ke/hs/rg/nl
Name of the Patient : Abc Xyz lmn / M / 52 yrs.
Referred by : Dr. Abc Xyza.
Examination : M.R.I. of the Cervico-dorsal Spine.
CLINICAL PROFILE :
H/O cervico-dorsal laminectomy with radical excision of an intramedullary lesion done on 00.00.00 (Grade II astrocytoma). Received radiotherapy (6 sittings).
For follow up.
EXAMINATION :M.R.I. of the cervico-dorsal spine was performed using the following parameters :5 mm thick T1 Weighted and T2 Weighted sagittal images.7 mm thick T1 Weighted and T2 Weighted axial images.OBSERVATION :There is evidence of laminectomy over the C4 to D3 levels with post-operative changes in the posterior soft tissues over these levels. The cervico-dorsal spinal cord over the C6 to D4 vertebral levels appear irregular. Patchy hypointense areas on the T1 Weighted images are noted in the cervico-dorsal spinal cord over these levels which appear hyperintense on the T2 Weighted images. The cervico-dorsal spinal cord over the C6-C7 to D2-D3 levels appears smaller in diameter.
Small postero-central protruded discs are noted at the C3-C4, C4-C5 and C5-C6 levels. The visualized cervico-dorsal vertebral bodies reveal normal signal intensity. The visualized pre and paravertebral soft tissues are unremarkable.There is no cord compression. ..2/.
- 2 -IMPRESSION :1. Post-operative status. 2. Irregularity of the cervico-dorsal spinal cord over the C6 to D4 vertebral levels with altered signal may be the sequelae of previous surgery with gliotic/ myelomalacic changes. The cord is atrophic over the C6-C7 to D2-D3 levels.As compared to the previous MRI dated 00.00.00 (scan no. 0000), there is no significant change noted.