Date : 00.00.00
Name of the Patient : Abc Xyzt Mlmn / M / 12 yrs.
Referred by : Dr. Abc XyzGawhale.
Examination : M.R.I. of the Lumbo-sacral Spine.
CLINICAL PROFILE :
C/O backache with pain radiating to BLE with tingling since 15 days.
C/O bladder involvement since 4 days.
M.R.I of the lumbo-sacral spine was performed using the following parameters :
5 mm thick T1 Weighted and T2 Weighted sagittal images.
6 mm thick T1 Weighted and T2 Weighted axial images.
The cervico-dorsal spine was screened with 4 mm thick T2 Weighted sagittal images and 7 mm thick T2 Weighted axial images.
Hypointense areas on the T1 Weighted images are seen to replace the normal marrow of the L4 vertebral body and its appendages. These are isointense to normal marrow on the T2 Weighted images. There is slight extension of this pathologic process into the left paravertebral soft tissue and the paraspinal soft tissues bilaterally. The cortical endplates are well-visualized. The adjoining discs are unremarkable.
An intermediate signal intensity lesion on the T1 Weighted images is seen within the spinal canal, most likely extradural in location over the L3 to S1 levels predominantly posteriorly and laterally. This is seen to turn mildly hyperintense on the T2 Weighted images.
The thecal sac over the L2 to S1 vertebral levels shows areas which are near isointense to nerve roots on all the pulse sequences. The intrathecal nerve roots cannot be differentiated from this lesion over these levels.
The remaining lumbar vertebral bodies and the intervertebral discs reveal normal signal intensity. The
screening images of the cervico-dorsal spine are unremarkable.
Altered signal of the L4 vertebra with extension into the extradural space over the L3 to S1 levels with presence of an intradural component over the L2 to S1 levels as described. This is not specific for a single etiology. The possibilities to be considered are :
1. Infective processes like tuberculosis.
2. Neoplasia like round cell tumors - less likely.