Date : 00.00.00
Name of the Patient : Abc Xyz Chlmn / F / 70 yrs.
Referred by : Dr. Abc Xyzbar.
Examination : M.R.I. of the Dorso-lumbar Spine.
CLINICAL PROFILE :
H/O backache with fever and chills.
Now C/O paraplegia with bladder involvement since 7 days.
M.R.I of the dorso-lumbar 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.
SOME IMAGES SHOW PATIENT MOTION.
There is slight anterior wedging of the D12 vertebral body.
There is replacement of the normal marrow of the D11 and D12 vertebral bodies by hypointense areas on the T1 Weighted images. This is seen to turn heterogeneously hyperintense on the T2 Weighted images. The antero-superior cortical endplate of the D12 and the antero-inferior cortical endplate of the D11 vertebral body is breached with involvement of the D11-D12 intervertebral disc. The pedicles of these vertebrae are also involved. There is mild pre and paravertebral soft tissue extension at the D11 and D12 vertebral levels. Very minimal anterior epidural extension is seen at the D12 level with compression of the conus and the nerve roots.
The rest of the visualized dorso-lumbar vertebral bodies and the remaining intervertebral discs reveal normal signal intensity. The facet joints are unremarkable.
The visualized dorso-lumbar spinal cord reveals normal signal intensity.
The conus medullaris terminates at the D11-D12 level.
The cervico-dorsal spine was screened with 4 mm thick T1 Weighted sagittal images which does not reveal any diagnostic feature of note.
The MRI features are suggestive of altered signal of the D11 and D12 vertebral bodies with involvement of the D11-D12 intervertebral disc and soft tissue extensions as described is not specific for a single etiology. The differential diagnosis would include,
1. Granulomatous infective process like tuberculosis.
2. Neoplastic process like round cell tumor (less likely).