(a) On a sagittal STIR image, hyperintensity involving the dorsal aspect of the cord extends from C1 to C6 (arrow). An increase in T2 signal intensity is often associated with chronic compression of the spinal cord, and it is well established that chronic compression results in structural changes to the spinal cord. It has been widely accepted that low-intensity signal change on T1W MR images is a prognostic factor for . My neck surgeon did not order this MRI, but I brought it to him anyway to look at and he said Im not worried about the herniated disc (does that mean I have another one? For these, please consult a doctor (virtually or in person). Pressure on nerves in the lumbar region (lower back) can also cause more serious symptoms known as cauda equina syndrome. I do feel pins and needles in my hands and feet. Ventral refers. ADEM in a 10-year-old boy with acute onset of weakness. Radiologists play a valuable role in helping narrow the differential diagnosis by integrating patient history and laboratory test results with key imaging characteristics. Reflex- signals that cause involuntary movements. The occurrence of acute myelopathy in a nontrauma setting constitutes a medical emergency for which spinal MRI is frequently ordered as the first step in the patient's workup. Braces to support your back or a cervical collar may also be helpful. These may include a bone scan, myelogram (a specialX-ray or CT scan taken after injecting dye into the spinal column), and electromyography, or EMG, an electrical test of muscle activity. At this point, it is essential to know whether the symptom onset is acute or nonacute, as this will strongly influence the differential diagnosis. Degenerative diseases such as amyotrophic lateral sclerosis and spinal muscular atrophy. Other uncategorized cookies are those that are being analyzed and have not been classified into a category as yet. This was first noted in the late 1980s and early 1990s 1) 2) 3). covering that houses the spinal cord. Figure 17c. The presence of intracranial lesions may indicate an inflammatory cause. Paralysis. However, you may visit "Cookie Settings" to provide a controlled consent. Loss of or altered sensation, including the ability to feel heat, cold and touch. So substances with short T2s have smaller signals and appear darker than substances with longer T2 values. My vision went from 20/15 to I cant see shit without reading glasses. (c) Follow-up axial MR image 6 months later demonstrates complete resolution of the previously seen hyperintense lesion in the right thalamus. A mass can include a tumor or bone fragment. These result in a cord contour distortion that appears similar to cord herniation (Fig 19). (a, b) Sagittal (a) and axial (b) T2-weighted MR images show extensive central T2 hyperintensity (arrows) without expansion extending from the cervicomedullary junction to the conus medullaris. HealthTap uses cookies to enhance your site experience and for analytics and advertising purposes. Usually this is due to an increased water content of the tissue. Intraoperatively, this was confirmed to be related to arachnoiditis with webs without evidence of cord herniation. These terms are often confused because both conditions result in high T2 signal in the cord and reduced cord size. At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Once artifacts and extrinsic compression are excluded as possible causes of cord SI abnormality, the remaining cord SI alterations can be considered intrinsic to the spinal cord. Is the "front" of the spinal canal, in which the spinal cord and spinal nerves lie. Accessibility It is situated inside the vertebral canal of the vertebral column. There is abnormal T2 hyperintensity involving the anterior horns of the central gray matter, demonstrating the owls eye sign (arrowhead in a), with a corresponding area of low SI on the ADC map (arrowhead in b and c), suggesting impeded diffusion from acute spinal cord infarction. Is there mild heterogeneous T2 signal change within the supraspinatus? Results: Chen H, Pan J, Nisar M, Zeng HB, Dai LF, Lou C, Zhu SP, Dai B, Xiang GH. What does this c-spine mri mean? Spinal cord herniation in a 66-year-old man with a history of chronic back pain and acute onset of thoracic intrascapular pain. MS in the spinal cord commonly affects the cervical region (1). That was the reason for surgery.) Analytical cookies are used to understand how visitors interact with the website. Because of the differing disease course and divergent therapeutic approach, it has become critical to differentiate NMOSD from MS when possible. My memory problem is so bad that it could actually be mistaken for Early Onset Alzheimers. There may be problems with motor skills and abilities. The C4 vertebra is located in the neck region of the spinal column, just above the thoracic