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Sunday, 27 December 2015 16:48

13781

sb/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc XyzSlmn / F / 12 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O delayed milestones with speech impairment.

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 T2 Weighted coronal images.

5 mm thick FLAIR coronal images.

OBSERVATION :

There are ill-defined, hyperintense areas on the proton, T2 Weighted and FLAIR images in the periventricular white matter bilaterally. These lesions appear hypointense on the 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.

IMPRESSION :

Altered signal in the periventricular white matter bilaterally is not specific for a single etiology. A metabolic disorder or a dysmyelinating etiology should be ruled out.



Sunday, 27 December 2015 16:48

13779

sb/bv/nl/rg.
/779 Date : 21/00.00.00

Name of the Patient : Abc Xyz M. lmn / M / 65 yrs.
Referred by : Dr. Abc Xyzthak.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to BLE with paresthesias since 1 1/2 months.
C/O urgency in passing urine.

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 lumbo-sacral spine with convexity to the left.

Severe degenerative changes are seen within the lumbar spine.

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

The lumbar intervertebral discs are reduced in height.

There is a posterior and bilateral far lateral disc bulge at the L5-S1 level, with bilateral neural foraminal narrowing. Facetal and ligamentum flavum hypertrophy is noted.

There is a posteriorly herniated disc at the L4-L5 level with thecal sac compression and bilateral neural foraminal narrowing. Bilateral far lateral disc herniations are noted. There is facetal and ligamentum flavum hypertrophy with canal stenosis. Similar changes are noted at L3-L4 level.
..2/.




Posterior disc bulges with peridiscal osteophytes are noted at the L1-L2 and L2-L3 levels with bilateral neural foraminal narrowing. Facetal hypertrophy is also noted at these levels.

Small posterior disc bulges with peridiscal osteophytes are noted in the lower dorsal region with facetal hypertrophy at the D11-D12 level.

Anterior disc herniations with anterior peridiscal osteophytes are noted in the lumbar region.

Type II degenerative marrow changes are noted adjacent to the L4-L5 and L5-S1 discs and Type III degenerative marrow changes are noted adjacent to the L3-L4 disc. The L3-L4 disc shows evidence of calcium/vacuum phenomena.

The rest of the lumbar vertebral bodies show spotty fatty marrow changes. 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 :

10.0 mm at L1-L2
11.0 mm at L2-L3
9.0 mm at L3-L4
10.0 mm at L4-L5
11.0 mm at L5-S1.
..3/.













- 3 - SCan-00009


IMPRESSION :

The MRI features are suggestive of severe degenerative changes in the lumbar spine with scoliosis of the lumbar spine with convexity to the left side with,

1. Posteriorly herniated discs with bilateral far lateral disc herniations at the L3-L4 and L4-L5 levels with facetal and ligamentum flavum hypertrophy.

2. Posterior disc bulges with peridiscal osteophytes at the L1-L2 and L2-L3 levels and facetal hypertrophy at these levels.

3. Small posterior disc bulges with peridiscal osteophytes in the lower dorsal region with facetal hypertrophy at the D11-D12 level.

4. Lumbar canal stenosis over the L3-L4 and L4-L5 levels with tight lumbar canal over the L1-L2, L2-L3 and L5-S1 levels.

Sunday, 27 December 2015 16:48

13778

sb/hs/nl/rg.
/00000 Date : 00.00.00

Name of the Patient : Abc Xyzlmn / M / 51 yrs.
Referred by : Dr. Abc Xyzah.
Examination : Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O weakness of the RUE and RLE since 00.00.00.
Known hypertensive.

EXAMINATION :

The brain was screened with 5 mm thick T2 Weighted axial images and 5 mm thick T1 Weighted sagittal images.

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

OBSERVATION :

Lacunar infarcts (iso to hyperintense to CSF) are noted in the pons, left lentiform nucleus, right thalamus and in the left parietal deep white matter.

Ill-defined, hyperintense areas on the T2 Weighted images in the posterior parietal, periventricular white matter and centrum semiovale bilaterally most likely represent ischemic changes.

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

INTRACRANIAL MRA :

There is slight decrease in calibre of the intracranial segment of the right internal carotid artery when compared to the left. The right vertebral artery and the A1 segment of the right anterior cerebral artery also appears hypoplastic.

- 2 - Scan-00008/00000


The petrous, cavernous and supraclinoid segments of the left internal carotid artery show normal signal and calibre. The visualized left 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 also appears 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 :

1. Lacunar infarcts in the pons, left lentiform nucleus, right thalamus and in the left parietal deep white matter.

2. Altered signal in the posterior parietal, periventricular white matter and centrum semiovale bilaterally most likely represent ischemic changes.

