ke/sb/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyz Shlmn / F / 18 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE :

Previous MRI s/o tuberculous spine involving the C5, C6 and C7 vertebrae. On AKT since February 0000.

EXAMINATION :

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

5 mm thick T1 Weighted and T2 Weighted sagittal images.

5 mm thick T1 Weighted and Fast Scan (T2 *) axial images.

5 mm thick T1 Weighted and STIR coronal images.

OBSERVATION :

Areas of hypointensity on the T1 Weighted images are still seen to involve the C5, C6 and C7 vertebral bodies and these vertebral bodies are seen to turn hyperintense on the T2 Weighted images.

There is extension of this pathologic process into the anterior and right lateral epidural space over the C4 to C7 vertebral levels with resultant indentation upon the spinal cord. The cord over these levels shows a subtle hyperintense signal on the T2 Weighted images suggesting cord edema/ischemia/myelitis. Also seen is encroachment into the neural foramina bilaterally at the C5-C6 and C6-C7 levels and on the right side at the C4-C5 and C7-D1 levels with encasement of the corresponding exiting nerve roots. The right pedicles of the C5, C6 and C7 vertebrae are involved.



The pathologic process is also seen to extend into the prevertebral, right paravertebral and right posterior paraspinal soft tissues over the C2 to C7 levels. There is partial encasement of the right vertebral artery over the C5 to C7 levels which however shows normal flow void signal. This soft tissue lesion is hypointense with a hyperintense rim on the T1 Weighted images and turns hyperintense with a hypointense rim on the Fast Scan (T2 *) images and this may represent an abscess (which appears to be loculated).

The C2-C3 to C5-C6 intervertebral discs show loss of water content. The C6-C7 intervertebral disc is hyperintense on the T2 Weighted images (? involved by the pathologic process).

The rest of cervical vertebral bodies and the remaining intervertebral discs show normal signal intensity. The joints of Luschka are unremarkable.

The atlanto-axial region and the cervico-medullary junction are unremarkable.

Mucosal thickening is noted in the sphenoid sinus.

IMPRESSION :

In a known C/O tuberculous spine, the MRI features are suggestive of altered signal of the C5, C6 and C7 vertebrae with soft tissue extensions and cord compression with cord edema/ischemia/myelitis over the C4 to C7 vertebral levels as described.

As compared to the previous MRI (study no.00004) dated 00.00.00, there is reduction in the pre and paravertebral soft tissue component as well as the epidural lesion and the degree of cord compression.