Date : 00.00.00
Name of the Patient : Abc XyzPilwalmn / F / 45 yrs.
Referred by : Dr. Abc Xyzchale.
Examination : M.R.I. of the Dorsal Spine.
CLINICAL PROFILE :
C/O weakness of BLE since 15 days.
M.R.I of the dorsal spine was performed using the following parameters :
4 mm thick T1 Weighted and T2 Weighted sagittal images.
6 mm thick T1 Weighted and T2 Weighted axial images.
The D3 vertebral body is as marked on the film.
There is near complete collapse of the D5 vertebral body. The D4, D5 and D6 vertebral bodies appear hypointense on the T1 Weighted images and hyperintense on the T2 Weighted images. Probable involvement of the D5-D6 disc on the left side is noted (scan 104.5). There is erosion of the right pedicle of D5.
There is seen a multiloculated, intermediate signal intensity, soft tissue mass lesion on the T1 Weighted images in the pre and paravertebral soft tissues, extending over the D4 to D8 vertebral levels. This lesion appears hyperintense on the T2 Weighted images. Extension of the soft tissue lesion into the anterior epidural space over the D4 to D6 levels is noted, with resultant cord compression. The dorsal spinal cord at the D5 and D6 levels shows a hyperintense signal on the T2 Weighted images, suggesting cord edema/ischemia.
There is involvement of the costo-vertebral joints at the D4, D5 and D6 vertebral levels.
Extension of the soft tissue lesion into the neural foramen at the D4-D5 and D5-D6 levels is also noted.
The rest of the visualized dorsal vertebral bodies and remaining intervertebral discs reveal normal signal intensity.
The conus medullaris terminates at the L1 level.
Screening, T1 Weighted sagittal images of the cervico-dorsal region shows central wedging of the C7 body, without change in signal intensity.
Near complete collapse of the D5 body with altered signal of the D4 to D6 vertebral bodies and probable involvement of the D5-D6 disc as described, most likely represents osteitis with discitis, probably tuberculous in etiology. Prevertebral, paravertebral and anterior epidural soft tissue lesion may represent abscess/granulation tissue. There is cord compression and cord signal alteration suggesting cord edema/ischemia.
The possibility of the above described lesion representing a neoplasm seems less likely.