Male, 54 years old, status post stem cell transplant with progressive a standing muscle weakness, now the level of the diaphragm. Spinal alignment is anatomic. Vertebral body height and morphology are normal. No concerning areas of marrow replacement or marrow edema are seen. The pattern of marrow enhancement is within normal limits.The visualized spinal cord shows normal signal intensity and caliber. On postcontrast images, there is the suggestion of enhancement along some of the cervical nerve roots. The cord itself shows no evidence of pathologic enhancement.C2-3: Facet hypertrophy. Minimal posterior disk osteophyte formation. No significant spinal canal or neuroforaminal stenosis. C3-4: Facet hypertrophy. Minimal posterior disk osteophyte formation. No significant spinal canal or neuroforaminal stenosis.C4-5: Facet hypertrophy. No significant disk degeneration, spinal canal stenosis or neuroforaminal narrowing. C5-6: Facet hypertrophy. Mild posterior disk osteophyte formation. No significant spinal canal or neuroforaminal stenosis.C6-7: Posterior disk osteophyte formation with asymmetric osteophytic ridging and or disk protrusion in the left foraminal and subarticular zones. Minimal displacement of the adjacent spinal cord is seen without cord signal abnormality. The left neural foramen is moderately narrowed. C7-T1: Facet hypertrophy. No significant disk degeneration, spinal canal or neuroforaminal stenosis.
1. Mild scattered enhancement of some of the cervical intradural nerve roots is suspected, though it is possible that this appearance may be due in part to imaging artifact. If further imaging evaluation is warranted, a dedicated pre- and post contrast study of the lumbar spine might be considered as subtle nerve root enhancement is usually more reliably diagnosed among the nerve roots of the cauda equina. If real, the differential for this finding would include post infectious and autoimmune phenomenon, non infectious inflammatory/granulomatous diseases, among numerous other etiologies.2. Relatively mild degenerative disk disease most severely affecting the C6-7 level where asymmetric left-sided osteophytic ridging and/or a disk protrusion results in mild cord deformation. No areas of high-grade spinal canal stenosis are seen.