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/48 Date : 00.00.00

Name of the Patient : Abc Xyz Mahlmn / F / 52 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to the RLE with paresthesias in BLE since 1 1/2 months.
Similar complaints 1 year back.

EXAMINATION :

M.R.I of the lumbo-sacral 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.

After administration of contrast the following parameters were used :

5 mm thick T1 Weighted sagittal images (with fat saturation).

6 mm thick T1 Weighted axial images (with fat saturation).

FEW IMAGES SHOW PATIENT MOTION.

OBSERVATION :

There appears to be sacralization of the L5 vertebra and the L1 vertebra is as marked on the film. Please correlate with plain radiographs.

There is evidence of an intradural lesion extending over the L2-L3 disc level to the L5-S1 disc level with posterior scalloping of the L4 and L5 vertebral bodies. This lesion is hyperintense to CSF but hypointense to normal marrow on the T1 Weighted images and hyperintense to both on the T2 Weighted images. After contrast administration, the lesion
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is seen to enhance peripherally whereas the centre remains hypointense. The CSF within the thecal sac below this lesion is hyperintense on all the pulse sequences and this may be due to the block superiorly. The nerve roots below the L2-L3 level are not well-visualized and cannot be differentiated from the lesion per se.

Mild posterior disc bulges are noted at the L3-L4 and L4-L5 levels. The L4-L5 facet joints show mild degenerative changes.

The L3-L4 intervertebral disc shows mild loss of water content.

The lumbar vertebral bodies and the remaining intervertebral discs reveal normal signal intensity. The rest of the facet joints and the visualized pre and paravertebral soft tissues are unremarkable.

The conus medullaris terminates at the D12-L1 level and the thecal sac terminates at the S1-S2 level.

The cervico-dorsal spine was screened with 5 mm thick T1 Weighted sagittal images (with fat saturation) after contrast administration and there is no focal area of enhancement within the cervico-dorsal spinal cord or along the meninges.

IMPRESSION :

The MRI features are suggestive of a mass lesion within the thecal sac extending over the L2-L3 to the L5-S1 disc levels as described. The differential diagnosis would include a nerve sheath tumor or an ependymoma.

There also appears to be sacralization of the L5 vertebra. Please correlate with plain radiographs.



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