Acute myeloblastic leukemia, not having achieved remission [C92.00], Reason for Study: ^Reason: RULE OUT SPINE LESION History: NEW MULTIPLE LESIONS IN BRAIN. C-SpineReplacements of normal bone marrow fat are seen at C7. T1 and T2 vertebral bodies with inhomogeneous enhancement of cervical vertebral bodies from C2 to T2 indicating possible metastatic lesions or post-treatment related.There is anterolisthesis of C4 on C5 with moderate to severe spinal canal stenosis from the C34 level to C56. The spinal cord signal intensity appears to be normal.T-Spine:Inhomogenous bone marrow signal intensities on whole T spine vertebral bodies but without evidence of compression fracture or obvious focal enhancing lesion.Spine cord signal intensity appears to be normal.Normal kyphotic angulation is preserved.L-Spine:Again inhomogeneous marrow signal intensities without compression fracture of lumbar vertebral bodies. Post contrast enhancement scan shows inhomogenous and somewhat mass like enhancement especially seen at the level of L2 to S1 indicating metastatic lesions. In addition, there is focal nodular intrathecal enhancement at the level of left S1 nerve root. This lesion may suggest possible intrathecal nodular enhancement or small nerve root sheath tumor. There is no definitive evidence of cauda equina enhancement. Bilateral iliac bones and sacrum also show inhomogenous enhancing lesions indicating possible metastatic lesions.There is grade 1 spondylolisthesis of L4 on L5 with severe spinal stenosis at the level of L45.Moderate degree spinal stenosis are seen from the level of L23 to L45 with disc dessication. Spinal cord signal intensity is normal. The conus medullaris terminates at the level of L1.
1. Diffuse multifocal bone marrow replacement with inhomogenous enhancing lesions on whole spine and bilateral ilium indicating metastatic lesions as described above.2. Single nodular enhancing lesion at the level of left S1 nerve root suggesting possible intrathecal metastatic nodule or incidental nerve sheath tumor.3. Degenerative changes of C and L spine with anterolisthesis of C4 on C5 and L4 on L5 as described above. No evidence of abnormal spinal cord signal intensity.