hs/bv
Date : 00.00.00

Name of the Patient : Abc XyzPalmn / M / 27 yrs.
Referred by : Dr. Abc Xyzndu / Dr. Abc Xyzdi.
Examination : M.R.I. of the Cervico-dorsal Spine.

CLINICAL PROFILE :

C/O paresthesias in BLE with inability to stand since 2-3 days.
H/O tuberculosis of spine since September 0000. On AKT since then.

EXAMINATION :

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

5 mm thick T1 Weighted and T2 Weighted sagittal images.

6 mm thick T1 Weighted and T2 Weighted axial images.

OBSERVATION :

Diffuse areas of hypointensity on the T1 Weighted images which turn hyperintense on the T2 Weighted images are seen to involve the D1 and D2 vertebral bodies and their spinous processes and pedicles, laminae and transverse processes on the right side. Also seen is similar involvement of the pedicle, transverse process and lamina of the D3 vertebra on the right side. The head and neck of the D2 and D3 ribs on the right side appear to be involved.

There is evidence of a large soft tissue component within the prevertebral soft tissues (right more than left) and within the paraspinal and paravertebral soft tissues on the right side over the C6/C7 to D4 vertebral levels. This soft tissue component is







hypointense on the T1 Weighted images and turns relatively hyperintense on the T2 Weighted images. There is encroachment into the neural foramina on the right side at the D1-D2 and D2-D3 levels. This soft tissue component is also seen to lie within the right lateral and posterior epidural space over the C7-D1 to D3-D4 levels. There is resultant compression and displacement of the spinal cord anteriorly and to the left over these levels. The cord over these levels shows a hyperintense signal on the T2 Weighted images suggestive of cord edema/ischemia/myelitis.

Note is made of pleural thickening on the right side. There is a suspicious old fracture of the odontoid process. Enlarged paratracheal lymph nodes are identified on the right side.

The CSF in the visualized upper dorsal region appears more hyperintense than normal and may be due to increased protein content.

The visualized cervico-dorsal intervertebral discs show loss of water content.

IMPRESSION :

In a known C/O tuberculosis, the MRI features are suggestive of involvement of the D1, D2 and D3 vertebrae with soft tissue extensions and cord compression with cord edema/ischemia/myelitis over the C7-D1 to D3-D4 levels.

However similar features may be seen in neoplastic processes like small cell tumors.