sb/ke/rg.
Date : 00.00.00

Name of the Patient : Abc Xyz Slmn / M / 21 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Dorsal Spine.

CLINICAL PROFILE :

Known C/O TBM with TB arachnoiditis. On AKT.
C/O numbness in BLE since June 0000.

EXAMINATION :

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

5 mm thick T1 Weighted and T2 Weighted sagittal images.

7 mm thick T1 Weighted and T2 Weighted axial images.

After administration of contrast 5 mm thick T1 Weighted sagittal, 7 mm thick T1 Weighted axial and 4 mm thick T1 Weighted coronal images were obtained. The cervico-dorsal and lumbar spines were screened with 4 mm and 5 mm thick T1 Weighted sagittal images.

The brain was screened with 5 mm thick T1 Weighted axial images.

OBSERVATION :

There is still seen an ill-defined, intermediate signal intensity mass lesion on the T1 Weighted images in the spinal canal at D4, D5 and D8 and D9 vertebral levels. This lesion is most likely intradural in location and appears hyperintense on the T2 Weighted images. The lesion is located posterior and more to the right of the dorsal spinal cord at these levels. The posterior margin of the dorsal spinal cord is not well-defined separately from the lesion on the T1 Weighted images. The surrounding CSF space appears effaced. The dorsal spinal cord over the D3 to D9 vertebral levels appears slightly hyperintense on the T2 Weighted images suggesting cord edema/ischemia. The CSF in the dorsal region appears slightly more hyperintense as compared to the normal.
..2/.






After administration of contrast, there is peripheral enhancement of the above described intradural lesions at D4, D5, D8 and D9 vertebral levels with enhancement of the posterior meninges over D2 to D11 vertebral levels.

A small, right paracentral protruded disc with peridiscal osteophyte is noted at the D2-D3 level.

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.

The conus medullaris terminates at D12 vertebral level.

Screening images of the cervical and lumbar spines are unremarkable except for slightly hyperintense signal of the CSF in the lumbar region.

Screening images of the brain reveal an approximately 4.0 mm diameter sized disc-enhancing lesion in the left parieto-occipital parafalcine cortex (scans 114.10). Suspicious patchy enhancement is noted in the region of the left cerebral peduncle.

The ventricular system is unremarkable. There is no midline shift. No basal enhancement is noted.

IMPRESSION :

Intradural-extramedullary, peripherally enhancing mass lesion in the dorsal region, posterior to the dorsal spinal cord at the D4, D5, D8 and D9 vertebral levels as described most likely represents granulation tissue/abscess, in the given clinical setting. Enhancement of the posterior meninges over D2 to D11 levels is noted. Altered cord signal over D3 to D9 vertebral levels may represent cord edema/ischemia.

Focal, disc enhancing lesion in the left parieto-occipital parafalcine cortex would represent a granuloma, in the given clinical setting.
..3/.




- 3 - Scan-00005


As compared to the previous MRI dated 00.00.00 (Study No.00006), there seems to be a decrease in the size of the intradural granulation tissue/abscess on the present study (the previous study was a non-contrast study).