Female, 39 years old, with metastatic breast cancer and back pain. Heterogeneous enhancing lesions within the left aspect of the T12 vertebral body in the right aspect of the L1 vertebral body have not significantly changed in size or morphology. Minimal associated concavity of the superior L1 endplate, and minimal posterior expansion of the L1 vertebral body, are unchanged.Small marrow replacing lesions within the left aspect of the L4 vertebral body and the left aspect of the L5 vertebral body are also redemonstrated without significant interval change. These lesions produce no significant osseous expansion. The L4 lesion enhances while the L5 lesion does not. A heterogeneous enhancing lesion within the left iliac bone is unchanged.Spinal alignment is anatomic. Vertebral body heights are preserved. Minimal disc bulging is evident at L3-4 with slight facet degeneration. Minimal disc bulging with a tiny left paracentral protrusion is evident at L4-5 along with mild facet degeneration. No significant spinal canal or foraminal compromise is demonstrated at any level. The visualized distal spinal cord and cauda equina are within normal limits. No pathologic intrathecal enhancement is seen.
Multiple metastatic lesions are redemonstrated including within the T12, L1, L4 and L5 vertebral bodies as well as the left iliac bone. There has been no significant interval change in size of these lesions. No new lesions are detected.