ke/bv/nl/nl
Date : 00.00.00
Name of the Patient : Abc XyzKlmn / F / 19 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Lumbo-sacral Spine.
CLINICAL PROFILE :
C/O backache with pain radiating to BLE since 4-5 months.
EXAMINATION :
M.R.I of the lumbo-sacral 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.
OBSERVATION :
There is sacralization of the L5 vertebral body and the D7 vertebral body is as marked on the film.
There is anterior wedging of the D11 vertebral body.
There is replacement of the normal marrow of the D9 and D10 vertebral bodies by hypointense areas on the T1 Weighted images. These are seen to turn heterogeneously hyperintense on the T2 Weighted images. The left pedicle and left lamina of these vertebral bodies and left transverse process of D10 are also involved by the pathology. There is left paravertebral soft tissue extension over the D8-D9 to D11 levels and left paraspinal extension at the D10 level with involvement of the costo-vertebral and costo-transverse joints at the D8-D9 and D10-D11 levels. There is left lateral epidural extension at over the D9 to D11 levels with encroachment into the left neural foramen at the D8-D9 and D9-D10 levels with encasement of the corresponding nerve roots. However there is no cord compression.
The L3, L4 and L5 vertebral bodies also show suspicious altered signal intensity suggestive of their involvement.
..2/.
The rest of the visualized dorso-lumbar vertebral bodies and the intervertebral discs reveal normal signal intensity. The facet joints and the visualized prevertebral soft tissues are unremarkable.
The conus medullaris terminates at the L1 level.
The cervico-dorsal spine was screened with 4 mm thick T2 Weighted sagittal images which do not reveal any diagnostic feature of note.
IMPRESSION :
The MRI features are suggestive of altered signal of the D9, D10, L3, L4 and L5 vertebrae with extensions as described and represents a granulomatous infective process like tuberculosis.
The possibility of a neoplastic process like a round cell tumor, is considered less likely.