3. Slight decrease in calibre of the intracranial segment of the right internal carotid artery when compared to the left, may be a normal variant.

4. Hypoplastic right vertebral artery and the A1 segment of the right anterior cerebral artery.



Sunday, 27 December 2015 16:48

13777

sb/bv/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyz Khakholmn / M / 44 yrs.
Referred by : Dr. Abc Xyzhtekar.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to the LUE and LLE with paresthesias.
H/O TBM with hydrocephalus in May 0000. VP Shunt was done.

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 lower lumbar intervertebral discs and loss of normal lumbar lordosis.

A small posterior disc bulge with peridiscal osteophytes is noted at the L5-S1 level.

A small postero-central protruded disc is noted at the L4-L5 level.

Facet joints in the lower lumbar region appear slightly hypertrophied.

Fat is noted in the filum terminale over the L2 to L5 vertebral levels.

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



The nerve roots in the lumbar region show normal distribution.

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 :

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

IMPRESSION :

1. A small posterior disc bulge with peridiscal osteophytes at the L5-S1 level.

2. A small postero-central protruded disc at the L4-L5 level.

3. Slight facetal hypertrophy in the lower lumbar region.

Sunday, 27 December 2015 16:48

13776

sb/bv/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyzen Kadlmn / F / 72 yrs.
Referred by : Dr. Abc Xyzdakia.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to BLE with paresthesias since 15-20 days.

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, except the L5-S1 disc.

There is mild scoliosis of the lumbar spine with convexity to the left side.

There is minimal forward translation of the L4 over the L5 vertebra.

There is a posterior disc bulge with left far lateral disc herniation at the L5-S1 level indenting the extraforaminal segment of the left L5 nerve root. Facetal and ligamentum flavum hypertrophy is noted at this level, with bilateral neural foraminal narrowing. The right S1 nerve root sleeve appears bigger than the left (scan 104.3) ? baggy nerve root sleeve.





There is a posteriorly herniated disc at the L4-L5 level with bilateral neural foraminal narrowing. A disc fragment is noted in the left neural foramen at the L4-L5 level, indenting the foraminal segment of the left L4 nerve root. There is also facetal and ligamentum flavum hypertrophy at the L4-L5 level with resultant canal stenosis.

A posteriorly herniated disc with peridiscal osteophyte is noted at the L3-L4 level with bilateral neural foraminal narrowing. Slight facetal and ligamentum flavum hypertrophy is noted at this level.

Minimal posterior disc bulges are noted at the L1-L2 and L2-L3 levels.

Lateral peridiscal osteophytes are seen in the lumbar region.

Anterior disc herniations with anterior peridiscal osteophytes are noted in the lumbar region.

Schmorls nodes/limbus vertebra are seen in the lumbar region.

The lumbar vertebral bodies show fatty marrow changes.
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.
..3/.














- 3 - Scan-00006


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

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

IMPRESSION :

1. Minimal forward translation of the L4 over the L5 vertebra.
2. A posteriorly herniated disc at the L4-L5 level with a disc fragment in the left neural foramen at the L4-L5 level, indenting the foraminal segment of the left L4 nerve root with facetal and ligamentum flavum hypertrophy.

3. A posterior disc bulge with left far lateral disc herniation at the L5-S1 level indenting the extraforaminal segment of the left L5 nerve root with facetal and ligamentum flavum hypertrophy.

4. A posteriorly herniated disc with peridiscal osteophyte at the L3-L4 level with bilateral neural foraminal narrowing with slight facetal and ligamentum flavum hypertrophy.

5. Canal stenosis at the L3-L4, L4-L5 and L5-S1 levels.

Sunday, 27 December 2015 16:48

13775

sb/bv/rg.
Date : 00.00.00

Name of the Patient : Abc XyzShlmn / M / 11 yrs.
Referred by : Dr. Abc Xyzhtekar.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O seizures since 4-5 months.
H/O fall prior to this.

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 and the third ventricles appear chinky. 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.

Incidentally noted is a Thorn waldts cyst in the posterior pharyngeal wall.

IMPRESSION :

No significant abnormality is detected on this study.
Sunday, 27 December 2015 16:48

13774

sb/sb/rg.
Date : 00.00.00

Name of the Patient : Abc XyzKhalmn / F / 32 yrs.
Referred by : Dr. Abc Xyzni.
Examination : M.R.I. of the Left Elbow.

CLINICAL PROFILE :

H/O accidental injury to the left elbow 1 year back with skin grafting.
Now C/O severe pain at the left elbow.

