Date : 00.00.00
Name of the Patient : Abc Xyzfula B. Slmn / F / 30 yrs.
Referred by : Dr. Abc Xyzrnad.
Examination : M.R.I. of the Dorso-lumbar Spine.
CLINICAL PROFILE :
Known C/O TB Meningitis.
C/O paraparesis since 1 month with neurogenic bladder (since 8 days).
M.R.I of the dorso-lumbar spine was performed using the following parameters :
4 mm thick T1 Weighted and T2 Weighted sagittal images.
7 mm thick T1 Weighted and T2 Weighted axial images.
There is central and anterior wedging of the D5, D6, D7 and D8 vertebral bodies. The D3 to D10 vertebral bodies show an ill-defined hypointense signal on the T1 Weighted images which appears hyperintense on the T2 Weighted images. The D5-D6 and D7-D8 intervertebral discs are also involved. There is erosion of the anterior and lateral margins of the D2 to D10 vertebral bodies. There is seen an intermediate signal intensity soft tissue lesion on the T1 Weighted images in the pre and paravertebral regions over D2 to D10 vertebral levels. This lesion appears hyperintense on the T2 Weighted images and represents an abscess/granulation tissue in the given clinical setting.
The margins of the dorsal spinal cord over D3 to D7 vertebral levels appear slightly irregular. There is a hyperintense signal on the T2 Weighted images in the dorsal spinal cord over the D3 to D5 vertebral levels. This signal is isointense to normal cord on the T1 Weighted images. There is no cord compression. Minimal soft tissue is noted in the anterior epidural space at the D7 and D8 vertebral levels.
The facet joints are unremarkable.
The conus medullaris terminates at the L2 level.
Altered signal of the D3 to D10 vertebral bodies and the D5-D6 and D7-D8 intervertebral discs most likely represent osteitis with discitis probably tuberculous in given clinical setting. Prevertebral and paravertebral soft tissue would represent granulation tissue/abscess.
Irregularity of the cord margins over the D3 to D7 vertebral levels with altered signal of the cord over D3 to D5 vertebral levels may be the sequelae of tuberculous meningitis and subsequent ischemic changes.
The possibility of a neoplasm is less likely.