sb/ke/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyzham Gulmn / M / 70 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to BLE with numbness since 1 month.

EXAMINATION :

M.R.I of the lumbo-sacral spine was performed using the following parameters :

5 mm thick T1 Weighted and T2 Weighted sagittal images.

5 mm thick T1 Weighted and T2 Weighted axial images.

The cervical and dorsal spines were screened with 4 mm thick T1 Weighted sagittal images.

OBSERVATION :

All the vertebrae of the spinal axis except the D7 vertebral body show a hypointense signal as compared to the normal marrow on the T1 Weighted images which appears slightly hyperintense on the T2 Weighted images. Slight central wedging of some of these vertebral bodies is noted with a bulge of the posterior margins of some vertebrae.

There is seen an intermediate signal intensity soft tissue lesion on the T1 Weighted images involving the spinous process of the L3 vertebra. This lesion appears hyperintense on the T2 Weighted images. Slight bulge of the L3 vertebral body is also noted.

There is slight loss of water content of the L3-L4 intervertebral disc.
Scan-00006

The D7 vertebral body shows evidence of a hyperintense signal on the T1 Weighted images with multiple linear striations which may suggest a hemangioma. Similar smaller lesions are noted in the D12, L4 and L5 vertebral bodies.

Slight hypertrophy of the facet joints in the lower lumbar region is noted.

Hyperintense signal is seen in the epidural space circumferentially at the L5 and L5-S1 levels on the T1 Weighted images and follows fat signal intensity characteristics on all the pulse sequences. This represent epidural lipomatosis.

The remaining intervertebral discs reveal normal signal intensity. The rest of the facet joints and the visualized pre and paravertebral soft tissues are unremarkable.

The conus medullaris terminates at the L1 level and the thecal sac terminates at the S1 level.

The antero-posterior dimensions of the lumbar canal at the level of the intervertebral discs are as follows :

18.0 mm at L1-L2
19.0 mm at L2-L3
16.0 mm at L3-L4
13.0 mm at L4-L5
13.0 mm at L5-S1.
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- 3 - Scan-00006


IMPRESSION :

Altered signal in the spinal axis as described is not specific for a single etiology.

A myeloproliferative disorder or metastasis may be considered as differential diagnosis.

The possibility of these changes representing conversion of yellow marrow to red marrow seems less likely, in view of the hyperintense signal on the T2 Weighted images.

Soft tissue lesion is noted around the spinous process of L3.