hs/sb/nl/rg.
/119 Date : 00.00.00
Name of the Patient : Abc XyzNarayalmn / M / 44 yrs.
Referred by : Dr. Abc Xyznghal.
Examination : M.R.I. of the Cervical & Dorsal Spines.
CLINICAL PROFILE :
C/O weakness of the LLE since 25 days.
Known C/O sarcoidosis.
EXAMINATION :
M.R.I of the cervical spine was performed using the following parameters :
4 mm thick T1 Weighted and T2 Weighted sagittal images.
5 mm thick Fast Scan (T2 *) axial images.
M.R.I of the dorsal spine were performed using the following parameters :
4 mm thick T1 Weighted and T2 Weighted sagittal images.
5 mm thick T2 Weighted axial images.
The brain was screened with 5 mm thick T2 Weighted axial images and after administration of contrast 5 mm thick T1 Weighted axial and sagittal images were obtained.
OBSERVATION :
There is slight enhancement along the leptomeninges along the anterior surface of the cervical spinal cord. Also seen is enhancement along the anterior surface of the brain-stem, the inferior aspect of the vermis and right cerebellar hemisphere and along the anterior surface of the right frontal lobe.
Hyperintense areas on the T2 Weighted images are seen within the right lentiform nucleus. It is hypointense on the T1 Weighted images and does not enhance. This may represent ischemia/infarction. Smaller similar areas are seen in the medulla.
..2/.
An irregularly defined area of hypointensity on the T2 Weighted images is seen in the medial right temporal lobe and this is seen to enhance. Smaller areas of enhancement are seen superior to the left Sylvian fissure and in the left insular cortex. There is mild prominence of the cerebral cortical sulci and cerebellar folia. Also seen is mild fullness of the ventricular system.
A small postero-central disc herniation more to the right of the midline is seen at the C5-C6 level. Postero-central disc protrusions are noted at the C3-C4 and C4-C5 levels. A posterior disc bulge is noted at the C2-C3 level.
The visualized cervico-dorsal vertebral bodies and spinal cord reveal normal signal intensity. The visualized cervico-dorsal intervertebral discs show loss of water content.
The conus medullaris terminates at the L1 level.
IMPRESSION :
In a known C/O sarcoidosis, the MRI features are suggestive of :
1. Enhancement of the leptomeninges along the anterior surface of the cervical spinal cord.
2. Areas of enhancement along the meninges along the anterior surface of the brain-stem, the inferior aspect of the vermis and right cerebellar hemisphere and along the anterior surface of the right frontal lobe.
3. Enhancing lesions in the medial right temporal lobe, superior to the left Sylvian fissure and in the left insular cortex would represent granulomas.
4. An area of altered signal within the right lentiform nucleus may represent an area of ischemia/infarction.