82-year-old female with bilateral lower extremity paresthesias, evaluate for cord compression. Right apical mass Please note that exam was terminated due to patient discomfort.There is a paravertebral soft tissue lesion which is hyperintense on STIR images and hypointense on T1 images along the left pleura and neural foramina extending from T6 to T8 with invasion into the spinal canal. The CSF is effaced at these levels and there appears to be mass-effect on the cord. Signal within the cord at these levels is difficult to evaluate and subtle signal abnormalities cannot be excluded. Signal within the remainder of the cord is normal.Multilevel degenerative changes throughout the spine with degenerative marrow signal abnormalities. There is a chronic appearing compression fracture at L1 with endplate deformities at T11 and T12. Mild scoliosis, otherwise alignment is anatomic. Focal areas of increased STIR signal within the T2 and T4 vertebral bodies are suspicious for metastatic foci. There are multilevel disk bulges within the lower lumbar spine, most severe at L4-L5, producing narrowing of the central canal which is incompletely evaluated.Right adnexal lesion with cystic components is partially visualized measuring up to 6.4 cm (501/16). Right apical mass is partially visualized and better evaluated on prior CT.
1.Left paravertebral lesion from T6 to T8 with extension into the spinal canal through the neural foramina producing compression of the spinal cord. Exam was terminated due to patient discomfort, however dedicated thoracic spine MRI is recommended for further evaluation.2.Lesions within the T2 and T4 vertebral bodies are suspicious for metastatic foci.3.Known right apical mass and left adnexal lesion are partially visualized.4.Multi-level degenerative changes including a mild compression fracture at L1.5.Findings suggest spinal stenosis at L4-5. Please correlate with clinical history.Findings discussed with admitting team, Dr.Kallepalli, at 9:45 a.m. on 1/20/2015.