 Thoracic spine:Marrow signal abnormality is noted throughout all osseous elements providing MRI evidence for diffuse metastatic disease.Osseous expansion causes left T6/7, bilateral T7/8, and left T8/9, foraminal narrowing.There has been collapse of the T11 vertebral body with retropulsion of fragments 5 mm posteriorly in a right paramedian direction causing slight flattening of the anterior right hemicord, however without cord signal abnormality or compression. Associated osseous expansion results in T10/11 and T11/12 foraminal narrowing bilaterally, worse on the right. Associated soft tissue extends beyond the vertebral body cortices anteriorly from T9 through T12.There are bilateral pleural effusions as demonstrated previously, right much greater than left.Lumbar spine:Marrow signal abnormality is noted throughout all osseous elements providing MRI evidence for diffuse metastatic disease.There has been near complete central collapse of L4, with MRI findings consistent with prior vertebroplasty as better demonstrated on the x-ray dated 4/24/2014. This is associated with approximately 4 mm retropulsion of fragments in the left paramedian direction which results in moderate left lateral recess and neural foraminal stenosis.At L3/4 there is mild bilateral neural foraminal stenosis from diffuse annular disc bulge. Degenerative changes are noted elsewhere in the lumbar spine, however without significant resulting associated stenosis.
1.Marrow signal abnormality is noted throughout the thoracic spine, lumbar spine, and visualized pelvis, providing MRI evidence for diffuse metastatic disease.2.Osseous expansion causes left T6/7, bilateral T7/8, and left T8/9, foraminal narrowing.3.There has been collapse of the T11 vertebral body with retropulsion of fragments 5 mm posteriorly in a right paramedian direction causing slight flattening of the anterior right hemicord, however without cord signal abnormality or compression. Associated osseous expansion results in T10/11 and T11/12 foraminal narrowing bilaterally, worse on the right. Associated soft tissue extends beyond the vertebral body cortices anteriorly from T9 through T12.4.There has been near complete central collapse of L4, with MRI findings consistent with prior vertebroplasty as better demonstrated on the x-ray dated 4/24/2014. This is associated with approximately 4 mm retropulsion of fragments in the left paramedian direction which results in moderate left lateral recess and neural foraminal stenosis.5.At L3/4 there is mild bilateral neural foraminal stenosis from diffuse annular disc bulge.6.There are bilateral pleural effusions as demonstrated previously, right much greater than left.