52-year-old male, evaluate lesion in cervical spine. Evaluate for tumor in cervical spine.IMAGE ACQUISITION: Contrast-enhanced CT of the cervical spine was performed after the administration of 80 mL of Omnipaque 350 at 2.5 ml/sec. Again seen is abnormal sclerosis of the left occipital condyle, left lateral mass of C1, posterior arch of C1 with associated collapse. This was previously described on the prior CT and its overall appearance of is unchanged. Associated soft tissue and marrow abnormalities are better appreciated on the recent MRI.Also seen is a subtle focus of cortical erosion along the medial aspect of the right occipital condyle which was present retrospectively on the prior CT. This lies just lateral to a fluid signal collection much better seen by prior MR technique.The vertebral arteries are patent.There is no evidence of fracture or significant degenerative disease in the cervical spine.A new air-fluid level is present in the sphenoid sinus.
1. Abnormal sclerotic change in the left occipital condyle and left C1 vertebra which has not significantly changed from the prior study. There is also subtle cortical erosion along the medial aspect of the right occipital condyle which was also present retrospectively on the prior CT. These findings in addition to the abnormalities seen on the recent MRI are suspicious for neoplastic disease versus osteoradionecrosis. Infection is considered less likely.2. New air-fluid level in the sphenoid sinus.