Date : 00.00.00
Name of the Patient : Abc XyzMalmn / F / 60 yrs.
Referred by : Dr. Abc Xyzhah.
Examination : M.R.I. of the Dorsal Spine.
CLINICAL PROFILE :
Known C/O multiple myeloma.
C/O weakness of BLE (left more than right), backache, herpes and retention of urine since 3-4 days.
M.R.I of the dorsal spine was performed using the following parameters :
4 mm thick T1 Weighted and T2 Weighted sagittal images.
5 mm thick T1 Weighted and T2 Weighted axial images.
There is replacement of the normal marrow of the right lamina and spinous process as well as the right transverse process of the D4 and D5 vertebral bodies by hypointense areas on the T1 Weighted images. These are seen to turn heterogeneously hypointense on the T2 Weighted images. A large posterior epidural lesion is seen extending over the D4 and the D5 levels which is seen to displace and compress the spinal cord anteriorly. The spinal cord at these levels shows a hyperintense signal on the T2 Weighted images and is isointense to the cord on the T1 Weighted images suggestive of cord edema/ischemia/myelitis.
There is slight wedging of the D8 vertebral body. Hypointense areas are also noted within the D2, D3, D7 and D8 vertebrae on the T1 Weighted images.
The rest of the visualized dorsal vertebral bodies reveal spotty changes. The intervertebral discs reveal normal signal intensity. The facet joints and the visualized pre and paravertebral soft tissues are unremarkable.
The conus medullaris terminates at the L1 level.
The lumbo-sacral spine was screened with 5 mm thick T1 Weighted sagittal images and which show anterior wedging of the L3 vertebral body. Few hypointense areas also noted in the lower dorsal and lumbar vertebrae.
In a known C/O multiple myeloma, the MRI features are suggestive of the pathologic process involving the D4 and D5 vertebral bodies with extensions and cord compression and cord edema/ischemia/myelitis as described. Also seen is involvement of the D2, D3, D7 and D8 vertebral bodies.