Davao Park District, Dakudao Loop, Lanang, Davao City, 8000 Philippines

MAGNETIC RESONANCE IMAGING REPORT

Hosp. No.: 02-23-56
Patient ID: CH23-
Name: FREY, NORBERT WERNER Age: 78 Sex: MALE
Address: DAVAO CITY
Examination: MRI WHOLE SPINE PLAIN Indication of Exam: FOR EVALUATION
Referring Physician: DR. Room No.: OUTPATIENT
Date & Time Performed: 10-19-2023 Released Date: 10-24-2023

TECHNIQUE: Standardized fat and water weighted pulse sequence were obtained in the standard protocol
Comparative MRI: Cervical MRI only 9-23-23

FINDINGS:

CERVICAL

Cervical spine alignment is maintained. No spondylolisthesis seen. Marginal spurs are seen in the anterior and
lateral margins of the cervical spine.The vertebral bodies have normal height. No abnormal marrow signal noted.

Disc level analysis:

C2-7- T2w hypointense changes are noted in the intervertebral disc spaces between C2-3 to C7-T1. C2-3 to C6-7 ,
there is a circumferential disc bulge with uncovertebral joint and ligamentum flavum hypertrophy.

There is mild spinal canal stenosis at the level of C2-3, C5-6 and C6-7. There is mild indentation noted at the
posterior margin of the spinal cord at the level of C2-3.

There is moderate bilateral neural foraminal stenosis at the level of C2-3 to C6-7 with suggestive contact of the
exiting roots of C2 to C7.

The spinal cord has a normal size and signal intensity.

The paraspinal muscles and retroperitoneum are unremarkable.

JIFFY C. CASAS, RRT SAMUEL B. BANGOY, MD, FPCR, FUSP, FCT-MRIS, FPSVIR
Radiologic Technologist Radiologist

This report is based on MR findings and should be correlated with clinical, laboratory and other imaging modalities.

ANC-IOR-FO-008 Effective Date: September 2020

 Davao Park District, Dakudao Loop, Lanang, Davao City, 8000 Philippines

CONCLUSION:

1. DEGENERATIVE SPONDYLOSIS OF THE CERVICAL SPINE WITH DISC DISEASE DISC BULGE AT C-3 AND C6-7,
UNCHANGED
2. CERVICAL HYPERLORDOSIS.

THORACOLUMBAR

Multilevel focal and diffuse thoracolumbar T2/T1 hyperintense and focal T1 hypointense changes are seen in the
thoracolumbar and sacral vertebrae. These exhibits hyperintense and hypointense signal intensity in STIR/Dixon,
respectively. Mild anterior compression deformities are seen in T5, T6 and T7 vertebral bodies. Mild thoracic
kyphosis is noted. Lumbar vertebral alignment is normal.

An intradural extramedullary spinal nodular lesion is seen at T1 level with associated narrowing of the central
spinal canal measuring 1.8 x 0.9 cm. This is isointense in T2 and T1.

Posterior paraspinal soft tissue mass is seen at T8-9 level more lateralize to the left and with lytic destruction of
the left transverse process of T9. There is intraspinal extension at the same level with obstruction of the central
spinal canal. This is approximately measures 4.5 x 4.4 x 1.5 cm (cctransap).

Intradural and extramedullary spinal mass is seen in S1-3 level. This exhibits isointense in T2 and T1 and with
intermediate increase signal intensity in T2 dixon. An ill-defined slightly lobulated irregular soft tissue mass is seen
at the right iliac region measuring 6.1 x 2.5 cm.

Likewise, incidental finding of T2/T1 hyperintense osseous changes is seen in the head and metaphysis of the
right humerus with intact cortices. There are also focal areas of mixed signal intensity at the metaphysis.

Focal lytic lesions are seen in the right lateral 4th and 6th ribs. Abnormal bone marrow signal intensities are seen
in the sacral alae and bilateral iliac bones. These exhibits iso- to hypointense signal intensities in T2 and T1,
respectively.

Spinal cord is normal in caliber and signal intensity. Normal conus medullaris that terminates at L1 level.

Disk levels:

C7- T7: Mild osteophytes are seen along the vertebral end-plate margins. There is decrease in disc height and with
dessications. No posterior annular disc bulge/protrusion. Normal central canal and neural foraminae. Bilateral
facet joints arthrosis demonstrated. Posterior longitudinal ligament and ligamentum flavum are normal.

