Cervical lesion, 6 month follow-up Again seen is T1 shortening involving the C1-C3 vertebral bodies consistent with prior radiation therapy. There is been slight increase in STIR hyperintensity and enhancement involving the inferior aspect of the odontoid process. Again seen are multiple abnormal foci of enhancement and T2/STIR hyperintensity involving the C3, C4, C5, C6, C7, T1, T2, and T2 vertebral levels consistent with known metastatic disease. Compared to prior, some of these lesions appear minimally more confluent, which may also be in part related to differences in technique. However no major change is appreciated. A C7 transverse process lesion measuring approximately 15 x 14 mm, previously 13 x 11 mm.Vertebral body heights and alignment are grossly unchanged including straightening and minimal anterolisthesis at the C7-T1 level similar to prior. There remains at least moderate spinal canal stenosis at the C3-C4 level related to prominent disc osteophyte complex and ligamentum flavum thickening and not significantly changed. Minimal enhancement along the anterior dura at this level is likely degenerative in etiology. There is T2 hyperintensity and volume loss consistent with myelomalacia at the C3-C4 level also unchanged. Minimal spinal canal narrowing at the C7-T1 level related to disc bulge also appears similar.No evidence of epidural tumor. No abnormal leptomeningeal or intramedullary enhancement.
1. Compared to 11/19/2015, there is stable to minimal worsening of diffuse metastatic disease involving the cervical and visualized upper thoracic spine. No evidence of pathologic fracture or epidural tumor.2. Moderate spinal canal stenosis at the C3-C4 level on a degenerative basis with cord myelomalacia is unchanged.