hs/sb/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyzn Chavalmn / M / 70 yrs.
Referred by : Dr. Abc Xyz Shah.
Examination : M.R.I. of the Dorsal Spine.

CLINICAL PROFILE :

C/O progressive paraparesis since 15 days.
Past H/O spinal surgery twice - 5 yrs ago and 10 yrs ago.

EXAMINATION :

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

5 mm thick T1 Weighted and T2 Weighted sagittal images.

7 mm thick T1 Weighted and T2 Weighted axial images.

OBSERVATION :

There appears to be laminectomy of the D8, D9 and D10 vertebrae with post-operative changes in the posterior soft tissues.

The dorso-lumbar vertebrae appear to be fused.

Areas of hypointensity on the T1 Weighted images which turn heterogeneously hyperintense on the T2 Weighted images are seen to involve the D9 to L3 vertebral bodies and appendages. The D10 to L2 vertebral bodies also show spotty fatty changes, as do the other visualized dorso-lumbar vertebral bodies. There is mild extension of the pathologic process into the pre and paravertebral soft tissues over these levels. Also seen is extension into the epidural space over the D9 to D12 levels with encasement and compression of the cord. The cord signal cannot be ascertained with any degree of reliability. The D10-D11 to L2-L3 intervertebral discs are not well identified. There also appears to be subtle involvement of the L4 vertebral body.





There is laminectomy of the L3, L4 and L5 vertebrae. The CSF within thecal sac over these levels is hyperintense to normal CSF on the T1 Weighted images and would reflect arachnoiditis.

Posterior disc bulges with peridiscal osteophytes are noted at the L4-L5 and L5-S1 levels.

IMPRESSION :

The MRI features are suggestive of :

1. Post-operative status.

2. Altered signal of the D9 to L4 vertebrae with soft tissue extensions and encasement of the cord is most likely the result of an infective process. A neoplastic process like a small cell tumor cannot be entirely excluded.

3. Arachnoiditis in the lumbar region as described.