Date : 00.00.00
Name of the Patient : Abc Xyzha Salulmn / F / 53 yrs.
Referred by : Dr. Abc Xyzrankar / Dr. Abc Xyzkar.
Examination : M.R.I. of the Dorsal Spine.
CLINICAL PROFILE :
C/O backache with tingling in BLE since 2 months.
H/O cervical lymphadenopathy 18 yrs back. Received AKT.
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.
5 mm thick Fast Scan (T2 *) coronal images.
There is seen an expansile lesion involving the left pedicle and the posterior elements of the D9 vertebra. This lesion is of intermediate signal on the T1 Weighted images and appears hyperintense on the T2 Weighted images. Involvement of the left costo-transverse and costo-vertebral joints at this level is noted. Altered signal is also noted in the body of the D9 vertebra, pedicles of D10 vertebra and the base of the spinous process of the D9 vertebra. There is resultant cord compression at the D9 and D10 vertebral levels. The dorsal spinal cord at these levels shows a hyperintense signal on the T2 Weighted images which suggests cord edema/ischemia. There is also encasement of the D8 nerve root within the neural foramen by the lesion.
The rest of the visualized dorsal vertebral bodies
show spotty fatty marrow changes. The dorsal intervertebral discs reveal normal signal intensity. The facet joints and the visualized pre and paravertebral soft tissues are unremarkable.
- 2 - Scan-00009
The conus medullaris terminates at the L1 level.
Note is made of paraaortic and paracaval lymph nodes in the lumbar region and mediastinal lymphadenopathy.
T1 Weighted sagittal images of the cervical and lumbar spines reveal spotty fatty marrow changes. No other significant abnormality is detected.
An expansile lesion involving the left pedicle and the posterior elements of the D9 vertebra with altered signal in the body of the D9, pedicles of the D10 vertebra and the spinous process of the D9 vertebra as described is not specific for a single etiology. Round cell tumor or metastasis may be considered as differential diagnosis. Tuberculosis may also be considered as a differential diagnosis in view of the past H/O tuberculous cervical lymphadenitis and pulmonary Kochs.
There is resultant cord compression and cord signal alteration at the D9 and D10 levels suggesting cord edema/ischemia.