Fig 3.

Multiple intramedullary spinal cord metastases, with visualization of other CNS metastases. A 60-year-old woman with a history of small-cell lung carcinoma, diagnosed 6.5 months prior, presented with several days of lower extremity weakness and urinary and stool incontinence. MR images of the cervical and thoracic spine with postcontrast fat-saturated consecutive sagittal T1-weighted images of the thoracic spine (A, B, C) and postcontrast sagittal T1-weighted image of the cervical spine (D) are shown. Several enhancing intramedullary lesions are present (white arrows in A, B, D). There is abnormal leptomeningeal enhancement with several small metastases studding the surface of the cord (arrows in C). Metastases are visualized in the lower pons and cerebellum (thick white arrows in D). Visualization on MR imaging of other CNS or spinal (non-spinal cord) metastases was common in this series, and more common in patients with multiple ISCMs.