 Images are somewhat motion degraded, especially postcontrast images, and repeats were attempted. Given this caveat:Brain:The ventricles and sulci are normal in size. The cerebellar tonsils are in normal position. There are no masses, mass effect or midline shift. The pituitary gland is normal in size. There is no evidence for intracranial hemorrhage or acute cerebral, brainstem or cerebellar infarction. No diffusion-weighted abnormalities are identified. There are no extraaxial fluid collections or subdural hematomas. Flow voids are present within the major vessels indicating patency. The paranasal sinuses and mastoid air cells are clear. There is no abnormal enhancement within the brain. Incidental note is made of an 11 mm, oval, T1 hypointense focus within the left parietal scalp, most likely representing an epidermal inclusion cyst.Cervical spine:Alignment is normal. The marrow signal is benign. The cervical cord is normal in signal without abnormal enhancement. The cervicomedullary junction is normal. The cerebellar tonsils are in normal position. The visualized paraspinal contents are unremarkable.C2/3: Mild facet hypertrophy without stenosis.C3/4: Left uncinate hypertrophy and bilateral facet hypertrophy. There is moderate left neural foraminal stenosis.C4/5: Trace anterolisthesis C4 and C5, diffuse annular disc bulge, left uncinate hypertrophy, ligamentum flavum thickening, severe left facet hypertrophy, and mild right facet hypertrophy. There is moderate to severe left neural foraminal stenosis.C5/6: Trace retrolisthesis C5 on C6, posterior osteophyte disc complex, bilateral uncinate hypertrophy, and ligamentum flavum thickening. There is moderate central stenosis with flattening of the cord, however without intrinsic cord signal abnormality. There is moderate to severe left neural foraminal and severe right neural foraminal stenosis.C6/7: Trace retrolisthesis C6 on C7, posterior osteophyte disc complex, bilateral uncinate hypertrophy, and ligamentum flavum thickening. There is mild to moderate central stenosis with flattening of the cord, however without intrinsic cord signal abnormality. There is moderate to severe bilateral neural foraminal stenosis.C7/T1: UnremarkableThoracic spine:There is a smooth, physiologic thoracic kyphotic curve. The vertebral body heights and disc spaces are maintained. Marrow signal intensity is benign throughout. There is no abnormal enhancement.T1/2 demonstrates no significant disc bulge or cord encroachment.T2/3 demonstrates no significant disc bulge or cord encroachment. T3/4 demonstrates no significant disc bulge or cord encroachment. T4/5 demonstrates no significant disc bulge or cord encroachment. T5/6 demonstrates no significant disc bulge or cord encroachment.T6/7 demonstrates no significant disc bulge or cord encroachment. T7/8 demonstrates no significant disc bulge or cord encroachment. T8/9 demonstrates no significant disc bulge or cord encroachment. T9/10 demonstrates a right paracentral disc protrusion causing flattening of the anterior right hemicord without intrinsic cord signal abnormality.T10/11 demonstrates no significant disc bulge or cord encroachment. T11/12 demonstrates no significant disc bulge or cord encroachment. T12/L1 demonstrates no significant disc bulge or cord encroachment. Lumbar spine:Alignment is anatomic. There are no fractures or subluxations. The conus is normal in signal and morphology and terminates at an appropriate level. There is no abnormal intrathecal enhancement.The sacrum and portions of the adjacent iliac bones demonstrate patchy enhancement with some associated STIR abnormality.T12/L1: Minimal disc bulge without stenosis.L1/2: Minimal disc bulge without stenosis.L2/3: Mild disc bulge without stenosis.L3/4: Mild disc bulge without stenosis.L4/5: Mild disc bulge and mild left facet hypertrophy without stenosis.L5/S1: Asymmetric bulge to the right and mild right facet hypertrophy. There is moderate right neural foraminal stenosis.
1.Images are somewhat motion degraded, especially postcontrast images, and repeats were attempted. Given this caveat, there is no convincing intrathecal enhancement to suggest the presence of metastatic disease.2.The sacrum and portions of the adjacent iliac bones demonstrate patchy enhancement with some associated STIR abnormality. The lumbar spine acquisition technique, this is only partially imaged, and is nonspecific in appearance. This may be secondary to metastatic disease, however may be a response to therapy, or even insufficiency fracture. The remaining osseous elements are intact without abnormal enhancement to suggest the presence of metastatic disease.3.C3/4: Moderate left neural foraminal stenosis.4.C4/5: Moderate to severe left neural foraminal stenosis.5.C5/6: Moderate central stenosis with flattening of the cord, however without intrinsic cord signal abnormality. There is moderate to severe left neural foraminal and severe right neural foraminal stenosis.6.C6/7: Mild to moderate central stenosis with flattening of the cord, however without intrinsic cord signal abnormality. There is moderate to severe bilateral neural foraminal stenosis.7.T9/10 demonstrates a right paracentral disc protrusion causing flattening of the anterior right hemicord without intrinsic cord signal abnormality.8.L5/S1: Moderate right neural foraminal stenosis.