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sb/bv/rg/nl
Date : 00.00.00

Name of the Patient : Abc XyzMaklmn / M / 39 yrs.
Referred by : Dr. Abc Xyzchale.
Examination : M.R.I. of the Dorso-lumbar Spine.

CLINICAL PROFILE :

Known C/O MR with epilepsy.
C/O retention of urine with weakness of BLE since 15 days. Also C/O swelling over BLE.

EXAMINATION :

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.

OBSERVATION :

The D8 vertebral body is as marked on the film.

There is anterior wedging of the D11 and D12 vertebral bodies, with erosion of the cortical endplates adjacent to the D11-D12 intervertebral disc.

The D10, D11, D12, L1 and L2 vertebral bodies show an ill-defined, hypointense signal on the T1 Weighted images which appears hyperintense on the T2 Weighted images. The D11-D12 intervertebral disc also appears hyperintense on the T2 Weighted images. Posterior elements of D11 vertebra also show altered signal.







There is seen an intermediate signal intensity, soft tissue mass lesion on the T1 Weighted images in the retrocrural prevertebral and paravertebral regions, extending over the D9 to L2 vertebral levels. This lesion appears hyperintense on the T2 Weighted images with multiple septae within. Resultant anterior displacement of the aorta is noted. Extension of this soft tissue lesion into the anterior epidural space over the D11 to L1 vertebral levels is noted with cord compression. The lower dorsal spinal cord over these levels show a hyperintense signal on the T2 Weighted images, which suggests cord edema/ischemia. Similar soft tissue lesion is also noted in the postero-lateral epidural space on the right over the L1 to L3 vertebral levels. There is encroachment of the soft tissue into the neural foramina bilaterally at the D12-L1 level and on the right side at the L1-L2 and L2-L3 levels and on the left side at the D10-D11 level.

The rest of the visualized dorso-lumbar vertebral bodies and intervertebral discs reveal normal signal intensity. The facet joints are unremarkable.

The conus medullaris terminates at the L1-L2 level.

Screening of the cervical spine reveals no feature of note.

IMPRESSION :

Anterior wedging of D11 and D12 vertebral bodies with altered signal of the D10, D11, D12, L1 and L2 vertebral bodies and the
D11-D12 intervertebral disc, most likely represents osteitis with discitis, probably tuberculous in etiology. Prevertebral, paravertebral and anterior epidural soft tissue lesion may represent an abscess/granulation tissue. There is resultant cord compression and cord signal alteration over D11 to L1 vertebral levels which represents cord edema/ischemia.

The possibility of the above described lesion representing a neoplasm seems less likely.


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