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Name of the Patient : Abc Xyzuru Dhiralmn / M / 81 yrs.
Referred by : Dr. Abc Xyzrohit / Dr. Abc Xyzmpat.
Examination : M.R.I. of the Dorsal Spine.

CLINICAL PROFILE :

C/O backache with pain radiating to the LLE with paresthesias.

EXAMINATION :

M.R.I. of the 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 and Fast Scan (T2 *) axial images.

After administration of contrast, the following parameters were used :

4 and 5 mm thick T1 Weighted sagittal images with fat saturation.

5 mm thick T1 Weighted axial images.

OBSERVATION :

There is a left paracentral disc herniation indenting the cord at the D6-D7 level.

Posterior disc bulges are noted at the D7-D8 and D8-D9 levels.

There is facetal hypertrophy at the D8-D9, D10-D11 and D11-D12 levels.

The visualized dorsal vertebral bodies and intervertebral discs reveal normal signal intensity. The visualized pre and paravertebral soft tissues are unremarkable.
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The dorsal spinal cord over the D9 to D11 levels shows a subtle hyperintense signal on the T2 Weighted and Fast Scan (T2 *) images [Scans : 109.15-18, 102.8-11].

After administration of contrast, there is no area of abnormal enhancement within the visualized spinal cord, along its surface or within the thecal sac/meninges [a linear area of enhancement seen within the spinal canal on the left at the D12 and L1 levels most likely represents partial volume averaging with a vessel].

The cervical and lumbar spines were screened with T2 Weighted and T1 Weighted sagittal images, respectively. They were screened with T1 Weighted sagittal images with fat saturation after contrast administration. Posterior disc herniations with peridiscal osteophytes are noted at the C5-C6 and C6-C7 levels. Ligamentum flavum hypertrophy is seen at the C5-C6 and C7-D1 levels. There is retroplacement of the L4 vertebra over the L5 vertebra. Also seen is a posterior disc herniation causing slight canal stenosis at the L4-L5 level. Bilateral far lateral disc herniations are seen at the L4-L5 level. There is facetal and ligamentum flavum hypertrophy at the L4-L5 and L5-S1 levels. A mild posterior disc bulge is noted at the L5-S1 level.

IMPRESSION :

The MRI features are suggestive of :

1. A left paracentral disc herniation indenting the cord at the D6-D7 level.

2. Subtle altered cord signal over the D9/D10 to D11 levels may represent cord edema/ischemia. Arachnoiditis should be ruled out.