Backache, unspecified [724.5] / Malignant neoplasm of breast (female), unspecified site [174.9], Reason for Study: ^Reason: met breast CA, urinary retention, eval for leptomeningeal spread. Also include upper sacrum given known met there. History: met br For the purpose of this dictation, the lowest visualized intervertebral disc space is labeled L5-S1. Again demonstrated multifocal metastatic lesions including right sacral ala (the largest one, 24mm x 25.2mm x 28mm), left sacral ala, left ilium and right ilium lesions. There is also subcutaneous nodule on the left side at the level of obturator foramen. On the L-spine, there are small metastatic lesions on the L4 and L5 vertebral bodies.There is normal lumbar lordosis. The spine alignment is anatomic. The vertebral body height is preserved. The signal of the visualized cord is normal. No evidence of spinal canal/neural foraminal narrowing. The conus medullaris terminates at the L2 level.There is no evidence of abnormal enhancement, cord compression or mass. There are multiple non enhancing low signal intensity lesions on post gadolinium T1 weighted images, no interval change comparing to Jun 20 2015 abdominal CT scan.Degenerative changes are specified by the intervertebral level as follows: T12-L1: no neuroforaminal narrowing or spinal stenosis. L1-L2: no neuroforaminal narrowing or spinal stenosis. L2-L3: no neuroforaminal narrowing or spinal stenosis. L3-L4: no neuroforaminal narrowing or spinal stenosis. L4-L5: minimal bulging of disc, no neuroforaminal narrowing or spinal stenosis. L5-S1: no neuroforaminal narrowing or spinal stenosis.
1. Multiple various sized vertebral bodies, sacrum, bilateral iliac and subcutaneous metastatic nodules as described above.2. No evidence of spinal canal stenosis or abnormal enhancement indicating spinal canal or spinal cord involvement. 