hs/bv
Date : 00.00.00

Name of the Patient : Abc Xyzbanu Shlmn / F / 13 yrs.
Referred by : Dr. Abc Xyzchale.
Examination : M.R.I. of the Dorsal Spine.

CLINICAL PROFILE :

C/O acute onset of weakness of BLE (left more than right) with fever since 00.00.00.
H/O backache since 8 days.

EXAMINATION :

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

4 mm thick T1 Weighted and T2 Weighted sagittal images.

5 mm thick T1 Weighted and T2 Weighted axial images.

3 mm thick T1 Weighted and T2 Weighted coronal images.

A contrast enhanced scan was refused.

OBSERVATION :

The D8 vertebra appears as marked on the film.

There is evidence of a fairly well-defined intradural/extramedullary mass lesion within the spinal canal at the D7 and D8 vertebral levels. It is seen to measure approximately 2.0 x 2.0 x 3.5 cms. This lesion shows mixed signal characteristics on the T1 Weighted images (with cystic/necrotic changes) and turns hyperintense on the T2 Weighted images. A smaller lesion having a diameter of approximately 1.0 cm is seen at the superior pole of this lesion probably in continuity with the above lesion.

There is resultant compression and anterior displacement (more to the right of the midline) of the spinal cord at the D7 and D8 vertebral levels. The cord over these levels shows a hyperintense signal on the T2 Weighted images and which would suggest cord edema/ischemia.

The visualized dorsal vertebral bodies and intervertebral discs reveal normal signal intensity. The facet joints and the visualized pre and paravertebral soft tissues are unremarkable.
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The conus medullaris terminates at the D12-L1 level.

IMPRESSION :

The MRI features are suggestive of an intradural/extramedullary mass lesion within the spinal canal at the D7 and D8 vertebral levels measuring approximately 2.0 x 2.0 x 3.5 cms. The differential diagnosis to be considered are :

1. Neurofibroma.

2. Meningioma.

3. Metastasis due to CSF seeding.

4. Dermoid/epidermoid.

A contrast enhanced scan would be worthwhile (with ? MRI/CT of the brain).