sb/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzi Slmn / M / 20 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

Known C/O TBM. On AKT. Now C/O headaches and fever.
Also C/O backache with paresthesias in BLE since 15 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.

OBSERVATION :

There is a hyperintense signal located within the left occipital cortex on the FLAIR images (scan 105.5) with a hypointense centre. This signal is not well-appreciated on the T2 Weighted, proton density and T1 Weighted images.

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.

Inflammatory changes are noted in the right maxillary antrum.

IMPRESSION :

Bright signal in the left occipital cortex on the FLAIR images is not specific for a single etiology.

This may represent an evolving granuloma or may represent ischemic changes, the result of vasculitis.

A contrast enhanced scan may be worthwhile.

sb/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyz Dclmn / M / 43 yrs.
Referred by : Dr. Abc XyzShah.
Examination : M.R.I. of the Dorsal Spine.

CLINICAL PROFILE :

H/O left thoracotomy with chest wall schwanomma removed (from 7th intercostal nerve).
C/O backache with occasional giddiness.

EXAMINATION :

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

4 mm thick T1 Weighted and T2 Weighted sagittal images.

5 mm thick T1 Weighted and T2 Weighted axial images.

OBSERVATION :

There is slight loss of water content of the mid and lower dorsal intervertebral discs.

There is a small, right paracentral disc herniation with peridiscal osteophyte at the D9-D10 level, indenting the dural theca anteriorly.

Small posterior peridiscal osteophyte is noted at the D10-D11 level.

Anterior peridiscal osteophytes are noted in the middorsal region more to the right of the midline.

Post-operative changes are noted in the left paravertebral region at the D7 and D8 vertebral levels.

A hemangioma with fat content is noted in the D12 vertebral body.


The rest of the visualized dorsal vertebral bodies and the remaining intervertebral discs reveal normal signal intensity. The facet joints and the visualized prevertebral soft tissues are unremarkable.

The visualized dorsal spinal cord reveals normal signal intensity.

The conus medullaris terminates at the L2 level.

The T1 Weighted sagittal images of the lumbar spine reveal a degenerated L5-S1 disc with a posterior peridiscal osteophyte at that level.

IMPRESSION :

1. Post-operative status.

2. Small, right paracentral disc herniation with peridiscal osteophyte at the D9-D10 level.

3. Small posterior peridiscal osteophyte at the D10-D11 level.

sb/ke/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzshna D. lmn / M / 56 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain and
Intracranial M.R.A.

CLINICAL PROFILE :

C/O giddiness, gait ataxia and speech disturbance since 3 days.
Known hypertensive and tobacco chewer.

EXAMINATION :

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

5 mm thick T1 Weighted and T2 Weighted axial images.

5 mm thick FLAIR coronal images.

Intracranial MRA was performed with 3D TOF sequence.

The neck MRA could not be performed as the patient was moving.

OBSERVATION :

BRAIN :

There are ill-defined, hyperintense areas on the T2 Weighted and FLAIR images in the thalami, bilaterally extending into the midbrain on either side and in the head of right caudate nucleus. These lesions appear iso to hypointense to normal white matter on the T1 Weighted images.

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

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


Mucosal thickening is noted in the ethmoidal air cells bilaterally.

INTRACRANIAL MRA :

Apparent narrowing of the M1 segment of the right middle cerebral artery in its mid segment is artifactual. Motion artifacts are noted in some images.

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

IMPRESSION :

Altered signal in the thalami, bilaterally and in the head of the right caudate nucleus most likely represents ischemic changes.

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

sb/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzsad Bharlmn / M / 59 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE :

C/O neckpain radiating to BUE with paresthesias since 3 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.

SOME IMAGES SHOW PATIENT MOTION.

OBSERVATION :

There is loss of normal cervical lordosis and loss of water content of the cervical intervertebral discs.

There are postero-central protruded discs with peridiscal osteophytes at the C3-C4 and C5-C6 levels, indenting the dural theca anteriorly.

A right paracentral protruded disc with peridiscal osteophytes is noted at the C4-C5 level indenting the dural theca anteriorly.

A left postero-lateral disc herniation with peridiscal osteophytes is noted at the C6-C7 level with slight left neural foraminal narrowing.

Posterior peridiscal osteophytes are noted at the C7-D1 level.


Degenerative changes of the joints of Luschka are noted on the right at the C3-C4, C4-C5 and C5-C6 levels with resultant right neural foraminal narrowing. Facetal hypertrophy is also noted at these levels bilaterally.

The visualized cervical vertebral bodies show spotty fatty marrow changes. The visualized pre and paravertebral soft tissues are unremarkable.

