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Name of the Patient : Abc XyzT. Pardlmn / F / 37 yrs.
Referred by : Dr. Abc Xyzwhale.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE :

C/O backache with radiation of pain to BLE with paresthesias. Past H/O tuberculous meningitis (12 years ago).

EXAMINATION :

M.R.I of the cervical spine was performed using the following parameters :

4 mm thick T1 Weighted and T2 Weighted sagittal images.

5 mm thick T1 Weighted and Fast Scan (T2 *) axial images.

The dorsal spine was screened with 4 mm thick T1 Weighted and T2 Weighted sagittal images.

OBSERVATION :

There is a posterior disc bulge with peridiscal osteophytes, more to the left of the midline, indenting the cord at the C4-C5 level.

The spinal cord from the C6 vertebral level to the D7/D8 vertebral level is thinned out.

Expansion of the cord is seen over the D9 to D11 levels. The cord over these levels shows a well-defined area which is nearly isointense to CSF on all the pulse sequences and would represent a cystic area. The cord over the D6 to D9 levels shows a hypointense signal on the T1 Weighted images and which turns hyperintense on the T2 Weighted images and may represent gliotic changes. The margins of the cord over these levels appear irregular.



The cervical intervertebral discs show loss of water content. Hemangiomas with fat content are seen within the C6 and D3 vertebral bodies.

The rest of the cervical vertebral bodies show normal signal intensity. The joints of Luschka and the visualized pre and paravertebral soft tissues are unremarkable.

The atlanto-axial region and the cervico-medullary junction are unremarkable.

IMPRESSION :

The MRI features are suggestive of thinning of the cord over the C6 to D7/D8 levels with signal alteration and a cystic component within the cord over the D9 to D11 levels. These changes may represent cord gliosis with syrinx formation, probably a result of previous meningitis.

The possibility of this representing a neoplastic process is less likely.

A contrast enhanced study may be worthwhile.




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