Spinal metastasis: thoracic spine MRI

(A) Sagittal T1-weighted, (B) T2-weighted, and (C) post-contrast T1 Dixon water-only MRI show near replacement of the vertebral body T7 by a tumor mass (white straight arrows), best seen as fat extinction in (A). Intraspinal epidural extension is depicted (straight black arrows) as well as cord displacement. (D) Axial T2-weighted MRI at the level of T7 shows extensive extraosseous soft tissue components on both sides (dashed white arrows) and substantial intraspinal epidural tumor extension (dashed black arrows). The cord is displaced backward and slightly to the left. Only very little CSF is visible dorsal to the cord. (Contributed by Kristine Ann Blackham MD.)