Cerebral metastasis - Bull's eye

sign

Coronal T1 C+

Axial FLAIR
Axial T1

Within the parieto-occipital region on the left is a very rounded brightly peripherally enhancing mass located
near the grey-white junction, surrounded by a moderate amount of vasogenic edema. The central region of
lower signal intensity does not enhance nor does it restrict (DWI not shown). Features are consistent with the
patient's known metastatic disease.

Nice example of Bull's eye sign in a patient with a cerebral metastasis.

Cerebral metastases - small cell

lung cancer

CT scan Axial non kontras

Selected non-contrast CT images demonstrate multiple supra and infratentorial cystic lesions with scant
surrounding edema.
Axial T1

Axial T2
Axial FLAIR

Axial T1
Axial FLAIR

Selected MRI images demonstrate the cystic lesions to have peripheral enhancement, minimal surrounding
edema, and no central diffusion restriction. They are most consistent with cystic cerebral metastases.

Cerebral metastasis - breast cancer

Ct nk
Single image of non-contrast study and post contrast demonstrate a heterogeneously enhancing right frontal
lobe mass with extensive surrounding edema. The mass has it's epicenter close to the grey white matter
junction. It appears a solitary lesion

Cystic cerebral metastases

CT NK

Ring enhancing cystic lesion (37 x 31 mm) in the left high frontal lobe with significant perilesional vasogenic
edema causing mass effect in the form of sulcal effacement and subfalcine herniation.

Cerebral metastases
CT nk

ill defined mass occluding right upper lobe bronchus, note the distal collapse and "mucus
bronchogram"- findings suggest malignancy

MRI

Ill-defined mass in the left posterior temporal lobe with edema, internal T1 hyperintensities seen. On
GRE, blooming due to internal hemorrhage. Ring enhancement in a cortical-based lesion.
Metastases from follicular
carcinoma thyroid

MRI

MR reveals left parietal lobe lesion with adjacent perilesional edema with an skull vault lesion at the
previous craniotomy site. Skull vault lesion shows intense homogeneous enhancement

Brain metastases involving the

interthalamic adhesion

MRI
Bilateral thalamic (and some smaller peripheral) metastases. The larger, partly cystic lesion on the right
traverses the midline across the 3rd ventricle.

Cerebral metastasis - solitary

CT NK

A 2cm rounded mass is present in the post-central gyrus, which is iso-dense to cortex pre-contrast and
demonstrates homogeneous contrast enhancement. It is located at the grey-white matter interface and
is surrounded by extensive vasogenic edema, which exerts significant mass effect.

Cerebral metastases (colorectal

cancer)

MRI

Mulitple mets
Hemorrhagic brain metastases

CT NK

Unenhanced CT reveals a several hypodense area of vasogenic edema in the right frontal lobe with two
scattered rounded dense images, After injection of intravenous contrast medium, these enhance
significantly, becoming apparent multiple other smaller similar images in both hemispheres.

Brain metastases from breast

cancer

CT NK
This CT shows two round lesions with ring-shaped enhancement in the right temporal region. There is
also perilesional edema.

Cerebral metastasis

CT NK

There is a well-defined, vividly contrast enhancing mass identified in the right frontal lobe measuring 25
x 20 x 18 mm (AP x lat x cc). The mass demonstrates a thick contrast-enhancing rim and a 6 x 6 mm focus
of central hypodensity/necrosis. There is extensive surrounding vasogenic edema resulting in mass-
effect with sulcal effacement, effacement of the right lateral ventricle and 3 mm left-sided midline shift.
No other mass, focal abnormality, intra or extra-axial collection is identified. Ventricles and basal
cisterns are within normal limits and age appropriate. Multiple small scattered intraparenchymal ring
enhancing lesions proved to be metastatic deposits
Cerebral metastasis

MRI

Multiple small scattered intraparenchymal ring enhancing lesions proved to be metastatic deposits

Hemorrhagic cerebral metastases

CT NK

 large (5.9 x 5.1 cm) intra-axial space occupying lesion with peripheral hyperdensity and central
hypodensity in the left parieto-temporal lobe
  with surrounding edema and mass effect - compressing left lateral ventricle, effacement of
sulcal spaces and midline shift (about 14mm) to right.

Pancoast tumor with cystic cerebral

metastasis

MRI
Two left frontal parasagittal and left cerebellar cystic lesions are noted, the latter one shows fluid/fluid
level with T1 hyperintense signal likely hemorrhage. They show rim enhancement after contrast and
surrounded by bain edema exerting mass effect upon the left lateral ventricle and left aspect of pons.

Brain metastases from lung cancer

CT NK
Computed tomography shows areas of parenchymal edema, which following the injection of contrast
media show several hyperdense round lesions within.

Metastatic lung cancer to the brain

MRI AXIAL

Multiple ring enhancing lesions are scattered at both cerebral and cerebellar hemispheres, they elicit
low signal at T1 WI, intermediate signal at FLAIR WI and marginal post contrast enhancement with no
diffusion restriction , they are surrounded by vasogenic edema.

Multiple ring enhancing lesions are scattered at both cerebral and cerebellar hemispheres, they elicit
intermediate signal at FLAIR WI and marginal post contrast enhancement with no diffusion restriction ,
they are surrounded by vasogenic edema.
Cerebral metastases (renal cell
carcinoma)

MRI

Intra axial grey white matter junction mass lesions seen in left frontal and right parietal lobes. Lesions
are T1 hypointense, T2 and FLAIR hyperintense, mild diffusion restricted and showing intense
gadolinium enhancement. Areas of T1 hyperintensity with blooming on T2* also seen suggestive of
hemorrhage. Moderate vasogenic edema seen in right parietal lobe around the lesion causing mild
effacement of ipsilateral lateral ventricle. No brain stem or cerebellar lesions.

Brain metastases from breast

cancer

MRI
Innumerable scattered bilateral focal enhancing lesions in both cerebral and cerebellar hemispheres,
with vasogenic edema and mass effect.

Conclusion

Large burden of intracranial metastatic disease.