T7-8: Mild osteophytes are seen along the vertebral end-plate margins. There is decrease in disc height and with
dessications. No posterior annular disc bulge/protrusion. Normal central canal and neural foraminae. Bilateral
facet joints arthrosis demonstrated. Posterior longitudinal ligament and ligamentum flavum are normal.

T8-9: Moderate osteophytes are seen along the vertebral end-plate margins. There is decrease in disc height and
with desiccations. No posterior annular disc bulge/protrusion. There is obstruction of central spinal canal and

JIFFY C. CASAS, RRT SAMUEL B. BANGOY, MD, FPCR, FUSP, FCT-MRIS, FPSVIR
Radiologic Technologist Radiologist

This report is based on MR findings and should be correlated with clinical, laboratory and other imaging modalities.

ANC-IOR-FO-008 Effective Date: September 2020

 Davao Park District, Dakudao Loop, Lanang, Davao City, 8000 Philippines

bilateral neural foraminae. Bilateral facet joints arthrosis demonstrated. Posterior longitudinal ligament and
ligamentum flavum are normal.

T9-12: Mild osteophytes are seen along the vertebral end-plate margins. There is decrease in disc height and with
desiccations. No posterior annular disc bulge/protrusion. Normal central canal and neural foraminae. Bilateral
facet joints arthrosis demonstrated. Posterior longitudinal ligament and ligamentum flavum are normal.

L1-2: Mild osteophytes are seen along the vertebral end-plate margins. Normal disc height and hydration. No
posterior annular disc bulge/protrusion. Normal central canal and neural foraminae. Bilateral facet joints arthrosis
demonstrated. Posterior longitudinal ligament and ligamentum flavum are normal.

L2-S1: Mild to moderate osteophytes are seen along the vertebral end-plate margins. Normal disc height and
desiccations. There is posterior disc bulge in L4-5. Normal central canal and neural foraminae. Bilateral facet joints
arthrosis demonstrated. Posterior longitudinal ligament and ligamentum flavum are normal.

Other findings:

Multiple varisized randomly scattered pulmonary nodules are seen in both lungs more in the right. Lytic lesions
are seen in the right lateral 4 th and 6th ribs demonstrated in coronal view.

Bilateral small cortical cysts are seen in both kidneys as well.

IMPRESSION:

1. T8-9 POSTERIOR PARASPINAL SOFT TISSUE MASS WITH INTRASPINAL EXTENSION AND CENTRAL CANAL
AND LEFT NEURAL FORAMINA OBSTRUCTION PROBABLE METASTATIC LESION. BIOPSY IS
RECOMMENDED.
2. INTRADURAL EXTRAMEDULLARY THORACIC (T1) AND SACRAL (S1-2) SPINAL MASSES CONSIDER
METASTATIC LESION WITH SPINAL CANAL STENOSIS AND OBSTRUCTION RESPECTIVELY
3. DIFFUSE AND FOCAL BONE THORACOLUMBAR AND SACRAL VERTEBRAL ABNORMAL BONE MARROW
CHANGES PROBABLE METASTATIC LESIONS AND MULTILEVEL MODIC’S TYPE 2 CHANGES
4. MULTILEVEL MILD TO MODERATE THORACOLUMBAR DEGENERATIVE JOINT DISEASE AND
SPONDYLOSIS DEFORMANS
5. MULTILEVEL DISC DESICCATIONS, T1-9 AND L2-S1 WITH POSTERIOR DISC BULGE AT L4-5

INCIDENTAL FINDING:

1. RIGHT HUMERAL ABNORMAL T2 HYPERINTENSE BONE MARROW CHANGES PROBABLE METASTATIC

LESION
2. BILATERAL ILIAC AND SACRAL ABNORMAL BONE MARROW SIGNAL INTENSITIES CONSIDER OSSEOUS
METASTASES
3. RIGHT ILIAC SOFT TISSUE MASS
4. BILATERAL PULMONARY NODULES CONSIDER METASTATIC LESION
5. BILATERAL SMALL CORTICAL RENAL CYSTS

JIFFY C. CASAS, RRT SAMUEL B. BANGOY, MD, FPCR, FUSP, FCT-MRIS, FPSVIR
Radiologic Technologist Radiologist

This report is based on MR findings and should be correlated with clinical, laboratory and other imaging modalities.

ANC-IOR-FO-008 Effective Date: September 2020