ke/hs/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyzn Malhlmn / M / 71 yrs.
Referred by : Dr. Abc Xyzmpat.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O tremulousness of the RUE since 4-5 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 and Fast Scan (T2 *) coronal images.
5 mm thick T1 Weighted sagittal images.

OBSERVATION :

There are hyperintense areas on the proton, T2 Weighted and FLAIR images in the periatrial white matter bilaterally. These are iso to hypointense to the white matter on the T1 Weighted images and are probably ischemic in etiology.

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

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.

Incidental note is made of pansinusitis.

IMPRESSION :

The MRI features are suggestive of :

1. Altered signal in the periatrial white matter bilaterally which is probably ischemic in etiology.

2. Mild cerebellar and cerebral atrophy.

ke/hs/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xlmn / M / 21 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

Alleged H/O vehicular accident 4-5 years back.
C/O low back pain and difficulty in squatting.

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 appears to be sacralization of the L5 vertebra and the D11 vertebra is as marked on the film. Please correlate with plain radiographs.

Very minimal posterior disc bulges are seen at the L4-L5 and L5-S1 levels.

The lumbar vertebral bodies and the 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-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 :

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

The cervico-dorsal spine was screened with 4 mm thick T2 Weighted sagittal images and which does not reveal any significant feature of note.

IMPRESSION :

The MRI features are suggestive of sacralization of the L5 vertebra. Please correlate with plain radiographs.

ke/sb/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyz Zlmn / M / 44 yrs.
Referred by : Dr. Abc Xyzzzare.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O numbness in the thumb and index fingers of the right hand since 2 days.
Known diabetic/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.

5 mm thick T1 Weighted sagittal images.

OBSERVATION :

There are ill-defined, hyperintense areas in the posterior parietal, periventricular deep white matter which may be ischemic in etiology. Similar smaller foci are noted in the frontal deep white matter bilaterally.

There is mild dilatation 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. No obvious vascular anomaly is identified on this study.

Incidental note is made of an empty sella.

The cervical spine was screened with 4 mm thick T2 Weighted sagittal images which shows small posterior disc bulges with peridiscal osteophytes over the C3-C4 to C6-C7 levels.



IMPRESSION :

1. Hyperintense areas in the periventricular deep white matter and in the frontal deep white matter bilaterally may be ischemic in etiology.

2. Small posterior disc bulges with peridiscal osteophytes over the C3-C4 to C6-C7 levels.

sb/ke/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzv Ylmn / M / 29 yrs.
Referred by : Dr. Abc Xyzisheri.
Examination : M.R.I. of the Cervico-dorsal Spine.

CLINICAL PROFILE :

H/O sudden onset of retention of urine with weakness of BLE on 00.00.00.
H/O fever 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.

8 mm thick T1 Weighted and Fast Scan (T2 *) and 10 mm thick T2 Weighted axial images.

OBSERVATION :

There is slight increase in diameter of the cervical spinal cord. There is an ill-defined, hyperintense signal on the T2 Weighted and Fast Scan (T2 *) images in the cervico-dorsal spinal cord, centrally, extending over the C2 to the tip of conus medullaris. This lesion appears hypointense to normal cord on the T1 Weighted images.

There are ill-defined, hyperintense areas on the T2 Weighted and Fast Scan (T2 *) images in the posterior paraspinal muscles in the cervical and upper dorsal regions. This signal appears iso to slightly hypointense to normal muscle on the T1 Weighted images.

The visualized cervico-dorsal vertebral bodies show preponderance of hematopoeitic marrow. The visualized intervertebral discs show normal signal intensity. The joints of Luschka and the visualized pre and paravertebral soft tissues are unremarkable.



There is no cord compression.

The conus medullaris terminates at the L2 level.

IMPRESSION :

Slight increase in the diameter of the cervico-dorsal spinal cord with altered signal in the cervical and dorsal spinal cords, centrally most likely suggest myelitis in the given clinical setting. Altered signal in the posterior paraspinal soft tissues in the cervical and upper dorsal regions would represent inflammatory/ischemic changes.

sb/ke/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyz Gonsalmn / M / 67 yrs.
Referred by : Dr. Abc Xyzauhan.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache since 1 months and sudden onset of weakness of BLE since 2 days.
H/O Surgery for Ca prostate 1 1/2 years ago.

