Malignant neoplasm of unspecified site of unspecified female breast [C50.919], Reason for Study: ^Reason: Metastatic breast cancer - restaging History: foot drop Motion artifacts degraded image quality.For the purpose of this dictation, the lowest visualized intervertebral disc space is labeled L5-S1. Nodular and somewhat tubular signal voids seen within L1, L4 and L5 vertebral bodies indicate previously infused PMMA for kyphoplasties, unchanged since prior scan.There are evidence of L34 and L45 laminectomy with postoperative changes such as enhancement of paraspinal muscles and laminectomy sites with localized fluid collections on incision site.Previously seen enhancing soft tissue masses encircling spinal canal are not seen. And there is no evidence of spinal stenosis at the level of L45.Enhancing lesions indicating metastatic foci are seen at L1, L4 and L5 as well as bilateral iliac bones. Comparing to prior scan, the enhancing portion of each lesion appear to be smaller than prior.The spine alignment is anatomic. The conus medullaris terminates at the T12-L1 level. There is no evidence of cord compression. Degenerative changes are specified by the intervertebral level as follows: T12-L1: There is linear/tubular signal void lesion on the superior aspect of the left neuroforamen indicating extracorporeal PMMA. No evidence of neuroforaminal narrowing or nerve root compression due to this PMMA material. Previously seen soft tissue component extending toward anterior epidural space of the vertebral metastasis is not visualized on today's scan. There is no evidence of neuroforaminal narrowing or spinal stenosis. L1-L2: no neuroforaminal narrowing or spinal stenosis. L2-L3: no neuroforaminal narrowing or spinal stenosis. L3-L4: Post laminectomy status. Right neuroforaminal narrowing due to enhancing soft tissue lesion, again, the enhancing soft tissue component appears to be slightly decreased in its extent. No spinal stenosis. L4-L5: Post laminectomy status. Redemonstration of enhancing lesions of the L4 vertebral body with bilateral mild neuroforaminal narrowing, slightly decreased enhancing component comparing to prior scan. No spinal stenosis. L5-S1: no neuroforaminal narrowing or spinal stenosis.
1. Interval near complete resolution of L45 level soft tissue mass with postoperative changes.2. Interval decrease of soft tissue component of vertebral body metastasis as well as the extent of enhancing portion at the level of L1, L4 and L5.3. Unchanged neuroforaminal narrowing at the level of L34 and L45. 4. There is no evidence of new abnormal enhancing lesion of vertebral body nor bilateral ilium on this scan.