Female, 50 years old, with numbness and weakness, history of neuromyelitis optica. Evaluate for new or worsening disease. Diffuse atrophy of the spinal cord is redemonstrated, particularly affecting the thoracic cord. Patchy abnormal signal is also redemonstrated in the cervical cord and to a lesser extent the thoracic cord. No pathologic spinal cord or leptomeningeal enhancement is appreciated. No epidural abnormalities are suspected.The thoracic kyphosis is slightly exaggerated, but spinal alignment is otherwise unremarkable. Vertebral body height and morphology are within normal limits. No evidence of pathologic marrow signal or enhancement is seen. Patchy opacification of the right mastoid air cells is noted.The intervertebral discs are grossly preserved with no significant disc bulging or herniation. No compromise of the spinal canal or neural foramina is detected.Bilateral pleural effusions have increased in size compared to the prior examination. The effusions have a somewhat loculated appearance in certain areas, and the adjacent lung parenchyma is enhancing.
1.Diffuse spinal cord atrophy and patchy abnormal signal are redemonstrated appearing grossly similar to the prior examination. These findings are compatible with the stated history of neuromyelitis optica. No definite evidence of any new or enhancing lesion is seen.2.Incidental note is made of bilateral pleural effusions, mildly increased in size since the prior examination, with a somewhat loculated appearance and with enhancement of the adjacent lung parenchyma. The possibility of infection is raised, for which correlation with clinical and laboratory findings may be helpful.