 There is redemonstration of a marrow replacing lesion in the right posterior T6 vertebral body extending into the right pedicle, transverse process, and lamina. It appears lower in signal on T1 indicating progressive sclerosis. There is also involvement of the superior and inferior articulating processes as well the pars interarticularis. There is increased anterior extent of the posterior body component of the marrow signal abnormality as seen on 6/25-27, corresponding to an area of subtle ground glass opacity on CT. There is slightly greater conspicuity of confluent enhancement than on the prior exam on the fat saturated postcontrast images. There is no definite epidural extension. There is surrounding mild STIR hyperintensity.At the T7 level, there is additional abnormal marrow signal in the midline posterior elements and along the right lamina with minimal extension along the right posterior pedicle which demonstrates STIR hyperintensity and enhancement on the current exam. This is new since the previous MRI but is consistent with a hypermetabolic lesion on PET/CT.There remains ill-defined somewhat linear opacity in the right lower lobe near the T6 level, which appears slightly decreased in confluence since the previous MRI.The thoracic spine is in normal alignment, with a normal thoracic kyphosis. The vertebral body and disk heights are well-maintained. The spinal cord is of normal caliber and signal. There is no pathological enhancement.There is no significant disk bulge, herniation, spinal canal or foraminal stenosis within the thoracic spine.Incidental note is again made of a heterogeneous oval left thyroid lobe lesion.
1. Slight progression of the anterior margin of the right T6 vertebral body metastatic lesion.2. Interval development since prior MRI of right T7 posterior element metastatic lesion corresponding to hypermetabolic lesion on PET scan.3. Redemonstration of linear opacity in the right lung which may represent an area of scarring.4. Grossly stable heterogeneous left thyroid lesion. Correlation with thyroid function tests is recommended and thyroid ultrasound may be obtained as clinically indicated.