Clinical question: Patient with history of metastatic urothelial cancer. Most recent CT shows new lesions to the thoracic spine. Please assess. Signs and symptoms: Metastatic cancer. Pre-and post-enhanced thoracic MRI:Examination demonstrate a focus of marrow signal replacement involving the posterior aspect of T7 vertebrae and left pedicle with enhancement and highly suggestive of a metastatic focus. There is no evidence of extra osseous extension of enhancement into the perispinal space or epidural space. There is also no detectable decreased height of T7 vertebrae to suggest fracture. The alignment of the vertebral column is also within normal. There is no evidence of any additional foci of marrow signal replacement of vertebral column or abnormal enhancement.The signal intensity and caliber of thoracic cord remains within normal limits and with out abnormal enhancement.Mild degenerative changes of spine is detected however without evidence of spinal canal or neural foraminal compromise at any level.The perispinal soft tissues are also within normal limits and without abnormal enhancement.
1.Mixed signal intensity and partially enhancing sclerotic metastatic lesion of T7 vertebrae as detailed. No evidence of compression deformity or extra osseous extension of enhancement and no spinal canal or neural foraminal compromise.2.Unremarkable pre-and post enhanced MRI of thoracic spine otherwise.