Metastatic thyroid cancer with multiple bone mets, PET 6/29/15 with possible T12 thecal lesion Cervical spine:The cervical vertebral bodies are appropriate in overall alignment and height. A low T1 and high T2 signal is seen in C4 vertebral body, which is nonenhancing.At C2-3 there is no significant compromise to the spinal canal or neural foramina.At C3-4 there is no significant compromise to the spinal canal or neural foramina.At C4-5 there is mild disc bulge and hypertrophy of the posterior ligament.At C5-6 there is mild bulge with no significant compromise to the spinal canal or neural foramina.At C6-7 there is mild disc bulge with no significant compromise to the spinal canal or neural foramina.At C7-T1 there is no significant compromise to the spinal canal or neural foramina.The vertebral artery flow voids appear to be intact.MRI thoracic spine:There are 11 rib bearing vertebrae and T12 hypoplastic rib in the right side. There are 4-type lumbar vertebrae present.The thoracic vertebral bodies are appropriate in the overall alignment and height. The thoracic spinal cord has normal signal characteristics and overall morphology. There is no compromise of thoracic spinal canal or exiting nerve roots. Lumbar spine:There are 11 rib bearing vertebrae and T12 hypoplastic rib in the right side. There are 4-type lumbar vertebrae present. There is T2 and STIR increased signal in the anterior inferior aspect of L2 and in the anterior superior aspect of L3.At L4-S1 there is loss of disc space height, disc desiccation and a diffuse disc bulge the fat surrounding the nerve roots at the lateral recess bilaterally is only partially effaced. The fat surrounding the exiting nerve roots within the neural foramina is effaced on the left side but not effaced on the right side.At L3-4 there is loss of disc space height and disc desiccation associated with the a disc bulge. There is mild narrowing of the neural foramina bilaterally. The fat surrounding the exiting nerve roots within the neural foramina is not effaced. There is only partial effacement of the fat at the lateral recesses bilaterally at this level.At L2-3 there is no significant compromise to the spinal canal or neural foramina. There are some endplate reactive changes present at this level associated with some loss of disc space height and disc desiccation.At L1-2 there is no significant compromise to spinal canal or neural foramina. There is mild disc bulge.At T12-L1 there is no significant compromise to spinal canal or neural foramina.
1.The lesion suspected to be present within the spinal canal at the T12 level is suggested on the the PET CT scan report from 6/29/2015 is not identified on the current exam.2.Please note that there are 11 rib-bearing vertebrae present and a hypoplastic rib on the right sided T12. There are only 4 nonrib-bearing lumbar vertebrae present. This affects enumeration of the thoracic and lumbar vertebrae.3.There is encroachment of the left-sided exiting nerve root at L4-S1 due to disc material which would affect the left L4 nerve root.