 Please note lack of contrast limits evaluation, especially for leptomeningeal metastatic disease. On the sagittal counter series, note is made of extensive, expansile T2 signal involving the brainstem, better characterized on MRI brain dated 1/30/2016.Thoracic spine:No discrete mass within the thoracic spinal canal is appreciated. Apparent region of low T1 signal in the dorsal epidural region of the thoracic spine is favored to represent artifact related to motion degradation. The alignment of the thoracic spine is anatomic. The vertebral body heights and intervertebral disc spaces are preserved. There is no abnormal bone marrow signal. There is no evidence of spinal canal stenosis or significant neural foraminal narrowing. The cord is normal in signal and caliber. There are multiple T2 hyperintense lesions involving several neural foramina, intercostal nerves, and posterior subcutaneous soft tissues most consistent with neurofibromas. No intraspinal extension. Lumbar spine:The alignment of the lumbar spine is anatomic. The vertebral body heights and intervertebral disc spaces are preserved. There is no abnormal bone marrow signal. There is no evidence of spinal canal stenosis or significant neural foraminal narrowing. The cord is normal in signal and caliber. There are multiple T2 hyperintense lesions involving the bilateral neural foramina and posterior subcutaneous tissues which are most consistent with neurofibromas. No intraspinal extension. Neurofibromas involving the lumbosacral plexus are also noted.
1. Please note patient could not tolerate the study including the post contrast sequences. Evaluation for leptomeningeal metastatic disease is severely limited by lack of intravenous contrast.2. No abnormal cord signal or intraspinal mass within the limits on noncontrast study.3. Numerous T2 hyperintense lesions involving several neural foramina in the thoracolumbar spine, intercostal spaces, and the posterior subcutaneous tissues compatible with multiple neurofibromas. 