Reason: assess cord astrocytoma for growth 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 dimension at the mid C6 level extending craniocaudally from the C3-C4 to the C7-T1 levels. Subtle areas of enhancement are again questioned. T2 hyperintensity involving the left lateral aspect of the cord at these levels is also again seen and not significantly changed.There is mild reversal of the normal cervical lordosis. Vertebral body heights are intact. 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 abnormal enhancement which is increased since prior, which may represent posttreatment change but suggest continued close follow.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 3/23/2016, cervical and thoracic astrocytomas demonstrate no appreciable change in size. Increased enhancement is noted associated with the thoracic lesion which may reflect posttreatment change and may also be in part related to slight differences in technique. Would suggest continued close follow-up.