Date : 00.00.00
Name of the Patient : Abc Xyzbi M.Y. Shlmn / F / 48 yrs.
Referred by : Dr. Abc Xyztcheswalla.
Examination : M.R.I. of the Dorso-lumbar Spine.
CLINICAL PROFILE :
C/O backache radiating to BLE (left more than right) with paresthesias.
M.R.I of the dorso-lumbar spine was performed using the following parameters :
5 mm thick T1 Weighted and T2 Weighted sagittal images.
6 mm thick T1 Weighted and T2 Weighted axial images.
The D11 vertebra appears to be as marked on the film.
There is collapse of the D10 vertebral body with slight anterior wedging.
There is replacement of the normal marrow of the D9 and D10 vertebral bodies by hypointense areas on the T1 Weighted images. These are seen to turn heterogeneously hyperintense on the T2 Weighted images. The pedicles of these vertebrae are also involved by the pathology. The superior and inferior cortical endplates of the D10 vertebral body and the inferior cortical endplate of the D9 vertebra are breached with involvement of the D9-D10 intervertebral disc. There is pre and paravertebral soft tissue extension at the D9 and D10 levels. Anterior epidural extension is also noted at this level with encroachment into the D9-D10 neural foramina bilaterally and encasement of the exiting nerve roots. The spinal cord at these levels shows a subtle hyperintense signal on the T2 Weighted images (is isointense to normal cord on the T1 Weighted images) suggestive of cord edema/ischemia/myelitis.
The rest of the visualized dorso-lumbar vertebral bodies and the remaining visualized intervertebral discs are unremarkable.
The conus medullaris terminates at the L1 level.
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The MRI features are suggestive of altered signal of the D9 and D10 vertebrae and D9-D10 intervertebral disc with soft tissue extensions as described and cord signal alteration at these levels represent cord edema/ischemia/myelitis. These features are not specific for a single etiology. This may represent an infective process like tuberculosis. The possibility of this being a neoplastic process like a small cell tumor or metastasis is less likely.