hs/sb/nl/rg.
Name of the Patient : Abc XyzPallmn / F / 59 yrs.
Referred by : Dr. Abc Xyzankhla.
Examination : M.R.I. of the Dorsal Spine.
CLINICAL PROFILE :
C/O weakness of BLE since February 0000.
C/O bladder/bowel involvement since 10-15 days.
H/O Ca Thyroid for which patient has been operated.
EXAMINATION :
M.R.I of the dorsal 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.
The brain was screened with the help of 5 mm thick T1 Weighted sagittal images and FLAIR coronal images.
The lumbar and dorsal spines were screened with 5 mm and 4 mm thick T1 Weighted sagittal images, respectively.
OBSERVATION :
Susceptibility artifacts are seen in the dorsal region, the result of placement of metal rods.
The D9 vertebral body is collapsed and seen to be predominantly hypointense on all the pulse sequences.
The D8 and D10 vertebral bodies are also involved by the pathology (hypointense on the T1 Weighted images).
There is extension of this pathologic process into the pre and paravertebral soft tissues and anterior and lateral epidural space over the D9 to D11 vertebral levels with resultant cord compression. The cord over these levels is hyperintense on the T2 Weighted images and may represent cord edema/ischemia.
..2/.
A soft tissue intensity lesion is seen in the upper dorsal spine in the right paraspinal region.
The L4 vertebral body is collapsed and shows a hypointense signal on the T1 Weighted images. It is seen to bulge posteriorly with compression upon the thecal sac. The pathologic process is seen to encase the thecal sac at the L4 level. L3 to L5 laminectomy is noted.
A fairly large soft tissue lesion which is hypointense on the T1 Weighted images and turns heterogeneously hyperintense on the FLAIR images is seen to involve the superior aspect of the skull vault. It is seen to indent the underlying fronto-parietal lobes.
A hyperintense signal on the FLAIR images is seen within the left occipital lobe with adjacent sulci being prominent.
IMPRESSION :
In a known C/O thyroid carcinoma, the MRI features are suggestive of secondaries involving the D9, D10, D11 and L4 vertebrae (with cord compression and cord edema/ischemia/myelitis over the D9 to D11 vertebrae) and within the skull vault.
The patient is status posterior spinal fixation.
As compared to the previous MRI dated 00.00.00, there is an increase in the degree of compression over the D9 to D11 levels and also at the L4 vertebral level.