Date : 00.00.00
Name of the Patient : Abc Xyz Prasad Shlmn / M / 50 yrs.
Referred by : Dr. Abc Xyzrnad.
Examination : M.R.I. of the Dorso-lumbar Spine.
CLINICAL PROFILE :
C/O paraplegia with severe backache and burning sensation in BLE since 15 days.
C/O bladder involvement since 1 day.
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.
FEW IMAGES SHOW PATIENT MOTION INSPITE OF SEDATION.
There is an ill-defined, hypointense signal on the T1 Weighted images involving the D10, D12, L2, L3, L5 and S1 vertebral bodies. These lesions appear iso to hyperintense to normal marrow on the T2 Weighted images. There is seen an intermediate signal intensity lesion on the T1 Weighted images in the left lateral and posterior epidural space over the D12 to L4 vertebral levels. This lesion appears hyperintense on the T2 Weighted images. Extension of the soft tissue along the neural foramina in the dorso-lumbar region is noted. Resultant mild cord compression and displacement of the lower dorsal spinal cord anterior and to the right of the midline is noted. The visualized lower dorsal spinal cord shows a hyperintense signal on the T2 Weighted images, suggesting cord edema/ischemia. The thecal sac in the upper and mid lumbar regions also appears slightly compressed. The intrathecal nerve roots in the lumbar region appear clumped, centrally.
Small posterior disc bulges are noted at the L3-L4, L4-L5 and L5-S1 levels.
The facet joints at the L3-L4, L4-L5 and L5-S1 levels appear slightly hypertrophied.
The L5-S1 intervertebral disc shows loss of water content.
Screening, T1 Weighted sagittal images of the dorsal and cervical spines reveal altered signal involving the mid dorsal vertebrae and the D2 vertebral body.
Altered signal of the mid dorsal vertebrae, lumbo-sacral vertebrae and the D2 vertebral body as described is not specific for a single etiology. These lesions may represent round cell tumor, metastases or multifocal tuberculosis.
Left lateral and posterior epidural soft tissue lesion over the D12 to L4 vertebral levels may represent soft tissue extension of the lesion/granulation tissue. There is resultant compression of the lower dorsal spinal cord with cord signal alteration suggesting cord edema/ischemia.