Metastatic right breast cancer. This is a limited examination, only sagittal T1 and STIR sequences were obtained to assess for cord compression. It is further limited by patient motion and inability to cooperate.Sagittal alignment is notable for cervical straightening as well as minimal anterior subluxation of L4 relative to L5. Vertebral body heights and alignment are otherwise maintained. Multilevel shallow ventral indentations of the thecal sac are caused by disc-osteophyte complexes in the cervical and thoracic regions which is most pronounced at C3-C4 where it is mild-to-moderate. There is no severe/significant spinal canal stenosis. The spinal cord grossly shows no abnormal signal.There is T2 signal in T8-T9 disc while there is desiccation involving the other thoracic discs. There is T2-hyperintense, T1-hypointense signal in the marrow subjacent to the T8-T9 endplates and also extending into the left T8-T9 neural foramen. Subtle endplate irregularity was evident at this level on prior chest CT from 10/27/2015. There is mild L5-S1 neural foraminal stenosis bilaterally. There is facet arthropathy at L4-L5 with mild joint distention.
1.Examination is limited to sequences per cord compression protocol. No evidence of cord compression. No evidence of pathologic compression fractures or epidural tumor within the limits of the study. Note this examination is not adequate for detecting small metastatic lesions in the spine.2.Disc and endplate marrow signal changes at T8-T9 are favored to be on a degenerative basis with degenerative changes and associated mild irregularity also evident on prior chest CT from 10/27/2015. Discitis-osteomyelitis however cannot be entirely excluded.3.Mild to moderate spinal canal stenosis is noted in the cervical spine on a degenerative basis.Dr. Monther Qandeel discussed the above findings with the care team over the phone on 3/5/2016 at about 10:00 AM. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.