sb/hs/rg.
Name of the Patient : Abc Xyz Jolmn / M / 11 yrs.
Referred by : Dr. Abc Xyzrani.
Examination : M.R.I. of the Lumbo-sacral Spine.
CLINICAL PROFILE :
C/O backache with pain radiating to the RLE.
EXAMINATION :
M.R.I of the lumbo-sacral 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 :
There is evidence of segmentation anomalies of the L5, S1, S2 and S3 vertebrae. Spina bifida is noted in the lumbo-sacral and sacral region over the L5 to S4 levels.
There is seen an intradural, fat signal intensity lesion on all pulse sequences in the thecal sac, posteriorly extending over the L5 to S3 vertebral levels. This represents an intradural lipoma. The tip of the spinal cord is tethered to this lipoma and is noted at the L5-S1 disc level. The subcutaneous fat is seen to extend upto the thecal sac in the sacral region.
The lower spinal cord splits into two hemicords over the L3 to L5 vertebral levels. There is no separate thecal sac or an obvious bony bar/fibrous band noted.
The thecal sac appears slightly capacious in the lumbo-sacral region and terminates at the S3 vertebral level.
..2/.
- 2 - Scan-00006
The lumbar vertebral bodies and the intervertebral discs reveal normal signal intensity. The facet joints and the visualized pre and paravertebral soft tissues are unremarkable.
The left kidney is not visualized in its normal position in the left renal fossa. Instead a pelvic kidney is noted in the midline over the L5 to S2 vertebral levels.
IMPRESSION :
The MRI features are suggestive of spinal dysraphism with segmentation anomalies of the lower lumbar and sacral vertebrae and an intradural lipoma over the L5 to S3 vertebrae, tethering the spinal cord at the L5-S1 disc level. Diastematomyelia is noted over the L3 to L5 vertebral levels without an obvious bony bar/fibrous band.
A pelvic kidney is also seen as described.