 The lumbar spine is in normal alignment, with a normal lumbar lordosis. There is minimal disc narrowing at from T12-L1 through L2-L3. The vertebral body and disk heights are otherwise well-maintained, with mild scattered disc desiccation. No worrisome focal marrow signal abnormality is appreciated. Similar to the appearance on recent MRI of the cervical and thoracic spine, there is diffuse enhancement along the surface of the distal cord and conus with mild enhancement of especially the distal cauda equina nerve roots. The distal spinal cord and conus are otherwise within normal limits with the conus terminating at the mid L1 level.At T12-L1 and L1-L2, there are very minimal disc bulges without stenosis.At L4-L5 and L5-S1, there are tiny central annular fissures. There is also prominent facet arthropathy at these levels.There is no significant disk bulge, herniation, spinal canal or foraminal stenosis within the remainder of the lumbar spine. .There is severe distention of the bladder. The liver appears significantly T2 hypointense which may indicate iron deposition
1. Leptomeningeal enhancement along the distal cord and conus as well as along the cauda equina nerve roots especially distally. Differential diagnosis again includes leptomeningeal infection/inflammation versus less likely neoplasm.2. Severe distention of the bladder.3. Very mild spondylotic changes without significant stenosis at any level.4. Prominent T2 hypointensity of the visualized liver which may relate to iron deposition.