The cervical spinal cord reveals normal signal intensity.

The atlanto-axial region and the cervico-medullary junction are unremarkable.

Screening, T1 Weighted sagittal images of the lumbar spine reveal posteriorly bulging discs at the L3-L4, L4-L5 and L5-S1 levels with slight bilateral neural foraminal narrowing.

IMPRESSION :

1. Postero-central protruded discs with peridiscal osteophytes at the C3-C4 and C5-C6 levels.

2. A right paracentral protruded disc with peridiscal osteophytes at the C4-C5 level.

3. A left postero-lateral disc herniation with peridiscal osteophytes at the C6-C7 level.

4. Posterior peridiscal osteophytes at the C7-D1 level.

5. Degenerative changes of the joints of Luschka on the right at the C3-C4, C4-C5 and C5-C6 levels with resultant right neural foraminal narrowing.

6. Facetal hypertrophy at the C3-C4, C4-C5 and C5-C6 levels bilaterally.

ke/sb/nl/nl
Date : 00.00.00

Name of the Patient : Abc XyzMlmn / M / 34 yrs.
Referred by : Dr. Abc Xyzngsarkar / Dr. Abc Xyzl Shah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O headaches since 2 months with increased frequency in passing urine.

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

Mild fullness of both the lateral ventricles is noted. There is slight prominence of the cerebral cortical sulci.

The 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 :

No significant abnormality is detected on this study.

sb/ke/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyz lmn / F / 48 yrs.
Referred by : Dr. Abc Xyzoshipura.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to BLE since 7 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 loss of normal lumbar lordosis and loss of water content of the L2-L3, L3-L4 and L4-L5 intervertebral discs.

A small posterior disc bulge is noted at the L5-S1 level. Facetal hypertrophy is also noted at this level.

Posterior and bilateral far lateral herniated discs are seen at the L4-L5 level with bilateral neural foraminal narrowing. Indentation of the right L5 nerve root is noted. There is also facetal and ligamentum flavum hypertrophy with canal stenosis at this level.

Left and right postero-lateral disc herniation is noted at the L3-L4 level with bilateral neural foraminal narrowing.

There is a right far lateral disc bulge at the L2-L3 level.

Facetal hypertrophy is also noted at the L1-L2 and L2-L3 levels.
- 2 - Scan-00009


A hemangioma with fat content is seen in the L4 vertebral body.

The rest of the lumbar vertebral bodies and the remaining intervertebral discs reveal normal signal intensity. 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 S2 level.

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

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

IMPRESSION :

1. A small posterior disc bulge at the L5-S1 level with facetal hypertrophy at this level.

2. Posterior and bilateral far lateral herniated discs at the L4-L5 level with bilateral neural foraminal narrowing and indentation of the right L5 nerve root. There is also facetal and ligamentum flavum hypertrophy with canal stenosis at this level.

3. Left and right postero-lateral disc herniation at the L3-L4 level with bilateral neural foraminal narrowing.

4. Facetal hypertrophy at the L1-L2 and L2-L3 levels.

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 Brain.

CLINICAL PROFILE :

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

5 mm thick FLAIR coronal images.

OBSERVATION :

There are well marginated, CSF intensity lesions on all the pulse sequences in the right inferior frontal and frontal regions, bilateral temporal cortex and in the right high parietal cortex. These lesions represent areas of cystic encephalomalacia, most likely the sequelae of previous cortical contusions, (in a known C/O head trauma). Ill-defined hyperintense signal on the proton, T2 Weighted and FLAIR images around these lesions and in the frontal, temporal and posterior parietal cortex, bilaterally represent gliotic changes in the given clinical setting.

Hyperintense signal on the proton, T2 Weighted and FLAIR images in the globus pallidi bilaterally, which appear hypointense on the T1 Weighted images may represent shearing injuries.

There is mild dilatation of both the lateral, third and the fourth ventricles. There is slight prominence of the cerebral cortical sulci, cerebellar folia and the basal cisternal spaces bilaterally. There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.


IMPRESSION :

1. Areas of cystic encephalomalacia with perilesional gliotic changes in the right inferior frontal and frontal regions, bilateral temporal cortex and in the right high parietal cortex.

2. Altered signal in the globus pallidi bilaterally, may represent shearing injuries.

sb/ke/nl/rg.
/885 Date : 00.00.00

Name of the Patient : Abc Xyzram Tlmn / M / 50 yrs.
Referred by : Dr. Abc Xyzah.
Examination : Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O 3 episodes of pain in the occipital region with change in voice and giddiness for 2-3 minutes since 15 days.

