Clinical question: Rule out cord compression. Signs and symptoms: T7 lesion, back pain. Complete spine MRI:Examination is performed utilizing cord compression protocol which is a limited exam.Within this limitation examination demonstrates postoperative changes of posterior fusion and placement of transpedicular screws extending from T4 inferiorly to T11. Although images are degraded due to metallic hardware artifact there is no definitive evidence of cord compression however this possibility cannot be entirely excluded due to limited visibility of the cord at the level of surgery. There is evidence of marrow signal changes of T6 and T7 with suggestion of subtle extraosseous extension of signal abnormality which is concerning for tumor. Correlate with history and comparison made prior exams if available. Beyond the region of surgery there is normal signal intensity and caliber of the cord and without mass effect.Advanced degenerative changes at L4-L5 and L5-S1 levels are noted.Follow-up with pre- and post enhanced dedicated imaging is recommended.
1.There are postoperative changes of posterior fusion with multilevel transpedicular screws placement from T4 through T8 and with highly suspected mass of T6 and T7 with extraosseous spread of tumor.2.Within the limitation of metallic hardware artifact there is no definitive detectable mass effect on the cord however this possibility cannot be entirely excluded due to limitation of the exam.3.Beyond the region of surgery no evidence of mass effect on the cord is detected.4.Advanced degenerative disc disease at L4-L5 and L5-S1 levels are noted.5.Follow-up imaging for better assessment of tumor and cord compression of thoracic spine is recommended.6.If there are outside studies available and provided to radiology department and addendum to this report will be submitted after comparison.