Name of the Patient : Abc Xyz lmn / F / 62 yrs.
Referred by : Dr. Abc Xyzagarkar / Dr. Abc Xyzlal.
Examination : M.R.I. of the Dorsal Spine.

CLINICAL PROFILE :

H/O trauma.
Known C/O Ca breast. Operated for the same.
C/O tingling in the RLE.

EXAMINATION :

M.R.I. of the dorsal spine was performed using the following parameters :

4 mm thick T1 Weighted and T2 Weighted sagittal images (with fat saturation).
5 mm thick T1 Weighted and T2 Weighted axial images.

OBSERVATION :

The D9 vertebra is as marked on the film.

There is collapse of D5 vertebral body.

Hypointense areas on the T1 Weighted images which turn heterogeneously hyperintense on the T2 Weighted images are seen in the D4, D5 and D6 vertebral bodies and the D10 vertebral body. Similar change is seen in the S2 vertebral body.

Expansile lesions are seen to involve the pedicles of the D5 vertebral body bilaterally and the right pedicle of the D4 and D6 vertebral bodies. Anterior and right postero-lateral soft tissue lesion is seen at the D5 level with impingement of the spinal cord. The spinal cord at this level shows a hyperintense signal on the T2 Weighted images and is isointense to hypointense to the


normal cord on the T1 Weighted images and would represent cord edema/ischemia/myelitis. The posterior appendages of the D4 and D5 vertebral bodies and the costo-vertebral and costo-transverse joints at the D4-D5 and D5-D6 levels are also involved by the pathology. Very minimal pre and paravertebral soft tissue is noted at the D5 and D6 levels. This shows intermediate signal intensity on the T1 Weighted images and is heterogeneously hyperintense on the T2 Weighted images.

The rest of the visualized dorsal vertebral bodies show spotty fatty marrow changes. The facet joints and the visualized pre and paravertebral soft tissues are unremarkable.

The cervical and dorsal spines were screened with T1 Weighted sagittal images and shows fatty marrow changes. Hypointense signal is noted in the S2 vertebral body.

The conus medullaris terminates at the L1 level.

IMPRESSION :

The MRI features are suggestive of :

1. Collapse of D5 vertebral body.

2. Altered signal in the D4, D5, D6, D10 and S2 vertebral bodies with involvement of the appendages as described with pre, paravertebral and epidural soft tissue lesion is as described. Altered signal at the D5 level would represent cord edema/ischemia/myelitis.

In a known C/O Ca breast, this most likely represents metastatic deposits.