66 year old male with lower extremity weakness. Rule out cord compression. MRI T-Spine: Note the contrast portion of the exam is motion degraded. The thoracic spine is in normal alignment. There is an expansile enhancing tumor involving the vertebral body of T5 with prominent posterior extension into the epidural space. This causes severe narrowing of the spinal canal with compression of the spinal cord and cord signal abnormality. There is up to 50% loss of height of the T5 vertebral body. The bilateral T5-6 neural foramina are narrowed secondary to tumor. There is thin superior and inferior extension of tumor within the anterior epidural space to the levels above and below the T5 tumor. There is thickening and enhancement involving the anterior paraspinal soft tissues at T5. Findings appear similar to those evident on prior CT.MRI Cord Compression Protocol.There is severe spinal cord compression in the thoracic spine T5 level as described above. The vertebral bodies within the cervical and lumbar spine are appropriate in the overall alignment and height. Multi-level degenerative changes involve the cervical spine with reversal of the lordotic curvature but no evidence of cord compression or visible cord signal abnormality. There are also multilevel degenerative changes involving the lumbar spine. Although there is no significant central spinal canal stenosis in the lumbar spine, there is a disc protrusion at L4-5 which causes left lateral recess and foraminal stenosis. The cervical and lumbar spinal cord have normal signal characteristics and overall morphology.
1.Expansile enhancing tumor involving the vertebral body of T5 with prominent posterior extension into the epidural space with severe spinal cord compression. 2.The T5 vertebral body tumor also contributes to bilateral T5-6 foraminal narrowing. 3.Loss of height of the T5 vertebral body of up to 50% may reflect a pathologic fracture.4.Evaluation of the cervical and lumbar spine was performed specifically for exclusion of cord compression only and does not exclude more subtle lesions such as intrinsic cord abnormalities. No cord compression is identified in the cervical or lumbar spine. Additional degenerative changes are as described above at these levels which and evaluated only on sagittal imaging.