hs/ke/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyzra Galmn / M / 31 yrs.
Referred by : Dr. Abc Xyzshi.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE :

C/O neckpain with radiation of pain to the LUE.

EXAMINATION :

M.R.I of the cervical spine was performed using the following parameters :

4 mm thick T1 Weighted and T2 Weighted sagittal images.

5 mm thick T1 Weighted and Fast Scan (T2 *) axial images.

OBSERVATION :

Mild posterior disc bulges are noted at the C2-C3, C3-C4 and C4-C5 levels. Small posterior peridiscal osteophytes are seen at the C4-C5 and C5-C6 levels.

Areas of hypointensity on all the pulse sequences are seen inbetween the odontoid process and transverse ligament and may represent pannus.

There is anterior wedging of the C6 vertebral body. There are areas of fatty replacement of normal marrow of the upper cervical vertebrae.

The cervical intervertebral discs show loss of water content.

The remaining cervical vertebral bodies show normal signal intensity. The joints of Luschka and the visualized pre and paravertebral soft tissues are unremarkable.
Scan-00003


The cervical spinal cord reveals normal signal intensity.

The cervico-medullary junction is unremarkable.

IMPRESSION :

1. Mild posterior disc bulges at the C2-C3, C3-C4 and C4-C5 levels.

2. Areas of altered signal inbetween the odontoid process and transverse ligament may represent pannus (? Rheumatoid Arthritis).

hs/ke/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyz lmn / M / 35 yrs.
Referred by : Dr. Abc Xyzpadia.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

Known C/O paranoid schizophrenia since 5 years.
Patient is drowsy since 3 days.

EXAMINATION :

M.R.I of the brain was performed using the following parameters :

5 mm thick T1 Weighted, proton and T2 Weighted axial images.

5 mm thick FLAIR coronal images.

3 mm thick T2 Weighted coronal images.

OBSERVATION :

There is no focal area of altered signal intensity in the brain parenchyma.

There is mild fullness of the third and both the lateral ventricles. There is mild prominence of the cerebral cortical sulci and cerebellar folia bilaterally.

There is slight hypoplasia of the right cerebellar hemisphere.

The fourth ventricle is normal. The basal cisternal spaces are unremarkable. There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.

IMPRESSION :

The MRI features are suggestive of :

1. Mild prominence of the cerebral cortical sulci and cerebellar folia bilaterally.

2. Hypoplasia of the right cerebellar hemisphere.

hs/ke/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyzissa Muklmn / F / 35 yrs.
Referred by : Dr. Abc Xyzapadia.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache with radiation of pain to the LLE with paresthesias.

EXAMINATION :

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

5 mm thick T1 Weighted and T2 Weighted sagittal images.
5 mm thick T1 Weighted and T2 Weighted axial images.

OBSERVATION :

Mild posterior disc bulges are noted at the L4-L5 and L5-S1 levels.

The right L4-L5 facet joint shows degenerative changes.

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

The conus medullaris terminates at the L1 level and the thecal sac terminates at the S1 level.

The antero-posterior dimensions of the lumbar canal at the level of the intervertebral discs are as follows :

18.0 mm at L1-L2
18.0 mm at L2-L3
17.0 mm at L3-L4
16.0 mm at L4-L5
14.0 mm at L5-S1.



IMPRESSION :

The MRI features are suggestive of :

1. Mild posterior disc bulges at the L4-L5 and L5-S1 levels.

2. Facetal arthropathy on the right side at the L4-L5 level.

ke/hs/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyzm Z. lmn / F / 18 yrs.
Referred by : Dr. Abc Xyzrekh.
Examination : M.R.I. of the Dorso-lumbar Spine.

CLINICAL PROFILE :

C/O backache with pain radiating to BLE with paresthesias since 1 1/2 years.
H/O fever +.

EXAMINATION :

M.R.I of the dorso-lumbar spine was performed using the following parameters :

5 mm thick T1 Weighted and T2 Weighted sagittal images.

5 mm thick T1 Weighted and T2 Weighted axial images.

OBSERVATION :

There is near complete collapse of the D11 vertebral body with wedging of the D9, D10 and D12 vertebral bodies and an angular kyphus at these levels.

There is replacement of the normal marrow of the D6, D7, D8, D9, D10, D11 and D12 vertebral bodies by hypointense areas on the T1 Weighted images. This is seen to turn heterogeneously hyperintense on the T2 Weighted images. The cortical endplates of the D12, D11, D10, D9 and the D7 vertebral bodies are breached with involvement of the D9-D10, D10-D11, D11-D12 and D7-D8 intervertebral discs. There is pre and paravertebral soft tissue extension over the D5 to D12 levels, right more than left. A small, extrapleural collection is noted at the D9 and D10 levels on the left side which is slightly hypointense to the muscle on the T1 Weighted images and turns hyperintense on the T2 Weighted images and would represent an abscess formation.



