45-year-old female with metastatic breast cancer and weakness, rule out cord compression Vertebral body heights are intact. Nonenhancing foci of increased signal within the L1 vertebral body likely represents focal fat. No osseous enhancing lesions. Alignment is anatomic. Normal signal within the distal cord, which ends at L1. Mild multilevel facet arthropathy.Multiple enhancing intrathecal nodules are present, the largest at L1-L2 measuring 1.5 x 1.6 cm (1001/27), likely representing metastases. This lesion causes moderate to severe central canal narrowing, compressing the cauda equina and extending into the right lateral recess of L3-L4 along the nerve root. Several additional smaller nodules are also evident along the conus and nerve roots of the cauda equina. In addition, there is diffuse mild thickening and enhancement cauda equina, indicating diffuse leptomeningeal spread of tumor.T12-L1: No central or neuroforaminal stenosis.L1-L2: No central or neuroforaminal stenosis. L2-L3: Large aforementioned metastatic deposit in the right lateral recess causing moderate to severe central canal narrowing. L3-L4: Large enhancing lesion extends inferiorly into the L3-L4 nerve root on the right. No central canal or neural foramina stenosis.L4-L5: Small enhancing lesion in the left lateral recess along L4. No central or neuroforaminal stenosis.L5-S1: No central or neuroforaminal stenosis.
Extensive intrathecal metastatic disease with gross nodules, including a 1.6-cm nodule at L1-L2 causing moderate to severe compression of the canal, as well as a finer leptomeningeal pattern disease.