Prostate cancer with bone metastasis. Evaluate for disease progression.. The patient could not tolerate doing the thoracolumbar examination and only the thoracic spine was scanned. There is anterior and posterior fusion of C3-C4. T1-hypointense signal at C5-C6 vertebral bodies and pedicles is incompletely assessed. In addition, the lesion with a central compression fracture involving the L1 vertebral body is not fully characterized, but there is apparently increased retropulsion. There is a rightward convex curvature that is mild and broad-based. The T1 and T2 hyperintense lesions involving the C7, T5, T7, T8, and T10 vertebral bodies are unchanged, most compatible with hemangiomas. Focal T1-hypointense, T2 hyperintense, contrast-enhancing marrow abnormality just subjacent to the focally deficient inferior endplate of T8 vertebral body is most likely a Schmorl node. A smaller similar one is present at T9 also along the inferior endplate. There is subtle increase in T2 signal and decrease in T1 signal along the anterior aspect of T11 and T12 vertebral bodies with associated mild contrast enhancement. This was present previously and may be degenerative in nature. The vertebral body heights are preserved. The minimal T2-T3 disc-osteophyte complex indenting the thecal sac but no causing significant spinal canal or foraminal narrowing has not changed. Otherwise, the disc space heights are preserved. There are prominent midthoracic anterior spinal osteophytes, which are predominately right-sided and may reflect diffuse idiopathic skeletal hyperostosis. The spinal cord displays normal signal and morphology. There is interval increase in size of a left retroperitoneal nodule, which may represent a lymph node metastases, although this is incompletely characterized.
1.The patient was unable to complete the examination and only the thoracic spine was imaged.2.Minimal, focal contrast enhancement along the inferior aspect of T8 and T9 vertebral bodies is probably related to Schmorl nodes. Multilevel hemangiomas are unchanged. There is no suspicious thoracic spine lesion, otherwise.3.The pathologic compression fracture involving the L1 vertebral body is not diagnostically imaged, but there is increased retropulsion.4.Interval increase in size of a left retroperitoneal nodule, which may represent a lymph node metastases, although this is incompletely characterized.