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hs/sb
Date : 00.00.00

Name of the Patient : Abc Xyz M. Klmn / M / 14 yrs.
Referred by : Dr. Abc XyzVaishnav.
Examination : M.R.I. of the Dorsal Spine.

CLINICAL PROFILE :

C/O swelling on the left side of the upper back since 1 month with evening rise of temperature.
Past H/O tuberculous abscess of the chest wall, which was drained. Has received 6 months of AKT.

EXAMINATION :

M.R.I of the dorsal spine was performed using the following parameters :

5 mm thick T1 Weighted and T2 Weighted sagittal images.

8 mm thick T1 Weighted and T2 Weighted axial images.

OBSERVATION :

Areas of hypointensity on the T1 Weighted images which turn hyperintense on the T2 Weighted images are seen to involve the D6 and D9 vertebral bodies and the left side of the D5 vertebral body and the right side of the D8 vertebral body. The right pedicles of the D8 and D9 vertebrae and the left pedicles of the D5 and D6 vertebral bodies are also involved.

There is a large left paracentral soft tissue component over the D5 to D7 vertebral levels. It is hypointense with a hyperintense rim on the T1 Weighted images and turns hyperintense with a hypointense rim on the T2 Weighted images and would represent a loculated abscess. Another near similar lesions are seen in the left posterior paraspinal soft tissues over the C6 to D6 vertebral levels and in the right posterior paraspinal soft tissues over the D1 to D9 vertebral levels. There is extension of the pathologic process into the posterior epidural space over the D5 to D7 vertebral levels with cord compression. The cord over these levels show a subtle hyperintense signal on the T2 Weighted images suggestive of cord edema/ischemia/myelitis.
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A small right paravertebral soft tissue component is noted at the D8 and D9 vertebral levels.

The rest of the visualized dorsal vertebral bodies and intervertebral discs are unremarkable.

Probable involvement of the posterior segments of the left D4 and D5 ribs and the manubro-sternum is noted.

IMPRESSION :

The MRI features are suggestive of a pathologic porcess most likely an infective lesion like tuberculosis involving the D5, D6, D8 and D9 vertebrae with multiple soft tissue lesions and cord compression over the D5 to D7 vertebral levels as described.

The possibility of this being a neoplastic process is less likely.


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