There is anterior epidural extension over the D9 to D11 vertebral levels with indentation upon the cord.

The visualized dorsal spinal cord shows normal signal intensity.

The rest of the visualized dorso-lumbar vertebral bodies and the remaining intervertebral discs reveal normal signal intensity. The facet joints are unremarkable.

The conus medullaris terminates at the L2 level.

IMPRESSION :

Near complete collapse of the D11 vertebral body with wedging of the D9, D10 and D12 vertebral bodies, angular kyphus at these levels, altered signal of the D6, D7, D8, D9, D10, D11 and D12 vertebral bodies, the D9-D10, D10-D11, D11-D12 and D7-D8 intervertebral discs with extensions as described and an abscess formation at the D9 and D10 levels is most probbaly due to a granulomatous infective process like tuberculosis.

The possibilitiy of this being a round cell tumor cannot be entirely ruled out, though less likely.

hs/ke/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyz Shlmn / M / 53 yrs.
Referred by : Dr. Abc Xyzh Shah / Dr. Abc Xyzmpat.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O paresthesias in the left half of the body since 2 days.
Alleged H/O fall 8 days ago.
H/O alcoholism.

EXAMINATION :

M.R.I of the brain was performed using the following parameters :

5 mm thick T1 Weighted, proton and T2 Weighted axial images.
5 mm thick FLAIR coronal images.

OBSERVATION :

There is evidence of an area of hypointensity on the T1 Weighted images which turns hyperintense on the FLAIR, proton and T2 Weighted images within the right thalamus. This may represent a fresh area of ischemia/infarction.

Multiple areas of hyperintensity on the FLAIR, proton and T2 Weighted images are seen within the white matter in the fronto-parietal lobes bilaterally. These are iso to hypointense to white matter on the T1 Weighted images and are most likely ischemic in etiology.

A lacunar infarct (isointense to hyperintense to CSF) is seen within the left lentiform nucleus.

There is mild prominence of the cerebral cortical sulci and cerebellar folia bilaterally.

Both the lateral, third and the fourth ventricles are normal. The basal cisternal spaces are unremarkable. There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.



IMPRESSION :

The MRI features are suggestive of :

1. An area of altered signal intensity within the right thalamus would most likely represent a fresh area of ischemia/infarction.

2. Multiple areas of altered signal intensity within the white matter in the fronto-parietal lobes bilaterally are most likely ischemic in etiology.

3. A lacunar infarct in the left lentiform nucleus.

hs/ke/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyzk Kuvlmn / M / 6 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

H/O fever with altered sensorium.
Patient has developed quadriparesis.

EXAMINATION :

M.R.I of the brain was performed using the following parameters :

5 mm thick T1 Weighted, proton and T2 Weighted axial images.

3 mm thick T2 Weighted coronal images.

4 mm thick FLAIR coronal images.

OBSERVATION :

There are diffuse areas of hypointensity on the T1 Weighted images which turn hyperintense on the proton, T2 Weighted and FLAIR images within the cerebral peduncles and thalamus bilaterally with indentation upon the third ventricle. The thalamus is seen to be bulky.

Areas with similar signal characteristics are seen to involve the right temporo-parietal lobes (cortical grey and subcortical white matter).

Both the lateral and the fourth ventricles are normal. The basal cisternal spaces are unremarkable. There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.







IMPRESSION :

Altered signal within the cerebral peduncles and thalamus bilaterally with indentation upon the third ventricle and in the right temporo-parietal lobes (cortical grey and subcortical white matter).

The possibilities to be considered are :

1. Venous infarct.

2. ADEM.

3. Mitochondrial encephalopathy (less likely).

As compared to the previous MRI (study no:00003) dated 00.00.00, there is marked increase in the size and distribution of the lesion.

sb/ke/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyzee Shlmn / F / 50 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to the RLE with paresthesias since 2 months.

EXAMINATION :

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

5 mm thick T1 Weighted and T2 Weighted sagittal images.

5 mm thick T1 Weighted and T2 Weighted axial images.

OBSERVATION :

There is loss of water content of the lumbar intervertebral discs.

There is Grade I spondylolisthesis of the L5 over the S1 vertebra without obvious spondylolysis (kindly correlate with plain radiographs).

A pseudo-posterior disc bulge at the L5-S1 level with bilateral neural foraminal narrowing. There is also hypertrophic facetal arthropathy with resultant canal stenosis at that level.

