There is a round focus of T2/FLAIR hyperintensity in the periventricular white matter of the right frontal lobe seen in the coronal imaging in series 8 image 21. This small focus is slightly more conspicuous on the current examination.
Similar appearance of postsurgical changes of left frontal craniotomy for resection of glioblastoma. The scattered T2/FLAIR signal abnormality and irregular enhancement within and around the resection cavity, essentially unchanged and without evidence to suggest disease progression.
There is a small focus of T2/FLAIR hyperintensity in the deep white matter of the contralateral right frontal lobe that is more conspicuous on today’s examination. While this may represent treatment related change, it warrants close attention on