 Brain MRI:There are a few scattered foci of T2 hyperintensity within the periventricular and subcortical white matter without associated mass effect, restricted diffusion, or susceptibility abnormality. The ventricles and sulci are normal in size. The cerebellar tonsils are in normal position. There are no masses, mass effect or midline shift. The pituitary gland is normal in size. There is no evidence for intracranial hemorrhage or acute cerebral, brainstem or cerebellar infarction. No diffusion-weighted abnormalities are identified. There are no extraaxial fluid collections or subdural hematomas. Flow voids are present within the major vessels indicating patency. A mucous retention cyst with inspissated secretions is present in the left maxillary sinus. Otherwise the paranasal sinuses and mastoid air cells are clear. Cervical and lumbar spine MRI:There is diffuse heterogeneity of the cervical and lumbar spine marrow appearing predominantly more hypointense on T1 than expected for patient age, however without corresponding worrisome lesions with sagittal STIR technique.Cervical spine MRI:Alignment is anatomic. There are no fractures or subluxations. The cervical and upper thoracic cord are normal in signal. The cervicomedullary junction is normal. The cerebellar tonsils are in normal position. The visualized paraspinal contents are unremarkable. A tracheostomy is in place.C2/3: UnremarkableC3/4: UnremarkableC4/5: Minimal posterior osteophyte disc complex without stenosis.C5/6: Mild posterior osteophyte disc complex and bilateral uncinate hypertrophy without stenosis.C6/7: Minimal posterior osteophyte disc complex without stenosis.C7/T1: UnremarkableLumbar spine MRI:Transitional anatomy is present with partial sacralization of L5 including bilateral pseudoarticulations.Alignment is anatomic. There are no fractures or subluxations. The conus is normal in signal and morphology and terminates at an appropriate level. The visualized intra-abdominal and paraspinal contents are unremarkable.T12/L1: UnremarkableL1/2: UnremarkableL2/3: Mild disc bulge without stenosisL3/4: Mild disc bulge without stenosisL4/5: Mild disc bulge without stenosisL5/S1:Mild disc bulge without stenosis
1.Mild chronic small vessel ischemic disease of the brain.2.There is diffuse heterogeneity of the cervical and lumbar spine marrow appearing predominantly more hypointense on T1 than expected for patient age, however without corresponding worrisome lesions with sagittal STIR technique. This is a nonspecific benign appearance and the differential diagnosis would most likely include anemia of any cause and/or chronic smoking.3.Minimal to mild degenerative changes throughout the cervical and lumbar spine without significant associated stenosis.