bv/hs/rg.
Date : 00.00.00
Name of the Patient : Abc Xyzanabanu Almn / F / 2 1/2 months
Referred by : Dr. Abc Xyzthure.
Examination : M.R.I. of the Dorso-lumbar Spine.
CLINICAL PROFILE :
C/O meningomyelocele since birth.
EXAMINATION :
M.R.I of the dorso-lumbar spine was performed using the following parameters :
5 mm thick T1 Weighted and T2 Weighted sagittal images.
4 mm thick T1 Weighted and T2 Weighted axial images.
OBSERVATION :
There is an open spinal canal posteriorly at the L3 vertebral level.
There is a soft tissue intermediate signal intensity lesion measuring approximately 3.5 x 1.5 x 1.2 cms located over the surface of the posterior back and extending over the D12 to the L4 vertebral levels. This mass is seen to follow CSF signal intensity on all the pulse sequences and represents a meningocele. There is a continuation of this mass with the thecal sac at the L3 vertebral level. The spinal cord is seen to be low lying with the spinal cord ending at the S1 to S3 vertebral levels. There is tethering of the spinal cord to a lipoma at this level. The spinal cord is divided at the L3 vertebral level into two segments (bar) and this is suggestive of diastematomyelia. A lipoma is also seen within the thecal sac at the S2/S3 vertebral levels.
The visualized dorso-lumbar vertebral bodies and intervertebral discs reveal normal signal intensity. The visualized pre and paravertebral soft tissues are unremarkable.
The visualized dorsal spinal cord reveals normal signal intensity. There is no extrinsic cord compression.
..2/.
- 2 - scan-00001
IMPRESSION :
The MRI features are suggestive of spinal dysraphism with a meningocele with tethering of the spinal cord into a lipoma with diastematomyelia as described.