Name of the Patient : Abc XyzKelmn / F / 35 yrs.
Referred by : Dr. Abc Xyzngsarkar.
Examination : M.R.I. of the Dorsal Spine.

CLINICAL PROFILE :

C/O weakness of BLE with incontinence of urine.
H/O TB spinal arachnoiditis for which patient is on AKT since 1 1/2 years.

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.

The cervical spine was screened with 4 mm thick T2 Weighted sagittal images.

OBSERVATION :

The D10 vertebral body is as marked on the film. Kindly correlate with plain radiographs.

There is increase in calibre of the dorsal spinal cord over the D3 to L2 vertebral levels. There is irregularity of the margins of the dorsal spinal cord over the D3 to D7 and over the L1 to L2 vertebral levels.

There is seen an intermediate signal intensity, intramedullary lesion in the dorsal spinal cord at the D8 and D9 vertebral levels. This lesion appears hypointense on the T2 Weighted images. Similar signal intensity focal lesions are noted at the D7 and D11 vertebral levels. Cystic changes are noted in the dorsal spinal cord over the D10 to D12 vertebral levels. The

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spinal cord over the D3 to D7 and over L1 and L2 vertebral levels appears hypointense on the T1 Weighted images and hyperintense on the T2 Weighted images. There is effacement of the CSF space around the spinal cord over the D3 to L2 vertebral levels.

There is an intermediate signal intensity on the T1 Weighted images in the right paravertebral region at the D12 and D12-L1 levels. This lesion appears hypointense on the T2 Weighted images and is probably retrocrural.

The visualized dorsal vertebral bodies and intervertebral discs reveal normal signal intensity. The facet joints and the visualized pre and left paravertebral soft tissues are unremarkable.

The conus medullaris terminates at the L2 level.

Screening images of the cervical spine do not reveal any significant feature of note.

IMPRESSION :

Patient is a known C/O TB arachnoiditis.

Intramedullary lesion at the D8 and D9 vertebral levels may represent a granuloma, probably a tuberculoma, in the given clinical setting. A syrinx is noted in the dorsal spinal cord over the D10 to D12 vertebral levels. Altered cord signal over the D3 to D7 and over L1 and L2 vertebral levels may represent cord edema/myelomalacia, the sequelae of previous arachnoiditis.

The lesion in the right paravertebral region at the D12 and D12-L1 levels may represent a calcified lesion, ?? calcified lymph node, ?? calcified abcess.

A contrast enhanced scan would be worthwhile.


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As compared to the previous MRI dated 00.00.0000, the intramedullary lesion at the D8 and D9 vertebral levels is a new finding. The syrinx over the D10 to D12 vertebral levels is more apparent on the present study.