MRI EXAMINATION OF THE HEAD WITH AND WITHOUT CONTRAST

MRI EXAMINATION OF THE HEAD WITH AND WITHOUT CONTRAST

INDICATION FOR STUDY:           Previous MRI examination from XXXXXXX.  Melanoma, recurrent.

FINDINGS:               Multiplanar and multisequence imaging was obtained on the 1.5 Tesla GE MRI with and without contrast.  The examination was compared to the prior study.  The prior examination report was reviewed.  There are changes consistent with defect in the superior aspect of the subcutaneous soft tissues over the calvarium consistent with prior surgery.  In this region though, there is an area of increased prominence to the soft tissue compared to the prior evaluation.  This area measures approximately 1.6 x 1 cm and seen on image 13 of series 9.  It is also seen on image 18 of series 8.  This may represent recurrent melanoma and would recommend clinical correlation.  The remainder of the subcutaneous soft tissues showed no other significant lesion.  The underlying calvarium, bony structures, brain parenchyma, and dura show no significant abnormality or abnormal enhancement.  These areas appear similar to what was seen previously.  There are significant age-related changes and periventricular white matter changes.  There is considerable atrophy centrally and cortically.  The possibility of NPH cannot completely be excluded.  There is no significant abnormal enhancing lesion or mass within the brain parenchyma.  The cerebellum, CP angles, and brainstem show age-related changes, atrophy, and small-vessel ischemic disease, but no other significant abnormality.  A preliminary report was discussed with Dr. XXXXXXX.  If there is any further concern, would recommend further evaluation as necessary.

IMPRESSION:          Slightly more prominent soft tissue mass in the subcutaneous soft tissue over the calvarium in the region of prior surgery as discussed.  The possibility of recurrent melanoma cannot completely be excluded.  There are significant age-related changes and small‑vessel ischemic disease.  This does not appear significantly changed compared to previously.  There is prominence to the ventricles and the possibility of NPH cannot be excluded.  There is no significant abnormal enhancement to the brain parenchyma.  Please see comments above.

Thank you for the referral.

XXXXXXX