70 year-old female with history of right lower extremity weakness. There is extensive bone marrow signal abnormality within all elements of the imaged spine and pelvis demonstrating low T1/high T2 signal and irregular enhancement after contrast administration. There are compression deformities of T12 and L5 and to a lesser extent L4 with associated increased STIR signal abnormality suggesting an acute to subacute process. There is slight retropulsion of T12, however the spinal canal and underlying cord are intact. Mild soft tissue thickening and enhancement within the ventral epidural space at L5-S1 may represent mild epidural tumor spread. There are diffuse enhancing lesions within the liver likely representing additional metastatic deposits.Multilevel degenerative changes are seen, as described below:T11-12: There is mild neuroforaminal narrowing on the right likely secondary to tumor involvement of the pedicle. No significant disc disease.T12-L1: There is mild neuroforaminal narrowing on the right likely secondary to tumor involvement of the pedicle. No significant disc disease.L1-2: No significant disc disease. The neuroforamina are patent.L2-3: There is mild annular disc bulge and facet hypertrophy. There is no significant spinal canal or neuroforaminal narrowing.L3-4: There is mild annular disc bulge and facet hypertrophy. A Schmorl's node is present within the superior endplate of L4. The spinal canal and neuroforamina are patent. L4-5: No significant disc disease. There is mild right greater than left facet hypertrophy. Mild neuroforaminal narrowing bilaterally. The spinal canal is patent.L5-S1: There is mild facet hypertrophy and annular disc bulge. There is mild neuroforaminal narrowing on the right. The spinal canal is patent.
1.Diffuse osseous metastatic disease with compression deformities at T12 and L5, and to a lesser extent, L4. There is mild retropulsion at T12 without significant spinal canal stenosis.2.Ventral epidural metastatic disease is suspected at L5-S1. There is no evidence of intrathecal metastatic disease.3.Diffuse liver metastases for which dedicated imaging is recommended.4.Relatively mild degenerative disc disease as above.