Reason: any evidence of a mass lesion? History: girl with NF1, autism and rather subtle left sided weakness MRI brain:There is no evidence of intracranial hemorrhage, mass, or acute infarct. There is increased T2 signal in the bilateral cerebellar white matter including the right middle cerebellar peduncle which is less pronounced than the prior exam. Additional foci of increased T2 signal within the bilateral basal ganglia and right midbrain, also appear less pronounced in the prior exam. These likely reflect focal areas of signal intensity (FASI) lesions commonly associated with NF1. The ventricles and sulci are slightly prominent for age, which may reflect mild volume loss. There is no midline shift or herniation. The major cerebral flow voids are intact. Optic nerves and optic chiasm are grossly unremarkable.MRI cervical spine:There is straightening of the cervical spine, otherwise alignment is anatomic. Vertebral body heights and disc spaces are maintained. No abnormal marrow signal. No abnormal signal within the cord. There is a small central disc protrusion at C6-C7 No significant spinal or neural foraminal narrowing. No neurofibromas are seen throughout the cervical spine. Multiple small lesions hyperintense on the coronal STIR sequence within the soft tissues of the neck bilaterally likely represent small lymph nodes. Areas of scattered opacity in the left greater than right lung likely represent areas of atelectasis.
1.Multiple foci of increased T2 signal within the cerebellum, brainstem and basal ganglia are less prominent than the prior exam and likely represent focal areas of signal intensity (FASI) lesions commonly associated with NF1 with interval expected evolution. However, if there is strong clinical concern for superimposed neoplasm, a contrast-enhanced study is recommended for more complete evaluation.2.No neurofibromas or other masses throughout the cervical spine.3.Small central disc protrusion at C6-C7 without significant spinal or neural foraminal stenosis.