Category: Musculoskeletal Imaging, Region: Other, Plane: Other
A) Sagittal contrast enhanced T1-weighted MRI of the lumbar spine demonstrates diffuse leptomeningeal spread of disease along the surface of the conus and cauda equina nerve roots (small white foci; left image). Axial contrast enhanced T1-weighted (middle image) and T2-weighted (right image) demonstrates a separate focus of leptomeningeal disease involving the dorsal T3 thecal sac. Diffuse enhancing metastatic disease was observed throughout the spine (not shown). B) Marked interval disease progression is evidenced by new and enlarging enhancing foci (arrow). Additionally, the T3 lesion was noted to exhibit mass effect upon the subjacent thoracic cord (arrow head).