43-year-old female with disturbance of skin sensation. History of metastases to the spine. Rule out cord compression. The spinal cord has normal signal characteristics and overall morphology. There is no evidence of spinal canal narrowing. There is abnormal STIR signal within the bone marrow consistent with metastatic lesions in the T8, L2, L3, and L4 vertebral bodies which have been present from prior studies dating back to 2014. There is mild endplate depression of the T8 level, slightly progressed compared to prior study which could represent early development of a pathologic fracture. There is a slight disc bulge at the L3-4 level without significant spinal canal stenosis.There are multiple new areas of signal abnormality suspicious for metastatic disease. There is heterogeneous marrow signal in the C6, T1, T2, and T3 vertebral bodies which is suspicious for metastatic disease. There is T1 hypoattenuation with associated STIR signal abnormality in the anterior-inferior portion of the T6 and T9 vertebral bodies. There is is an expansile lesion with increase in STIR signal within the spinous process at the T7 level. There is an expansile lesion with STIR hyperintensity in the L5 pedicle. Homogeneous STIR signal abnormality is also present within the sacrum suspicious for metastatic disease. There is mild increased STIR signal in the posterior soft tissues at the level of the L2-L4 levels which likely represents dependent edema, given normal marrow signal in adjacent posterior elements.
1.This is a limited exam specific for the exclusion of cord compression only and does not exclude more subtle lesions such as intrinsic cord abnormalities. No cord compression is identified.2.Multiple new multilevel lesions as above suspicious for metastatic disease and consistent with disease progression. Due to the screening nature of this protocol details are not as evident on imaging as dedicated protocols of the spine.