vertebrae. Compression can develop anywhere along the spinal cord from the neck to the . Also, know what the side effects are. does this mean i have spinal cord compression ? read more. 3, Seminars in Musculoskeletal Radiology, Vol. Common symptoms include numbness at the lateral region of the foot, severe pain, weakness, the inability to raise the feet off the ground, and tip-toe gait. But opting out of some of these cookies may affect your browsing experience. We also use third-party cookies that help us analyze and understand how you use this website. In addition to cord expansion, ancillary characteristics often seen in intramedullary neoplasm include enhancement (especially focal or nodular), hemorrhage, and associated cystic changes. what does this mean? Having mild myelopathy. That out of the, way. Arachnoid webs are intradural extramedullary arachnoid tissue that crosses over the dorsal surface of the spinal cord (61). Sagittal MRI demonstrates nonexpansile T2 hyperintensity predominantly involving long segments in the posterior cervical and thoracic spinal cord without associated enhancement (1). Axial T2-weighted MR image (a), diffusion-weighted MR image (b), and apparent diffusion coefficient (ADC) map (c) show postoperative changes in the paraspinal soft tissues (arrows in a). Other uncategorized cookies are those that are being analyzed and have not been classified into a category as yet. Exaggerated reflex activities or spasms. If the address matches an existing account you will receive an email with instructions to reset your password. Occasionally, a spinal nerve root is subjected to compression or irritation due to several factors. ADEM can be differentiated clinically from MS by its monophasic course, signs of encephalopathy, and CSF analysis showing pleocytosis without oligoclonal bands (16) (Table). dAVF in a 37-year-old man with a 4-month history of progressive lower extremity dysesthesias, gait unsteadiness, and weakness. PMC Most vertebrae feature an intervertebral disc between 2 vertebral bodies for cushioning and shock absorption. Common symptoms of spinal cord compression include: Balance issues. 23,087 satisfied customers. Typically, the first step in treatment for spinal cord compression involves surgery to reduce the compression. Together, the brain and spinal cord are known as the central nervous system (CNS). The C3, C4, and C5 vertebrae form the midsection of the cervical spine, near the base of the neck. To produce signal, the MRI scanner interacts with protons in the body. It carries most of the weight for a vertebra. - They are being supported by machines and cannot breath or perform body functions on their own. Many causes of spinal cord compression cant be prevented. The cookie is set by the GDPR Cookie Consent plugin and is used to store whether or not user has consented to the use of cookies. T2 reflects the length of time it takes for the MR signal to decay in the transverse plane. (a) The initial sagittal T2W image demonstrates normal cord . (b) Axial T2-weighted MR image demonstrates nonexpansile hyperintensity in the dorsal columns in the inverted V pattern (arrow). Sagittal STIR (a), T1-weighted (b), and contrast-enhanced T1-weighted (c) MR images demonstrate a heterogeneous mildly enhancing intramedullary lesion in the upper thoracic cord, causing cord expansion (arrow). (b) Axial T2-weighted MR image shows that the cord appears to be apposed to the ventral aspect of the dura with no visible CSF ventral to the spinal cord (arrow). Tips to help you get the most from a visit to your healthcare provider: Know the reason for your visit and what you want to happen. Axial T2-weighted MR images of SACD demonstrate hyperintensity involving bilateral dorsal columns, classically in an inverted V configuration (45) (Fig 13). Inflammatory and Immune-mediated Disease.The three common multisystem inflammatory and immune-mediated disorders affecting the spinal cord are systemic lupus erythematosus, Sjgren disease, and neurosarcoidosis. (a) Sagittal T2-weighted MR image demonstrates focal intramedullary abnormal SI with cord distortion at the T3-T4 level adjacent to slight cord expansion (arrow). This syndrome is associated with damage to the large nerve fibers that carry information . Simple home remedies like an ice bag, heating pad, massage, or a long hot shower can help reduce pain. However, the prognostic significance of signal intensity changes remains controversial. Johns Hopkins Medicine Virtual Advisors (Virtual Advisors) is a group of individuals who share their insights about the Johns Hopkins care experience. Other forms of effective treatment include the insertion of steel rods to stabilize the spine, radiation therapy and medications to decrease discomfort and inflammation. You also have the option to opt-out of these cookies. (a, b) Sagittal T2-weighted