The MRI

A couple of people on the team said - what is it - hard to describe without the diagnosis so here is what the MRI peeps said.  My Doc warned me that reading it sounds like I am done - but that's their job.  Main positives are the fact they aren't screwing up bones and such and the brain is not affected.  Woo hoo - I have spent a lot of time cutting and pasting words into the google to figure it out
So here it is:

EXAMINATION: MRI THORACIC SPINE WO CONTRAST

CLINICAL HISTORY: M54.2 Cervicalgia, M54.12 Radiculopathy cervical region, neck pain radiating to left upper extremity

COMPARISON: None.

Frontal and lateral views of the thoracic spine were obtained.

FINDINGS: There is a metastatic lesion in the posterior T2 vertebral body measuring 1.4 cm. There is some enhancement in the bilateral T3 rib head regions and extension to the facets. There is another metastatic lesion at T4 measuring 14 mm. These are both confined to the vertebral bodies without extraosseous extent. In the right T6 transverse process and rib head there is a focal metastatic lesion with some extension into the T6-T7 foramen. Correlate for a right T6 radiculopathy. There is also a focal soft tissue mass/adenopathy adjacent to the trachea at approximately the T5 level.

There is posterior spinous process enhancement at T6 and T8.

Despite the metastatic disease in the bones there is no significant canal narrowing. The spinal canal remains widely patent despite mild posterior protrusions and upper mid thoracic spine without stenosis. The spinal cord is intact without signal change, effacement or atrophy. Sagittal imaging shows preservation of the neural foramina fat except for the T6-T7 level on the right where there is some enhancement in the superior foramen from extraosseous extent of disease.

There is no acute fracture. There is no spondylolisthesis.

IMPRESSION:

Findings are consistent with osseous metastatic disease involving the posterior vertebral bodies of T2 and T4. There is also metastatic involvement in the right T6 transverse process, facet and rib head with extension to the right T6-T7 foramen. Other metastatic lesions are also identified as detailed above.

Despite these changes, there is no significant canal narrowing. The spinal cord is intact.

CLINICAL HISTORY: M54.2 Cervicalgia, M54.12 Radiculopathy cervical region, neck pain paresthesias left upper extremity

COMPARISON: None.

FINDINGS:

Suspicious focal lesions within the bone marrow involving the base of skull, calvarium, C1 vertebral body, T2 vertebral body, T3 posterior elements and T4 vertebral body. Largest lesion is in the T2 vertebral body and measures 1.3 cm. No extensions of the canal.

Mild disc space narrowing and endplate degenerative changes at C5-6.

Facet arthropathy and uncal arthrosis causes mild to moderate left C5-6 foraminal narrowing.

No other levels of canal or foraminal narrowing in the cervical spine.

No suspicious focal bone marrow lesions.

Visualized spinal cord is normal in appearance.

IMPRESSION:

Multiple suspicious bone marrow lesions concerning for metastatic disease or multiple myeloma without pathologic fracture or definite extension into the canal.

No central canal narrowing.

Mild to moderate left C5-6 foraminal narrowing.

MRI BRAIN W WO CONTRAST - Details

EXAMINATION: MRI BRAIN W WO CONTRAST

COMPARISON: None

CLINICAL HISTORY H53.2 Diplopia, M54.2 Cervicalgia, neck pain going to left arm..

TECHNIQUE: Multiplanar multisequence examination was performed with and without contrast

FINDINGS:

There is no definite diffusion restriction.

There is abnormal thickening of the calvarium in the region of the torcular possibly with appears to be anterior displacement of the torcular. There is heterogeneous flow in the right transverse sinus and in the posterior third of the superior sagittal
sinus.

There is diffuse dural thickening and enhancement of the tentorium, the posterior falx, and overlying the cerebral and cerebellar convexities.

The craniocervical junction is unremarkable.
IMPRESSION:

No definite acute ischemia.

Thickening of the calvarium in the area of the torcular with anterior displacement of the torcular and heterogeneous flow in the sinuses. I cannot exclude an osseous lesion. Correlation with CT of the brain with and without contrast is suggested.

Possible partial dural venous sinus thrombosis which could account for the heterogeneous flow in the dural sinuses. This could be better evaluated with MR venography.

Dural thickening and enhancement overlying the convexities and the falx and tentorium possibly due to intracranial hypotension. Please correlate clinically for history of CSF leak or previous lumbar puncture.

And the family history as well -

Maternal grandmother, adenocarcinoma of colon at age 39 (resection), reoccurrence with metastasis to liver age 75. Died

Maternal aunt, adenocarcinoma of colon with metastasis at age 46, died

Paternal grandfather, small cell lung cancer(long time smoker), died age 76

Father died age 58, metastatic melanoma, primary lesion unknown.