sb/ke/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyzh Sonalmn / M / 53 yrs.
Referred by : Dr. Abc Xyzhtekar.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE :

C/O weakness of the RUE and RLE with bladder involvement.
H/O suprapubic cystotomy done 2 1/2 years back.
Known C/O TBM.

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.

3 mm thick T2 Weighted coronal images.

OBSERVATION :

There is loss of normal cervical lordosis and loss of water content of the cervical intervertebral discs.

There is seen an ill-marginated, most likely intradural - extramedullary mass lesion in the spinal canal to the right of the cervical spinal cord at the C4 vertebral level measuring approximately 1.0 x 0.8 x 2.1 cms. This lesion is nearly isointense to the normal cord on the T1 Weighted images and appears hypointense on the T2 Weighted images. The lesion has a broad base towards the dural theca. There is resultant cord compression and displacement of the cervical spinal cord to the left, at that level. The cervical spinal cord along its entire extent appears slightly swollen and shows a hyperintense signal on the T2 Weighted images which suggest cord edema/ischemia.



There is a fairly large, postero-central and right postero-lateral (foraminal) disc herniations with peridiscal osteophytes at the C5-C6 level with right neural foraminal narrowing.

A right paracentral protruded disc with peridiscal osteophytes is noted at the C4-C5 level.

A small postero-central protruded disc is noted at the C2-C3 level.

The cervical vertebral bodies show spotty fatty marrow changes. The joints of Luschka and the visualized pre and paravertebral soft tissues are unremarkable.

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

IMPRESSION :

1. An approximately 1.0 x 0.8 x 2.1 cms. sized intradural - extramedullary mass lesion in the spinal canal to the right of the cervical spinal cord at the C4 vertebral level, follows the signal characteristics of a tuberculoma (patient is a known C/O TBM). The possibility of this lesion being intramedullary in location cannot be entirely excluded. The possibility of this lesion representing a meningioma also seems less likely.

2. Altered cord signal in the cervical region suggest cord edema/ischemia.
..3/.












- 3 - Scan-00004



3. A fairly large, postero-central and right postero-lateral (foraminal) disc herniations with peridiscal osteophytes at the C5-C6 level with right neural foraminal narrowing.

4. A right paracentral protruded disc with peridiscal osteophytes at the C4-C5 level.

5. A small postero-central protruded disc at the C2-C3 level.

A contrast enhanced scan is essential.