47-year-old female with a history of coccygeal chordoma status post resection. Patient presents with pain. Again seen are post operative changes of prior coccygeal resection, appearing similar to the prior study. There is increased signal abnormality on fluid sensitive sequences, which does not enhance on postcontrast images most consistent with postoperative changes. Note is made of foci of metallic susceptibility artifact in the surrounding area also likely postoperative in etiology. No pathologic enhancement is identified on postcontrast sequences. No evidence of residual or recurrent tumor.The patient is status post hysterectomy. There is a focus of increased signal abnormality on both T1 and T2-weighted images within the S2 vertebral body, which demonstrates fat signal intensity on all sequences, likely representing a hemangioma, appearing similar to the prior study. No additional bone marrow signal abnormality is identified. Although this examination was not protocoled for evaluation of the lumbar spine, there is an apparent disc protrusion at the level of L5/S1, which results in narrowing of the lateral recess and posterior displacement of the S1 nerve root as well as left neural foramen narrowing, which can be a source of pain. There is also an apparent disc protrusion at the level of L4/L5. There is increased signal abnormality within the protrusion suggestive of an annular fissure, which can be a source of pain. These findings are better characterized on the recent MRI lumbar examination. Please see the accompanying report for additional details.
Postoperative changes without evidence of residual or recurrent tumor. Other findings as described above.