 BRAIN: There is no suspicious intracranial enhancement, acute infarct, mass, or cerebral edema. There are no definite cortical dysplasias, heterotopic gray matter or evidence of mesial temporal sclerosis. There are few nonspecific periventricular and subcortical T2 hyperintensities in the supratentorial brain. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The skull and extracranial soft tissues are unremarkable. LUMBAR: There is a large bulky structure in the pelvis which is incompletely imaged showing heterogeneous enhancement, likely representing a large fibroid uterus. There is apparent displacement of the fluid filled endometrial canal to the right of midline. In addition, there is partial visualization of a T2 hyperintense structures within the right upper pelvis which may be the location of the right ovary or may represent loops of bowel.The exam is mildly limited due to motion degradation on axial postcontrast images. The last well formed disk space is referred to as L5-S1. There is normal lumbar alignment and vertebral body heights. The disk heights are preserved. The osseous marrow signal is within normal limits for patient age. The conus terminates at mid L2 level. The conus shows normal signal intensity. There is mild developmental narrowing of the lumbar central spinal canal due to short pedicles and prominent dorsal epidural fat.There is subcutaneous edema in the deep posterior soft tissues lumbar region with enhancement, nonspecific, likely due to dependent edema although etiologies such as cellulitis are not excluded. There is no suspicious enhancement in the lumbar spine elsewhere.T12-L1: No disk herniation or spinal stenosis.L1-2: No disk herniation or spinal stenosis.L2-3: No disk herniation or spinal stenosis.L3-4: No disk herniation or spinal stenosis.L4-5: Mild disk bulge and facet arthropathy with no spinal stenosis.L5-S1: Mild disk bulge and moderate bilateral facet arthropathy causing no significant stenosis.
1.Essentially unremarkable MRI of the brain.2.Minimal lower lumbar spondylosis with no significant spinal stenosis.3.Nonspecific mild deep subcutaneous soft tissue edema of the posterior lower back with enhancement, likely representing dependent edema although etiologies such as cellulitis need to be excluded clinically.4.Extremely large bulky structure in the pelvis which is incompletely imaged showing heterogeneous enhancement likely represents a large fibroid uterus with presumed rightward displacement of the fluid-filled endometrial canal. However, this needs to be confirmed with ultrasound.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.