 Images are somewhat limited by patient motion. The spine is in normal alignment. The vertebral body and disk heights are well-maintained. No worrisome focal marrow signal abnormality is appreciated.Corresponding to the prior questioned abnormality seen on MRI brain, there is abnormal decreased AP dimension of the upper thoracic cord extending down to at least the T9 level. Cord thickness is as low as 1 mm AP at the mid C5 level, as compared to more normal caliber along the distal thoracic cord 3 mm AP. Overall, the cord contour appears flattened and the cord is ventrally located within the spinal canal. There is a low conus termination at the mid L3 level. No abnormal fat signal is identified within the distal thecal sac. There is trace ill-defined apparent T2 hyperintensity in the center of the cord extending from the cervicomedullary junction down to at least the C6-C7 level on the axial images, although sagittal 3-D T2 weighted images do not demonstrate a corresponding abnormality and this is felt to be artifactual in etiology. Thin section 3-D T2 weighted images demonstrate normal thickness of the tectum, although it appears slightly elongated, with slight decreased conspicuity of T2 signal along the narrowed cerebral aqueduct, although it is grossly patent. There is suggestion of linear T2 hypointensity along its mid portion. There is mass effect from significantly dilated supratentorial ventricles upon the brainstem and diminutive posterior fossa structures. Upon CSF flow imaging, there is evidence of biphasic CSF flow along the prepontine cistern and ventral upper spinal canal, with diminished dorsal upper cervical spinal canal biphasic flow. No significant biphasic flow is identified through the expected location of the cerebral aqueduct. Minimal flow is suggested in the region of the fourth ventricle and its outlets.Prominence fluid signal seen within the visualized paranasal sinuses. There are patchy pulmonary opacities predominantly in the dependent left lung which are nonspecific but may represent areas of atelectasis. Please see prior brain MRI report for more details regarding intracranial abnormalities.
1.Confirmation of abnormal flattening of the cord contour with thinning of caliber along the majority of the thoracic cord. Given its central location within the spinal canal, there may be dorsal arachnoid septations or arachnoid cyst resulting in mass effect.2.Tectum appears be elongated with suboptimal visualization of the T2 signal in the narrowed cerebral aqueduct, although it is grossly patent with potential septations along its midportion. This may result in the supratentorial severe hydrocephalus. There may also in part be mass effect from the dilated ventricles upon the brainstem as well as diminutive posterior fossa structures. CSF flow appears diminished dorsally along the upper cervical spinal canal without definite identified flow in the expected location of the cerebral aqueduct.3.No definite abnormal cord signal, with previously questioned abnormality likely artifactual.4.Abnormal low conus termination at the mid L3 level without other MR findings of tethered cord although prone imaging was not obtained. Please correlate clinically.5.Patchy pulmonary opacities in the left lung which are nonspecific but may represent areas of atelectasis.