PMC6560324_01
Sagittal gadolinium-enhanced T1-weighted Turbo Spin Echo Fat Sat MR image. The dorsal spinal cord is deformed and compressed by a sleeve of enhancing tissue, centered at the T2-T3 levels and extending between T2 and T7. The posterior body of T7 is infiltrated by a blastic lesion (hypointense on T1, T2, and STIR sequences) with peripheral enhancement (red arrow) highly suggestive of a bone metastasis.
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The study revealed signs of diffuse medullary metastatic disease, assuming a sleeve-like appearance in the dorsal segment (Figure 1), filling the perimedullary subdural space, most significantly at the T2-T3 level, and molding the posterior medulla (Figures 1 and 2). Besides the above-described lesions, there was evidence of bone deposits in the right pedicle of T4 and the vertebral body of T7 (Figure 1).
Axial gadolinium-enhanced T1-weighted Turbo Spin Echo MR image. An enhancing mass surrounds, deforms, and compresses the spinal cord all around its perimeter but most exuberantly in the left posterior side (red arrow).
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The study revealed signs of diffuse medullary metastatic disease, assuming a sleeve-like appearance in the dorsal segment (Figure 1), filling the perimedullary subdural space, most significantly at the T2-T3 level, and molding the posterior medulla (Figures 1 and 2).
(a) Sagittal gadolinium-enhanced T1-weighted Turbo Spin Echo Fat Sat MR image. Multiple round enhancing foci (red arrows) sticking to the posterior medulla, corresponding to diffuse leptomeningeal spread of metastases. (b) Sagittal T2 Short Time Inversion Recovery (STIR) MR image. The leptomeningeal metastases are also well depicted as hipointense nodules on the STIR sequence (yellow arrows) surrounded by the T2-hyperintense CSF.
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Additionally, leptomeningeal metastatic spread was also observed as disperse small nodular foci, sticking to the spinal cord and the dorsal roots (Figures 3(a) and 3(b)).