Lumbar vertebral metastases

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Image 1

Clinical History: 
A 61 year old man with small cell carcinoma of the lung

Diagnosis:
Lumbar vertebral metastases

MR Technique: 
Sagittal 4mm 2D FSE T1- and T2-weighted images of the lumbar spine are presented, obtained at 1.5 T on a Siemens Avanto MR system. Sequence specific parameters were TR/TE = 665/7.9 and 3130/98, with scan times of 3:35 and 3:32 respectively.

Imaging Findings:
The principal findings are most evident on the T1-weighted scan. There is near diffuse abnormal low signal intensity (SI) to the marrow of the lumbar vertebral bodies, equal or lower in SI than the intervertebral disks (a critical observation). A few spared areas of normal fatty marrow remain, for example the superior posterior portion of L1, and the majority of L4. The marrow appears heterogeneous on the T2-weighted scan, but the extent of marrow replacement is difficult to define. The sensitivity of this scan is also diminished by the lack of fat saturation. The imaging findings overall are compatible with extensive marrow replacement by metastatic disease. There are superimposed mild generalized degenerative changes.