Neuro_MR_LSpine: 24 F, bilateral extremity tingling.

MRI LUMBAR SPINE WITH AND WITHOUT CONTRAST:

 

CLINICAL HISTORY: 24-year-old female with numbness and tingling in arms and legs.

 

FINDINGS: 

Counting from C2, there are five lumbar type vertebral bodies. The last well-formed disc is labeled as L5-S1.

 

Localizer image: No visible abnormality.

 

Alignment: Normal.

 

Bone marrow: T1 and T2 hyperintensity in L5 vertebral body likely representing hemangioma. 

 

Vertebrae: There is congenital narrowing of the spinal canal due to short pedicles. Multi-level degenerative changes as follows:

 

L1-L2: Normal.

 

L2-L3: Normal.

 

L3-L4: Central posterior disc protrusion resulting in moderate spinal canal stenosis. No significant neural foraminal stenosis.

 

L4-L5: Broad-based posterior disc bulge with annular fissure without significant spinal canal or neural foraminal stenosis.

 

L5-S1: Normal.

 

Distal cord and conus: Normal.

 

Cauda equina and nerve roots: Diffuse enhancement of the cauda equina nerve roots with marked involvement of the posterior nerve roots and mild involvement of the anterior nerve roots. The extra-foraminal 

portions of the nerve roots also demonstrate enhancement.

 

Extra-vertebral soft tissues: Normal.

 

Visualized abdomen/pelvis: No visible abnormality.

 

Additional comment: None.

  

IMPRESSION: 

 

1.  Diffuse cauda equina nerve root enhancement, posterior greater than anterior. Differential considerations include infectious, 

inflammatory, demyelinating or paraneoplastic etiologies.

 

2.  Congenital spinal canal narrowing with superimposed degenerative changes at L3-4 and L4-5 discs described above.

(Guillain-Barre)