Date : 00.00.00
Name of the Patient : Abc Xyzi Palmn / F / 45 yrs.
Referred by : Dr. Abc Xyzrankar.
Examination : M.R.I. of the Cervico-dorsal Spine.
CLINICAL PROFILE :
Known C/O Kochs spine with paraplegia since April 0000.
M.R.I of the cervico-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.
FEW IMAGES SHOW PATIENT MOTION.
There is near complete collapse of the D2 vertebral body with retropulsion and a resultant kyphus at this level.
Areas of hypointensity on the T1 Weighted images which turn heterogeneously hyperintense on the T2 Weighted images are seen to involve the D1, D2 and D3 vertebral bodies and the apendages of the D2 and D3 vertebrae. Also seen is involvement of the D1-D2 and D2-D3 intervertebral discs.
There is extension of this pathologic process into the anterior and left lateral epidural space and the pre and paravertebral soft tissues over the D1 to D3 levels. The cord is seen to be compressed at the D2/D3 levels. The spinal cord at these levels shows a hyperintense signal on the T2 Weighted images and this would be suggestive of cord edema/ischemia/myelitis.
The costo-vertebral joints on the left side at the D2 and D3 levels are involved by the pathologic process.
Small postero-central disc herniations are seen at the C5-C6 and C6-C7 levels. Ligamentum flavum hypertrophy is also seen at these levels.
The cervical intervertebral discs show loss of water content.
The rest of the visualized cervico-dorsal vertebral bodies and the remaining dorsal intervertebral discs show normal signal intensity.
The MRI features are suggestive of a pathologic process involving the D1, D2 and D3 vertebrae and the D1-D2 and D2-D3 intervertebral discs with soft tissue extensions and cord compression with cord edema/ischemia/myelitis as described. This most likely represents an infective process like tuberculosis.
The possibility of this being a neoplastic process like a small cell tumor is less likely.
As compared to the previous MRI dated 00.00.00, there is no significant change in the degree of cord compression.