ke/hs/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyz lmn / M / 29 yrs.
Referred by : Dr. Abc Xyzrnad.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O weakness of the RLE and RUE since 2 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.

5 mm thick T1 Weighted sagittal images.

OBSERVATION :

There is a hypointense area on the T1 Weighted images within the left putamen posteriorly and the body of the caudate nucleus on the left side. This is seen to turn hyperintense on the proton, T2 Weighted and FLAIR images and would most likely represent a fresh infarct.

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 :

An area of altered signal within the left putamen posteriorly and the body of the caudate nucleus on the left side and this would most likely represent a fresh infarct.

ke/hs/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyz Plmn / M / 24 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O seizures since 3 years.

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 is unremarkable on either side.

There is slight fullness of both the lateral, third and fourth ventricles.

There is mild prominence of the cerebral cortical sulci and cerebellar folia bilaterally. The basal cisternal spaces are unremarkable. There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.

IMPRESSION :

Mild cerebral and cerebellar atrophy.

ke/hs/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyza Almn / F / 18 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O seizures since 4 years.

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 are fairly well-defined areas which are near isointense to CSF on all the pulse sequences within the left temporal and left parietal lobes. Adjacent to these are areas which are hypointense on the T1 Weighted images and which turn hyperintense on the Proton, T2 Weighted and FLAIR images and would represent gliotic changes. These lesions in toto would represent areas of cystic encephalomalacia.

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 :

Areas of cystic encephalomalacia within the left temporal and left parietal lobes.

ke/hs/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyzlmn / M / 24 yrs.
Referred by : Dr. Abc Xyzrekh.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache with paresthesias in BLE since 1 month.

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 forward translation of the L5 vertebra over the S1 vertebra and mild retroplacement of the L4 vertebra over the L5 vertebra.

A right paracentral disc herniation is seen at the L5-S1 level with indentation upon the thecal sac and the traversing right S1 nerve root.

A posterior disc herniation is noted at the L4-L5 level with anterior indentation of the thecal sac.

A large posterior disc herniation is seen at the L3-L4 level with compression of the thecal sac and resultant canal stenosis. Superior and inferior migration of a disc is noted.

The L3-L4 facet joints bilaterally and the left L4-L5 facet joint show degenerative changes.
Scan-00004


A left far lateral (extraforaminal) disc herniation is seen at the L3-L4 level.

A small left paracentral disc herniation is seen at the L2-L3 level. A postero-central disc protrusion is noted at the L1-L2 level. The lumbar intervertebral discs show loss of water content.

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 L1 level and the thecal sac terminates at the S2 level.

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

10.0 mm at L1-L2
10.0 mm at L2-L3
4.0 mm at L3-L4
12.0 mm at L4-L5
9.0 mm at L5-S1.

IMPRESSION :

1. Forward translation of the L5 vertebra over the S1 vertebra and mild retroplacement of the L4 vertebra over the L5 vertebra.

2. A right paracentral disc herniation at the L5-S1 level with indentation upon the traversing right S1 nerve root.
..3/.











- 3 - Scan-00004


3. A posterior disc herniation at the L4-L5 level.

4. A large posterior disc herniation at the L3-L4 level with canal stenosis.

5. A small left paracentral disc herniation at the L2-L3 level.

6. A postero-central disc protrusion at the L1-L2 level.

7. Facetal arthropathy at the L3-L4 level bilaterally and at the L4-L5 level on the left side.

ke/sb/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyzl Ylmn / M / 25 yrs.
Referred by : Dr. Abc Xyzel.
Examination : M.R.I. of the Brain & Orbits.

CLINICAL PROFILE :

Excision of the right orbital tumor on 00.00.00.
C/O pain and watering in the right eye.

EXAMINATION :

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

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

3 mm thick T1 Weighted and STIR coronal images.

5 mm thick T1 Weighted sagittal images.

OBSERVATION :

There are post-operative changes in the right zygomatic region and the lateral aspect of the right orbit. Streaking of fat in that region is seen which is hypointense on the T1 Weighted images.

A small hyperintense area is noted on the STIR images postero-inferior to the eyeball and inferior to the right optic nerve which is of intermediate signal on the T1 Weighted images and would represent ? post-operative changes, ?? residual tumor.

The optic nerves show normal signal intensity.

There is no focal area of altered signal intensity in 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. No obvious vascular anomaly is identified on this study.

IMPRESSION :

Post-operative status.

Altered signal intensity lesion inferior to the right optic nerve is ? post-operative change, ?? residual tumor.

