Date : 00.00.00
Name of the Patient : Abc Xyzn Suryawalmn / M / 50 yrs.
Referred by : Dr. Abc Xyzhtekar.
Examination : M.R.I. of the Dorso-lumbar Spine.
CLINICAL PROFILE :
C/O backache radiating to BLE with paresthesias.
H/O laminectomy at D11/D12/L1 and L5-S1 levels with total excision of SOL on 00.00.00. HP s/o ependymoma.
M.R.I of the dorso-lumbar spine was performed using the following parameters :
5 mm thick T1 Weighted and T2 Weighted sagittal images.
5 mm thick T1 Weighted and T2 Weighted axial images.
There is evidence of laminectomy of the D12, L1, L5 and S1 vertebrae with post-operative changes in the posterior soft tissues over these levels.
The conus medullaris and intrathecal nerve roots at the D12 and L1 levels are posteriorly placed and may be adhered to the theca. The CSF space anteriorly is seen to be prominent.
There is mild retroplacement of the L4 vertebra over the L5 vertebra.
Posterior disc bulges are noted at the L3-L4, L4-L5 and L5-S1 levels.
The L1-L2, L4-L5 and L5-S1 facet joints show degenerative changes.
The visualized dorso-lumbar vertebral bodies show areas of fatty replacement of normal marrow and this may be a result of radiotherapy.
The visualized dorso-lumbar intervertebral discs show loss of water content.
The visualized pre and paravertebral soft tissues are unremarkable.
The conus medullaris terminates at the D12 level.
The MRI features are suggestive of :
1. Post-operative status. No obvious residual/recurrent mass lesion is seen. If clinically indicated a contrast enhanced scan may be worthwhile.
2. Posterior disc bulges at the L3-L4, L4-L5 and L5-S1 levels.
3. Facetal arthropathy at the L1-L2, L4-L5 and L5-S1 levels.
4. Clumped intrathecal nerve roots at the D12 and L1 levels with prominent CSF space anterior to the nerve roots (?? arachnoid cyst).
5. Fatty marrow changes in the visualized dorso-lumbar vertebral bodies may be the sequelae of previous radiotherapy.