Clinical question: Rule out mass, cauda equina. Signs and symptoms: Left sciatica, urinary incontinence, concern for lumbosacral compression. Nonenhanced lumbar MRI:There is normal anatomical alignment the vertebral column.There is normal signal intensity and height and morphology of vertebral bodies and posterior elements.There is no distal spinal canal compromise or stenosis at any level.There is advanced degenerative changes at L4 -- L5 and L5 -- S1 levels. Significant left and moderate right neural foraminal compromise at L5 -- S1 level is detected. Moderate right and mild left neural foraminal compromise at L4 -- right is present.Incidental note is made of multiple superficially located well demarcated cysts of the kidneys.Nonenhanced total spine MRI:Examination is performed utilizing cord compression protocol and without axial series.The signal intensity in the alignment of vertebral column is unremarkable.The signal intensity and caliber of the cervical and thoracic cord is within normal.There is no evidence of a spinal stenosis or compromise at any level. Note however should be made that this examination contains no axial series.Degenerative changes of the cervical spine in particular at C5 -- 6 results in mild central spinal stenosis.
1.Nonenhanced total spine MRI utilizing cord compression protocol demonstrate mild central spinal stenosis at C5-C6 and unremarkable otherwise.2.Nonenhanced lumbar MRI demonstrate normal signal intensity and alignment of the vertebral column without central spinal stenosis. There is degenerative changes at L4 -- L5 and L5 -- S1 levels with resultant moderate to severe neural foraminal compromise at the L4 -- L5 as detailed.