Date : 00.00.00
Name of the Patient : Abc Xyzant S. Mhlmn / M / 51 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Cervical Spine.
C/O neck pain with paresthesias in BUE and BLE with weakness and gait imbalance since 6 months with weak grip.
M.R.I of the cervical spine was performed using the following parameters :
5 mm thick T1 Weighted and T2 Weighted sagittal images.
5 mm thick T1 Weighted and Fast Scan (T2 *) axial images.
There is flattening of the spinal cord on the left side at the C4 and C5 vertebral levels. A hyperintense focus on the Fast Scan (T2 *) images is seen in the region of the anterior horn cells on the left side within the spinal cord over the C4-C5 to the C5-C6 levels and on the right side at the C5-C6 level. Such changes may be seen with motor neuron disease.
A postero-central disc herniation is seen to indent the thecal sac at the C6-C7 level.
Postero-central disc protrusions are seen at the C4-C5 and C5-C6 levels.
A posterior disc bulge is noted at the C3-C4 level.
Small posterior peridiscal osteophytes are noted over the C3-C4 to the C6-C7 levels.
The cervical intervertebral discs show loss of water content.
There is evidence of a lesion which is hyperintense to muscle but hypointense to fat on the T1 Weighted images and turns hyperintense to both on Fast Scan (T2 *) images and is located lateral to the right carotid sheath over the C2-C3 to C3-C4 level. This may represent a portion of an enlarged right parotid gland or enlarged lymphnode.
The cervical vertebral bodies show normal signal intensity. The joints of Luschka and the visualized pre and paravertebral soft tissues are unremarkable.
The atlanto-axial region and the cervico-medullary junction are unremarkable.
The MRI features are suggestive of :
1. Motor neuron disease involving the cervical spinal cord as described.
2. A postero-central disc herniation at the C6-C7 level.
3. Postero-central disc protrusions at the C4-C5 and C5- C6 levels.
4. A lesion located lateral to the right carotid sheath over the C2-C3 to C3-C4 level may represent a portion of an enlarged right parotid gland or enlarged lymphnode. Further evaluation of the same would be worthwhile.