Part D Other observations Site Mass observed Location of origin relative to Number of Size of largest Signal Intensity uterus masses T1 T2 T1-FS TUBAL No Medial Length ………….. cm High High High Yes Lateral Width ………….. cm Intermediate Intermediate Intermediate Right Other (describe) Transverse ..………… cm Low Low Low Left .................................... PARA-OVARIAN No Medial Length ………….. cm Yes Lateral Width ………….. cm High High High Right Other (describe) Transverse ..………… cm Intermediate Intermediate Intermediate Left .................................... Low Low Low BOWEL Small Length ………….. cm No Sigmoid Width ………….. cm High High High Yes Rectum Transverse ..………… cm Intermediate Intermediate Intermediate Other (describe) Low Low Low .................................... Presence of (abnormal) small bowel in pelvis Bowel thickening? Normal No Abnormal Yes Sigmoid/ rectum No Yes If abnormal, enhanced with contrast Mesenteric/ antimesenteric No Yes No Mucosal/ submucosal No Yes Yes BLADDER Dome Length ………….. cm No Posterior Width ………….. cm High High High Yes Anterior Transverse .………… cm Intermediate Intermediate Intermediate Other (describe) Low Low Low ....................................
Part D Other observations Site Mass observed Location of origin relative to uterus Number of masses Size of largest Signal Intensity T1 T2 T1-FS TUBAL No Yes Right Left Medial Lateral Other (describe) .................................... Length ………….. cm Width ………….. cm Transverse ..………… cm High Intermediate Low High Intermediate Low High Intermediate Low PARA-OVARIAN No Yes Right Left Medial Lateral Other (describe) .................................... Length ………….. cm Width ………….. cm Transverse ..………… cm High Intermediate Low High Intermediate Low High Intermediate Low BOWEL No Yes Small Sigmoid Rectum Other (describe) .................................... Length ………….. cm Width ………….. cm Transverse ..………… cm High Intermediate Low High Intermediate Low High Intermediate Low Normal Abnormal If abnormal, enhanced with contrast No Yes Presence of (abnormal) small bowel in pelvis No Yes Bowel thickening? Sigmoid/ rectum No Yes Mesenteric/ antimesenteric No Yes Mucosal/ submucosal No Yes BLADDER No Yes Dome Posterior Anterior Other (describe) .................................... Length ………….. cm Width ………….. cm Transverse .………… cm High Intermediate Low High Intermediate Low High Intermediate Low
Form-07(a)(b)---Medal-study-MRI-Report-v1-7-04-03-2013.docx