Date : 00.00.00
Name of the Patient : Abc Xyz Rlmn / F / 54 yrs.
Referred by : Dr. Abc XyzV. Shah.
Examination : M.R.I. of the Lumbo-sacral Spine.
CLINICAL PROFILE :
M.R.I of the lumbo-sacral 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.
The lumbar intervertebral discs except at the L4-L5 level show loss of water content.
There is a hypointense signal on the T1 Weighted images within the L4 vertebral body and pedicle on the right side. This is not well appreciated on the T2 Weighted images.
An intradural lesion which is isointense to fat on all the pulse sequences is seen over the L5-S1 to the S2-S3 level. The filum terminale is inserted into this lipoma. The conus medullaris is seen to be low lying and terminates at the L3 vertebral level.
There is slight retroplacement of the L5 vertebra over the S1 vertebra. A small postero-central disc herniation is noted at the L5-S1 level. A posterior disc bulge is noted at the L4-L5 level.
Mild facetal hypertrophy is noted at the L3-L4, L4-L5 and L5-S1 levels.
The rest of the lumbar vertebral bodies reveal normal signal intensity. The remaining facet joints and the visualized pre and paravertebral soft tissues are unremarkable.
The antero-posterior dimensions of the lumbar canal at the level of the intervertebral discs are as follows :
20.0 mm at L1-L2
20.0 mm at L2-L3
19.0 mm at L3-L4
19.0 mm at L4-L5
15.0 mm at L5-S1.
The MRI features are suggestive of :
1. A low lying conus medullaris with insertion of the filum terminale into an intradural lipoma which is seen to extend over the L5-S1 to S2-S3 levels.
2. A small postero-central disc herniation at the L5-S1 level.
3. Altered signal in the L4 vertebral body and pedicle on the right side is not specific for a single etiology. Osteitis may be considered.