Clinical question: NSCLC; new lesions throughout spine. Signs and Symptoms: NSCLC; new lesions throughout spine Pre and post enhanced thoracic MRI:Examination demonstrates diffuse intraosseous enhancing metastatic lesions of the thoracic spine primarily involving vertebral bodies and to a lesser degree of the posterior elements. There is no evidence of fracture or malalignment.There is no detectable extraosseous spread of tumor into the spinal canal or neural foraminal and no evidence of spinal canal or neural foraminal compromise at any level.There is no detectable signal abnormality of the cord or abnormal enhancement.Incidental note is made of right-sided pleural effusion measuring maximum of 14 mm in thickness.Pre and post enhancement lumbar MRI:This examination also demonstrate fairly extensive enhancing osseous metastatic lesions involving nearly all visualized bony structures of the region of the exam.There is no evidence of fracture or malalignment. There is a large Schmorl's node along the superior endplate of L2.There is no evidence of extraosseous spread of tumor into the spinal canal/epidural space or the neural foramina.Normal signal intensity of the lower most visualized thoracic cord, conus and cauda equina without detectable abnormal enhancement.
1.Examination of thoracic spine demonstrate diffuse enhancing osseous metastatic lesions without detectable extraosseous spread of tumor. No fracture or malalignment. No spinal stenosis or neural foraminal compromise. Normal signal intensity and caliber of thoracic cord and without abnormal enhancement.2.Examination of the lumbosacral spine demonstrate diffuse enhancing osseous metastatic lesions without evidence of fracture or malalignment or extraosseous spread of tumor. Normal signal intensity of conus and cauda equina without abnormal enhancement. No spinal stenosis at any level.