ke/bv/rg.
Date : 00.00.00

Name of the Patient : Abc Xyz Plmn / F / 22 yrs.
Referred by : Dr. Abc Xyztel.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE :

H/O fever with chills since 8 days.
C/O quadriparesis since 3 days.

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 :

The cervical spinal cord appears swollen and is hypointense to the normal cord on the T1 Weighted images. This is seen to turns hyperintense on the T2 Weighted and Fast Scan (T2 *) images. Superiorly this is seen to extend upto the cervico-medullary junction and inferiorly upto the D7 vertebral level. Slight effacement of the CSF space in the upper cervical region is noted. The gray and white matter differentiation is lost in the upper cervical region.

There are small posterior disc bulges at the C3-C4 and C4-C5 levels with anterior indentation of the thecal sac. The upper cervical intervertebral discs show loss of water content.

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

The atlanto-axial region is unremarkable.
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IMPRESSION :

The MRI features are suggestive of a swollen cervical spinal cord with altered signal extending upto the cervico-medullary junction superiorly and inferiorly upto the D7 vertebral level is not specific for a single etiology. The possibilities to be considered are,

1. Myelitis (most likely).

2. Demyelination.

3. Ischemia/infarction (less likely).

If clinically indicated, a contrast enhanced scan may be worthwhile.