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sb/hs/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzi Jlmn / F / 42 yrs.
Referred by : Dr. Abc Xyzve.
Examination : M.R.I. of the Dorsal Spine.

CLINICAL PROFILE :

C/O backache since 4 months.
H/O low grade fever, loss of appetite and weight.

EXAMINATION :

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.

The lumbar spine was screened with 5 mm thick T1 Weighted sagittal images.

OBSERVATION :

The L4 vertebral body is as marked on the film and the L5 vertebra appears to be sacralized. Please correlate with plain radiographs.

There is Grade I spondylolisthesis of the L4 over the L5 vertebra with probable spondylolysis at L4, bilaterally.

There are ill-defined, hyperintense areas on the T2 Weighted images in the D7 and D8 vertebral bodies. These areas appear hypointense on the T1 Weighted images. The D7-D8 intervertebral disc is also reduced in height and appears hyperintense on the T2 Weighted images. Similar signal intensity changes are noted in the L4, L2, D11, D10, D5, D1 and D2 vertebral bodies and in the ala of the sacrum to the left.



There is an intermediate signal intensity soft tissue lesion on the T1 Weighted images in the right paravertebral region, prevertebral region and in the anterior epidural space at the D7 and D8 vertebral levels. This lesion appears hyperintense on the T2 Weighted images and is also seen to extend into the neural foramen at the D7-D8 level bilaterally and minimally into the left paravertebral region. There is mild cord compression at the D7 and D8 levels. The dorsal spinal cord at these levels shows a subtle hyperintense signal on the T2 Weighted images which suggests cord edema/ischemia/myelitis.

The rest of the visualized dorsal vertebral bodies and the remaining intervertebral discs are unremarkable.

The conus medullaris terminates at the L1-L2 level.

IMPRESSION :

Altered signal in the D7 and D8 vertebral bodies and the D7-D8 intervertebral disc suggests osteitis with discitis, most likely tuberculous in etiology. Prevertebral and paravertebral soft tissue lesion would represent granulation tissue/abscess. There is also cord compression and cord signal alteration at this level suggesting cord edema/ischemia/myelitis.

Altered signal is also noted in the L4, L2, D11, D10, D5, D1 and D2 vertebral bodies and in the ala of the sacrum to the left and this also represents osteitis.

The possibility of these lesions representing a neoplastic process like a small cell tumor is less likely.


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