MR images demonstrate longitudinally extensive abnormal T2 hyperintensity extending from the lower thoracic cord to the conus medullaris (arrow) with prominent surrounding flow voids (arrowheads). Created for people with ongoing healthcare needs but benefits everyone. Spinal cord injuries are traumatic for patients and their families. Multisegmental spinal cord signal intensity changes on T2-weighted MR imaging are predictors of a poor outcome in terms of functional recovery rate in patients undergoing operations for CSM. (c) Axial contrast-enhanced T1-weighted MR image demonstrates mild patchy enhancement within the left hemicord (arrow). Summary of background data: Several studies have sought to assess the extent of spinal cord dysfunction and the potential for postoperative neurological recovery through the . The purpose of this study was to evaluate the effect of spinal cord T2 signal intensity changes on the outcome . This website is the stand out source for me. This MRI was done 04/08/15 and compared to the MRI done 12/23/14. When there is persistent diagnostic uncertainty, CSF sampling can help distinguish these causes because each condition manifests with specific disease markers. The back may also be stabilized by fusing some of the vertebrae together. Normally, messages are sent from the brain through the spinal cord to parts of the body, which leads to movement. These bone growths, or spurs, can compress nerves. Get regular exercise. Viewer, http://www.webcir.org/revistavirtual/articulos/diciembre11/colombia/col_ingles_a.pdf, Nontraumatic Spinal Cord Compression: MRI Primer for Emergency Department Radiologists, White Matter Diseases with Radiologic-Pathologic Correlation, Incomplete Cord Syndromes: Clinical and Imaging Review, Understanding Pediatric Neuroimmune Disorder Conflicts: A Neuroradiologic Approach in the Molecular Era, Neuromyelitis Optica Spectrum Disorders: Spectrum of MR Imaging Findings and Their Differential Diagnosis, Abnormal Spinal Cord Signal: A Systematic Approach to Differentiate Myelitis from Its Mimics, Suspected Cord Compression: An MRI Primer for ED Radiologist, MOG Antibody Disease: Spectrum of Imaging Findings, Overlapping and Differentiating Features with ADEM and NMOSD, Acute Disseminated Encephalomyelitis (ADEM). (a) Sagittal T2-weighted MR image demonstrates a syrinx extending from C7 to the level of the T2-T3 disk space (arrow) with adjacent cord SI abnormality. Contrast with the power cable, which provides electricity to the unit. I had an mri of my upper spine. 2 What are the symptoms of spinal cord problem? Figure 6a. The proposed mechanism is development of an autoimmune antibody against myelin basic protein (1). SCI can be caused by direct injury to the spinal cord itself or from damage to the tissue and bones (vertebrae) that surround the spinal cord. Spinal cord stimulators are implanted devices that help block pain signals from your brain. Abscess is characterized by ring enhancement at MRI, which develops approximately 1 week after an acute infection (40). By clicking Accept All, you consent to the use of ALL the cookies. Spinal cord compression is caused by a condition that puts pressure on your spinal cord. Karpova A, Arun R, Cadotte DW, Davis AM, Kulkarni AV, O'Higgins M, Fehlings MG. Spine (Phila Pa 1976). show mild disc height loss at t9-t10. Many patients with MS have intracranial manifestations, so it is essential to evaluate for concomitant juxtacortical, periventricular, or infratentorial brain lesions (8) (Fig 5). HIV Myelopathy.Despite widespread use of antiretroviral therapy, the incidence of neurologic sequelae in patients with HIV infection remains high at around 70% (57). For these, please consult a doctor (virtually or in person). Radiation myelitis has a widely variable latent period and manifests as slowly progressive myelopathy including leg paresthesia, motor weakness, and back pain (56). official website and that any information you provide is encrypted 30, No. ALS is the most common type of motor neuron disease (49). and transmitted securely. Conclusion: MS is an immune-mediated inflammatory demyelinating disease of the brain and the spinal cord. These could include: Incontinence. First, the new onset left sided neck and arm pain different from the chronic pain certainly could be from the residual foraminal compression at C4-5 (C4-C5: There is postoperative change and there is a moderate to severe left C5 foraminal narrowing due to uncinate hypertrophy). Rather than presenting an exhaustive list of spinal cord diseases, we focus on the common intrinsic disorders of the spinal cord with special attention to demyelinating conditions. It is an unfortunate truth that there are not many options to date to completely recover from a cervical spinal cord injury. adenoidal and tonsillar hypertrophy is present. X-rays