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 are small bright foci on the T2 Weighted images in the left centrum semiovale along the watershed zone of the left anterior and middle cerebral arteries. These most likely represent ischemic changes.

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

INTRACRANIAL MRA :

There is concentric narrowing of the cavernous segment of the left internal carotid artery with resultant mild stenosis of the said vessel. There is however, good signal of the distal intracranial vessels on the left side.

The petrous, cavernous and supraclinoid segments of the right internal carotid artery and the petrous and supraclinoid segment of the left internal carotid artery show normal signal and calibre. The visualized anterior cerebral, middle cerebral, basilar, vertebral and posterior cerebral arteries also show normal signal, calibre and wall margins. No obvious aneurysm or vascular malformation is identified.
..2/.







NECK MRA :

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

IMPRESSION :

1. Small bright foci on the T2 Weighted images in the left centrum semiovale along the watershed zone of the left anterior and middle cerebral arteries most likely represent ischemic changes.

2. Concentric narrowing and stenosis of the cavernous segment of the left internal carotid artery may be atherosclerotic in the etiology.

sb/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzi Slmn / M / 20 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Dorsal Spine.

CLINICAL PROFILE :

Known C/O TBM. On AKT.
C/O backache with paresthesias in BLE since 15 days.

EXAMINATION :

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

4 mm and 5 mm thick T1 Weighted sagittal images.

5 mm thick T1 Weighted and T2 Weighted axial images.

4 mm thick T2 Weighted sagittal images through the cervico-dorsal region.

OBSERVATION :

There is seen an ill-defined, intermediate signal intensity mass lesion on the T1 Weighted images in the spinal canal extending over the D2 to atleast the L2 vertebral level. This lesion is most likely intradural in location and appears hyperintense on the T2 Weighted images. The lesion is located posterior and more to the right of the dorsal spinal cord over these levels. The posterior margin of the dorsal spinal cord is not well-defined separately from the lesion on the T1 Weighted images. The surrounding CSF space appears effaced. The dorsal spinal cord at the D3, D4 and D7 vertebral levels appears slightly hyperintense on the T2 Weighted images suggesting cord edema/ischemia.

A small, right paracentral protruded disc with peridiscal osteophyte is noted at the D2-D3 level.
Scan-00006



The visualized dorsal 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 cannot be well differentiated on this study.

The T2 Weighted sagittal images of the cervical spine reveal a small, postero-central protruded disc at the C5-C6 level.

IMPRESSION :

Intradural mass lesion within the spinal canal extending over the D2 to atleast the L2 vertebral level, along the posterior margin of the dorsal spinal cord as described is not specific for a single etiology. This most likely represents intradural granulation tissue/abscess, with arachnoiditis, in view of h/o tuberculous meningitis. The possibility of a neoplasm seems less likely.

A contrast enhanced scan is essential to delineate the lesion within the dorsal spinal cord.

sb/bv/nl/rg.
Scan No. : 00005 Date : 00.00.00

Name of the Patient : Abc Xyzr Huslmn / M / 50 yrs.
Referred by : Dr. Abc Xyzddiqui.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

H/O catch 16 days back with weakness of the LLE, pain and 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.

PATIENT DID NOT ALLOW COMPLETION OF STUDY AS PATIENT WAS IN SEVERE PAIN. SOME IMAGES SHOW PATIENT MOTION. PATIENT REFUSED SEDATION.

OBSERVATION :

There is loss of normal lumbar lordosis and loss of water content of all the lumbar intervertebral discs except the L5-S1 disc.

There is mild replacement of L3 over L4 vertebral bodies.

A fairly large, posteriorly herniated disc with peridiscal osteophytes is noted at the L3-L4 level with thecal sac compression and canal stenosis.

Small posterior disc herniations with peridiscal osteophytes are noted at the L4-L5 and L2-L3 levels.

Small posterior peridiscal osteophyte is noted at the L1-L2 level.


Facetal hypertrophy is noted in the lumbar region.

The pedicles of the lumbar vertebrae appear congenitally short in their antero-posterior dimensions.

The lumbar vertebral bodies reveal normal signal intensity. 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 :

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

IMPRESSION :

1. A fairly large, posteriorly herniated disc with peridiscal osteophytes at the L3-L4 level.

2. Small posterior disc herniations with peridiscal osteophytes at the L4-L5 and L2-L3 levels.

3. Facetal hypertrophy in the lumbar region.

4. Congenitally short pedicles of the lumbar vertebrae in their antero-posterior dimensions.

5. Lumbar canal stenosis at the L2-L3, L3-L4 and L4-L5 levels.