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sb/ke/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzlmn / M / 55 yrs.
Referred by : Dr. Abc Xyzbar.
Examination : M.R.I. of the Dorsal Spine.

CLINICAL PROFILE :

C/O weakness of the RLE with retention of urine since 4 days.

EXAMINATION :

M.R.I of the dorsal spine was performed using the following parameters :

4 mm thick T1 Weighted and T2 Weighted sagittal images.
5 mm and 6 mm thick T1 Weighted and T2 Weighted axial images.

OBSERVATION :

The D7 vertebral body is as marked on the film.

There is central wedging of the D5 vertebral body. The D4, D5 and D6 vertebral bodies appear hypointense on the T1 Weighted images and heterogeneously hyperintense on the T2 Weighted images. The intervening intervertebral discs are unremarkable. There is erosion of the right sided pedicle and transverse process of the D3, D4, D5 and D6 vertebrae with involvement of the right lamina and spinous process of some of these vertebrae.

There is an intermediate signal intensity soft tissue lesion on the T1 Weighted images in the right paravertebral and right posterior paraspinal regions, extending over the D3 to D6 vertebral levels. This lesion appears heterogeneously hyperintense on the T2 Weighted images. There is extension of the soft tissue lesion into the right lateral and posterior epidural space with resultant cord compression and displacement of the dorsal spinal cord anteriorly and to the left at these levels. The dorsal spinal cord at these levels shows a hyperintense signal on the T2 Weighted images suggesting cord edema/ischemia. Some anterior epidural soft tissue is noted at the D5 vertebral level. Involvement of the right sided costo-vertebral and costo-transverse joints at the D5 and D6 levels is noted with probable erosions of the head and neck of the corresponding right sided ribs at these levels.
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The rest of the visualized dorsal vertebral bodies and intervertebral discs reveal normal signal intensity. The facet joints are unremarkable.

The conus medullaris terminates at the L1 level.

Screening, T1 Weighted sagittal images of the lumbar spine reveal altered signal in the L1 and L4 vertebral bodies and an expansile lesion involving the right pedicle, transverse process and spinous process of L1. Fatty changes are noted in the L2, L3, L5 and the sacral vertebral bodies.

Screening, T1 Weighted sagittal images of the cervical spine do not reveal any significant feature of note.

IMPRESSION :

Central wedging of the D5 vertebral body with altered signal of the D4, D5 and D6 vertebral bodies with right paravertebral, right posterior paraspinal and epidural soft tissue lesion as described is not specific for a single etiology. These lesions may represent :

1. Metastasis.

2. Round cell tumor.

3. Less likely to represent tuberculosis.

There is resultant cord compression and cord signal alteration at the D5 and D6 vertebral levels.

Similar lesions are noted in the L1 and L4 vertebrae.


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