A follow-up scan is recommended.

ke/hs/nl/nl
Date : 00.00.00

Name of the Patient : Abc XyzDalmn / M / 87 yrs.
Referred by : Dr. Abc Xyzcha.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache with pain radiating to BLE with paresthesias (left more than right) since 1 month.

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 scoliosis of the lumbar spine with convexity to the right. Left lateral subluxation of the L2 over the L3 vertebra is noted. There is retroplacement of the L2 over the L3 vertebrae.

There is a diffuse posterior disc bulge with peridiscal osteophytes at the L5-S1 level. Severe hypertrophic facetal arthropathy is seen at this level with ligamentum flavum hypertrophy and a resultant tight canal.

Posterior peridiscal osteophytes are seen at the L2-L3, L3-L4 and the L4-L5 levels with bilateral neural foraminal narrowing. Facetal arthropathy is also noted at these levels. There is ligamentum flavum hypertrophy at the L4-L5 level.

Large anterior peridiscal osteophytes are seen in the lower lumbar region.
Scan-00001

Bilateral far lateral (extraforaminal) disc herniations are seen at the L2-L3, L3-L4, L4-L5 and L5-S1 levels and on the right side at the L1-l2 level.

Diffuse fatty changes are seen in the lumbar vertebral bodies. The lumbar intervertebral discs show loss of water content.

The conus medullaris terminates at the L1 level.

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

21.0 mm at L1-L2
18.0 mm at L2-L3
17.0 mm at L3-L4
15.0 mm at L4-L5
12.0 mm at L5-S1.

There is replacement of the normal marrow of the visualized sacrum bilaterally by hypointense areas on the T1 Weighted images. These are seen to turn mildly hyperintense on the T2 Weighted images. Similar well-circumscribed areas are also noted in the visualized iliac bones bilaterally.

Well-circumscribed hypointense areas are noted on the T1 Weighted images within the L5 and L1 vertebral bodies. These are seen to turn heterogeneously hyperintense on the T2 Weighted images.

IMPRESSION :

The MRI features are suggestive of :

1. Scoliosis of the lumbar spine with convexity to the right. Left lateral subluxation of the L2 over the L3 vertebra is noted. There is retroplacement of the L2 over the L3 vertebrae.
..3/.








- 3 - Scan-00001



2. Diffuse posterior disc bulge with peridiscal osteophytes at the L5-S1 level with severe hypertrophic facetal arthropathy, ligamentum flavum hypertrophy and a resultant tight canal at this level.

3. Posterior peridiscal osteophytes at the L2-L3, L3-L4 and L4-L5 levels with facetal arthropathy at these levels and ligamentum flavum hypertrophy at the L4-L5 level.

4. Large anterior peridiscal osteophytes in the lower lumbar region.

5. Altered signal in the sacrum, and visualized iliac bones and the L5 and L1 vertebral bodies may represent metastasis/small cell tumors.

The possibility of this being an infective process is considered to be unlikely.

ke/hs/nl/nl
/902 Date : 00.00.00

Name of the Patient : Abc Xyzar Shlmn / M / 31 yrs.
Referred by : Dr. Abc Xyzh.
Examination : M.R.I. of the Brain and
Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O left sided hemiparesis since 2 days.
HIV +ve.

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.

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

OBSERVATION :

BRAIN :

There is a hypointense area on the T1 Weighted images in the right corona radiata. This is seen to turn heterogeneously hyperintense on the proton, T2 Weighted and FLAIR images.

Hypointense areas are noted on the T1 Weighted images in the right frontal deep white matter, right lentiform nucleus and the right insular cortex. These are seen to follow CSF intensity characteristics on all the pulse sequences and would represent lacunar infarcts. Perilesional gliosis is also seen (better appreciated on the FLAIR images).

There is slight fullness of the both the lateral ventricles.



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

Incidental note is made of left maxillary polyp and mucosal thickening in the ethmoidal air cells.

INTRACRANIAL MRA :

There is narrowing of the M1 segment of the right middle cerebral artery as compared to the left. The distal portion is grossly narrowed with paucity of the vessels in the region of the right Sylvian fissure.

The right anterior communicating and the right vertebral arteries are hypoplastic.

The petrous, cavernous and supraclinoid segments of the internal carotid arteries bilaterally show normal signal and calibre. The visualized anterior 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 is hypoplastic.

The common carotid arteries and their extracranial branches appear normal bilaterally. There are no vessel wall irregularities or stenosis of the vessels noted.
..3/.














- 3 - Scan-00000/902


IMPRESSION :

1. Altered signal in the right corona radiata is not specific for a single etiology. The possibilities to be considered are :

a. Infarct.
b. Granuloma - less likely.

