 Total spine findings: The cervical and thoracic spinal cord is enlarged with intrinsic abnormal T2 hyperintensity predominantly noted involving bilateral dorsal columns, although also involving the bilateral lateral-most aspects of the cord in skip-like fashion, extending from C1 through T12. There is no associated abnormal enhancement (the appearance of enhancement at T1 is felt to be secondary to artifact).Cervical spine:Alignment is normal. The marrow signal is benign. The cervicomedullary junction is normal. The cerebellar tonsils are in normal position. The visualized paraspinal contents are unremarkable.C1/2: UnremarkableC2/3: UnremarkableC3/4: UnremarkableC4/5: UnremarkableC5/6: UnremarkableC6/7: UnremarkableC7/T1: UnremarkableThoracic spine:There is a smooth, physiologic thoracic kyphotic curve. The vertebral body heights and disc spaces are maintained. Marrow signal intensity is benign throughout. There are no masses. There is no abnormal enhancement.T1/2 demonstrates no significant disc bulge or cord encroachment.T2/3 demonstrates no significant disc bulge or cord encroachment. T3/4 demonstrates no significant disc bulge or cord encroachment. T4/5 demonstrates no significant disc bulge or cord encroachment. T5/6 demonstrates no significant disc bulge or cord encroachment.T6/7 demonstrates no significant disc bulge or cord encroachment. T7/8 demonstrates no significant disc bulge or cord encroachment. T8/9 demonstrates a tiny anterior disc protrusion without significant resulting mass effect or stenosis.T9/10 demonstrates no significant disc bulge or cord encroachment.T10/11 demonstrates no significant disc bulge or cord encroachment. T11/12 demonstrates no significant disc bulge or cord encroachment. T12/L1 demonstrates no significant disc bulge or cord encroachment. Lumbar spine:Alignment is anatomic. There are no fractures or subluxations. The marrow signal is benign. The visualized intra-abdominal and paraspinal contents are unremarkable. There is no abnormal enhancement.T12/L1: UnremarkableL1/2: UnremarkableL2/3: UnremarkableL3/4: UnremarkableL4/5: UnremarkableL5/S1: Unremarkable
The cervical and thoracic spinal cord is enlarged with intrinsic abnormal T2 hyperintensity predominantly noted involving bilateral dorsal columns, although also involving the bilateral lateral-most aspects of the cord in skip-like fashion, extending from C1 through T12. There is no associated abnormal enhancement. This constellation of findings, in context of the clinical history, is most consistent with subacute combined degeneration. The differential diagnosis would less likely include demyelination or transverse myelitis. Given lesional appearance, neoplasm is felt to be unlikely.