Date : 00.00.00
Name of the Patient : Abc Xyz. Ralmn / F / 15 yrs.
Referred by : Dr. Abc XyzShah.
Examination : M.R.I. of the Dorsal Spine.
CLINICAL PROFILE :
C/O tuberculosis of the spine. An antero-lateral decompression was done over the D7 to the D9 levels on 00.00.00. For follow-up.
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.
Post-operative changes are seen in the right paraspinal and right paravertebral soft tissues over the D6 to D9 vertebral levels.
There is anterior wedging with collapse of the D8 vertebral body. Posterior subluxation of the D8 vertebra is seen with impingement of the spinal cord.
There is replacement of the normal marrow of the D5, D6, D7, D8 and D9 vertebral bodies by hypointense areas on the T1 Weighted images. These are seen to turn heterogeneously hyperintense on the T2 Weighted images. The pedicles of these vertebrae and the posterior appendages of the D7 and D8 vertebrae are involved by the pathology. The superior and inferior cortical endplates of the D8 and D7 vertebrae are breached with involvement of the D7-D8 intervertebral disc. There is pre and paravertebral soft tissue extension over the D5 to D9 vertebral levels which is hypointense with a hyperintense periphery on the T1 Weighted images and turns hyperintense on the T2 Weighted images and would
represent abscess formation. The costo-vertebral and costo-transverse joints at the D7-D8 and D8-D9 levels are involved. There is slight extension into the posterior paraspinal soft tissues at the D7, D8 and D9 vertebral levels. There is circumferential epidural extension of the soft tissue lesion over the D7 and D8 levels with severe compression of the spinal cord at the D7-D8 and D8 levels. The spinal cord over the D2 to D11 levels shows a hyperintense signal on the T2 Weighted images (isointense to normal cord on the T1 Weighted images) suggestive of cord edema/ischemia/myelitis.
The aorta and IVC are displaced anteriorly by the pre and paravertebral soft tissue lesion.
The rest of the visualized dorsal vertebral bodies and remaining intervertebral discs reveal normal signal intensity.
The conus medullaris terminates at the D12-L1 level.
The lumbo-sacral spine was screened with 5 mm thick T1 Weighted sagittal images and does not reveal any diagnostic feature of note.
In a known C/O tuberculosis of the spine, the MRI features are suggestive of :
1. Post-operative status.
2. Altered signal of the D5, D6, D7, D8 and D9 vertebral bodies and the D7-D8 intervertebral disc suggests osteitis with discitis, most likely tuberculous in etiology. Pre and paravertebral soft tissue lesion over the D5 to D9 vertebral levels may suggest an abscess formation. There is cord compression as described and cord signal alteration over the D2 to D11 levels suggestive of cord edema/ischemia/myelitis.
As compared to the previous MRI (study no. 00008) dated 00.00.00, there is a decrease in the size of the soft tissue component of the lesion.