Date : 00.00.00
Name of the Patient : Abc Xyzhai lmn / M / 81 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Dorsal Spine.
CLINICAL PROFILE :
C/O weakness of BLE with acute onset of bladder/bowel incontinence.
M.R.I of the dorsal spine was performed using the following parameters :
5 mm thick T1 Weighted and T2 Weighted sagittal images.
8 mm thick T1 Weighted and T2 Weighted axial images.
SOME IMAGES SHOW PATIENT MOTION.
There ie evidence of a mass lesion within the epidural space posteriorly and more to the left over the D8 to D11 vertebral levels. It is of intermediate signal intensity on all the pulse sequences. The cord is compressed and displaced anteriorly and to the right. The cord is hyperintense on the T2 Weighted images over these levels and would suggest cord edema/ischemia/myelitis.
There is involvement of the D9 and D10 pedicles on the left side with encroachment into the left D9-D10 neural foramen. Also seen is involvement of the left costo-vertebral joints and head and neck of the rib at this level. A small left paravertebral soft tissue component is seen at the D9 and D10 levels.
The rest of the visualized dorsal vertebral bodies show normal signal intensity. The visualized dorsal intervertebral discs show loss of water content.
The MRI features are suggestive of a pathologic process within the posterior epidural space, more to the left over the D8 to D11 vertebral levels as described with cord compression and cord edema/ischemia/myelitis.
The differential diagnosis would include :
1. Infective process like tuberculosis.
2. Neoplasia like small cell tumors or secondaries.