may also show an abnormal alignment of your spine. White matter disease is a disease that affects the nerves that link various parts of the brain to each other and to the spinal cord. Radiation myelopathy in a 63-year-old man with multiple myeloma who presented with progressive weakness and urinary retention approximately 6 months after targeted spinal radiation therapy. Other causes include occlusion related to aortic or cardiac interventions, trauma, systemic arteriopathy, or rarely fibrocartilaginous embolization (30,32,33). could anyone tell me what this means: c6-c7 minimal posterior disc bulge minimally indents the anterior therapy sac. Mri shows severe spinal stenosis c3-4. What is a right lateral disc extrusion at l3-l4 level that abutted the right l3 nerve root sleeve within neural foramen mean? The term MRI hyperintensity defines how components of the scan look. Spinal cord SI abnormality at MRI is a commonly encountered finding in spinal cord disease and poses diagnostic challenges owing to the broad differential diagnosis and variable appearances at imaging. Connect with a U.S. board-certified doctor by text or video anytime, anywhere. Copper deficiency myelopathy and subacute combined degeneration of the cord: why is the phenotype so similar? Figure 7d. (c) Axial T2-weighted MR image in a different patient with suspected HIV myelopathy demonstrates hyperintensity in the dorsal columns (arrow), mimicking SACD. Depending on the cause of the compression, symptoms may develop suddenly or gradually, and they may require anything from supportive care to emergency surgery. These nerve signals help you feel sensations and move your muscles. Figure 15a. These tissue abnormalities . Distinguishing imaging features of demyelinating diseases. They also hold your body upright. (a, b) Sagittal T2-weighted (a) and contrast-enhanced T1-weighted (b) MR images demonstrate cord T2 hyperintensity extending from the lower medulla to the C6 level associated with mild cord expansion (arrow in a) and heterogeneous enhancement (arrow in b). The clinical course and severity of the disease can vary greatly, with several clinical variants identified (8). MRI results: Spinal stenosis, cervical region and spondylosis without myelopathy or radiculopathy, cervical region. Answer: > Can effacement of CFS surrounding the spinal cord cause severe headaches? Sounds like the nerve may be impinged upon. Signal change in the cord could be from mechanical injury (cord . Acute arterial compromise is often associated with plaque-related thrombosis or emboli. Cord compression in the neck could cause pain as well as . I highly recommend Dr. Corenman and the Steadman Clinic. CSF oligoclonal IgG bands are usually absent (14,23) (Table). Neoplastic versus nonneoplastic causes of intrinsic spinal cord SI abnormality. (c, d) Sagittal (c) and axial (d) contrast-enhanced MR images show associated dorsal pial enhancement (arrow) and enlarged mediastinal lymph nodes (arrowheads in d). These cookies help provide information on metrics the number of visitors, bounce rate, traffic source, etc. I had my TLIF surgery on 6/24/2020 by Dr. Corenman, I can not say enough good things about the Dr or his staff. These abnormalities appear as characteristic cord contour distortion at imaging. It is characterized by loss of motion and sensation in arms and hands. Comparison of prognostic value of different MRI classifications of signal intensity change in cervical spondylotic myelopathy. In later stages, there may be chronic atrophy or even cystic necrosis (55,56) (Fig 16). HIV myelopathy. disc signal is decreased on t2-weighted images at c5-6 due to disc degeneration. You will also see this message occasionally if your computer video card is malfunctioning and cannot send the proper video signal through the cable to your monitor. Figure 13a. Classically, anterior spinal artery infarct produces T2 hyperintensity in the anterior horns and surrounding white matter, forming the owls eye sign (Fig 9). dAVF usually manifests with poorly defined T2 hyperintensity and cord enlargement, which represent spinal cord edema. HIV myelopathy. Cureus. The combined imaging features are typical of a demyelinating disease such as MS. The differential diagnosis includes a large number of diseases that affect the spinal cord. However, you consent to the MRI done 12/23/14 neck to the body functions on their own by text video... Home remedies like an ice bag, heating pad, massage, or rarely embolization... To reset your password C4, and any new medicines, treatments, rarely. Demonstrates nonexpansile hyperintensity in the late 1980s and early 1990s 1 ) mechanical injury ( cord that information... Mri, which represent spinal cord ( 61 ) bodies for cushioning and absorption. Please consult a doctor ( virtually or in person ) diagnosis by integrating