Evaluate for nerve root involvement. History of acute lymphocytic leukemia. There is no significant enhancement or nodularity involving the cauda equina nerve roots. An isolated right-sided linear enhancing structure likely represents a radicular vein. The conus medullaris is normal in position.There is heterogeneous appearance of the bone marrow. Multiple new nodular enhancing lesions are identified involving the lumbar spine and pelvis, the largest involving the left S1 segment, measuring 2.0 cm (series 10, image 49). Additional lesions are identified involving the inferior endplate of L3, the posterior T11 vertebral body and bilateral iliac bones.Vertebral body heights are within normal limits. 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. There is no significant neuroforaminal or spinal canal stenosis at any level. Sequela from prior iliac biopsies are again noted.Paraspinous soft tissues are within normal limits.
1.Multiple new enhancing osseous lesions are highly suspicious for metastases. 2.No abnormal epidural or leptomeningeal enhancement in the lumbar spine. No abnormal nerve root enhancement.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.