Document 6535852

 442 West Broadway, Glendale CA 91204. PHONE: 818-502-0593. FAX: 800-854-5638
NAME: XXXXX, XXXXX DOB: X/X/XXXX STUDY DATE: 5/18/2009 10:08:29 AM PATIENT ID: XXXXXXXXX EXAM ID: XXXXX REFERRING: XXXXX, XXXXX COMPARISON: None available HISTORY: Endometrial carcinoma, compression fracture, back pain, suspected metastatic disease MRI OF THE LUMBAR SPINE (WITHOUT IV CONTRAST) TECHNIQUE: MRI of the lumbar spine was performed using a General Electric 1.5 Tesla MRI scanner. No IV contrast was utilized and there were no complications.The following pulse sequence weightings were acquired non-­‐contrast: Sagittal T1 fast spin-­‐
echo, sagittal T2 fast spin-­‐echo, sagittal STIR, axial T1 fast spin-­‐echo, and axial T2 fast spin-­‐echo. FINDINGS: The normal lumbar lordosis is maintained. There is increased T1 signal intensity at the sacrum which can be correlated with any history of radiation therapy to the pelvis. At the T12 vertebral body, anterior wedging with approximately 30% anterior vertebral body height loss is unchanged and suggestive of partial compression fracture. At the T12/L1 level, the central canal as well as bilateral neural foramina are patent. At the L1/2 level, the intervertebral disc demonstrates loss of signal intensity as well as slight loss of disc height. The central canal as well as bilateral neural foramina are patent. At the L1/2 level, intervertebral disc demonstrates a block broad base posterior disc bulge measuring approximately 2 mm. Facet arthrosis is mild. Right foraminal narrowing is mild, central canal narrowing is minimal, and left neural foraminal narrowing is minimal. The L3 vertebral body demonstrates approximately 30% vertebral body height loss suggesting partial compression fracture which is unchanged. At L3/4 level, there is loss of disc signal intensity as well as disc height. There is a broad based posterior as well as bilateral far lateral disc bulge. Bulging into the far right lateral recess measures up to approximately 3 mm. Bulging posteriorly measures approximately 3 mm. Facet arthrosis and ligamentum flavum hypertrophy are moderate. The right neural foramen demonstrates moderate narrowing, the central canal demonstrates mild narrowing, and the left neural foramen demonstrates mild narrowing. At the L4/5 level, there is evidence of significant compression fracture and infiltration involving up to 90% of the L5 vertebral body height. There is some retropulsion into the central canal measuring up to 6 mm. There is also bulging into the left lateral recess by approximately 3 mm. Facet arthrosis and hypertrophy is moderate to severe. Right neural foraminal narrowing is moderate, central canal narrowing is moderate to severe, and left neural foraminal narrowing is minimal. 1 442 West Broadway, Glendale CA 91204. PHONE: 818-502-0593. FAX: 800-854-5638
The L5/S1 intervertebral disc demonstrates preservation of signal intensity as well as disc height. There is a small left foraminal disc bulge measuring up to 2 mm. Facet arthrosis is relatively severe at the right greater than left facets. The right neural foramen, central canal, and the left neural foramen are patent. Within the pelvis there is an adnexal cyst which measures approximately 2.6 x 1.8 cm which is unchanged. No prevertebral lymphadenopathy is seen. Note paraspinal soft tissue abnormality seen. FINAL IMPRESSIONS: 1. Increased T1 signal intensity in the sacrum may be correlated with more specific radiation therapy history. 2. Interval infiltration of the L5 vertebral body with retropulsion into the central canal 5-­‐6 mm. 90% of the vertebral bodies involved and findings are suspicious for pathologic infiltration and pathologic compression fracture. Right neural foraminal narrowing is noted at the L4/5 level, central canal narrowing is moderate to severe, left neural foraminal narrowing is mild at that level. 3. T12 anterior wedging of approximately 30% is grossly unchanged. 4. Anterior wedging and partial compression fracture 30% is unchanged. 5. L3/4 level posterior and circumferential disc bulge measures up to 3 mm. moderate right foraminal narrowing and mild central canal narrowing. 6. Adnexal cyst measuring approximately 2.6 x 1.8 cm is unchanged. PRIOR STUDY CURRENT STUDY Arash Afari, MD Diplomate, American Board of Radiology 2