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There is a 9 x 11 x 20 mm intramedullary mass in the upper cervical spinal cord. It is centrally located and extends between C2/3 and mid C4 levels. Associated cord expansion is noted.
Pre-contrast, the mass shows heterogeneous high T2 signal and T1 signal slightly less than that of spinal cord. There is an associated tumour syrinx extending between C1/2 and the lower C4 vertebral levels (37 mm craniocaudally), at the inferior aspect of which there is low T2 signal compatible with a "hemosiderin cap". The mass shows avid, homogeneous enhancement.
The remainder of the cervical spinal cord is normal in signal and calibre. The cervico-medullary junction is normally positioned. Posterior disc-osteophyte complexes at C5/6, C6/7, and C7/T1 mildly narrow the central vertebral canal. The neural exit foramina are adequate.