Date : 00.00.00
Name of the Patient : Abc Xyzan R. lmn / M / 55 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Dorsal Spine.
CLINICAL PROFILE :
C/O weakness of BLE since 15-20 days.
H/O laminectomy with discectomy at L2/L3/L4 on 00.00.00.
M.R.I of the dorsal spine was performed using the following parameters :
4 mm thick T1 Weighted and T2 Weighted sagittal images.
6 mm thick T1 Weighted and T2 Weighted axial images.
There is slight decrease in height of the D7 and D8 vertebral bodies. The D6, D7 and D8 vertebral bodies, pedicles and laminae appear hypointense on the T1 Weighted images and hyperintense on the T2 Weighted images. The D7-D8 intervertebral disc margins appear irregular.
There is seen an intermediate signal intensity soft tissue lesion on the T1 Weighted images in the prevertebral, paravertebral and anterior epidural regions over the D6 to D8 vertebral levels. This lesion appears hyperintense on the T2 Weighted images. There is resultant cord compression at the D7 and D8 vertebral levels. The dorsal spinal cord at these levels shows a hyperintense signal on the T2 Weighted images suggesting cord edema/ischemia. Extension of the soft tissue component into the neural foramen at the D7-D8 level is also noted. Probable involvement of the left side costo-vertebral and costo-transverse joints at the D8 vertebral level is noted with involvement of the head and neck of the left 8th rib.
The rest of the visualized dorsal vertebral bodies reveal normal signal intensity. The visualized intervertebral discs show loss of water content. The facet joints are unremarkable.
The conus medullaris terminates at the L2 level.
Screening, T1 Weighted sagittal images of the lumbar spine reveals evidence of surgical intervention in the soft tissues in
the posterior lumbar region.
1. Post-operative status in the lumbar region.
2. Altered signal in the D6, D7 and D8 vertebral bodies pedicles and laminae and the D7-D8 intervertebral disc most likely represents osteitis with discitis, probably tuberculous in etiology. Prevertebral, paravertebral and epidural soft tissue lesion would represent granulation tissue/abscess. There is resultant cord compression at the D7 and D8 vertebral levels with cord signal alteration suggesting cord edema/ischemia.
The possibility of this lesion representing a neoplasm seems less likely.