71-year-old male with left-sided weakness status post EVAR, TEVAR. Evaluate for cord compression There is extensive artifact from the adjacent aortic stent graft. Within these limitations, there is an area of T2/STIR signal abnormality seen on sagittal sequences in the distal cord/conus. This is supported by additional T2 hyperintensity seen on axial imaging series 11, images 14-16.The vertebral bodies are appropriate in the overall alignment and height. There is mild disc disease and disc height loss involving L4-5 level and a moderate disc disease and disc height loss involving the L5-S1 level. Additional facet hypertrophy at the L5-S1 level contributes to moderate bilateral neural foraminal stenosis at this level but there is no significant spinal canal stenosis or cord compression at any level in the spine.Additional degenerative changes are also visualized in the cervical spine with multilevel disc height loss most prominent at the C5-6 level on the provided sagittal sequences. At this level there is moderate spinal canal stenosis.The large aortic aneurysm is only partially visualized and perhaps better appreciated on the previous CTA of the chest abdomen and pelvis from 7/21/2016. There are bilateral pleural effusions with right basilar pulmonary opacity which may relate to atelectasis.
1.Exam is limited by artifact from the adjacent aortic stent graft. Within these limitations, concerning for an acute cord infarct involving the distal cord/conus provided the patient's history, although other etiologies could have a similar appearance. There is no evidence of cord compression. Diffusion-weighted images were attempted but were nondiagnostic secondary to the susceptibility artifact.2.Multilevel degenerative changes mostly involving the cervical and lumbar spine with at most moderate spinal canal stenosis at C5-6 and at most moderate bilateral neural foraminal narrowing at the L5-S1 level.Due to the screening nature of this protocol details are not as evident on imaging as dedicated protocols of the spine.