EXAMINATION :

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

5 mm thick T1 Weighted and T2 Weighted (with fat saturation) axial images.
4 mm thick T1 Weighted and STIR coronal images.
4 mm thick T1 Weighted and T2 Weighted (with fat saturation) sagittal images.

OBSERVATION :

There is evidence of susceptibility artifacts in the posterior soft tissues of the left elbow joint. It is hence, difficult to completely evaluate the olecranon process.

The bones of the left elbow joint show normal alignment and signal characteristics. No obvious fractures/bone erosion or destruction is noted. The muscles around the left elbow joint show normal signal characteristics. The fat planes are well-identified. No obvious nerve entrapment is noted. No obvious vascular anomaly is identified on this study.

Minimal fluid is noted in the radio-humeral joint.

IMPRESSION :

Post-operative (skin grafting) status, with susceptibility artifacts in the posterior soft tissues of the left elbow joint.

No other significant abnormality is detected on this study.

No previous radiographs were available for review/comparison.


Sunday, 27 December 2015 16:48

13773

sb/hs/nl/rg.
Date : 00.00.00
Name of the Patient : Abc Xyza S. Shilmn / F / 10 yrs.
Referred by : Dr. Abc Xyzdeo. Examination : M.R.Cholangiogram.
CLINICAL PROFILE :
C/O abdominal pain since 20 days.EXAMINATION :
MR Cholangiogram was performed. 7 mm thick T1 Weighted and T2 Weighted axial images. 7 mm thick T2 Weighted coronal images.OBSERVATION :
There is evidence of fusiform dilatation of the common bile duct (CBD) which measures approximately 2.7 cms in its maximum transverse dimension. The CBD is seen to taper at its terminal end. An inclusion defect is noted at the terminal end of the CBD, which is hypointense on the T2 Weighted images and most likely represents a calculus. The gall bladder is well distended and shows multiple calculi within its lumen. The cystic duct is not well identified. Mild dilatation of the common hepatic duct and the left and right hepatic ducts is noted. Minimal dilatation of the intrahepatic biliary radicles is identified.

The liver parenchyma shows no focal area of altered signal.
Both the visualized kidneys, pancreas and spleen are normal in size and shape.
IMPRESSION :

The MRCP features are suggestive of fusiform dilatation of the common bile duct with mild dilatation of the right and left hepatic ducts and common hepatic duct. A choledochal cyst is a likely possibility. A calculus is noted at the terminal end of the common bile duct. The gall bladder also shows multiple calculi.

Sunday, 27 December 2015 16:48

13772

sb/bv/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyzchand lmn / M / 46 yrs.
Referred by : Dr. Abc XyzChogle.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE :

C/O neck pain radiating to the RUE since 00.00.00.

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 :

There is slight loss of water content of all the cervical intervertebral discs.

Small postero-central disc herniations with peridiscal osteophytes are noted at the C5-C6 and C6-C7 levels (larger at the C5-C6 level) indenting the dural theca anteriorly.

The cervical vertebral bodies show normal signal intensity. The joints of Luschka and 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.

IMPRESSION :

Small postero-central disc herniations with peridiscal osteophytes at the C5-C6 and C6-C7 levels (larger at the C5-C6 level).

Sunday, 27 December 2015 16:48

13771

ke/sb/nlrg.
Scan No : 0000 Date : 00.00.00

Name of the Patient : Abc Xyznd Shlmn / M / 37 yrs.
Referred by : Dr. Abc Xyzngsarkar.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache with tingling in BLE (left more than right) since August 0000.

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 right postero-lateral disc herniation with peridiscal osteophytes at the L4-L5 level with antero-lateral indentation of the thecal sac. There is inferior migration of the disc fragment with impingement of the right L5 nerve root.

A left postero-lateral disc herniation with peridiscal osteophyte is noted at the L5-S1 level with left neural foraminal narrowing. The L4-L5 and L5-S1 intervertebral discs show loss of water content.

The L4-L5 and L5-S1 facet joints appear hypertrophied.

The lumbar vertebral bodies and the remaining 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 D12-L1 level and the thecal sac terminates at the S2-S3 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
16.0 mm at L2-L3
16.0 mm at L3-L4
12.0 mm at L4-L5
13.0 mm at L5-S1.

IMPRESSION :

1. A right postero-lateral disc herniation with peridiscal osteophytes at the L4-L5 level with inferior migration of the disc fragment and impingement of the right L5 nerve root.

2. A left postero-lateral disc herniation with peridiscal osteophyte at the L5-S1 level.

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