sb/ke/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyz Gonsalmn / M / 67 yrs.
Referred by : Dr. Abc Xyzauhan.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache since 1 months and sudden onset of weakness of BLE since 2 days.
H/O Surgery for Ca prostate 1 1/2 years ago.

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 an ill-defined, hypointense signal on the T1 Weighted images in nearly all the lumbar and sacral vertebral bodies. This signal appears iso to slightly hypointense to the normal marrow on the T2 Weighted images. The posterior elements of most the vertebrae also seem to be involved.

There is an intermediate signal intensity soft tissue lesion on the T1 Weighted images in the epidural space, circumferentially at the L2 vertebral level. This lesion appears slightly hyperintense on the T2 Weighted images. There is resultant thecal sac compression and clumping of the intrathecal nerve root, centrally at this level. Destruction of the right pedicle, right transverse process and right lamina of L2 vertebra is noted.

The lumbar intervertebral discs reveal normal signal intensity. The facet joints and the visualized pre and paravertebral soft tissues are unremarkable.
..2/.







The lower dorsal spinal cord shows normal signal intensity.

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

Screening T1 Weighted coronal images of the pelvic bones reveal ill-defined hyperintense signal in the iliac bones bilaterally.

Screening T1 Weighted sagittal images of the cervico-dorsal region reveal involvement of nearly all the cervico-dorsal vertebrae and their posterior elements. No obvious cord compression is noted on this study.

IMPRESSION :

1. In a known C/O Ca prostate, altered signal in nearly all the vertebrae of the spinal axis including the pelvic bones would represent metastatis.

2. Thecal sac compression at the L2 vertebral level by circumferential epidural soft tissue at this level and destruction of the right pedicle, transverse process and lamina of L2 vertebra.