Date : 00.00.00
Name of the Patient : Abc Xyzelmn / M / 13 yrs.
Referred by : Dr. Abc Xyzdar.
Examination : M.R.I. of the Dorso-lumbar Spine.
CLINICAL PROFILE :
H/O hairy patch on the back since birth. Patient has difficulty in walking.
M.R.I of the dorso-lumbar spine was performed using the following parameters :
5 mm thick T1 Weighted and T2 Weighted sagittal images.
6 mm thick T1 Weighted and T2 Weighted axial images.
4 mm thick T1 Weighted coronal images.
There is evidence of an expansile intramedullary mass lesion at the L2 and L3 vertebral levels. It is slightly hyperintense to CSF on all the pulse sequences. A solid component which is near isointense to normal cord is also noted. The thecal sac is seen to bulge posteriorly into the defect (due to spina bifida at the L2 and L3 vertebral levels). Also seen is slight scalloping of the posterior aspect of the L2 and L3 vertebral bodies.
The spinal cord is low lying and the conus medullaris is seen at the L3-L4 level.
An area which is isointense to CSF is seen within the cord over the D12 to L2 levels and most likely represents a syrinx.
A linear tract is seen to extend from the surface of the back upto the spinal cord at the L3 level.
The rest of the visualized dorso-lumbar vertebral bodies and intervertebral discs reveal normal signal intensity.
The MRI features are suggestive of :
1. An expansile intramedullary lesion within the cord at the
the L2 and L3 vertebral levels as described may represent an epidermoid/dermoid cyst, especially in view of the dorsal dermal sinus.
2. Low lying spinal cord.
3. Syrinx over the D12 to L2 vertebral levels.
4. Dorsal dermal sinus at the L3 vertebral level.