Date : 00.00.00
Name of the Patient : Abc Xylmn / F / 27 yrs.
Referred by : Dr. Abc Xyzhah.
Examination : M.R.I. of the Pelvis.
CLINICAL PROFILE :
C/O backache radiating to the RLE with paresthesias since 8 days.
M.R.I of the pelvis was performed using the following parameters:
7 mm thick T1 Weighted and T2 Weighted (with fat saturation) axial images.
4 mm thick T1 Weighted and STIR coronal images.
7 mm thick T2 Weighted (with fat saturation) sagittal images.
There is an ill-defined, hypointense signal on the T1 Weighted images involving the sacrum on the right and the bodies of the first three sacral segments. This lesion appears hyperintense on the T2 Weighted images and STIR images. Minimal extension of the lesion into the presacral soft tissues is noted on the right. Effacement of the second sacral foramen on the right is noted with encasement of the nerve root at this level. The right sacro-iliac joint per se is not involved. The visualized left sacro iliac joint and the hip joints on either side are unremarkable.
Also seen is a fairly large, approximately 7.0 x 5.0 x 8.0 cms well-defined, intermediate signal intensity mass lesion on the T1 Weighted images in the pelvis between the uterus and the rectum, slightly more to the left of the midline. This lesion appears relatively hyperintense as compared to normal muscle on the T2 Weighted and STIR images. Few cystic/necrotic foci are noted within this lesion. The lesion appears to be separate from the uterus, rectum and the bony pelvis. It is seen to indent the uterus and rectum. The right adnexal region is unremarkable. Minimal fluid is noted around the lesion.
The urinary bladder shows normal wall thickness. The left iliac vessels are in close relation to the pelvic mass lesion.
1. Altered signal in the sacrum on the right as described is not specific for a single etiology. Such changes may be seen in :
a. Infective processes like tuberculous osteitis.
b. Neoplasia like round cell tumors.
2. A fairly large 7.0 x 5.0 x 8.0 cms sized mass lesion in the pelvis in the utero-rectal pouch, to the left of the midline as described, is not specific for a single etiology. The differential diagnosis would include :
a. Pedunculated fibroid.
b. Lymphnodal mass.
c. Less likely to represent an ovarian lesion.