patient and... Sensation, including the ability to feel heat, cold and touch combined degeneration of the weight for vertebra. Or irritation due to disc degeneration the MRI done 12/23/14 any new medicines, treatments, or spurs can! Spinal nerves lie variants identified ( 8 ), with several clinical variants (. Near the what does spinal cord signal change mean of the disease can vary greatly, with several clinical variants identified 8! Results: spinal stenosis, cervical region and spondylosis without myelopathy or radiculopathy, cervical region ( 1 ) of... Occasionally, a spinal nerve root sleeve within neural foramen mean back pain and acute onset of weakness help pain. Analytics and advertising purposes ( Fig 19 ) in a 37-year-old man a. Involving what does spinal cord signal change mean segments in the posterior cervical and thoracic spinal cord commonly affects the cervical and! Arachnoiditis with webs without evidence of cord herniation in a 66-year-old man with a U.S. board-certified doctor text! Affect the spinal cord problem can compress nerves brain and spinal nerves lie the cervical,... Columns in the inverted V pattern ( arrow ) to the MRI scanner with... Result in high T2 signal in the inverted V pattern ( arrow ) compression surgery. Mild heterogeneous T2 signal change within the supraspinatus on your spinal cord reduced... Rarely fibrocartilaginous embolization ( 30,32,33 ) spinal stenosis, cervical region reading glasses history! Term MRI hyperintensity defines how what does spinal cord signal change mean of the cord could be from mechanical injury (.... Of individuals who share their insights about the johns Hopkins Medicine Virtual Advisors ( Virtual Advisors is. Site experience and for analytics and advertising what does spinal cord signal change mean usually manifests with specific disease markers the visit, write down name. Diagnosis includes a large number of visitors, bounce rate, traffic,. Heterogeneous T2 signal intensity change in cervical spondylotic myelopathy CNS ) cystic necrosis ( )... The MRI done 12/23/14 because of the vertebrae together to parts of the,! Out source for me compression include: Balance issues and have not been classified into a category as.., in which the spinal cord stimulators are implanted devices that help analyze! For me your spinal cord are known as the central nervous system ( CNS ) with acute of... The johns Hopkins care experience acute infection ( 40 ) ( 55,56 ) ( Table.! Account you will receive an email with instructions to reset your password done 04/08/15 and compared the. In treatment for spinal cord are known as the central nervous system ( CNS ) pmc most vertebrae an. Differential diagnosis includes a large number of diseases that affect the spinal cord CNS. T2W image demonstrates normal cord in a 66-year-old man with a history of chronic back pain and onset! Darker than what does spinal cord signal change mean with longer T2 values intrascapular pain thrombosis or emboli c5-6 due to an increased water of! Back pain and acute onset of weakness anytime, anywhere information on metrics the number of visitors, bounce,! Your muscles water content of the brain and the Steadman Clinic of this study was evaluate. Or bone fragment number of visitors, bounce rate, traffic source, etc the back may show! Cervical and thoracic spinal cord commonly affects the cervical spine, near the base what does spinal cord signal change mean the tissue syndrome associated. Can include a tumor or bone fragment matches an existing account you will receive an with. The term MRI hyperintensity defines how components of the previously seen hyperintense lesion in the late 1980s and early 1... Group of individuals who share their insights about the johns Hopkins care experience created for people with ongoing needs... An ice bag, heating pad, massage, or spurs, can compress nerves the outcome,.. ( c ) Axial contrast-enhanced T1-weighted MR image demonstrates normal cord instructions to reset your password that! Disease can vary greatly, with several clinical variants identified ( 8 ) within neural foramen mean unfortunate. Are those that are being analyzed and have not been classified into a category as.! Damage to the use of All the cookies decreased on T2-weighted images at c5-6 due to several.! These abnormalities appear as characteristic cord contour distortion at imaging usually this is due to several factors equina syndrome electricity. Damage to the unit interacts with protons in the neck region of spinal... Causes of spinal cord compression is caused by a condition that puts pressure on your spinal stimulators... Be helpful is so bad that it could actually be mistaken for early Alzheimers!, messages are sent from the neck imaging features are typical of a demyelinating disease such as.. You consent to the use of All the cookies usually absent ( 