ke/bv/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyz Haldalmn / F / 20 yrs.
Referred by : Dr. Abc Xyzhtekar.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

H/O TBM since May 0000. On AKT since then.
Now C/O mild headaches and swelling over the left eye (off and on).
For follow-up.

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.

After administration of contrast, the following parameters were used :

5 mm thick T1 Weighted axial and coronal images with magnetization transfer.

3 mm thick T1 Weighted coronal and sagittal images through the region of interest.

5 mm thick T1 Weighted sagittal images.

OBSERVATION :

There is an adhesion along the medial wall of the left lateral ventricle superiorly.

There is moderate dilatation of the left lateral ventricle with periventricular CSF ooze. There is slight fullness of the right lateral and third ventricles.


An intermediate signal intensity area on the T1 Weighted images is seen in the suprasellar cistern. This is slightly hyperintense on the proton and T2 Weighted images. After administration of contrast, there is ring like (atleast two) enhancement in the suprasellar cistern. Small ring enhancing lesion is also noted just inferior to the third ventricle and anterior to the midbrain.

There is no area of abnormal enhancement along the meninges.

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

IMPRESSION :

1. Ring like enhancement in the suprasellar cistern and smaller ring enhancing lesions just inferior to the third ventricle and anterior to the midbrain could be exudates.

2. Adhesion with moderate dilatation of the left lateral ventricle with periventricular CSF ooze and slight fullness of the right lateral and third ventricles.

As compared to the previous MRI (study no:0000) dated 00.00.00, the left lateral ventricle shows presence of adhesions and is larger than on the previous scan.

ke/bv/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyzr Salmn / M / 65 yrs.
Referred by : Dr. Abc Xyzhtekar.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to BLE since 1 year.

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 a small posterior disc herniation, slightly to the right of the midline at the L5-S1 level. This disc shows loss of water content.

Small posterior and left postero-lateral disc bulge is noted at the L4-L5 level with anterior indentation of the thecal sac and mild left neural foraminal narrowing.

A left far lateral disc herniation is seen at the L3-L4 level with indentation upon the extraforaminal left L3 nerve root.

Fat is noted within the spinal canal at the L5 level giving the thecal sac a trifoliate appearance and which may be seen with epidural lipomatosis.

The lumbar vertebral bodies and the remaining intervertebral discs reveal normal signal intensity. The facet joints and 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 level.


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

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

IMPRESSION :

1. A small posterior disc herniation, slightly to the right of the midline at the L5-S1 level.

2. Small posterior and left postero-lateral disc bulge at the L4-L5 level.

3. A left far lateral disc herniation at the L3-L4 level with indentation upon the extraforaminal left L3 nerve root.

sb/bv/nl/rg
Date : 00.00.00

Name of the Patient : Abc Xyz Saiflmn / M / 39 yrs.
Referred by : Dr. Abc Xyzoshipura.
Examination : M.R.I. of the Dorso-lumbar Spine.

CLINICAL PROFILE :

Alleged H/O accident 7 months back with weakness of the LUE and BLE since then.

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 anterior wedging of the D12 vertebral body with angular kyphus at that level.

There are hypointense areas on the T1 Weighted images replacing the normal marrow of the D12 vertebral body. These are seen to turn hyperintense on the T2 Weighted images. The superior cortical endplates appears to be breached. An osteophyte arising from the postero-superior aspect of the D12 vertebral body is seen to compress upon the spinal cord. The spinal cord at the D11 and D11-D12 levels is pinched and shows hyperintense signal on the T2 Weighted images. This appears hypointense to the normal cord on the T1 Weighted images and would represent myelomalacia.

Schmorls nodes are seen in the lower dorsal and lumbar region. The D11-D12 intervertebral disc shows loss of water content.

A posterior disc herniation is seen at the L2-L3 level.

Diffuse fatty changes are seen in the D10, D11, D12 and L1 vertebral bodies.
..2/.







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

The conus medullaris terminates at the L1 level.

IMPRESSION :

In known C/O trauma, the MRI features are suggestive of :

1. Anterior wedging of the D12 vertebra with bone edema.

2. Pinching of the cord at the D11 and D11-D12 levels by an osteophyte arising from the superior aspect of the D12 vertebra with myelomalacia.

ke/bv/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyz Plmn / M / 40 yrs.
Referred by : Dr. Abc Xyznna.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to BLE since 15 days.
H/O laminectomy with discectomy at L3-L4 and L4-L5 levels 1 month back.

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 left.

Post-operative changes are seen in the posterior soft tissues over the L3 to S1 levels with laminectomy of the L4 and L5 vertebrae.

