Sunday, 27 December 2015 16:48

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Date : 00.00.00

Name of the Patient : Abc Xyz. Klmn / F / 17 yrs.
Referred by : Dr. Abc Xyzrges.
Examination : M.R.I. of the Dorsal Spine.

CLINICAL PROFILE :

C/O bacakche since 1 month with fever and gradual progressive weakness of BLE since 10 days.

EXAMINATION :

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

4 mm thick T1 Weighted and T2 Weighted sagittal images.

6 mm thick T1 Weighted and T2 Weighted axial images.

OBSERVATION :

Areas of hypointensity on the T1 Weighted images which turn hyperintense on the T2 Weighted images are seen to involve the D10 and D11 vertebral bodies and pedicles and antero-inferior aspect of the D9 vertebral body. The intervening intervertebral discs are unremarkable.

There is extension of this pathologic process into the right paravertebral and prevertebral (subligamentous) soft tissues over the D8 to D11 levels and this may represent an abscess/granulation tissue. A smaller, soft tissue component is noted in the left paravertebral region.

Also seen is extension of the soft tissue into the anterior epidural space over the D10 and D11 vertebral levels with extension into the D10-D11 neural foramina bilaterally. There is compression of the spinal cord at the D10 and D11 levels. The cord over the D8 to D12 vertebral levels shows a hyperintense signal suggestive of cord edema/ischemia/myelitis.

Enlarged right hilar and subcarinal lymphnodes are noted.
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The rest of the visualized dorsal vertebral bodies and intervertebral discs reveal normal signal intensity.

The conus medullaris terminates at the L1 level.

IMPRESSION :

The MRI features are suggestive of a pathologic process involving the D9, D10 and D11 vertebrae with cord compression and cord edema/ischemia/myelitis as described. This is most likely the result of an infective process like tuberculosis. The possibility of this being a neoplastic process like a small cell tumor cannot be entirely excluded.
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