Clinical question: Evaluate for progression of atrophy and information weight NMO. Signs and symptoms: NMO with paraplegia, worsening weakness. Pre-and post-enhanced cervical MRI:Examination redemonstrates patchy foci of T2 and T2 stir hyperintensity throughout cervical cord and with resultant decreased cord caliber/atrophy (most noticeably at C2 level) without appreciable significant change since prior exam from 2013. Examination however is degraded due to motion artifact which precludes precise comparison. Post-enhanced images also fail to demonstrate any convincing evidence of an abnormal foci cord or leptomeningeal enhancement.There is normal signal intensity and the alignment of the vertebral column and without evidence of spinal canal or neural foraminal compromise or stenosis.Pre-and post-enhanced thoracic MRI:This examination is also mildly compromised due to motion artifact. Within this limitation examination redemonstrates previously known extensive atrophic changes of thoracic cord secondary to NMO. There is a new focus of T2 hyperintensity and with resultant decreased cord caliber anteriorly on the right at T9 -- T10 disk level (axial T2 series 1502 images 18 through 20. There is no convincing evidence of enhancement of this new however chronic lesion.Additionally a new focus of T2 hyperintensity in the posterior left lateral aspect of the cord at the level of T10 lower endplate (axial T2 series 1502 image 15) without detectable change in the caliber of the cord. There is enhancement or an artifact of this finding on sagittal T1 post enhanced series 1801 image 8. The enhancement however cannot be confirmed on axial post enhanced series.The signal intensity and alignment of the tubercle is within normal and without detectable spinal canal or neural foraminal compromise/stenosis.
1.Suboptimal pre-and post enhanced MRI of cervical spine demonstrate atrophic changes of cervical cord more noticeable at C2 level and without convincing evidence of any new lesion or detectable abnormal enhancement.2.Pre-and post enhanced MRI of thoracic spine demonstrate extensive atrophic changes of the thoracic cord secondary to patient's known NMO. New since prior exam is a small focus of T2 hyperintensity and decreased cord caliber at T9 -- T10 disk level without detectable abnormal enhancement. Additional focus of T2 hyperintensity in the posterior left lateral aspect of the cord at the level of inferior endplate of T10 without change in the caliber of the cord or definitive evidence of enhancement as detailed.