sb.bv.rg.

Name of the Patient : Abc Xyzhandra lmn / M / 79 yrs.
Referred by : Dr. Abc Xyzo.
Examination : M.R.I. of the Cervico-dorsal Spine.

CLINICAL PROFILE :

Known C/O Ca Colon. Operated for the same in 0000.
C/O paraplegia 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 dorso-lumbar spine was screened with 4 mm thick T1 Weighted sagittal images.

OBSERVATION :

There is near complete collapse of the D5 vertebral body, which is slightly retropulsed. The antero-inferior segment of the D4 vertebra, visualized D5 vertebral body and antero-superior segment of the D6 vertebral body appear hypointense on the T1 Weighted images and hyperintense on the T2 Weighted images. The D4-D5 and D5-D6 intervertebral discs appear intact.

There is seen a circumferential epidural soft tissue lesion over the D4 to D6 vertebral levels which is of intermediate signal on the T1 Weighted images and is hyperintense on the T2 Weighted images. There is resultant cord compression over these levels. The cervico-dorsal spinal cord over D2 to D8 vertebral levels shows a hyperintense signal on the T2 Weighted images which suggests cord edema/ischemia. Minimal pre and paravertebral soft tissue lesion is noted over the D4 to D6 vertebral levels.
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The posterior elements of D5 vertebra, the body of C7 vertebra and the posterior elements of the visualized D4 vertebra also show altered signal.

The costo-vertebral and costo-transverse joints at the D5 and D6 vertebral levels are also involved. The inferior articular facet of L4 is also involved.

Degenerative changes are noted in the mid and lower cervical region.

The rest of the visualized cervico-dorsal vertebral bodies and the visualized dorso-lumbar vertebral bodies show spotty fatty marrow changes. The visualized cervico-dorsal intervertebral discs show loss of water content. The facet joints are unremarkable.

Suspicious parenchymal lesion is noted in the right lung which need to be further investigated, if clinically indicated. Enlarged subcarinal lymphnodes are also noted.

IMPRESSION :

In a known C/O adenocarcinoma of the colon (status post-operative), the MRI features suggest multiple metastatic deposits in the C7, D4, D5 and D6 vertebrae and L4 facet as described. Circumferential epidural soft tissue lesion is noted over D4 to D6 vertebral levels with cord compression. Cord signal alteration over D2 to D8 vertebral levels would represent cord edema/ischemia.

Soft tissue in the right lung needs to be further investigated.