Female, 65 years old, with history of pancreatic cancer and back pain. Thoracic:Spinal alignment is anatomic. Vertebral body morphology and signal characteristics are within normal limits. No pathologic marrow enhancement is seen.The spinal cord demonstrates normal signal intensity and morphology throughout. No pathologic parenchymal or leptomeningeal enhancement is seen. No epidural abnormalities are present.The intervertebral disc spaces are preserved with no significant disc bulging or disc herniations. No significant narrowing of the spinal canal or neural foramina is seen.Incidental note is made of a right thyroid nodule measuring up to 29 mm in size.Lumbar:A 16 x 12 mm area of marrow replacement within the sacrum, spanning S2 and S3, and a 27 x 23 mm area of marrow replacement in the left posterior iliac bone are new from the prior examination. Both of these lesions enhance avidly.Elsewhere, no pathologic marrow replacement or enhancement is seen. Vertebral body morphology is otherwise unremarkable. Spinal alignment is anatomic.The visualized distal spinal cord, conus and nerve roots of the cauda equina are unremarkable. No pathologic parenchymal or leptomeningeal enhancement is seen. No epidural abnormalities are evident.Axial images are degraded by motion artifact, but within this limitation, very mild disc bulging is seen at most lumbar levels with progressive facet arthropathy at lower lumbar levels. At no point is there any large disc bulge or disc herniation. The spinal canal and neural foramina are not significantly compromised.A lobular T2 hyperintense lesion is evident within the posterior liver.
1.New metastatic lesions are evident within the sacrum and left iliac bone.2.No additional concerning lesions are seen in the lumbar or thoracic spine.3.No significant spinal canal or neuroforaminal stenosis is noted.