Name of the Patient : Abc Xyzlmn / M / 50 yrs.
Referred by : Dr. Abc Xyzrekh.
Examination : M.R.I. of the Dorsal Spine.

CLINICAL PROFILE :

Known C/O Kochs spine.
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 axial images.

OBSERVATION :

The D6 and D10 vertebral bodies are as marked on the film.

There is partial collapse of the D8 and D9 vertebral bodies. The D8 and D9 vertebral bodies appear hypointense on the T1 Weighted images and heterogeneously hyperintense on the T2 Weighted images. The pedicles of these vertebrae also show altered signal. The D8-D9 intervertebral disc is reduced in height and shows a hyperintense signal on the T2 Weighted images. The cortical endplates adjacent to the D8-D9 intervertebral disc are eroded.

Altered signal is also noted in the D6 and D7 vertebral bodies.

There is seen an intermediate signal intensity soft tissue lesion on the T1 Weighted images in the prevertebral and paravertebral (more on the right) regions over the D6 to D9 vertebral levels. This lesion appears hyperintense on the T2 Weighted images. Extension of the soft tissue lesion into the anterior epidural space over the D8 and D9 vertebral levels is noted, with cord
compression. The spinal cord at the D9 vertebral level shows a subtle hyperintense signal on the T2 Weighted images which
appears isointense on the T1 Weighted images and represents cord edema/ischemia. There is extension of the soft tissue lesion into the neural foramen at the D8-D9 level, bilaterally.

The rest of the visualized dorsal vertebral bodies show spotty fatty marrow changes.

The remaining dorsal intervertebral discs show loss of water content.

Slight facetal hypertrophy is noted at the D8-D9, D9-D10, D10-D11 and D11-D12 level.

The conus medullaris terminates at the D12-L1 level.

Screening T1 Weighted sagittal images of the cervico-dorsal spine do not reveal any significant feature of note.

Screening T1 Weighted sagittal images of the lumbo-sacral spine reveal slight forward translation of the L4 vertebra over the L5 vertebra with a small, pseudo-posterior disc herniation [more to the left of the midline] at that level. Suspicious spondylolysis at L4 is noted. An ill-defined hypointense areas with hyperintense periphery on the T1 Weighted images is seen in the L2 vertebral body on the left side.

IMPRESSION :

Altered signal of the D6, D7, D8 and D9 vertebral bodies and the D8-D9 intervertebral disc most likely represents osteitis with discitis probably tuberculous in etiology. Prevertebral and paravertebral soft tissue lesion would represent granulation tissue/abscess. There is resultant mild cord compression at D8 and D9 levels with altered cord signal at the D9 vertebral level suggestive of cord edema/ischemia.

The possibility of this lesion representing a neoplasm seems less likely.

Altered signal intensity lesion in the L2 vertebral body on the left side may represent osteitis or an hemangioma.