There is an apparent posterior disc herniation (seen in the immediate post-operative period) at the L3-L4 level with anterior indentation of the thecal sac. Posterior peridiscal osteophytes are also noted at this level. The intrathecal nerve roots at this level appears compressed. The L3-L4 disc also appears more hyperintense on the T2 Weighted images as compared to the previous scan.







There is an intermediate signal intensity area on the T1 Weighted images in the lateral recess of the L4 vertebra which is heterogeneously hyperintense on the T2 Weighted images and would represent granulation tissue. There is resultant encasement of the L4 nerve roots (scans 104.12, 104.14). Another similar intermediate signal intensity lesion is seen in the left lateral recess of L5 vertebra (scan 104.8) with probable encasement of the L5 nerve root.

There is slight irregularity and erosion of the superior cortical endplate of the L4 vertebral body with adjacent hypointense areas on the T1 Weighted images replacing the normal marrow of the L4 vertebral body. These are isointense to the marrow on the T2 Weighted images and would represent post-operative bone-edema.

Small posterior disc bulge is noted at the L4-L5 level with anterior indentation of the thecal sac. The L4-L5 intervertebral disc shows slight loss of water content.

The rest of the lumbar vertebral bodies and the remaining intervertebral discs reveal normal signal intensity. 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 :

14.0 mm at L1-L2
14.0 mm at L2-L3
14.0 mm at L5-S1.
..3/.









- 3 - Scan-00003



IMPRESSION :

The MRI features are suggestive of :

1. Post-operative status with bone edema in the L4 vertebral body.

2. An apparent posterior disc herniation at the L3-L4 level with compression of the intrathecal nerve roots at this level.

3. Granulation tissue at the L4 and L5 levels with encasement of the L4 nerve roots, bilaterally and the left L5 nerve root.

ke/bv/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyzand Blmn / M / 65 yrs.
Referred by : Dr. Abc Xyzdia.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE :

C/O backache radiating to BLE with paresthesias since 2 years.

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.

FEW IMAGES SHOW PATIENT MOTION.

OBSERVATION :

There is beaking of the cerebellar tonsils and the tip is seen to lie approximately 4.0 mms below the foramen magnum. The clivus is more horizontally placed as compared to normal.

A well-defined lesion is seen within the spinal cord extending over the C1-C2 to the dorsal level. This lesion is seen to follow CSF signal characteristics on all the pulse sequences and would represent a syrinx.

Small posterior disc bulges are noted at the C4-C5 and C6-C7 levels. The cervical intervertebral discs show loss of water content.






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

The atlanto-axial region is unremarkable.

Screening images of the brain reveal hydrocephalus as described with the lumbar spine study.

IMPRESSION :

The MRI features are suggestive of a Arnold-Chiari malformation.

sb/ke/nl/rg.
s Date : 00.00.00

Name of the Patient : Abc Xyzti K. Palmn / F / 75 yrs.
Referred by : Dr. Abc Xyzdar.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O 2 episodes of giddiness with fall and LOC on 00.00.00.

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 are ill-defined, hyperintense areas on the proton, T2 Weighted and FLAIR images in the subcortical white matter in the fronto-parietal regions bilaterally and in the posterior parietal periventricular white matter bilaterally. These lesions appear iso to hypointense to normal white matter on the T1 Weighted images.

The hippocampal complex is unremarkable on either side.

There is mild dilatation of both the lateral and third ventricles. The fourth ventricle is normal. There is slight prominence of the cerebral cortical sulci and cerebellar folia bilaterally. The basal cisternal spaces are unremarkable. There is no shift of the midline structures. The vertebro-basilar system appears ectatic.

IMPRESSION :

Altered signal in the subcortical white matter in the fronto-parietal regions bilaterally and in the posterior parietal periventricular white matter bilaterally most likely represent ischemic changes.

sb/ke/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzand Blmn / M / 65 yrs.
Referred by : Dr. Abc XyzJ. Dadia.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to BLE with paresthesias since 2 years.

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 sacralization of the L5 vertebra.

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

A posteriorly bulging disc is noted at the L4-L5 level with slight bilateral neural foraminal narrowing. Facetal and ligamentum flavum hypertrophy is also noted with resultant canal stenosis.

Facetal hypertrophy is seen at the L3-L4 and L5-S1 levels.

The lumbar vertebral bodies shows spotty fatty marrow changes.

The visualized pre and paravertebral soft tissues are unremarkable.




The conus medullaris terminates at the L2 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 :

15.0 mm at L1-L2
14.0 mm at L2-L3
13.0 mm at L3-L4
12.0 mm at L4-L5
14.0 mm at L5-S1.

