FINDINGS: No restricted diffusion. Advanced volume loss for age. No extraaxial fluid collection. Ventricles and sulci are prominent. Normal major intracranial flow-voids. No T1 signal abnormality. Post contrast images show no enhancing intraaxial or extraaxial mass, but there is abnormal pachymeningeal enhancement. Specifically, there is diffusely thickened enhancement involving the pachymeninges. The smooth, regular enhancement is felt less likely to represent dural metastases, given the uniformity. I believe that this is post treatment in nature. The T2 sequences show several foci of subcortical white matter, measuring 5 mm, image 11, series 6. There is no enhancement corresponding to this.
Limited views of the orbits and sinuses are unremarkable.
IMPRESSION:
1. Diffuse, smooth homogeneous enhancement of the pachymeninges. Most likely, this is related to post treatment change; dural metastases are unlikely, given the smooth nature and uniform distribution.
2. Several small scattered foci of white matter T2 hyperintensity is nonspecific. No enhancement corresponding to these lesions. It is possible that these are related to post treatment change, but given the patient's history of malignancy, short-term interval follow up is recommended to exclude early developing metastases. Follow up in 2-3 months is recommended.
3. Advanced volume loss for age, likely treatment related.
A Brain MRI was ordered just as good measure. I was not showing any signs of neurological symptoms. Doctor Matei was happy to announce upon reading this report that I showed no sign of cancer in my brain. So, despite the way this reads, this is good news. Part of the reason I include them is so that you can see the validity and seriousness of my health.
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