Clinical question: Cord compression. Signs and symptoms: Metastatic NSCLC, bilateral thigh weakness. Nonenhanced total spine MRI:Examination demonstrate normal anatomical alignment of vertebral column.There is no evidence of a spinal canal compromise or stenosis and no detectable mass effect on the cord or the cauda equina.The signal intensity and caliber of the cord and cauda equina remains within normal.Examination demonstrates a tiny focus of T1 hypointense and T2 STIR hyperintense in the T4 vertebral body, tiny similar lesion in the superior body of L1 and inferior body of T12 and a larger focus with similar signal change in the vertebral body of L5 which considering history of malignancy they could represent small intraosseous metastatic lesions.No detectable. Spinal soft tissue abnormalities.
1.No evidence of cord compression.2.Small foci of T2 STIR hyperintensity in the vertebral bodies of T4, T12, L1 and L5 which considering patient's history of malignancy possibility of metastatic disease should be considered. Follow-up with further studies is recommended.