Reason: spinal cord astrocytoma s/p RT and TMZ. History: spinal cord astrocytoma. CERVICAL SPINE:T2 hyperintense expansile mass within the right aspect of the cord extending from the C3-C4 level to C7-T1 is not appreciably changed in size measuring approximately 1.5 x 1.2 cm in the transverse and AP dimensions in the axial plane at the mid C6 level. T2 hyperintensity involving the left lateral aspect of the cord at these levels is also again seen and not significantly changed. There are faint small foci of ill-defined enhancement involving the left lateral aspect of the cervical cord at the C5 and C7 levels and also present previously.There is mild reversal of the normal cervical lordosis. Vertebral body heights are maintained. Mild multilevel disc desiccation with mild degenerative disc disease at C5-C6 and C6-C7 is unchanged. Diffuse T1 hyperintensity throughout the vertebral bodies likely related to radiation. Postsurgical changes along the posterior cervical spine with laminectomies at C5 and C6 are unchanged.THORACIC SPINE:T2 hyperintense expansile mass centered on the left aspect of the cord extending from the T2-T3 level to the T8 level is unchanged in size and overall distribution, measuring 11 x 10 mm in the axial plane at the mid T4 level similar to prior. Cord signal abnormality involving the right lateral aspect of the cord is also not significant changed. There is faint diffuse enhancement of the lesion which less conspicuous than on 6/8/2016 with artifacts and differences in contrast timing somewhat limiting comparison. There is however no new suspicious enhancement to suggest progression.No significant spinal or neural foraminal narrowing throughout the thoracic spine. Central disc protrusion at T7-T8 as well as additional mild multilevel degenerative changes are not significantly changed. Vertebral body heights and alignment are normal. T1 hyperintensity in the marrow likely reflects post radiation change.
Compared to 9/7/2016 and 6/8/2016, there is no evidence of interval progression cervical and thoracic astrocytomas.