Name of the Patient : Abc Xyz lmn / F / 48 yrs.
Referred by : Dr. Abc Xyzar.
Examination : M.R.I. of the Dorso-lumbar Spine.
CLINICAL PROFILE :
C/O backache since 2 months with paraparesis since 4 days.
M.R.I of the dorso-lumbar 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 D9 and D10 vertebral bodies appear hypointense on the T1 Weighted images and hyperintense on the T2 Weighted images. The D9-D10 intervertebral disc also appears hyperintense on the T2 Weighted images.
There is an intermediate signal intensity mass lesion on the T1 Weighted images in the prevertebral, paravertebral and anterior epidural regions at the D9 and D10 vertebral levels. This lesion also appears hyperintense on the T2 Weighted images. There is resultant cord compression at the D9 and D10 vertebral levels with a subtle hyperintense signal on the T2 Weighted images in the dorsal spinal cord over these levels which suggests cord edema/ischemia/myelitis.
Slight facetal hypertrophy is noted at the D11-D12, D10-D11, D9-D10, D8-D9, D6-D7 and D4-D5 levels.
The D7-D8 and L1-L2 intervertebral discs show loss of water content.
The rest of the visualized dorso-lumbar vertebral bodies and the remaining intervertebral discs reveal normal signal intensity.
The conus medullaris terminates at the L2 level.
Screening T1 Weighted sagittal images of the lumbo-sacral spine, reveal a small posterior disc herniation at the L5-S1 level with facetal hypertrophy in the lumbar region.
Perineural cysts are noted at the S2 vertebral level.
Screening T1 Weighted sagittal images of the cervical spine reveal a probable retroesophageal subclavian artery.
Altered signal of the D9 and D10 vertebral bodies and the D9-D10 intervertebral disc most likely represents osteitis with discitis probably tuberculous in etiology. Prevertebral, paravertebral and anterior epidural soft tissue lesion would represent granulation tissue/abscess. There is resultant cord compression and cord signal alteration over the D9 and D10 vertebral levels suggesting cord edema/ischemia/myelitis.
The possibility of this lesion representing a neoplasm is less likely.
Facetal hypertrophy is noted in the dorsal and lumbar region as described.