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MRI OF CERVICAL SPINE
TECHNIQUE AND SEQUENCES: 1.5 TESLA
Pre-gadolinium : Axial: T1WI, T2WI Coronal : T2WI Sagittal: T1WI, T2WI & STIR Sagittal scan of whole spine: T2WI
Post-gadolinium: Axial, coronal & sagittal : T1WI with fs
Findings:
There is mild reverse cervical lordosis without subluxation.
There is severe irregular narrowing with moderate central disc protrusion of C4/5 level with mild thicken ligamnetum flavum causing severe anterior indentation to spinal canal and narrowing bilateral neural foramens, as resulting severe compression of spinal cord with focal cord edema and bilateral C5 exiting nerve roots.
There is moderate board-based circumferential discs bulging of C5/6 and C6/7 intervertebral discs with mild thicken ligamentum flavum causing anterior indentation to thecal sac and narrowing and bilateral neural foramens, as resulting mild compression of spinal cord of this levels and moderate compression bilateral C6 and C7 exiting nerve roots.
There is moderate board-based circumferential discs bulging of partial visualized L3/4 and L4/5 intervertebral discs with mild thicken ligamentum flavum causing anterior indentation to spinal canal and adjacent nerve root clumping.
There is also decreased signal intensity (SI) on T2WI of all cervical intervertebral discs, degenerative change.
Conus medullaris is located at L1/2 level.
There is heterogeneous SI of fatty marrow showing high SI on T1WI & T2WI with dropped SI on STIR, osteoporotic change.
Paravertebral muscles and soft tissue are unremarkable.
Visualized both lungs are unremarkable.
There is marked enlarge thyroid gland with multiple various size nodules & masses and internal calcific and cystic component, the largest mass about 7.2 cm, extending from submandibular level to T3 level.
IMPRESSION: Mild reverse cervical lordosis associated severe irregular narrowing with moderate central disc protrusion of C4/5 level with mild thicken ligamnetum flavum causing severe compressive myelopathy and severe compression of bilateral C5 exiting nerve roots.
Moderate board-based circumferential discs bulging of C5/6 and C6/7 intervertebral discs with mild thicken ligamentum flavum causing mild compression of spinal cord of this levels and moderate compression bilateral C6 and C7 exiting nerve roots.
Moderate board-based circumferential discs bulging of partial visualized L3/4 and L4/5 intervertebral discs with mild thicken ligamentum flavum causing anterior indentation to spinal canal and adjacent nerve root clumping, please correlated with MRI lumbosacral spine for more detail.
Degenerative change of all cervical intervertebral discs.
Cervical spondylosis.
Marked enlarge thyroid gland with multinodular goiter, possibly either benign or malignancy, please correlated with clinical data and tissue sampling.
Wirampa Lamanchai, MD.
Radiologis