ke/bv/rg.
Name of the Patient : Abc Xyznnisha Anlmn / F / 56 yrs.
Referred by : Dr. Abc Xyzlankar.
Examination : M.R.I. of the Dorso-lumbar Spine.
CLINICAL PROFILE :
C/O numbness over the lower back and abdomen with bladder/bowel involvement since 1 month.
H/O Malaria 15 days back.
EXAMINATION :
M.R.I of the dorso-lumbar spine was performed using the following parameters :
5 mm thick T1 Weighted and T2 Weighted sagittal images.
5 mm thick T1 Weighted and T2 Weighted axial images.
OBSERVATION :
There is replacement of the normal marrow of the L5, S1 and S2 vertebral bodies by hypointense areas on the T1 Weighted images. This is seen to turn heterogeneously hyperintense on the T2 Weighted images. There is destruction of the pedicles of the L5 and S1 vertebral bodies bilaterally. There is minimal pre and paravertebral soft tissue extension over the L5 to the S2 vertebral levels. A large anterior epidural extension is seen over the L4 to S2 vertebral levels with severe compression of the thecal sac. There is extension into the L5-S1 neural foramina bilaterally and as well as the upper sacral foramina with encasement of the nerve roots. Slight extension into the L4-L5 neural foramina on the left side is also seen with encasement of the left L4 nerve root.
Hypointense areas on the T1 Weighted images are also noted within the iliac bones bilaterally, right sacral ala, L1, L2, L3, L4, D10, D8, D7, D6, D4 and D3 vertebral bodies.
..2/.
- 2 - Scan-00005
The rest of the visualized dorso-lumbar vertebral bodies and intervertebral discs reveal normal signal intensity. The facet joints are unremarkable.
The visualized lower dorsal spinal cord reveals normal signal intensity.
The conus medullaris terminates at the L1 level.
IMPRESSION :
The MRI features are suggestive of :
1. Altered signal of the L5, S1 and S2 vertebral bodies
with destruction of the pedicles of the L5 and S1 vertebral bodies bilaterally with anterior epidural extension over the L4 to S2 levels and extensions as decribed.
2. Altered signal of the iliac bones bilaterally, right sacral ala, L1, L2, L3, L4, D10, D8, D7, D6, D4 and D3 vertebral bodies.
This most likely represents metastasis.
The possibility of multifocal tuberculosis should be excluded.