 Lack of contrast limits evaluation for small lesions including small foci of epidural tumor. Again seen is osseous metastatic disease throughout the thoracic spine. Relatively larger lesions are present at the T7 and T8 levels which were present previously. No new large lesions are evident although there is suggestion of increased tumor infiltration involving the T10 and T11 vertebral bodies with worsening diffuse T1 hypointensity. Thoracic vertebral body heights are maintained. Alignment is maintained. Previously seen epidural tumor at the T7-T8 level on MRI 3/10/2015 study has regressed and no longer appreciable. Thoracic spinal canal demonstrates no significant stenosis at any level.Axial T2 images of the lower thoracic spine were not obtained. Based on the sagittal sequences there is a large right paraspinous mass extending from the right T9-T10 to the T12 levels with extension into the lower thoracic neural foramina. No obvious extension into the spinal canal or mass effect on the cord based on the sagittal sequences.LUMBAR SPINE
Please note patient could not tolerate the full study and limited sequences of the thoracic and lumbar were obtained. There is no evidence of a new pathologic compression fracture, significant spinal canal stenosis at any level, or epidural tumor. If complete MRI study cannot be obtained, follow-up bone scan or PET may be helpful to assess the burden of active osseous metastatic disease.There is a right lower thoracic paraspinous mass which appears to extend into the neural foramina. No significant intraspinal extension is appreciated based on the sagittal sequences. Dorsal epidural tumor at the T7-T8 level seen on prior study from 3/10/2015 has regressed and no longer appreciated.