Date : 00.00.00
Name of the Patient : Abc Xyzlam lmn / M / 19 yrs.
Referred by : Dr. Abc Xyzzzare.
Examination : M.R.I. of the Dorsal Spine.
CLINICAL PROFILE :
C/O backache with progressive weakness of BLE since 1 month.
M.R.I of the dorsal spine was performed using the following parameters :
4 mm thick T1 Weighted and T2 Weighted sagittal images.
4 mm thick T1 Weighted and T2 Weighted axial images.
The cervical spine was screened with 4 mm thick T2 Weighted sagittal images and the lumbo-sacral spine was screened with 5 mm thick T1 Weighted images.
Areas of hypointensity on the T1 Weighted images which turn mildly hyperintense on the T2 Weighted images are seen to involve most of the dorsal vertebral bodies and their appendages.
There is extension of this pathologic process into the pre and paravertebral soft tissues and the epidural space at the D5 and D6 levels with resultant encasement of the cord. The D5-D6 intervertebral disc is seen to be involved by the pathologic process. Soft tissue lesion is also noted within the posterior epidural space at the D7 and D8 levels.
The spinal cord over the D5 to D8 vertebral levels shows a hyperintense signal on the T2 Weighted images and this may represent cord edema/ischemia/myelitis.
Soft tissue extension is also noted in the epidural space and the pre and paravertebral soft tissues at the D11 and D12 levels.
There appear to be enlarged mediastinal lymphnodes.
The visualized lumbar and sacral vertebrae appear hypointense on the T1 Weighted images. There also appear to be enlarged lymphnodes in the visualized lumbar prevertebral space.
The conus medullaris terminates at the L1 level.
The MRI features are suggestive of a pathologic process involving most of the dorsal and lumbo-sacral vertebrae with soft tissue extensions and cord compression and cord signal alteration suggestive of cord edema/ischemia/myelitis over the D5 to the D8 vertebral levels.
The possibilities to be considered are,
1. An infective process like tuberculosis.
2. Neoplastic processes like secondaries or small cell tumors.