 Thoracic spine: There is a low T1 signal, enhancing lesion involving the posterior elements of T6 with mild expansion of the left lamina and pedicle. There is no discernible compromise to spinal canal or neural foramen. The thoracic spine is in normal alignment. The vertebral body and disk heights are well maintained. There is overall heterogeneity of the bone marrow signal with multiple T1 and T2 hyperintense lesions, compatible with focal fatty marrow and/or intraosseous hemangiomas and what may represent radiation effects in the upper thoracic vertebrae. The spinal cord is of normal caliber and signal. There is no pathological enhancement of the spinal cord. There are minimal disc bulges at T10-11 and T11-12. There is no other significant disc bulge, herniation, spinal canal or foraminal stenosis within the thoracic spine. There is an enhancing lesion with low T1 signal in the posterior aspect of the left eighth rib. The left adrenal gland is enlarged, nodular and enhancing measuring up to 2.4 cm. There are partly imaged and incompletely characterized abnormalities in the right lung. Lumbar spine: The lumbar spine is in normal alignment. There is diffusely heterogeneous bone marrow signal multiple foci of T1 and T2 signal which may relate to intraosseous hemangiomas or focal fatty marrow. There is degenerative endplate marrow signal change at L4-5. There is no definite pathological enhancement. Interspinous process enhancement and edema at the L2-3 level are also likely degenerative in nature. The distal spinal cord and conus are within normal limits. There are mild disc bulges with central disc protrusions at L3-4 and L4-5, which along with bilateral facet arthropathy and ligamentum flavum thickening results in mild spinal canal and right neural foraminal stenoses. Mild disc bulges and bilateral facet arthropathy are present at the remaining levels without significant spinal canal or neural foraminal stenosis.
1. Metastatic lesions involving the posterior elements of T6, left posterior eighth rib, and left adrenal gland. 2. No significant spinal canal stenosis, neural foraminal narrowing or abnormal thoracic spinal cord signal.3. Lumbar degenerative changes predominantly at L3-4 and L4-5 with mild spinal canal and right neural foraminal stenoses at these levels.4. Partly imaged and incompletely characterized abnormalities in the right lung. Please refer to the prior chest CT report for details. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.