 MRI brain: There is no evidence of acute ischemia, edema or mass effect. There are no areas of abnormal signal. The ventricles and sulci are within normal limits. The basal cisterns remain patent. There is no midline shift or mass effect. No extra-axial fluid collection is identified.Normal flow-voids are demonstrated in the major intracranial vascular structures. The midline structures and craniocervical junction are within normal limits.There are mildly prominent bilateral cervical lymph nodes, nonspecific. There is mildly heterogeneous attenuation involving the bilateral parotid glands which can be seen in connective tissue disorders such as Sjogren's disease.MRI spine:There is extensive expansile T2 signal abnormality throughout the cervical spinal cord extending up to T2-T3 level. There are additional areas of hyperintense T2 signal abnormality involving T10 and T7-T8 vertebral levels, which are of indeterminate age but does not clearly appreciated on prior MRI dated 8/26/2015.The spine is in normal alignment. The vertebral body and disk heights are well-maintained. No worrisome focal marrow signal abnormality is appreciated. The distal spinal cord and conus are within normal limits with the conus terminating at the lower L1 level.There is no significant disk bulge, herniation, spinal canal or foraminal stenosis within the spine.There is diffuse hypointense signal involving the liver and spleen. Nonspecific mild diffuse low T1 marrow signal which can be seen in conditions such as anemia.
1. Interval development of extensive T2 signal abnormality throughout the cervical spinal cord, extending up to T2-T3 consistent with inflammatory myelitis related to NMO, for example. Additional small foci of T2 hyperintensity at the T7-T8 and T10 levels may also represent inflammatory/demyelinating plaques, possibly chronic but not seen on prior MRI from 8/26/2015. 2. Unremarkable MRI brain.3. Low T2 signal is noted in the partially imaged liver and spleen which can be seen with iron deposition and can be correlated with clinical findings.4. Mild heterogeneous signal involving the bilateral parotid glands which can be seen in connective tissue disorders such as Sjogren's.