A small postero-central protruded disc is noted at the L4-L5 level. Bilateral far lateral disc bulges are also noted at this level. There is also facetal hypertrophy at the L4-L5 level.

A small posterior disc bulge is noted at the L3-L4 level.
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The lumbar vertebral bodies reveal normal signal intensity. The rest of the facet joints and the visualized pre and paravertebral soft tissues are unremarkable.

The conus medullaris terminates at the D12-L1 level and the thecal sac terminates at the S1 level.

The antero-posterior dimensions of the lumbar canal at the level of the intervertebral discs are as follows :

14.0 mm at L1-L2
13.0 mm at L2-L3
10.0 mm at L3-L4
9.0 mm at L4-L5
10.0 mm at L5-S1.

IMPRESSION :

1. Grade I spondylolisthesis of the L5 over the S1 vertebra without obvious spondylolysis (kindly correlate with plain radiographs).

2. A pseudo-posterior disc bulge at the L5-S1 level with bilateral neural foraminal narrowing. There is also hypertrophic facetal arthropathy with resultant canal stenosis at that level.

3. A small postero-central protruded disc at the L4-L5 level wtih facetal hypertrophy at this level.

4. A small posterior disc bulge at the L3-L4 level.

sb/ke/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyzsh Panlmn / M / 10 yrs.
Referred by : Dr. Abc Xyzhtekar.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

H/O single episode of blackout with giddiness and fall with LOC for 1-2 minutes 8 days back.
C/O headaches and diminished vision since then.

EXAMINATION :

M.R.I of the brain was performed using the following parameters :

5 mm thick T1 Weighted, proton and T2 Weighted axial images.

3 mm thick T1 Weighted and T2 Weighted coronal images.

OBSERVATION :

There is no focal area of altered signal intensity in the brain parenchyma.

The hippocampal complex on either side is unremarkable.

Both the lateral, third and the fourth ventricles are normal. The basal cisternal spaces are unremarkable. There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.

IMPRESSION :

Normal study of the Brain.

sb/ke/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyzndan Palmn / M / 45 yrs.
Referred by : Dr. Abc Xyzmpat.
Examination : Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O numbness on the left side of the face and weakness of the LUE since 00.00.00.

EXAMINATION :

The brain was screened with 5 mm thick T2 Weighted axial images and 5 mm thick FLAIR coronal images.

Intracranial and neck MRA were performed with 3D TOF and 2D TOF sequences, respectively.

OBSERVATION :

There is no focal area of altered signal intensity within the brain parenchyma.

Both the lateral, third and the fourth ventricles are normal. The basal cisternal spaces are unremarkable. There is no shift of the midline structures.

INTRACRANIAL MRA :

The right vertebral artery is hypoplastic.

The petrous, cavernous and supraclinoid segments of the internal carotid arteries bilaterally show normal signal and calibre. The visualized anterior cerebral, middle cerebral, basilar, left vertebral and posterior cerebral arteries also show normal signal, calibre and wall margins. No obvious aneurysm or vascular malformation is identified.






NECK MRA :

The right vertebral artery in the neck is also hypoplastic.

The common carotid arteries and their extracranial branches appear normal bilaterally. There are no vessel wall irregularities or stenosis of the vessels noted.

IMPRESSION :

No significant abnormality is detected on the intracranial and neck MRA on this study.

ke/hs/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzr V. Goslmn / M / 60 yrs.
Referred by : Dr. Abc Xyzhah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O left sided hemiparesis.
Known hypertensive.

EXAMINATION :

M.R.I of the brain was performed using the following parameters :

5 mm thick T1 Weighted, proton and T2 Weighted axial images.

5 mm thick FLAIR coronal images.

OBSERVATION :

There is a large lesion which is extracerebral in location in the right fronto-parietal region having a maximum width of 3.0 cms. This is hyperintense on all the pulse sequences and would represent extracellular methemoglobin. Multiple septae are seen within this lesion. There is mass effect upon the underlying brain parenchyma with effacement of the adjacent sulci, right Sylvian fissure and compression of the right lateral and third ventricles. There is shift of the midline structures to the left. A similar smaller lesion is noted in the posterior parietal region on the left side.

There is slight fullness of the left lateral ventricle. The fourth ventricle is normal. There is prominence of the cerebral cortical sulci on the left side and of the cerebellar folia bilaterally.

No obvious vascular anomaly is identified on this study.





IMPRESSION :

1. A large lesion which is extracerebral in location (hematoma)
in the right fronto-parietal region having a maximum width of 3.0 cms. (? chronic subdural ? extradural)

2. A small extracerebral collection of blood in the posterior parietal region on the left side.