Small cell lung cancer with liver metastasis. Back pain. Rule out cord compression. There are numerous T1-hypointense, T2-hyperintense lesions involving the anterior and posterior elements throughout the spine, which are compatible with metastasis. None of the lesions is associated with significant osseous expansion or pathologic fracture; the vertebral bodies are preserved in height and the spinal canal is preserved other than mild narrowing caused by cervical intervertebral discs. The bone marrow signal from T2 through T9 is relatively fatty than the other levels, with less extensive metastatic involvement, which likely reflects previous radiation treatment. Alignment of the spine is anatomic. There appears to be high T2 signal in the spinal cord extending from C2 through C7 levels. The rest of the spinal cord otherwise appears unremarkable. The paravertebral soft tissues are unremarkable. However, there are multiple liver lesions.
1. Extensive metastatic disease involving the imaged axial skeleton, but no evidence of associated pathologic fracture or significant spinal canal stenosis. 2. Apparent high T2 signal extending from C2 through C7 levels may represent artifact or perhaps myelomalacia related to the adjacent degenerative spondylosis. Dedicated imaging of the cervical spine may be useful for further characterization if clinically warranted.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.