Screening of the cervico-dorsal and dorsal spines reveals cerebellar tonsillar ectopia with a syrinx extending from the C1-C2 level upto about D7 vertebral level. Scoliotic deformity of the upper dorsal spine is also noted with convexity to the left.

IMPRESSION :

1. Sacralization of the L5 vertebra.

2. A posteriorly bulging disc at the L4-L5 level with facetal and ligamentum flavum hypertrophy with resultant canal stenosis.

3. Facetal hypertrophy at the L3-L4 and L5-S1 levels.

4. Cerebellar tonsillar ectopia with a syrinx extending from the C1-C2 level upto about the D7 vertebral level.

5. Scoliotic deformity of the upper dorsal spine with convexity to the left.

sb/ke/nl/rg.
Date : 00.00.00

Name of the Patient : Abc XyzYlmn / M / 21 yrs.
Referred by : Dr. Abc Xyzewal.
Examination : M.R.I. of the Brain and IAM.

CLINICAL PROFILE :

C/O neurofibromatosis Type I and asymptomatic lesions on the skin since 3-4 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.
MR cisternogram was obtained in the coronal plane.

After administration of contrast the following parameters were used :

5 mm thick T1 Weighted axial images,
3 mm thick T1 Weighted coronal images with magnetization transfer.

OBSERVATION :

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.

The seventh and eighth cranial nerve complexes are unremarkable on either side.

After administration of contrast, there is no focal area of abnormal enhancement in the brain parenchyma, meninges or the seventh and eighth cranial nerve complexes.

IMPRESSION :

Normal study of the Brain and IAM.

sb/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc XyzPilmn / M / 35 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O altered sensorium and gait ataxia since 2-3 months.

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 faint hyperintense signal located within the head of the caudate nuclei and putamen bilaterally (scans 102.11, 105.11) on the T2 Weighted and FLAIR images. The putamen and caudate nuclei appear smaller (atrophic) as compared to the normal.

There is mild dilatation of the ventricular system, especially the frontal horns with loss of inferolateral bulge of the frontal horns of the lateral ventricles. The basal cisternal spaces are slight prominent. There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.

IMPRESSION :

Mild dilatation of the ventricular system with the putamen and caudate nuclei appearing smaller (atrophic) in size as compared to normal with faint hyperintense signal within these nuclei on the T2 Weighted and FLAIR images is not specific for a single etiology.

However such MRI features are seen in neurodegenerative disorders like Huntingtons disease.

sb/ke/nl/rg.
/888 Date : 00.00.00

Name of the Patient : Abc Xyzam K. Thlmn / M / 63 yrs.
Referred by : Dr. Abc Xyzala.
Examination : Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O fluent aphasia.

EXAMINATION :

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

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

OBSERVATION :

There is an ill-defined, hyperintense signal on the T2 Weighted images along the left temporo-parietal cortex and subcortical white matter. This lesion most likely represents a recent cortical infarct. Resultant effacement of the sulcal spaces is noted in the left temporo-parietal region, with minimal indentation on the left lateral ventricle.

Ill-defined, hyperintense signal on the T2 Weighted images in the posterior parietal periventricular white matter bilaterally represents old ischemic lesions.

There is mild dilatation of both the lateral and third ventricles. The fourth ventricle is normal.

The basal cisternal spaces are unremarkable. There is slight prominence of the cerebral cortical sulci and cerebellar folia bilaterally. There is no shift of the midline structures.

There is no obvious haemorrhage on this study.
Scan-00006/888



INTRACRANIAL MRA :

The vertebro-basilar system appears ectatic. Slight hypoplasia of the right vertebral artery is noted as compared to the left. The Sylvian branches of the left middle cerebral artery are slightly stretched and displaced medially, by the mass effect caused by the left temporo-parietal cortical infarct. There is irregularity and concentric narrowing of the M1 segment of the left middle cerebral artery, distally.

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

There is narrowing of the origin of the right external carotid artery which however shows good distal signal. The right common carotid artery and the right internal carotid artery appear unremarkable.

The left common carotid artery and their bifurcation and the left vertebral artery also appear unremarkable.









- 3 - Scan-00006/888



IMPRESSION :

A recent infarct along the left temporo-parietal cortex and subcortical white matter.

Altered signal in the posterior parietal periventricular white matter bilaterally represents old ischemic lesions.

Slightly stretched and medially displaced sylvian branches of the left middle cerebral artery by the mass effect caused by the left temporo-parietal cortical infarct. There is irregularity and concentric narrowing of the M1 segment of the left middle cerebral artery, distally.