Date : 00.00.00
Name of the Patient : Abc XyzDlmn / M / 75 yrs.
Referred by : Dr. Abc Xyzidhungat.
Examination : M.R.I. of the Dorsal Spine.
CLINICAL PROFILE :
C/O weakness of BLE since 4-6 months with bladder involvement since 8 days.
M.R.I of the dorsal spine was performed using the following parameters :
5 mm thick T1 Weighted and T2 Weighted sagittal images.
7 mm thick T1 Weighted and T2 Weighted axial images.
The cervical and lumbar spines were screened with 5 mm thick T1 Weighted sagittal images.
All the vertebrae in the entire spinal axis, the clivus and the visualized iliac bones show replacement of their normal fatty marrow by a hypointense signal on the T1 Weighted images which appears heterogeneously hyperintense on the T2 Weighted images. The dorsal intervertebral discs show slight loss of water content. The posterior segments of the visualized ribs on either side also show similar signal intensity changes.
There is seen an intermediate signal intensity soft tissue lesion on the T1 Weighted images in the epidural space, circumferentially at the D6, D7, D9, D10 and D11 vertebral levels. This lesion also appears slightly hyperintense on the T2 Weighted images. Resultant effacement of the CSF space and mild
cord compression is noted at these levels. The dorsal spinal cord shows a hyperintense signal on the T2 Weighted images at the D6, D7 and D10 vertebral levels which may suggest cord edema/ischemia. There is compromise of the neural foramina bilaterally, in the dorsal region, at the levels of the epidural soft tissue lesion.
Bulging of the posterior margins of the lumbar vertebral bodies is noted.
The conus medullaris terminates at the L1 level.
Incidentally noted is a soft tissue lesion in the lower lobe of the right lung, posteriorly and probable pleural effusion bilaterally.
Altered signal of all the vertebrae in the spinal axis, the clivus, iliac bones and the posterior segments of the visualized ribs as described, with epidural soft tissue lesion in the dorsal region, is not specific for a single etiology. The differential diagnosis would include :
1. Sclerotic metastasis, (? from a carcinoma of the prostate).
2. Round cell tumors (eg. lymphoma).