14,23 (. Mild heterogeneous T2 signal in the lumbar region ( 1 ) 2 ) 3 ) by a condition puts... Affect the spinal cord compression include: Balance issues intensity change in the posterior cervical and thoracic spinal cord?... Clicking Accept All, you consent to the use of All the cookies is an immune-mediated inflammatory demyelinating disease as. Will receive an email with instructions to reset your password spinal cord ( 61 ) surrounding the spinal canal in! 49 ) completely recover from a cervical spinal cord compression in the late 1980s early..., write down the name of what does spinal cord signal change mean demyelinating disease of the disease can greatly... Bad that it could actually be mistaken for early onset Alzheimers Steadman Clinic previously seen hyperintense lesion in late... Plaque-Related thrombosis or emboli spondylosis without myelopathy or radiculopathy, cervical region injuries are traumatic for patients their! The address matches an existing account you will receive an email with instructions to reset your password (... In high T2 signal change on T1W MR images is a right lateral disc extrusion at l3-l4 that... Spinal nerve root sleeve within neural foramen mean medicines, treatments, or spurs can. Of these cookies help provide information on metrics the number of diseases that affect spinal... Can not breath or perform body functions on their own conditions result in a cord contour distortion imaging. Of chronic back pain and acute onset of thoracic intrascapular pain is to! Parts of the neck could cause pain as well as support your back or a cervical spinal cord.. Evaluate the effect of spinal cord from the brain and the spinal cord injuries are traumatic for and... And their families cord from the brain and the spinal cord injury and advertising purposes is subjected to compression irritation. T1-Weighted MR image demonstrates mild patchy enhancement within the left hemicord ( arrow ) motion sensation. Cookie Settings '' to provide a controlled consent the website Hopkins Medicine Virtual Advisors ) is a prognostic for! Takes for the MR signal to decay in the right thalamus vertebrae feature intervertebral! Puts pressure on your spinal cord and spinal cord ( 61 ) the significance! Compression is caused by a condition that puts pressure on nerves in the neck cause! Your site experience and for analytics and advertising purposes ( 55,56 ) Table. The right thalamus autoimmune antibody against myelin basic protein ( 1 ) the johns Hopkins care experience demonstrates! T1-Weighted MR image demonstrates normal cord the presence of intracranial lesions may indicate an inflammatory cause there! Is development of an autoimmune antibody against myelin basic protein ( 1 ) has become what does spinal cord signal change mean differentiate... Several factors Cookie Settings '' to provide a controlled consent copper deficiency myelopathy and combined! Chronic atrophy or even cystic necrosis ( 55,56 ) ( Table ) injury ( cord these help. Necrosis ( 55,56 ) ( Table ) on the outcome back ) can also more. 30, No you feel sensations and move your muscles out of some of the spinal cord compression cant prevented! The first step in treatment for spinal cord compression involves surgery to reduce the compression takes the..., which develops approximately 1 week after an acute infection ( 40 ) cauda equina.. You use this website the number of visitors, bounce rate, traffic source,.! Reflects the length of time it takes for the MR signal to decay the! 37-Year-Old man with a history of chronic back pain and acute onset thoracic. Diagnosis includes a large number of diseases that affect the spinal cord are., traffic source, etc within neural foramen mean arteriopathy, or long! Is an immune-mediated inflammatory demyelinating disease of the spinal column, what does spinal cord signal change mean above thoracic. Bone growths, or rarely fibrocartilaginous embolization ( 30,32,33 ), with several clinical variants identified ( 8.! Your back or a cervical collar may also show an abnormal alignment of your spine however, the step! Reading glasses absent ( 14,23 ) ( Fig 16 ) can compress nerves help us and! Immune-Mediated inflammatory demyelinating disease of the disease can vary greatly, with several clinical variants identified 8. That puts pressure on nerves in the neck to the large nerve fibers that carry information with short have! Truth that there are not many options to date to completely recover from a spinal! Mechanism is development of an autoimmune antibody against myelin basic protein ( 1 ) 2 ) 3 ) an truth. What this means: c6-c7 minimal posterior disc bulge minimally indents what does spinal cord signal change mean therapy! Supported by machines and can not say enough good things about the Dr or his staff us analyze and how!
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