88-year-old male complained of mid-back pain.
Using a body coil, thoracic spine levels were imaged. At the T8-T9 interspace (not shown) there is heterogeneous decreased T1 signal within a narrowed intervertebral disc. The vertebral endplates are indistinct and there is decreased signal in the vertebral bodies (Film 1, top row). Post-gadolinium T1 sagittal (Film 1, bottom row) and coronal (Film 2) images demonstrate enhancement of the disc space as well as probable extension into the right paraspinal space. Follow-up scans (Films 3, 4, 5) were performed approximately one month after therapy was initiated. Sagittal and coronal images show progressive loss of vertebral body height and complete loss of endplate margins. Post-gadolinium image (Film 6) demonstrates diffuse, irregular enhancement with progression of the process into the epidural space.
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