45 years Female (DOB: 2/18/1971)Reason: please evaluate progression of disease and compare to imaging brought in from. History: progressive LE weakness with T4 sensory level. MRI spine shows T-spine T2 non-enhancing lesionsPROVIDER NAME: JAMES A MASTRIANNI JAMES A MASTRIANNI MRI brain:The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal enhancing mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.On susceptibility weighted imaging there is a hypointense focus present in the left inferior parietal lobule subcortical white matter. This is not readily identified on any of the other pulse sequences. There is no associated contrast enhancement.Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.MRI cervical spine:The cervical vertebral bodies are appropriate in overall alignment and height. The cervical spinal cord has normal signal characteristics and overall morphology. No abnormal enhancing lesions are identified in the cervical spine.At C2-3 there is no significant compromise to the spinal canal or neural foramina.At C3-4 there is no significant compromise to the spinal canal or neural foramina.At C4-5 there is no significant compromise to the spinal canal or neural foramina.At C5-6 there is no significant compromise to the spinal canal or neural foramina.At C6-7 there is no significant compromise to the spinal canal or neural foramina.At C7-T1 there is no significant compromise to the spinal canal or neural foramina.The vertebral artery flow voids appear to be intact.Thoracic spine:The thoracic vertebral bodies are appropriate in the overall alignment and height. There is a T2 hyperintense lesion present in the right hemicord at the T2 vertebral body level C1 vertebral body level length. Another T2 hyperintense lesion is present in the left hemicord at the T2 and T3 vertebral body levels. Additional T2 hyperintense lesions are present at T3-4 on the left side extending one vertebral body length and at the T5-6 level in the left hemicord staining under 1 vertebral body level length. There is no associated contrast enhancement with these lesions.There is no compromise of thoracic spinal canal or exiting nerve roots. No abnormal enhancing lesions are identified in the thoracic spine.Lumbar spine:Five lumbar type vertebral bodies are presumed to be present which are appropriate in overall alignment and height. The conus medullaris on sagittal imaging is grossly intact. No abnormal enhancing lesions are identified in the lumbar spine. There is a transitional vertebra present with sacralization of L5.At L5-S1 there is no significant compromise to spinal canal or neural foramina. There is mild ligamentum flavum hypertrophy present at this level.At L4-5 there is no significant compromise to spinal canal or neural foramina. There is mild ligamentum flavum hypertrophy present at this level.At L3-4 there is no significant compromise to spinal canal or neural foramina.At L2-3 there is no significant compromise to spinal canal or neural foramina.At L1-2 there is no significant compromise to spinal canal or neural foramina.There are cystic lesions present in the pelvis. A multicystic lesion in the right hemipelvis is suspected to represent an ovary. There is a larger cyst associated with this measuring 34 x 20 mm axial dimensions
1.There are multiple lesions present in the upper thoracic spinal cord. Etiology is uncertain. They appear to involve gray matter. Demyelinating disorder could have this appearance. Alternatively, myelitis may have a similar appearance.2.A microhemorrhage in the left inferior parietal lobule in isolation is of unknown clinical significance.3.There is a cystic lesion present in the pelvis which is not completely imaged on this exam. One possibility this represents an ovarian cyst. If clinically appropriate additional imaging of the pelvis may be of further benefit.4.An alphanumeric page and email were sent to Dr Kamson.