61-year-old female with a history of lower extremity weakness and numbness with upgoing babinski for several months, history of ALL. Possible lumbosacral nerve root enhancement on prior MRI at Mayo. Please eval for evidence of nerve root infiltration or other structural abnormality to explain her symptoms. There continues to be no suspicious nodular enhancement involving the cauda equina nerve roots. There is increased enhancement involving an isolated right-sided linear structure possibly representing the right L5 nerve root, less likely radicular vein. There is also suggestion of some left-sided cauda equina nerve roots which are enhancing less so compared to the previous exam. These findings are nonspecific but may represent an inflammatory process. The conus medullaris shows normal signal. Alignment is notable for unchanged minimal retrolisthesis of L1 relative to L2 which is associated with desiccation and mild disc height loss. The other intervertebral discs are preserved in height. The vertebral bodies are preserved in height. There is no significant neuroforaminal or spinal canal stenosis. The bone marrow signal is preserved. There are changes of presumed bone marrow biopsies in the posterior iliac bones.
1.Previously seen minimal contrast enhancement of the cauda equina nerve roots appears decreased on the left compared to the prior exam. There is however increased enhancement involving an isolated right-sided linear structure, possibly representing the right L5 nerve root or less likely radicular vein. These findings are nonspecific especially given history of lumbar punctures and chemotherapy for leukemia. Possibility of an ongoing inflammatory process affecting the cauda equina nerve roots remains, but would correlate with clinical findings and CSF analyses. There is however no clear nodular leptomeningeal enhancement to suggest leukemic infiltration by imaging. 2.Minimal degenerative changes in the lumbar spine without significant spinal canal foraminal stenosis at any level. 