56-year-old female with back pain, a history of lytic bone lesions seen on CT and metastatic ovarian cancer. MRI C-Spine:There is a small T2 hyperintense lesion, with a somewhat ring appearance, within the right posterolateral medulla.A focal marrow abnormality which is hypointense on both T1 and T2 are present within the C7 vertebral body and correlates with a sclerotic focus on previous chest CT. A hemangioma is noted within the C4 vertebral body.The craniovertebral junction appears within normal limits. There is straightening of the cervical spine. The cervical vertebral bodies are appropriate in height. There are multilevel degenerative changes including multilevel disc height loss most conspicuous at the C5-6 level with multilevel. However there is no significant spinal canal stenosis in the cervical spine. There is at most mild to moderate left sided neural foraminal narrowing at the C5-6 level The cervical spinal cord has normal signal characteristics and overall morphology. The vertebral artery flow voids appear to be intact. The paraspinous soft tissue structures appear within normal limits.MRI T-Spine:Focal marrow abnormalities which are hypointense on both T1 and T2 are present within the thoracic spine, correlating with primarily sclerotic foci on previous chest/abdomen CT. Specifically, these can be found within the inferior endplate of T2, the vertebral body of T3, the vertebral body of T4, and separately the posterolateral leftward aspect of T4 vertebral body extending into the adjacent pedicle,The thoracic spine is in normal alignment. The vertebral body and disk heights are well-maintained. The spinal cord is of normal caliber and signal. There is no significant disk bulge, herniation, spinal canal or foraminal stenosis within the thoracic spine. Note is again made of bilateral pleural effusions, lymphadenopathy, as well as T2 hyperintense liver lesions.
1.There is a small T2 hyperintense lesion, with a somewhat ring appearance, within the right posterolateral medulla. This is highly suspicious for metastasis and could be better characterized by brain MRI with contrast.2.There are several T1 and T2 hypointense lesions within the cervical and thoracic osseous spine, correlating with primarily sclerotic foci identified on prior chest/abdomen CT, consistent with metastasis. There is no epidural tumor or cord involvement.3.The extent of osseous metastatic disease could be further characterized by bone scan.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.