ke/sb/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzkant Shelmn / M / 47 yrs.
Referred by : Dr. Abc Xyzhta.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE :

C/O neckpain with swelling on the left side of the neck.
C/O neckpain with stiffness of the neck since 3 months.

EXAMINATION :

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

4 mm thick T1 Weighted and T2 Weighted sagittal images.

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

OBSERVATION :

There is a fairly large, well-defined lesion in the posterior triangle of the neck on the left side, laterally measuring approximately 3.0 x 3.5 x 5.2 cms. This lesion is seen to extend from the C2-C3 to C6-C7 levels. This lesion is hypointense in the centre, with hyperintense periphery on the T1 Weighted images. This is seen to turn hyperintense with a hypointense periphery on the Gradient images. Similar smaller lesions are noted anteriorly, posterior to the carotid sheath. There is resultant displacement of the carotid sheath anteriorly. Hyperintense signal is also noted in the soft tissues adjacent to the carotid sheath on the left side at the C1 to C3 levels.

The tip of the odontoid process appears hypointense on the T1 Weighted images and is seen to turn heterogeneously hyperintense on the T2 Weighted images. A small posterior disc bulge with peridiscal osteophyte is noted at the C5-C6 level with anterior indentation of the thecal sac. Small posterior disc bulges are seen at the C4-C5 and C6-C7 levels. The cervical intervertebral discs show loss of water content.
..2/.






The rest of the cervical vertebral bodies show normal signal intensity. The joints of Luschka and the visualized pre and paravertebral soft tissues are unremarkable.

The cervical spinal cord reveals normal signal intensity.

The cervico-medullary junction is unremarkable.

Enlarged lymphnodes are noted deep to the sternocleidomastoid muscles, bilaterally.

IMPRESSION :

The MRI features are suggestive of :

1. A large abscess measuring approximately 3.0 x 3.5 x 5.2 cms. in the posterior triangle of the neck on the left side, laterally, with probable small necrotic nodes.

2. Altered signal in the odontoid process most likely is
infective in etiology, probably tuberculous.

3. A small posterior disc bulge with peridiscal osteophyte at the C5-C6 level.

4. Small posterior disc bulges at the C4-C5 and C6-C7 levels.

5. Enlarged lymphnodes deep to the sternocleidomastoid muscles, bilaterally.