Hepatitis C virus infection and liver cirrhosis. Hepatocellular carcinoma. Back pain. Cervical Spine:Cervicothoracic and craniocervical articulations are anatomic. Alignment throughout the remainder of the cervical spine is notable for minimal reversal of the lordosis which may reflect patient position or muscle spasm. Vertebral body heights are preserved. Marrow signal shows no suspicious focality. The spinal cord shows normal morphology and signal. Following contrast injection, there is no abnormal spinal cord or the image of contrast enhancement.C2-C3: No spinal canal or foraminal stenosis.C3-C4: Shallow disc-osteophyte complex. No spinal canal or foraminal stenosis.C4-C5: Disc-osteophyte complex indents the anterior aspect of thecal sac but with preservation of the CSF surrounding the cord. There is mild, right more than left, uncovertebral preoperative change causing minimal, probably insignificant right foraminal stenosis.C5-C6: Disc-osteophyte complex also causes small anterior indentation of the thecal sac without significant narrowing of the spinal canal. Uncovertebral and facet proliferative changes cause mild bilateral foraminal narrowing.C6-C7: No spinal canal or foraminal stenosis.C7-T1: No spinal canal or foraminal stenosis.Thoracic Spine:Alignment of the thoracic spine is normal. The vertebral bodies are present in height. Marrow signal is notable for fat signal intensity in the T7 vertebral body, most compatible with a hemangioma. The thoracic spinal cord shows normal morphology and signal characteristics.T7-T8 and T8-T9: Degenerative dens as more pronounced on the left causing mild left anterolateral indentation of the thecal sac but no significant narrowing.There is no significant degenerative disease or spinal canal/foraminal stenosis at the other levels.There is dependent atelectasis in the lungs which is minimal.Lumbar Spine:Alignment is notable for straightening which may reflect patient positioning muscle spasm. Vertebral body heights are preserved. Marrow signal shows no suspicious focality. The lumbar spinal canal is narrowed by congenitally short pedicles and superimposed degenerative disease as described below. This is most pronounced at L4-5. The conus medullaris shows normal morphology and signal characteristics. T12-L1 and L1-L2: No significant degenerative disease. No spinal canal or foraminal stenosis.L2-L3: Disc bulge is associated with a small right paracentral extrusion that migrates cranially for a short distance. The disc mildly to moderately narrows the right subarticular recess and spinal canal. There is minimal right foraminal narrowing.L3-L4: Disc bulge is associated with bilateral subarticular recess narrowing and mild bilateral foraminal narrowing. Ligamenta flava thickening contributes to mild to moderate central canal narrowing.L4-L5: Disc bulge along with severe ligamenta flava thickening result in severe central spinal canal narrowing. There is also bilateral mild foraminal narrowing of the disc and mild facet proliferative change.L5-S1: No significant degenerative disease. No spinal canal or foraminal stenosis.There is free fluid in the pelvis. Small T2 hypointense focus in the ventral upper uterine body/fundus may represent an incidental leiomyoma.
1.Lumbar spondylosis is most pronounced at the L4-L5 where there is severe central spinal canal narrowing (caused by the disc, congenitally short pedicles as well as ligamenta flava thickening).2.Mild cervical and thoracic spondylosis without significant narrowings.3.There is no suspicious osseous lesion to indicate metastasis.4.Fluid in the peritoneal cavity may related to liver dysfunction. Other findings are described above.