Clinical question: Cord compression? Enhancing lesion? Signs and symptoms: Bilateral lower extremity weakness. Enhanced cervical MRI:Examination demonstrates no detectable abnormal enhancement of the cord or the leptomeninges.There is enhancement along the adjacent endplates to C3-C4 disc space representing expected enhancement of degenerative changes.There is evidence of prior laminectomy at C4, C5 and C6 levels with resultant expansion of thecal sac and the expected minimal enhancement of postoperative changes posteriorly. There is revisualization of a focus of myelomalacia with decreased cord caliber similar to prior exam extending from C4 through C6.No evidence of a spinal canal compromise and no detectable abnormal enhancement of the cord or the meninges.Pre and post enhanced thoracic MRI:Examination demonstrates normal anatomical alignment of vertebral, without concerning detectable signal abnormality. No evidence of abnormal enhancement of the vertebral column is detected.Mild degenerative changes however without evidence of central spinal stenosis is detected.The signal intensity and caliber of the thoracic cord remains within normal limits and without detectable abnormal enhancement.Unremarkable perispinal soft tissues.
1.Post contrast cervical MRI exam demonstrate minimal expected enhancement of degenerative changes. Revisualization of myelomalacia and decreased cord caliber and without detectable cord or meningeal enhancement.2.Unremarkable pre and post enhanced MRI of thoracic spine.