sb/ke
Date : 00.00.00

Name of the Patient : Abc Xyz Shilmn / F / 17 days.
Referred by : Dr. Abc XyzMehta.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O swelling over the low back since birth with defect in BLE (right more than left).

EXAMINATION :

M.R.I of the lumbo-sacral spine was performed using the following parameters :

3 mm thick T1 Weighted and T2 Weighted sagittal images.

5 mm thick T1 Weighted and T2 Weighted axial images.

OBSERVATION :

The L5 vertebral body is as marked on the film.

There is probable fusion and segmentation anomalies of the D9 to L1 vertebral bodies.

There is seen a fairly large, intermediate signal intensity lesion on the T1 Weighted images traversing the spinal canal, antero-posteriorly over the D10 to L1 vertebral levels. This lesion follows marrow signal intensity on all pulse sequences and represents a bony bar. The spinal cord is seen to split into the two hemi-cords over about the D7 to L5 vertebral levels. Separate thecal sac are noted at the levels corresponding to the bony bar. The left hemi-cord is slightly smaller than the right. Another, probable bony/fibrous band is noted at the L4-L5 level (scans 106.4, 107.4 & 107.5). The spinal cords probably unite distally at about the S1 vertebral level.

The thecal sac seems to extend upto the sacro-coccygeal junction and is open towards the skin surface at that level.
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A small, intradural lipoma is noted at the tip of the thecal sac with the filum terminale, probably tethered to it (scans 102.4, 103.5, 103.6).

A syrinx is noted over the D4 to D6 vertebral levels.

The rest of the visualized dorso-lumbar vertebral bodies and the intervertebral discs reveal normal signal intensity. The visualized pre and paravertebral soft tissues are unremarkable.

IMPRESSION :

The MRI features suggests a diastematomyelia with hemi-cords extending over the D7 to L5 vertebral levels. A bony bar is noted over about the D10 to L1 vertebral levels with a another bony/fibrous bar at the L4-L5 level. A syrinx is noted over the D4 to D6 vertebral levels. An intradural lipoma is noted at the sacro-coccygeal junction with filum terminale probably tethered to a lipoma. Segmentation anomalies and fusion of the D9 to L1 vertebral bodies is noted.