Reason: 66 y/o hx of leukemia, concern for cord compression History: back pain CORD COMPRESSION PROTOCOL:Extensive osseous metastatic disease involving the spine, ribs and sternum appearing similar to the prior CT. There is severe kyphosis of the thoracic spine with thoracic spine findings detailed below.Exaggerated lordosis of the cervical spine with multilevel degenerative disc disease, most severe at C3-C4 and C5-C6. Posterior disc osteophyte complex at C3-C4 and C5-C6 producing effacement of the ventral thecal sac. Diffuse osseous metastatic disease of the lumbar spine with mild anterior wedging of L1. No significant central canal stenosis.THORACIC SPINE MRI:Diffuse osseous metastatic disease with severe kyphosis centered at C5-C6. There is loss of vertebral body height at T6, T9 and L1. No abnormal signal within the cord. No epidural extension is noted throughout the thoracic spine.C7-T1: No significant central or neural foraminal stenosisT1-T2: No significant central or neural foraminal stenosisT2-T3: No significant central or neural foraminal stenosisT3-T4: No significant central or neural foraminal stenosisT4-T5: Osseous expansion from tumor extending inferiorly with effacement of the ventral thecal sac but no significant central stenosis. Expansion along the bilateral neural foramina producing mild foraminal stenosisT5-T6: Osseous expansion from tumor posteriorly into the left neural foramina and along the left lateral recess inferiorly producing moderate central canal stenosis. Severe left neural foraminal stenosis. Mild right neural foraminal stenosis.T6-T7: Osseous expansion from tumor along the left lateral recess and left neural foramina with mild central canal stenosis. Severe left neural foraminal stenosis. No right neural foraminal stenosis.T7-T8: Osseous expansion from tumor around the the left neural foraminal. Moderate left neuroforaminal stenosis. No right neural foraminal stenosis. No significant central canal stenosis.T8-T9: Osseous expansion from tumor in the left lamina and paraspinal soft tissues and along the left neural foramina producing mild to moderate central canal stenosis. Mild bilateral neural foraminal stenosis.T9-T10: No significant central canal stenosis. Moderate right neural foraminal stenosis mild left neural foraminal stenosis.T10-T11: No significant central or neural foraminal stenosisT11-T12: No significant central or neural foraminal stenosisT12-L1: No significant central or neural foraminal stenosisBilateral renal cysts. Small right pleural effusion with right apical pleural thickening and nodular opacities better characterized on recent CT chest.
1.No abnormal T2 signal to suggest acute cord compression2.Widespread osseous metastatic disease with multiple chronic compression fractures involving T6, T9 and L1. There is osseous expansion of tumor along the left lateral recess of T6 producing moderate central canal stenosis. There are additional levels of less severe central canal stenosis as well as multilevel neural foraminal stenosis in the mid thoracic spine.3.Small right pleural effusion with right apical pleural thickening and nodular opacities better characterized on recent CT chest.