Name of the Patient : Abc Xyzeetlmn / M / 22 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Cervical Spine.
CLINICAL PROFILE :
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.
There is replacement of the normal marrow of the inferior aspect of the clivus on the left side, left occipital condyle and the left lateral mass of the atlas by hypointense areas on the T1 Weighted images. These are seen to turn heterogeneously hyperintense on the T2 Weighted and Fast Scan (T2 *) images. There is a large left paravertebral soft tissue extension extending from the base of the skull to the C2-C3 level. This lesion in the anterior aspect is hypointense on the T1 Weighted images and turns hyperintense on the T2 Weighted images and represents an abscess formation. There is slight extension of the pathologic process into the left paravertebral soft tissues at the C2 vertebral level with encasement of the left vertebral artery. This shows normal flow-void signal on all the pulse sequences.
The cervical intervertebral discs except for the C5-C6 disc show loss of water content.
The rest of the cervical vertebral bodies show normal signal intensity. The joints of Luschka are unremarkable.
The cervical spinal cord reveals normal signal intensity.
The atlanto-axial region and the cervico-medullary junction are unremarkable.
The MRI features are suggestive of alteration of the normal marrow of the inferior aspect of the clivus on the left side, left occipital condyle and the left lateral mass of the atlas with an abscess formation at the C2-C3 level and extensions as described is most probably due to granulomatous infective process like tuberculosis.
The possibility of this representing a neoplastic process like a round cell tumor is less likely.