Female, 76 years old, with headaches. Brain:Postcontrast imaging only was acquired as a supplement to the recent prior noncontrast brain MRI. No pathologic parenchymal or extra-axial enhancement is observed.Cervical spine:The typical cervical lordosis is straightened which is likely positional. Sagittal alignment is otherwise unremarkable. Vertebral body height and morphology are within normal limits. No pathologic marrow replacement or marrow enhancement is seen.Ill-defined T2 hyperintensity is noted within the spinal cord at the C4-5 level. There is no associated pathologic enhancement and the cord in this region is not particularly expanded. The spinal canal is congenitally slender. No discrete epidural abnormalities are suspected.C2-3: Left facet arthropathy. Minimal posterior disc-osteophyte complex formation. No significant spinal canal stenosis. No significant foraminal narrowing.C3-4: Mild posterior disc-osteophyte complex formation. Mild generalized spinal canal stenosis. Moderate left and mild right foraminal narrowing. C4-5: Left facet arthropathy. Posterior disc-osteophyte complex formation. Mild to moderate generalized spinal canal narrowing. Severe left and moderate right foraminal narrowing.C5-6: Left facet arthropathy. Posterior disc-osteophyte complex formation. Mild generalized spinal canal narrowing. Severe left and mild right foraminal narrowing. C6-7: Bilateral facet arthropathy. Mild posterior disc-osteophyte complex formation. Mild generalized spinal canal narrowing. Moderate bilateral foraminal narrowing. C7-T1: Facet arthropathy. Posterior disc-osteophyte complex formation. No significant spinal canal stenosis. Mild bilateral foraminal narrowing.
1.No enhancing lesions are demonstrated on the postcontrast evaluation of the brain.2.Ill-defined signal abnormality is seen within the spinal cord at the C4-5 level. There is no associated enhancement or evidence of cord expansion. As such, chronic myelomalacia is favored over edema. The etiology for this finding is uncertain, though given that the C4-5 level shows a mild to moderate spinal canal stenosis, this could represent sequelae of chronic degenerative impingement or prior trauma.3.Relatively mild degenerative disc findings are seen. However, as these are superimposed on a congenitally slender canal, canal stenosis ranging from mild to moderate is seen at multiple levels. Variable foraminal narrowing is also noted as above.