 The cervical lordosis, thoracic kyphosis and lumbar lordosis are preserved. The vertebral bodies are normally aligned. There is subtle anterior wedging of the T8 vertebral body as well as approximately 50% loss of central T9 vertebral body height. Subtle irregularity and enhancement at the inferior endplate of T9 may be related to Schmorl's node formation, as this process appears to extend from the disc. The remaining vertebral body heights and intervertebral disc spaces are maintained.There is prominent leptomeningeal enhancement within the visualized posterior fossa, brainstem, and cervical through lower thoracic spinal canal. The spinal leptomeningeal enhancement is most prominent in the dependent cranial portions. The spinal cord itself demonstrates normal signal and morphology. Of note, posterior fossa and brainstem leptomeningeal enhancement as well as upper cervical spinal canal enhancement was grossly not present on outside brain MRI from 8/25/2016.C3-C4: There is a left paracentral posterior disc osteophyte complex causing moderate to severe left and mild right neuroforaminal stenosis.C4-C5: There is a small posterior disc osteophyte complex without significant spinal canal or neural foraminal stenosis.C5-C6: There is a small posterior disc osteophyte complex causing moderate to severe left and moderate right neuroforaminal stenosis.C6-C7: There is moderate left greater than right neuroforaminal stenosis secondary to uncovertebral joint hypertrophic degenerative change.L3-L4: Thre is a diffuse disc bulge effacing the right ventral thecal sac and crowding resulting in posterior displacement of the descending right L4 nerve root.L4-L5: There is a diffuse disc bulge and mild narrowing of the right greater than left neural foramina.A subcentimeter cyst is visualized in the right kidney.
1. There is leptomeningeal enhancement involving the visualized posterior fossa, brainstem, and cervical through lower thoracic cord. Considering that enhancement was grossly not present on prior brain MRI from August 25, 2016 and that the enhancement is most prominent involving the dependent cranial portions of the spinal canal rather than layering in the distal thecal sac, these findings are favored to relate to hemorrhagic product deposition from recent pineal region tumor biopsy and associated reactive enhancement. However, metastatic disease is difficult to exclude. Follow-up exam is recommended.2. Chronic appearing T9 compression deformity and mild chronic anterior wedging of the T8 vertebral body.