Date : 00.00.00
Name of the Patient : Abc Xyza Chaudlmn / F / 32 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Dorsal Spine.
CLINICAL PROFILE :
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.
There is near complete collapse of the D4 vertebral body and slight anterior wedging of the D3 and D5 vertebral bodies, with an angular kyphus at this level.
The D3, D4 and D5 vertebral bodies appear hypointense on the T1 Weighted images and heterogeneously hyperintense on the T2 Weighted images. The D3-D4 and D4-D5 intervertebral discs are not well identified, with breach of the adjacent cortical endplates.
There is seen an intermediate signal intensity lesion on the T1 Weighted images in the prevertebral, paravertebral and anterior epidural space over the D3 to D5 vertebral levels. This lesion appears hyperintense on the T2 Weighted images. There is resultant cord compression over these levels. The dorsal spinal cord over these levels shows a subtle hyperintense signal on the T2 Weighted images suggesting cord edema/ischemia.
The rest of the visualized dorsal vertebral bodies and the remaining intervertebral discs reveal normal signal intensity. The facet joints are unremarkable.
Note is made of enlarged right paratracheal and carinal lymph nodes.
The conus medullaris terminates at the L1 level.
Near complete collapse of the D4 vertebral body with altered signal of the D3, D4 and D5 vertebrae and non-visualization of the D3-D4 and D4-D5 intervertebral disc as described, most likely represents osteitis with discitis, probably tuberculous in etiology. Prevertebral, paravertebral and anterior epidural soft tissue lesion would represent granulation tissue/abscess. There is resultant cord compression and cord signal alteration suggesting cord edema/ischemia.
The above described lesion to represent a neoplasm is less likely.