altered mental status, unspecified [R41.82] / Disorder of brain, unspecified [G93.9] / Vascular headache, not elsewhere classified [G44.1], Reason for Study: ^Reason: poorly differentiated urothelial bladder cancer presented with AMS , R/o leptomeningeal spread. This is a limited examination with post contrast examinations only were performed.There is about 3cm sized heterogeneously enhancing pre sacral mass lesion with central non enhancing portion which may represent metastatic lesion.There is no evidence of abnormal enhancement on spinal cord, thecal sac or vertebral bodies throughout. Lower lying spinal cord is again demonstrated associated with spina bifida of sacrum. There is normal cervical lordosis. The cranial-cervical junction is normal. There is normal thoracic kyphosis and lumbar lordosis. The spine alignment is anatomic. The vertebral body height is preserved. The cord signal is normal. The conus medullaris terminates at the level of L5S1. There is evidence of tethered cord or spinal dysraphism. There is no evidence of abnormal enhancement, cord compression or mass.
1. About 3cm sized inhomogeneously enhancing right side pelvic mass likely represent metastatic lesion.2. Tethered cord with spina bifida of sacrum.3. No evidence of abnormal enhancement on spinal cord, thecal sac or vertebral body.