 Cervical: There is evidence of osseous metastatic disease in the cervical spine with more diffuse marrow infiltration noted involving the C4 vertebral body extending into the posterior elements on the right. This lesion is new since prior MRI cervical spine from 2/20/2014. No evidence of epidural tumor in the cervical spine. No compression fractures in the cervical spine. Vertebral body heights and alignment are maintained. No cord signal abnormality. There are mild degenerative changes in the cervical spine including multilevel facet arthropathy. No significant spinal canal or neural foraminal stenosis is appreciated although motion degradation slightly limits evaluation. Thoracic: There is evidence of multifocal osseous metastatic disease. There is a small osseous lesion involving the the anterior inferior T1 vertebral body. There is a larger lesion involving the dorsal aspect of the T2 vertebral body. Small scattered lesions are seen throughout the thoracic spine more inferiorly as well with larger lesions involving the T8 and T9 vertebral bodies. Posterior element involvement is noted at multiple levels as well. No new compression fractures are demonstrated. Minimal irregularity/compression deformity involving the superior T3 endplate and mild wedging of the T6 and T7 vertebral bodies are unchanged.Compared to 2/20/2014, T8 and T9 lesions appear similar. Small T1 lesion is new/larger. There are multiple small new lesions involving the T2 T3, T4, T5, and T6 levels with posterior element involvement at multiple levels. There is extensive enhancing epidural tumor which extends from the C7-T1 level to the T3-T4 level with significant narrowing of the spinal canal from T1-T2 through the T2-T3 level and deformity of the cord. No cord signal abnormality is appreciated. These findings are new since 2/20/2014.Prominence of the epidural fat in the thoracic spine is again noted narrows the thoracic spinal canal more diffusely. No high-grade stenosis in the thoracic spine at additional levels however is demonstrated. There is narrowing of the left T2-3 neural foramen as well as the right T2-T3 and T9-T10 neural foramina. Otherwise no significant foraminal stenosis is appreciated. Prominent right posterior medial 9th and 10th rib involvement is again noted. Right lower lobe consolidation and small right pleural effusion noted. Please refer to prior chest CT.
1. Compared to prior cervical and thoracic spine MRI from 2/20/2014, there is progression of metastatic disease with new C4 lesion as well as multiple new upper thoracic lesions.2. There is interval development of extensive epidural tumor which extends from the C7-T1 level to the T3-T4 level with significant narrowing of the spinal canal from T1-T2 through the T2-T3 level with deformity of the cord. No cord signal abnormality is appreciated. 3. Subtle irregularity involving the superior endplate of the T3 vertebral body and mild wedging of the T6 and T7 vertebral bodies are similar to prior. No new pathologic compression fractures.