hs/ke/nl/rg.
Name of the Patient : Abc Xyzlmn / M / 37 yrs.
Referred by : Dr. Abc Xyzhah.
Examination : M.R.I. of the Dorsal Spine.
CLINICAL PROFILE :
Alleged H/O vehicular accident with backache radiating to BLE and weakness of BLE with bladder involvement.
EXAMINATION :
M.R.I of the dorsal spine was performed using the following parameters :
4 mm thick T1 Weighted and T2 Weighted sagittal images.
5 mm thick T1 Weighted and T2 Weighted axial images.
The lumbar spine was screened with 5 mm thick T1 Weighted sagittal images and the cervical spine was screened with 4 mm thick T1 Weighted sagital images.
OBSERVATION :
The D8 vertebral body is decreased in height and is centrally wedged. The D8 vertebral body is seen to bulge circumferentially with slight indentation upon the cord.
Areas of hypointensity on the T1 Weighted images which turn mildly hyperintense on the T2 Weighted images are seen to involve the D4, D5, D7, D8 and D11 vertebral bodies.
There is slight extension of this pathologic process into the anterior epidural space and right paravertebral soft tissues at the D7 and D8 vertebral levels. The D7 and D8 pedicles are also involved.
Scan-00008
There is a large soft tissue component within the right paravertebral soft tissues and right lateral epidural space at the D4 and D5 levels with destruction of the right D4 and D5 pedicles. The cord over these levels is compressed and displaced to the left. The cord over these levels shows a hyperintense signal on the T2 Weighted images and which would represent cord edema/ischemia. Also seen is destruction of the head and neck of the right rib at these levels.
Hypointense areas on the T1 Weighted images are also seen to involve the L3 and C7 vertebral bodies and the right iliac bone. Also seen is retroplacement of the L5 vertebra over the S1 vertebra. A small posterior disc herniation with peridiscal osteophytes is noted at the L5-S1 level.
A few of the visualized dorsal intervertebral discs show loss of water content.
The rest of the visualized dorsal vertebral bodies reveal normal signal intensity. The facet joints are unremarkable.
The visualized lower dorsal spinal cord reveals normal signal intensity.
The conus medullaris terminates at the L1 level.
Soft tissue lesions are also seen in the left lung and in the region of the right adrenal gland. Also seen are enlarged mediastinal lymph nodes.
IMPRESSION :
The MRI features are suggestive of a pathologic process involving multiple vertebrae, the right iliac bone, the left lung and within the right adrenal region. This may represent a neoplastic process like secondaries or small cell tumors.
The possibility of this being an infective process like tuberculosis though less likely cannot be entirely excluded.