bv/ke/rg.
Date : 00.00.00

Name of the Patient : Abc Xyz Llmn / M / 29 yrs.
Referred by : Dr. Abc Xyzabar.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to the RLE.
Received 6 cycles of Chemotherapy for Non-Hodgkins lymphoma, completed on 00.00.00.
For follow up.

EXAMINATION :

M.R.I of the lumbo-sacral 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.

OBSERVATION :

There is evidence of hemi-laminectomy of the L5 and S1 vertebral bodies on the right side.

Areas of hypointensity on the T1 Weighted images which turn heterogeneously hyperintense on the T2 Weighted images are seen to involve the L5 vertebral body, the transverse processes, pedicles and articular pillars. There appears to be a suspicious break of its superior cortical endplate.

There is extension of this pathologic process into the paravertebral soft tissues on the right side over the L4 to S1 vertebral levels. Also seen is extension into the anterior and
right lateral epidural space over the L3 to the S1 vertebral level with encroachment into the L4-L5 neural foramina bilaterally and on the right side at the L5-S1 level. In some parts, the soft tissue is seen to encircle the thecal sac. There is resultant indentation of the thecal sac over these levels.

A hypointense focus on the T1 Weighted images is seen in the right iliac bone adjacent to the right sacro-iliac joint.
..2/.

- 2 - scan-00002


The L4-L5 intervertebral disc shows loss of water content.

The rest of the lumbar vertebral bodies reveal spotty fatty changes. Fatty changes are also visualized in the L5 vertebral body on the left side. This suggests healing of the disease process. The remaining intervertebral discs reveal normal signal intensity. The facet joints and the visualized prevertebral soft tissues are unremarkable.

The conus medullaris terminates at the L1 level and the thecal sac terminates at the S1 level.

IMPRESSION :

In a known C/O Non-Hodgkins lymphoma, the MRI features are suggestive of the pathologic process involving the L5 vertebra with soft tissue and epidural extension and a smaller lesion in the right iliac wing as described.

As compared to the previous MRI dated 00.00.00 (Study No.00009) the patient is now status post-operative. The left half of the L5 vertebra now shows fatty changes suggesting healing. There is reduction in the paravertebral and the epidural soft tissue component. The previously identified interaortico-caval lymphnodes are no longer visualized.