Reason: L gastrocnemius AVM, please evaluate extent of mass History: above BONES: The distal femurs, proximal tibias, and proximal fibulas have normal bone marrow signal.SOFT TISSUES: Within the left medial head of the gastrocnemius (series 601, image 25) there is a area of T2 and T1 hyperintensity with enhancement on the postcontrast images measuring 19 x 18 mm, previously 15 x 7 mm. Susceptibility artifact and posttreatment changes are noted in this location. No significant flow voids identified on T2 weighted images. Normal muscular branches are seen without large feeding vessel identified.The remaining musculature of the distal thigh and lower leg appears normal.VASCULATURE: Normal popliteal artery, proximal anterior tibial, posterior tibial, and peroneal artery are seen without evidence of significant stenosis, occlusion, or aneurysm. Please note that the technique was optimized for imaging of major vessels and does not resolve small caliber arteries such as the geniculate arteries.
Slight increase in size of previously treated AVM without large feeding vessel or flow voids to suggest rapid flow. IR consultation with diagnostic angiogram and possible re-embolization can be considered if clinically warranted.