51-year-old woman, evaluate for progression of meningioma and cervical or lumbar cord or nerve root compression. BRAIN: This examination is mildly limited by patient motion. A right parietal extra-axial mass is stable from the exam in 2011 and there is no significant surrounding mass effect or edema. There is no signal abnormality on the diffusion-weighted images to suggest infarct. Susceptibility weighted images are normal without evidence of hemorrhage. There are a few small, scattered areas of subcortical white matter hyperintensity on FLAIR images suggestive of small vessel ischemic disease. The ventricles and cisterns are normal in size and configuration. There is a partially empty sella. The orbits are unremarkable. Flow voids of the major intracranial vasculature appear normal.CERVICAL SPINE: This examination is mildly limited by patient motion. There is narrowing of the inferior endplate of T7 and superior endplate of T1 in the AP dimension. Additionally, there is posterior scalloping deformity from C7 to T1. The intervertebral disc space is preserved, but these findings are highly suggestive of congenital fusion. There is degenerative disc disease at C6/C7 with a new shallow protrusion, just to the left of midline. There is mild effacement of the subarachnoid space anterior to the cord with mild flattening of the cervical cord, left greater than right, otherwise the cord signal remains normal. There is minimal neural foraminal stenosis at C6/C7. There is loss of normal cervical lordosis. Vertebral body heights are preserved. The bone marrow signal is benign. The cervicomedullary junction is normal. The cerebellar tonsils and visualized portion of the posterior fossa are unremarkable. The visualized paraspinal structures are normal.LUMBAR SPINE: Five lumbar type vertebral bodies are presumed to be present. Vertebral body heights are within normal limits. There is slight exaggeration of the normal lumbar lordosis. The bone marrow signal is benign. The conus medullaris is normal in position. The paraspinal soft tissues are within normal limits.degenerative changes are seen, as described below:L1-L2: No significant disc disease. No spinal canal or neural foraminal stenosis.L2-L3: No significant disc disease. No spinal canal or neural foraminal stenosis.L3-L4: There is ligamentum flavum hypertrophy and facet disease with a mild facet joint effusion on the left. No spinal canal or neural foraminal stenosis.L4-L5: There is ligamentum flavum hypertrophy and facet disease with mild facet joint effusions bilaterally. No spinal canal or neural foraminal stenosis.L5-S1: There is disc desiccation with very mild disc bulge. There is ligamentum flavum hypertrophy and facet disease with a mild facet joint effusion on the right. The neural foramina are mildly narrowed bilaterally. There is no spinal canal stenosis. There is a probable cyst posteroinferior to the right articular facet which is not in the spinal canal but this is only included on the sagittal images.
1.Stable small right parietal meningioma.2.Findings highly suggestive of congenital C7/T1 fusion with new mild disc bulge at C6/C7 causing mild effacement of the spinal canal. No abnormality in cord signal.3.Multilevel lumbar facet joint arthropathy with mild narrowing of the neural foramina at L5/S1, otherwise no significant spinal canal or neural foraminal stenosis.