Technique: Multiplanar multisequence imaging including pre- and post-contrast T1, T2, FLAIR, DWI/ADC and stereotaxis.
Findings: There is a superficially located mass in the left superior frontal gyrus anteriorly measuring 22 x 13 x 20 mm (AP x LR x SI). This has developed in the region of subcortical FLAIR hyperintensity present on the previous MRI. The mass is centred on the grey-white matter junction involving both cortex and subcortical white matter and has a broad dural abutment. The mass demonstrates subtle intrinsic T1 hyperintensity and blooming consistent with blood product and heterogeneous solid contrast enhancement. The lesion is of heterogeneous T2 signal with mixed hyperintense and hypointense components. No central restricted diffusion in the mass. Extensive surrounding vasogenic oedema in the left frontal and parietal lobes. There is associated mass effect on the left lateral ventricle and sulci and rightward midline shift of 7 mm. No other intracranial mass. No hydrocephalus.
Conclusion: Left superior frontal gyrus mass associated with extensive vasogenic oedema and mass effect most likely represents a metastasis.