Metastatic breast cancer, low back pain, leg weakness, urinary straining. The vertebral bodies are appropriate in the overall alignment and height. The spinal cord displays grossly normal signal characteristics and overall morphology. There is no compromise of the spinal cord or cauda equina. There is a partially imaged lesion within the upper right sacral ala that is T1 hypointense and T2 hyperintense and that appears to impinge upon the exiting nerve roots. An additional lesion with similar signal characteristics is present within the posterior aspect of the T9 vertebral body, as well as a smaller lesion within the L4 vertebral body with no associated extension into the adjacent spinal canal. There are several T2 hyperintense subcutaneous nodules posterior to the spine. For example, a subcutaneous nodule posterior to the upper thoracic spine measures up to 15 mm. There are incompletely imaged lesions in the lungs and abdomen.
1. No spinal cord or cauda equina compression is identified. This is a limited exam specific for the exclusion of cord compression only and does not exclude more subtle lesions such as intrinsic cord abnormalities. 2. Findings likely represent metastatic disease to the spine, specifically in the right sacral ala, as well as the T9 and L4 vertebral bodies, with likely associated impingement on the exiting nerve roots by the sacral lesion. 3. There are likely additional sites of metastatic disease within the subcutaneous tissues posterior to the spine, as well as known metastatic disease to the mediastinum, lungs, and liver, which are incompletely imaged and characterized. Please refer to prior CT studies for additional findings. Due to the screening nature of this protocol details are not as evident on imaging as dedicated protocols of the spine.Findings were discussed with Dr. Stephen Constantine by phone on 6/19/2015 at 4:50 PM.