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 an ill-defined, hypointense signal on the T1 Weighted images in nearly all the lumbar and sacral vertebral bodies. This signal appears iso to slightly hypointense to the normal marrow on the T2 Weighted images. The posterior elements of most the vertebrae also seem to be involved.

There is an intermediate signal intensity soft tissue lesion on the T1 Weighted images in the epidural space, circumferentially at the L2 vertebral level. This lesion appears slightly hyperintense on the T2 Weighted images. There is resultant thecal sac compression and clumping of the intrathecal nerve root, centrally at this level. Destruction of the right pedicle, right transverse process and right lamina of L2 vertebra is noted.

The lumbar intervertebral discs reveal normal signal intensity. The facet joints and the visualized pre and paravertebral soft tissues are unremarkable.
..2/.







The lower dorsal spinal cord shows normal signal intensity.

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

Screening T1 Weighted coronal images of the pelvic bones reveal ill-defined hyperintense signal in the iliac bones bilaterally.

Screening T1 Weighted sagittal images of the cervico-dorsal region reveal involvement of nearly all the cervico-dorsal vertebrae and their posterior elements. No obvious cord compression is noted on this study.

IMPRESSION :

1. In a known C/O Ca prostate, altered signal in nearly all the vertebrae of the spinal axis including the pelvic bones would represent metastatis.

2. Thecal sac compression at the L2 vertebral level by circumferential epidural soft tissue at this level and destruction of the right pedicle, transverse process and lamina of L2 vertebra.

sb/ke/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzaghralmn / M / 15 yrs.
Referred by : Dr. Abc Xyztrak.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

Alleged H/O fall with left sided hemiplegia in 0000 from which patient has recovered partially.

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 and Fast Scan (T2 *) coronal images.

OBSERVATION :

There is volume loss in the right posterior parietal region. CSF signal intensity lesion on all the pulse sequences is noted in the right posterior parietal region which represents an area of cystic encephalomalacia. Perilesional white matter hyperintense signal on the proton, T2 Weighted and FLAIR images in that region most likely represents gliotic changes.

There are ill-defined, hyperintense areas on the proton, T2 Weighted and FLAIR images in the periventricular white matter bilaterally and in the corona radiata and centrum semiovale bilaterally. These lesions appear hypointense to normal white matter on the T1 Weighted images. Involvement of the genu and splenium of the corpus callosum is noted.

There is mild fullness of both 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. No obvious vascular anomaly is identified on this study.

IMPRESSION :

1. Volume loss in the right posterior parietal region with altered signal as described represents cystic encephalomalacia with perilesional gliotic change most likely the sequelae of a previous vascular insult.

2. Altered signal in the periventricular white matter bilaterally and in the corona radiata and centrum semiovale bilaterally is not specific for a single etiology. Ischemic changes or demyelinating lesions may be considered as differential diagnosis.

ke/sb/nl/nl
Date : 00.00.00

Name of the Patient : Abc XyzJhalmn / M / 42 yrs.
Referred by : Dr. Abc Xyzin.
Examination : M.R.I. of the Left Arm.

CLINICAL PROFILE :

C/O pain in the left arm with slight swelling (on and off) since 4 years.

EXAMINATION :

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

5 mm thick T1 Weighted and 8 mm thick T2 Weighted axial images.

4 mm thick T1 Weighted sagittal images.

4 mm thick T1 Weighted and Gradient (with fat saturation) coronal images.

OBSERVATION :

There is no obvious mass lesion in the visualized left arm. The visualized bones show normal configuration and signal intensity. No obvious bone destruction or erosion is evident.

The visualized soft tissues and muscles surrounding the left arm are unremarkable.

IMPRESSION :

Normal study of the Left Arm.

ke/sb/nl/rg.
/29 Date : 00.00.00

Name of the Patient : Abc Xyzh Pilmn / M / 50 yrs.
Referred by : Dr. Abc Xyzikhalikar.
Examination : M.R.I. of the Brain and
Intracranial and Neck M.R.A.

