ke/bv/rg.
Date : 00.00.00
Name of the Patient : Abc Xyzvi Jailmn / F / 50 yrs.
Referred by : Dr. Abc Xyzar.
Examination : M.R.I. of the Dorsal Spine.
CLINICAL PROFILE :
Known C/O Kochs spine. Operated for the same 6 months back (exact details not available).
C/O backache radiating to BLE with weakness since 1 year.
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 thick T1 Weighted and T2 Weighted axial images.
OBSERVATION :
There is collapse of the D10 and D11 vertebral bodies with an angular kyphus at this level with obliteration of the D10-D11 intervertebral disc.
Post-operative changes are seen in the posterior soft tissues at the D9, D10, D11 and D12 vertebral bodies with laminectomy over the D9 to the D11 vertebral bodies.
There is replacement of the normal marrow of the D10, D11 and the anterior portion of the D12 vertebral body by hypointense areas on the T1 Weighted images. These are seen to remain hypointense with few hyperintense areas on the T2 Weighted images. There is posterior bulging of the D10 and D11 vertebral bodies with posterior displacement and compression of the spinal cord at the D10 and D11 levels. The spinal cord at these levels appears to be of smaller calibre and shows subtle hyperintense signal on the T2 Weighted images suggestive of cord myelomalacia. Pre and paravertebral soft tissue extension over the D9-D10 to D11-D12 levels is noted which is of intermediate signal intensity on the T1 Weighted images and is heterogeneously hypointense on the T2 Weighted images. The costo-vertebral and the costo-transverse joints are disrupted.
..2/.
The lower dorsal intervertebral discs show loss of water content.
Suspicious hyperintense signal is seen in the D3 vertebral body.
The rest of the visualized dorsal vertebral bodies reveal normal signal intensity. The facet joints are unremarkable.
The conus medullaris terminates at the L1 level.
Posterior disc herniations are noted at the L3-L4, L4-L5 and L5-S1 levels.
IMPRESSION :
In a known C/O tuberculosis, the MRI features are suggestive of :
1. Patient is status post-operative.
2. Collapse of the D10 and D11 vertebral bodies with angular kyphus at this level with obliteration of the D10-D11 intervertebral disc and also involvement of the D12 vertebra.
3. Posterior displacement with altered signal within the spinal cord with smaller calibre over the D9 to D11 levels is suggestive of myelomalacia.