Clinical question: Lesions. Signs and symptoms: Numbness and tingling sensation Pre-and post-enhanced brain MRI:Negative diffusion weighted series. There is normal anatomical morphology and signal intensity of the brain parenchyma on all MRI sequences. The cerebral cortex, cortical sulci, ventricular system, CSF spaces and myelination the brain is within normal. The signal voids of major intracranial arterial branches are identified.Post-enhanced images demonstrate no detectable abnormal parenchymal or leptomeningeal enhancement.Unremarkable calvarium, scalp and orbits and without detectable abnormal enhancement.All the paranasal sinuses and bilateral mastoid air cells and middle ear cavities demonstrate normal pneumatization signal patterns.Pre-and post enhanced cervical MRI:There is normal signal intensity and caliber of the cervical cord and without detectable abnormal enhancement.The signal intensity of vertebral column demonstrate minimal changes secondary to degenerative disease and unremarkable otherwise. There is no detectable abnormal enhancement the vertebral column.Foramen magnum is unremarkable.C2 -- C3 is unremarkable.C3 -- C4 is unremarkable.C4 -- C5 demonstrate mild degenerative disk disease with resultant mild to moderate right neural foraminal compromise and unremarkable otherwise.C5 -- C6 demonstrate moderate disk disease and loss of disk height shallow broad based bulging disk and bilateral uncovertebral hypertrophic changes are noted. There is moderate bilateral neural foraminal compromise and mild central spinal stenosis.C6 -- C7 demonstrate moderate disk disease and loss of disk height, prominent left lateral disk -- osteophyte complex results in subtle flattening in posterior displacement of the cord on the left. No spinal stenosis or neural foraminal compromise. The signal intensity of the cord remains within normal.C7 -- T1 is unremarkable.Pre-and post enhanced thoracic MRI:Examination demonstrate normal signal intensity and caliber the thoracic cord and without evidence of abnormal enhancement.The signal intensity and the anatomical alignment of vertebral column is unremarkable and without detectable abnormal enhancement.There is no evidence of spinal canal or neural foraminal compromise at any level.At T2 a mesh and one there is a right lateral small disk protrusion (axial T2 series 28 image 38 and sagittal T2 series 23 image 8) with subtle effacement of the ventral subarachnoid space however without spinal stenosis or neural foramina compromise.Pre-and post enhanced lumbosacral spine:There is normal anatomical alignment and signal intensity which column. There is normal signal intensity and morphology of the conus and the cauda equina. There is no detectable abnormal enhancement the vertebral column, conus or cauda equina.There is no evidence of spinal canal or neural foraminal compromise at any level. Mild facet and ligamentum flavum hypertrophic changes at L5 -- S1 and to a lesser degree at L4 -- L5 levels are noted.
1.Unremarkable pre-and post enhanced brain MRI.2.Pre-and post enhanced cervical MRI demonstrate normal signal intensity of the cord without abnormal enhancement. Mild-to-moderate degenerative disk disease with resultant mild central spinal stenosis at C5 -- C6 as detailed. Left lateral disk osteophyte complex at C6 the C7 with resultant subtle indentation of the ventral aspect of the cord. Neural foraminal compromise as detailed per level above.3.Pre-and post enhanced MRI of thoracic spine demonstrate normal signal intensity and caliber of the cord and without abnormal enhancement. No spinal stenosis or neural foraminal compromise. Tiny right-sided disk protrusion at T12 with subtle effacement of the ventral subarachnoid space.4.Unremarkable pre-and post enhanced lumbosacral spine MRI.