SB/KE/NL/RG.
Date : 00.00.00

Name of the Patient : Abc Xyz Mlmn / M / 37 yrs.
Referred by : Dr. Abc Xyzrani.
Examination : M.R.I. of the Dorso-lumbar Spine.

CLINICAL PROFILE :

C/O backache with weakness of the RLE and tingling in the RUE and RLE since February 0000.
Operated for an ependymoma in the dorsal region in February 0000. Radiotherapy received.

EXAMINATION :

M.R.I of the dorso-lumbar 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.

After administration of contrast, 5 mm thick T1 Weighted sagittal images and 5 mm thick T1 Weighted axial images (with fat saturation) were obtained.

OBSERVATION :

There is evidence of laminectomy over the D12 to L3 vertebral levels with post-operative changes in the soft tissues in the posterior dorso-lumbar region over these levels.

There is seen an intradural-extramedullary mass lesion in the lower dorsal spinal cord at the conus-cauda region, at the L1 and L2 vertebral levels. This lesion is of intermediate signal on the T1 Weighted images and appears heterogeneously hyperintense on the T2 Weighted images. The tip of the conus medullaris and the intrathecal nerve roots are not well identified separately in that region.
Scan-00007


There is scalloping of the posterior margin of the D12, L1 and L2 vertebrae.

A hypointense signal on the T1 Weighted images which turns hyperintense on the T2 Weighted images is noted in the mid and lower dorsal spinal cord, centrally, over about D5 to L1 vertebral levels, which represents a syrinx.

The D12 to L3 vertebral bodies show fatty marrow changes, the sequelae of previous radiotherapy.

The visualized dorso-lumbar intervertebral discs show normal signal.

The facet joints and the visualized pre and paravertebral soft tissues are unremarkable.

After administration of contrast, there is enhancement of the previously described intradural-extramedullary lesion at the L1 and L2 vertebral levels. There is no other focal area of abnormal enhancement in the visualized dorsal spinal cord or the meninges.

IMPRESSION :

1. Post-operative, post-radiotherapy status.

2. An enhancing intradural-extramedullary lesion in the spinal canal at the L1 and L2 vertebral levels as described represents a residual/recurrent ependymoma. A syrinx is noted in the dorsal spinal cord over the D5 to L1 vertebral levels.

As compared to the previous MRI dated 00.00.00, there is no significant change noted.