 This is a motion degraded exam affecting multiple sequences limiting the sensitivity of the study. The ventricles and sulci are mildly prominent compatible with age-appropriate volume loss. There is mild patchy abnormal T2/FLAIR hyperintensity within the periventricular white matter which is nonspecific. The cisterns remain patent. There is no midline shift or mass effect. There are no areas of abnormal signal or pathological enhancement. There is no diffusion abnormality. 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 is minimal right maxillary and trace bilateral ethmoid sinus mucosal thickening.MRI neck: This is a significantly motion degraded exam. There is a large lobulated oval lesion in the right posterior upper back soft tissues involving the subcutaneous fat causing mass effect upon the adjacent trapezius muscle. There is extension to the skin surface. This lesion approximately measures 34 x 19 mm in maximum axial dimensions. This lesion is slightly hyperintense on T1-weighted sequence and homogeneously T2 hyperintense. No definite enhancement is associated with this lesion. The lesion demonstrates restricted diffusion.PHARYNX/LARYNX: The nasopharynx, oropharynx, and hypopharynx are grossly unremarkable. The larynx is grossly unremarkable The upper trachea and esophagus are unremarkable.GLANDS: The noncontrast appearance of the submandibular, sublingual, and parotid glands bilaterally is unremarkable. There are multiple T2 hyperintense enhancing nodules in the bilateral thyroid gland left more than the right, largest left thyroid nodule measures up to 15 x 12 mm. ORAL CAVITY: The oral tongue and the floor of mouth are grossly unremarkable.CERVICAL SOFT TISSUES: Scattered small cervical lymph nodes are identified.OTHER: There is a pulmonary opacity involving the posterior segment of the right upper lobe. In addition, there are coarse linear and nodular opacities in the right upper lobe.
1. Motion degraded exam. No evidence of intracranial mass. 2. 34 x 19 mm lobulated cystic structure in the subcutaneous fat in the right upper posterior soft tissue with corresponding restricted diffusion most compatible with epidermoid cyst. 3. Bilateral thyroid nodules, left more than the right. Recommend further evaluation with dedicated ultrasound neck.4. Nonspecific pulmonary opacity in the right upper lobe mostly involving posterior segment which is confluent and concerning for possible focal consolidation, although there may be some degree of atelectasis. Also scattered areas of linear and nodular opacities. Clinical correlation will be helpful.