Numerous (approximately 20) intracranial, supratentorial, bilateral masses are noted. The largest is centred on the junction of the left anterior and middle cranial fossa, and demonstrates (to gray matter) iso-intense T1 signal, heterogenous iso/high T2/FLAIR signal and vivid high post-contrast T1 FS signal with internal flow voids indicative of blood vessels.
Other lesions demonstrate similar characteristics (some small lesions lack internal flow voids). Masses appear to be extra-axial as they distort overlying cerebral gyri and sulcli and many demonstrate a dural tail. High T2/FLAIR signal noted within the white matter of the left cerebral hemisphere, consistent with vasogenic oedema.
The largest masses are on the left and along with vasogenic oedema produce left-to-right midline shift of approximately 4mm and result in significant partial effacement of the left lateral ventricle and mild left uncal herniation.
No susceptibility artefact to indicate haemorrhage. No diffusion restriction. Basal ganglia calcification is noted.
Findings are consistent with multiple meningiomas. It is unlikely that these dural masses represent metastases, particularly in view of the spoke-wheel blood supply demonstrated in the largest lesion.