CLINICAL PROFILE :

Known C/O Parkinsonism.
C/O excessive sleep since 2 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 and Fast Scan (T2 *) coronal images.

5 mm thick T1 Weighted sagittal images.

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

OBSERVATION :

BRAIN :

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

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

The fourth ventricle is normal. The basal cisternal spaces are prominent. There is no shift of the midline structures.

Incidental note is made of left maxillary sinusitis.


INTRACRANIAL MRA :

The A1 segment of the left anterior cerebral artery appears hypoplastic and the left vertebral artery is smaller in calibre as compared to the right.

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

NECK MRA :

Small filling defects are seen along the posterior walls of the internal carotid artery just distal to the common carotid bifurcation, bilaterally and could be due to atherosclerotic plaques.

The common carotid arteries and their extracranial branches appear normal bilaterally. The left vertebral artery is hypoplastic.

IMPRESSION :

1. Filling defects along the posterior walls of the internal carotid artery just distal to the common carotid bifurcation, bilaterally, could be due to atherosclerotic plaques.

2. No significant abnormality is detected within the intracranial MRA or the brain parenchyma on this study.

hs/ke/rg/nl
Date : 00.00.00

Name of the Patient : Abc XyzJhalmn / M / 42 yrs.
Referred by : Dr. Abc Xyzin.
Examination : M.R.I. of the Dorsal Spine.

CLINICAL PROFILE :

C/O backache since 3-4 years.

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 :

The site of tenderness has been marked with the help of Vitamin E capsules (isointense to fat).

Mild posterior disc bulges with small peridiscal osteophytes are seen over the D4-D5 to the L1-L2 levels.

Mild facetal/capsular ligament hypertrophy is seen at the D8-D9 level.

The visualized dorsal intervertebral discs show loss of water content with some of them being decreased in height.

The visualized dorsal vertebral bodies reveal normal signal intensity. The remaining facet joints and the visualized pre and paravertebral soft tissues are unremarkable.

The visualized dorsal spinal cord reveals normal signal intensity.
Scan-00006


The conus medullaris terminates at the D12 level.

The lumbar spine was screened with 5 mm thick T1 Weighted sagittal images and reveals a posteriorly bulging discs indenting the thecal sac and narrowing both neural foramen at the L3-L4 and L4-L5 levels.

IMPRESSION :

The MRI features are suggestive of :

1. Mild posterior disc bulges with small peridiscal osteophytes over the D4-D5 to the L1-L2 levels.

2. Mild facetal/capsular ligament hypertrophy at the D8-D9 level.

hs/sb/nl/rg.
Date : 00.00.00

Name of the Patient : Abc XyzR. Inspelmn / M / 47 yrs.
Referred by : Dr. Abc Xyznshah.
Examination : M.R.I. of Both Hips.

CLINICAL PROFILE :

C/O pain in the region of the left hip.
Patient is taking steroids.

EXAMINATION :

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

5 mm thick T1 Weighted and STIR coronal images.

5 mm thick T1 Weighted and T2 Weighted (with fat saturation) axial images.

5 mm thick Proton density sagittal images.

OBSERVATION :

There is evidence of an area which is hyperintense on all the pulse sequences within the left femoral head and is surrounded by a hypointense rim. Also seen are areas of hypointensity on the T1 Weighted images which turn hyperintense on the T2 Weighted and STIR images within the left femoral head and may represent bone edema. There is slight irregularity of the contour of the left femoral head. A left hip joint effusion is also noted.

An area which is isointense to fat on all the pulse sequences is seen within the right femoral head. It is surrounded by a hypointense rim on all the pulse sequences with an inner hyperintense signal on the T2 Weighted and STIR images suggestive of a double line sign. The contour of the right femoral head is well maintained.
Scan-00005


Fatty changes are noted within the acetabulum bilaterally.

There is a small left hip joint effusion.

IMPRESSION :

The MRI features are suggestive of Class B avascular necrosis involving the left femoral head and Class A avascular necrosis involving the right femoral head (Mitchells classification).