I recently had a thoracic MRI because of mid-back pain and I'm wondering if you could help me interpret the results. My doctor went over most of them, but I was wondering if you could supply a second opinion for me. This was noncontrast.
Findings: The thoracic spine is normal. The cervical spine bulging of the annulus and central protrusions are seen at C4-5, C5-6, and C6-7. There is no cord deformity. Axial images were not included of these levels.
T1-T12 - There is no protrusion, central canal, or foraminal stenosis. The cord and thecal sac contents are normal. Moderate dorsal paraspinal muscle atrophy is seen. A small right pleural effusion is identified measuring maximally .5 cm. Cardiomegaly is identified.
A region of increased signal intensity is seen on the T1 and T2 sequence in the left side of the T5 vertebral body consistent with a small hemangioma.
1. There is no protrusion, central canal or foraminal stenosis identified in the thoracic spine. There are protrusions seen in the cervical spine. There is no canal stenosis in the cervical spine.
2. There is no cord deformity.
3. A small right pleural effusion is seen. The heart is prominent. This may be further characterized with a chest radiograph or echocardiography if there are signs and symptoms of cardiomegaly.
4. A curvature of the spine is identified convex to the right measuring 5 degrees.
So, I have a few different questions. First of all, the hemangioma - is that pretty common? I've never really heard of them before, but I know they are benign. Is that a common location to have one? The back pain I've been having is in my upper left side, essentially the scapular region. I've had it off and on for a decade. Could this be the cause?
My other question is in regards to the enlarged heart. My heart is sort of a mess because of what I was born with: Atrial Septal Defect, Coarctation of the Aorta (repaired twice), Bicuspid aortic valve, subaortic membrane, and small aortic aneurysm (at the the sight of the coarcation repair). I am followed by a congenital heart specialist and I had a very extensive cardiac MRI last April that demonstrated all my previous problems. I have never been told I have an enlarged heart, however. I have attached the images - I'm wondering if you could tell me exactly how enlarged it is.
In the images, you'll also see a bright spot on my liver. Is that a blood vessel?
Thank you for all your help.
Hemangioma is a very very common benign spot that can be anywhere in the spine. it is not a cause of any symptoms and is a "don't touch lesion".
I would not necessarily rely on the evaluation of the heart size on the thoracic MRI. the best way to look at it would be on echocardiogram or a plain chest xray. given your complicated history with various congenital anomalies; I would listen to your specialist. If you are curious about this comment in the report, I would bring it up with him/her and get the answers.
Unfortunately, the images that you have attached don't show much of anything. I know it is hard to pick out the right images from the stack. I wouldn't worry about it too much.
Hope this is somewhat helpful.