26-year-old woman with history of pelvic pain. PELVIS:UTERUS, ADNEXA: Fibroid uterus with largest measuring a subserosal fibroid measuring 14 x 11 mm located in the posterior body of the uterus (801/16). Endometrial stripe normal in size. Junctional zone within normal limits, no evidence of adenomyosis. Ovaries appear normal with small follicles.BLADDER: No significant abnormality noted.LYMPH NODES: No significant lymphadenopathy noted.BOWEL, MESENTERY: Suboptimal evaluation on this nondedicated exam but located posterior to the rectum and in the presacral space is a rounded complex fluid and T1 hyperintense signal containing focus that measures 19 x 12 mm (image 206 series 1502). Appears to communicate with adjacent rectum via dominant fistulous tract located approximately 8 cm from the anal verge and measuring approximately 15 mm in length, image 16 series 1401 and image 15 series 801. These findings demonstrate associated restricted diffusion and, particularly with respect to the aforementioned rounded structure, delayed rim enhancement. Difficult to exclude postcontrast enhancement within this lesion due to inherent T1 hyperintense signal. More subtle appearing perianal fistulous linear tract arising from the 12 o'clock position on image 11 series 1401 nonspecific, may be artifactual. Visualized terminal ileum (imaged on coronal T2 imaging sequence) unremarkable.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1.Suboptimal assessment on this nondedicated exam but findings suspicious for perirectal abscess formation, please refer to discussion above. Also among differential considerations rarer entities such as tailgut cyst formation. Correlation with patient's clinical history/physical exam and laboratory values recommended.2.Visualized terminal ileum (only imaged on coronal T2 imaging sequence) unremarkable.3.Fibroid uterus as above.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.