 Brain MRI:Lobular abnormality is noted centered within the clivus extending into the adjacent sphenoid sinuses (right greater than left). There are also several foci of signal abnormality throughout the calvarium.There are a few scattered foci of T2 hyperintensity within the white matter without restricted diffusion or susceptibility abnormality.The ventricles and sulci are normal in size. The cerebellar tonsils are in normal position. There are no masses, mass effect or midline shift. The pituitary gland is normal in size. There is no evidence for intracranial hemorrhage or acute cerebral, brainstem or cerebellar infarction. No diffusion-weighted abnormalities are identified. There are no extraaxial fluid collections or subdural hematomas. Flow voids are present within the major vessels indicating patency. Mucosal thickening is present within left maxillary sinus. Fluid is also present within bilateral mastoid air cells.Limited cord compression spine MRI:Widespread abnormality can be found throughout the spine with vertebral body compression deformities at several levels. Multilevel stenoses are present throughout the cervical spine as well as at the T4-T6 levels secondary to a combination of degenerative changes as well as osseous expansion. There is also narrowing of the central canal from L3 through L4, also secondary to osseous expansion. There also appear to be foci of epidural extension at the T4/5 as well as L2/3 levels. There appears to be moderate central stenoses within the cervical spine, however severe at the T4-T6 levels, with more moderate stenoses involving the lumbar spine.
1.Minimal chronic small vessel ischemic disease. No acute ischemia.2.There is widespread myeloma involvement throughout the spine with vertebral body compression deformities at multiple levels throughout each segment, including possible epidural extension at the T4/5 as well as L2/3 levels.There appears to be moderate central stenoses within the cervical spine, however severe at the T4-T6 levels by definition resulting in cord compression, with more moderate stenoses involving the lumbar spine. Given the widespread skeletal pathology without comparison, it is uncertain the chronicity of the cord compression and stenoses.