 There is abnormal T2 hyperintensity at the dorsal paramedian cord at the C7-T1 level extending to the T1-T2 level. There is associated abnormal enhancement. The signal abnormality appears to be present on prior cervical MRI study. Dorsal paramedian cord T2 hyperintensity is also seen from the lower T3 to the lower T4 level with minimal enhancement. No signal abnormality is seen in the remainder of the thoracic cord.The thoracic spine is in normal alignment, with a normal thoracic kyphosis. The vertebral body heights are well maintained. No worrisome focal marrow signal abnormality is appreciated. There is a small left central disc extrusion at the T6-T7 level with minimal cranial extension abutting the ventral aspect of the cord. There is otherwise no significant disk bulge, herniation, spinal canal or foraminal stenosis within the thoracic spine.There are multiple cysts in the bilateral kidneys, some of which demonstrate T1 hyperintensity compatible with proteinaceous or hemorrhagic cysts.1. LUMBAR SPINE
T2 signal abnormality with enhancement in the cervical cord is partially imaged and appears to extend in an interrupted fashion into the dorsal aspect of the upper thoracic cord to the T1-T2 level. There is additional, but similar signal abnormality extending from the T3 to T4 levels. Given the multifocal dorsal distribution, differentials include metabolic processes such as B12 deficiency, inflammatory processes such as neurosarcoid, infection such as varicella zoster or HIV, demyelinating lesion such as NMO, and less likely neoplasm.