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Expansion of the cervical cord from a peripherally enhancing lesion which extends for a distance of approximately 7.6 cm between C4 and T1.
The cervical cord between the levels of C4 and C7/T1, there is a heterogeneous T2-hyperintense lesion which expands the cord. It measures up to 7.4 x 7.1 mm in the axial plane at C6 and extends for a distance of approximately 7.6 cm. The lesion is predominantly hypointense on T1 and demonstrates thick peripheral enhancement. The rim of the lesion demonstrates T2 hypointensity. There is increased T2 signal extending superiorly to the cervical medullary junction and inferiorly to approximately the level of T6, involving predominantly central grey matter of the cord.
No other cord lesions are identified. No evidence of discitis or vertebral body osteomyelitis. No extradural collection identified. The conus terminates at L1.
In the correct clinical context, the findings are compatible with a spinal cord abscess, although this is an uncommon entity. The findings are more likely those of a spinal cord tumour (?ependymoma or less likely lymphoma) possibly with hemorrhage accounting for the non-enhancing, T2 intense central portion & rapid progression of symptoms. The appearance is not typical for a demyelinating plaque given the extent and the presence of cord expansion.