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d Date : 00.00.00

Name of the Patient : Abc Xyz lmn / F / 21 yrs.
Referred by : Dr. Abc Xyzrani.
Examination : M.R.I. of the Cervico-dorsal Spine.

CLINICAL PROFILE :

C/O TB of left TM joint. Craniotomy with excision of tumor (tuberculoma) in left occipital lobe done on 00.00.00.
For follow up. On AKT since May 0000.

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 slight anterior wedging of the D3 and D4 vertebral bodies. The D3-D4 intervertebral disc is reduced in height and shows loss of water content.

The D3 and D4 vertebral bodies on the right appear hypointense on the T1 Weighted images and hyperintense on the T2 Weighted images. There is an intermediate signal intensity soft tissue lesion on the T1 Weighted images in the right paravertebral region over the D3 to D5 vertebral levels. This lesion appears hyperintense on the T2 Weighted images and shows a well-marginated hypointense rim, peripherally. Erosion of the right lateral margin and right pedicle of D3 and D4 vertebrae is noted. Extension of soft tissue lesion into the right neural foramen at the D3-D4 and D4-D5 levels and in the anterior right lateral epidural space at D3 and D4 levels is noted. There is
Scan-00003


also involvement of the D3 and D4 ribs proximally and the respective costo-vertebral joints on the right side. There is however no significant cord compression. The dorsal spinal cord over the D2 to D4 vertebral levels shows an ill-defined hyperintense signal on the T2 Weighted images which suggests cord edema/ischemia.

A similar smaller lesion is noted in the left paravertebral region at the D2 and D3 vertebral levels. The left half of the D3 and D4 vertebral bodies show spotty fatty marrow changes which may suggests partial healing. The posterior elements of the D4 and D5 vertebrae seems to be involved by the lesion with subtle hyperintense signal on the T2 Weighted images in the right half of the D5 vertebral body.

A congenital block C5/C6 vertebra is noted.

The rest of the visualized cervico-dorsal vertebral bodies and the remaining intervertebral discs reveal normal signal intensity. The facet joints are unremarkable.

IMPRESSION :

Altered signal of the D3 and D4 vertebral bodies as described most likely represents osteitis, probably tuberculous osteitis. Right paravertebral soft tissue lesion at the D3 and D4 vertebral levels may represent granulation tissue, which is seen to extend into the anterior and right lateral epidural space. Altered signal in the dorsal spinal cord over the D2 to D4 vertebral levels suggests cord edema/ischemia.

Altered signal in the D5 vertebra and the posterior elements of the D4 and D5 may also represent osteitis.

The possibility of the neoplasm is less likely.

Previous investigations were unavailable for comparison.

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