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Name of the Patient : Abc Xyzath Mirlmn / M / 45 yrs.
Referred by : Dr. Abc Xyzmath.
Examination : M.R.I. of the Cervico-dorsal Spine.

CLINICAL PROFILE :

Known C/O squamous cell Ca of larynx.
C/O weakness of BLE since 1 week.

EXAMINATION :

M.R.I of the cervico-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.

The lumbar and dorsal spines were screened with 5 mm thick T1 Weighted and 4 mm thick T2 Weighted sagittal images respectively.

OBSERVATION :

There is near complete collapse of the D2 vertebral body.

The D1, visualized D2 and D3 vertebral bodies appear hypointense on the T1 Weighted images and heterogeneously hyperintense on the T2 Weighted images. The D1-D2 and D2-D3 intervertebral discs are well-identified. There is involvement of the right lamina and pedicle of D1 and both pedicles and laminae of D2 vertebra. The right costo-vertebral joint at D1 and D2 vertebral levels are also involved. There is seen an intermediate signal intensity soft tissue lesion on the T1 Weighted images in the prevertebral, paravertebral and anterior epidural regions over D1 and D3 vertebral levels. This lesion appear slightly hyperintense on the T2 Weighted images. There is resultant cord compression, maximum at the D2 vertebral level with hyperintense signal on the T2 Weighted images in the dorsal spinal cord at the D1 and D2 levels which suggests cord edema/ischemia.

Small posterior disc bulges with peridiscal osteophytes are noted at the C5-C6 and C6-C7 levels.
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The visualized cervico-dorsal intervertebral discs loss of water content.

The rest of the visualized cervico-dorsal vertebral bodies reveal normal signal intensity. The facet joints are unremarkable.

Screening images of the dorsal and lumbar spine do not reveal any significant feature of note.

Incidentally noted are multiple soft tissue lesions in the lung parenchyma on either side which may represent metastasis, in the given clinical setting.

IMPRESSION :

Near complete collapse of the D2 vertebral body with altered signal of the D1, visualized D2 and D3 vertebral bodies as described is not specific for a single etiology. These changes may represent metastasis, in the given clinical setting.

Prevertebral, paravertebral and anterior epidural soft tissue lesion is noted over the D1 and D3 vertebral levels with cord compression, maximum at the D2 vertebral level with cord signal alteration at the D1 and D2 levels which suggests cord edema/ischemia.

Focal soft tissue lesions in the lung parenchyma on either side may represent metastasis, in the given clinical setting.

The possibility of the above described vertebral lesions and the lesions in the lung parenchyma representing infective/inflammatory lesions is less likely.
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