ke/hs/rg/nl

Name of the Patient : Abc Xyz lmn / F / 43 yrs.
Referred by : Dr. Abc Xyzhah.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O weakness of the LLE since 3 days.

EXAMINATION :

M.R.I of the lumbo-sacral 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.

OBSERVATION :

There appears to be sacralization of the L5 vertebra and the D12 vertebra is as marked on the film. Please correlate with plain radiographs. Mild retroplacement of the L3 over the L4 and L4 over the L5 vertebra is noted.

There is a well-defined extradural mass lesion (with ? intradural extension) in the left lateral recess of the L1 vertebral body encroaching into the L1-L2 neural foramen on the left side. This lesion is seen to follow CSF signal intensity characteristics on all the pulse sequences. There is resultant scalloping of the left pedicle and posterior aspect of the body on the left side of the L1 vertebra. There is displacement of the thecal sac to the right. Also seen is widening of the left neural foramen.

A posterior and left far lateral disc herniation with posterior peridiscal osteophytes is seen at the L4-L5 level with anterior indentation of the thecal sac and indenting upon the exiting left L4 nerve root.
Scan-00009



A small posterior disc herniation with posterior peridiscal osteophytes is seen at the L3-L4 level with anterior indentation of the thecal sac. Bilateral far lateral disc bulges are seen at this level.

The L4-L5 facet joint on the left side and the L3-L4 facet joints bilaterally show hypertrophic degenerative changes. Mild ligamentum flavum hypertrophy is noted over the L3-L4 to the L4-L5 levels. There is facetal hypertrophy on the right side at the L4-L5 level.

The lumbar intervertebral discs show loss of water content. The visualized pre and paravertebral soft tissues are unremarkable.

The conus medullaris terminates at the D12-L1 level and the thecal sac terminates at the S1 level.

The antero-posterior dimensions of the lumbar canal at the level of the intervertebral discs are as follows :

21.0 mm at D11-D12
21.0 mm at D12-L1
20.0 mm at L1-L2
22.0 mm at L2-L3
20.0 mm at L3-L4
15.0 mm at L4-L5
11.0 mm at L5-S1.

The cervico-dorsal and dorsal spine was screened with 4 mm thick T2 Weighted sagittal images and which shows a small posterior disc herniation with posterior peridiscal osteophytes at the C6-C7 level with anterior indentation of the thecal sac. Small posterior peridiscal osteophytes are also seen at the D8-D9 level. The cervical and dorsal intervertebral discs show loss of water content. Facetal hypertrophy is seen at the D9-D10 and D10-D11 levels.
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- 3 - Scan-00009



IMPRESSION :

1. Sacralization of the L5 vertebra. Please correlate with plain radiographs.

2. An extradural mass lesion (with ? intradural extension) in the left lateral recess of the L1 vertebral body encroaching into the L1-L2 neural foramen on the left side as described and which may represent an arachnoid cyst/meningeal cyst.

3. A posterior and left far lateral disc herniation with posterior peridiscal osteophytes at the L4-L5 level and indenting the exiting left L4 nerve root.

4. A small posterior disc herniation with posterior peridiscal osteophytes at the L3-L4 level.