2. Lacunar infarcts in the right frontal deep white matter, right lentiform nucleus and the right insular cortex.

3. Narrowing of the M1 segment of the right middle cerebral artery as compared to the left. The distal segment is grossly narrowed with paucity of the vessels in the region of the right Sylvian fissure (? vasculitis).

ke/hs/nl/nl
Date : 00.00.00

Name of the Patient : Abc XyzMlmn / M / 25 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Cervico-dorsal Spine.

CLINICAL PROFILE :

C/O neckpain with difficulty in walking and straining while passing urine since 2 months.

EXAMINATION :

M.R.I of the cervico-dorsal spine was performed using the following parameters :

4 mm thick T1 Weighted and T2 Weighted sagittal images.

7 mm thick T1 Weighted and T2 Weighted axial images.

The dorsal spine was screened with 4 mm thick T2 Weighted sagittal images.

OBSERVATION :

There is an extradural/extramedullary mass lesion in the spinal canal anteriorly extending over the D1 to the D5-D6 level. This lesion is slightly hyperintense to CSF on the T1 Weighted images and turns hyperintense on the T2 Weighted images. There is posterior displacement of the cord over these levels. The cord signal over these levels cannot be ascertained with any degree of certainty.

There is slight posterior scalloping of the D3 and D4 vertebral bodies.









The visualized cervico-dorsal vertebral bodies and intervertebral discs reveal normal signal intensity. The visualized pre and paravertebral soft tissues are unremarkable.

IMPRESSION :

An extradural/extramedullary mass lesion in the spinal canal anteriorly extending over the D1 to the D5-D6 level. The differential diagnosis would include :

1. Arachnoid cyst.

2. Neurentric cyst.

ke/bv/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyz Tanalmn / M / 61 yrs.
Referred by : Dr. Abc Xyzah / Dr. Abc Xyzr.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O altered behaviour since 8 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 T1 Weighted coronal images.
5 mm thick T1 Weighted sagittal images.

OBSERVATION :

There is a hyperintense area on the proton, T2 Weighted and FLAIR images in the right paraatrial deep white matter. This is isointense to the white matter on the T1 Weighted images (scans 106.5, 103.13, 102.13).

Similar areas are also seen in the left paraatrial deep white matter and in the pons.

There is mild fullness of both the lateral ventricles. The third and the fourth ventricles are normal. Mild prominence of the cerebral cortical sulci and cerebellar folia is noted. The basal cisternal spaces are unremarkable. There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.








Incidental note is made of bilateral maxillary sinusitis and mucosal thickening in the ethmoidal air cells and the frontal sinus.

IMPRESSION :

1. Altered signal in the paraatrial deep white matter bilaterally and in the pons is probably ischemic in etiology.

2. Age related cerebral and cerebellar atrophy.

ke/bv/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyzkala Plmn / F / 60 yrs.
Referred by : Dr. Abc Xyzchale.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O weakness of the LLE since 00.00.00.
Now C/O paresthesias in the LUE and on the left side of the face.

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 scoliosis of the lumbar spine with convexity to the right.

There is a posterior and right far lateral disc herniation at the L4-L5 level with anterior indentation of the thecal sac and the extraforaminal portion of the right L4 nerve root. The L4-L5 facet joints show mild degenerative changes.

A small posterior and left postero-lateral disc herniation is noted at the L3-L4 level with mild left neural foraminal narrowing. The L3-L4 facet joints also show mild degenerative changes.

A small posterior disc herniation is seen at the L5-S1 level.

There is a posterior disc bulge at the L2-L3 level. The lumbar intervertebral discs show loss of water content.


The lumbar vertebral bodies reveal spotty fatty changes suggesting osteoporosis. The visualized pre and paravertebral soft tissues are unremarkable.

The conus medullaris terminates at the D12 level and the thecal sac terminates at the L5-S1 level.

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

19.0 mm at L1-L2
19.0 mm at L2-L3
17.0 mm at L3-L4
13.0 mm at L4-L5
11.0 mm at L5-S1.

The cervico-dorsal and dorsal spines were screened with the help of 4 mm thick T2 Weighted sagittal images and which does not reveal any diagnostic feature of note.

There is no cord compression.

IMPRESSION :

The MRI features are suggestive of :

1 A posterior and right far lateral disc herniation at the L4-L5 level indenting the thecal sac and the extraforaminal portion of the right L4 nerve root.

2 A small posterior and left postero-lateral disc herniation at the L3-L4 level.