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MRI - Interesting Cases 1 |
This is the first of a continuing series of interesting cases from the new MRI unit at St Vincent’s Hospital, Lismore.
Case 1
48 year old male referred by his GP for an MRI of the thoracic spine. He presented with a seven month history of mid-thoracic pain, radiating to the right shoulder.
Sagittal MRI of the thoracic spine - T2-weighted image
The sagittal MR image shows an extramedullary soft tissue mass centred at T6. An incidental rounded high intensity lesion in the T11 vertebral body represents a haemangioma.
Axial MRI at the T6 level - T2-weighted image
On the axial image, the mass is high signal intensity and occupies up to 75% of the spinal canal. The spinal cord, of lower signal intensity, is displaced antero-laterally to the left. The mass is also seen extending through the right T5 exit foramen, infiltrating the paraspinal soft tissues.
The provisional diagnosis of lymphoma was made on these images and this was later confirmed histologically.
MRI is the gold-standard for investigating spinal pathology, especially back pain and sciatica.
Craig Dyer is a partner with North Coast Radiology, Lismore and Ballina, NSW, Australia.
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