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/32 Date : 00.00.00

Name of the Patient : Abc Xyz N. lmn / F / 55 yrs.
Referred by : Dr. Abc Xyzhta.
Examination : M.R.I. of the Cervico-dorsal Spine.

CLINICAL PROFILE :

H/O fall with loss of sensation waist downwards and bladder/bowel involvement since 15 days.

EXAMINATION :

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

5 mm thick T1 Weighted and T2 Weighted sagittal images.

5 mm thick T1 Weighted and T2 Weighted axial images.

OBSERVATION :

There is near complete collapse of the D2 vertebral body. The D1, D2 and D3 vertebral bodies appear hypointense on the T1 Weighted images and hyperintense on the T2 Weighted images. The D2-D3 intervertebral disc appears hyperintense on the T2 Weighted images. Involvement of the spinous processes of the D2 and D3 vertebrae is also noted.

There is a fairly large prevertebral and right paravertebral intermediate signal intensity soft tissue lesion on the T1 Weighted images extending over C6 to D4 vertebral levels. This lesion appears heterogenously hyperintense on the T2 Weighted images. Resultant anterior displacement of the trachea is noted. There is also extension of the soft tissue lesion into the anterior and right lateral epidural space over C6-C7 to D4 vertebral levels, with cord compression and posterior displacement of the cord. The upper dorsal spinal cord over D1 to D4 vertebral levels shows a hyperintense signal on the T2 Weighted images which suggests cord edema/ischemia.
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The D4 vertebral body shows altered signal along its right lateral margin.

The rest of the visualized cervico-dorsal vertebral bodies show spotty fatty marrow changes. The D5, D6, D7 and D8 vertebral bodies appears slightly wedged, centrally.

The facet joints are unremarkable.

Screening T1 Weighted sagittal images of the dorso-lumbar spine reveal a hypointense signal involving the L3 vertebral body.

IMPRESSION :

Near complete collapse of D2 vertebral body with altered signal of the D1 to D3 vertebral bodies and the D2-D3 intervertebral disc suggests osteitis with discitis, most likely tuberculous in etiology. Prevertebral, right paravertebral and anterior epidural soft tissue lesion as described may represent granulation tissue/abscess. There is cord compression and cord signal alteration over D1 to D4 vertebral levels which suggests cord edema/ischemia.

The D4 and L3 vertebrae also show altered signal as described.

The possibility of the above described lesion representing a neoplasm seems less likely.

Slight central wedging of the D5 to D8 vertebral bodies as described may be due to osteoporosis.


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