ke/bv/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyz Someslmn / F / 43 yrs.
Referred by : Dr. Abc Xyzmeshwar.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

H/O seizures (1st episode 2 months back and 2nd episode 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.
5 mm thick T1 Weighted sagittal images.

OBSERVATION :

There is no focal area of altered signal intensity in the brain parenchyma. Hyperintense foci in the centrum semiovale bilaterally represent dilated perivascular spaces.

The hippocampus is unremarkable on either side.

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 :

Normal study of the Brain.

hs/ke/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyzed Balmn / M / 46 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE :

C/O pain in BUE since 6 months with paresthesias.

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 evidence of a postero-central disc herniation with peridiscal osteophytes indenting the cord at the C6-C7 level. The cord at this level shows a hyperintense signal on the T2 Weighted and Fast Scan (T2 *) images and may represent cord contusion/edema.

A right postero-lateral disc herniation with peridiscal osteophyte is seen to indent the right antero-lateral aspect of the cord and narrow the right neural foramen at the C5-C6 level.

There is a postero-central disc protrusion with small peridiscal osteophytes at the C4-C5 level. A posterior disc bulge with small peridiscal osteophytes is noted at the C3-C4 level.

The C5-C6 facet joints bilaterally show degenerative changes.

The joints of Luschka show degenerative changes bilaterally over the C3-C4 to the C6-C7 levels and on the left side at the C2-C3 level.

The tip of the odontoid process is ill-defined and shows a few hypointense areas on all the pulse sequences and may represent sclerotic changes (? degeneration).

The cervical intervertebral discs show loss of water content.

The upper cervical vertebral bodies show areas of fatty replacement of normal marrow. Anterior disc herniations with peridiscal osteophytes are seen at the C4-C5 and C5-C6 levels. The visualized pre and paravertebral soft tissues are unremarkable.

The cervico-medullary junction is unremarkable.

IMPRESSION :

The MRI features are suggestive of :

1. A postero-central disc herniation with peridiscal osteophytes with a resultant tight canal at the C6-C7 level.

2. Altered cord signal at the C6-C7 level may represent cord contusion/edema.

3. A right postero-lateral disc herniation with peridiscal osteophyte at the C5-C6 level.

4. A postero-central disc protrusion with small peridiscal osteophytes at the C4-C5 level.

5. Facetal arthropathy at the C5-C6 level bilaterally.

ke/hs/rg/nl
Date : 00.00.00

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

CLINICAL PROFILE :

Known C/O MR with seizures since the age of 1 year.

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.

5 mm thick T1 Weighted sagittal images.

OBSERVATION :

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

The hippocampal complex on either side is unremarkable.

The left lateral ventricle is prominent as compared to the right and this may be a normal variant. 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 enlarged adenoids.

IMPRESSION :

No significant abnormality is detected within the brain on this study.

ke/bv/rg/nl
Date : 00.00.00

Name of the Patient : Abc XyzS. lmn / F / 45 yrs.
Referred by : Dr. Abc Xyzhtekar.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to the LLE with paresthesias since 3 months.

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 :

The L4-L5 and L5-S1 intervertebral discs show loss of water content.

The L5 vertebra is as marked on the film.

There is a left postero-lateral disc herniation at the L5-S1 level indenting the exiting left S1 nerve root. Mild left neural foraminal narrowing is noted at this level. Mild ligamentum flavum and facetal hypertrophy is also seen at this level with resultant canal stenosis.

A small posterior disc herniation is seen at the L4-L5 level. The L4-L5 facet joints show degenerative changes.

Type II degenerative changes is noted in the L5 vertebral body adjacent to the L5-S1 intervertebral disc.

The rest of 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 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 :

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

IMPRESSION :

The MRI features are suggestive of :

1. A left postero-lateral disc herniation at the L5-S1 level indenting the exiting left S1 nerve root with facetal and ligamentum flavum hypertrophy with canal stenosis at this level.

2. A small posterior disc herniation at the L4-L5 level with facetal arthropathy.

ke/bv/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyz Plmn / M / 50 yrs.
Referred by : Dr. Abc Xyzrankar.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE :

H/O anterior approach with discectomy at the C2-C3 and C3-C4 levels on 00.00.00.
C/O weakness of BUE and BLE with bladder/bowel involvement since then.

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 are large apparent disc herniations at the C2-C3 and C3-C4 levels with anterior compression of the cord. The spinal cord at these levels shows a hyperintense signal on the T2 Weighted and Fast Scan (T2 *) images. This is isointense to the normal cord on the T1 Weighted images suggestive of cord edema/ischemia/myelomalacia. Heterogeneously hypointense areas in the prediscal region at the C2-C3 level may represent bone grafts.

Small posterior disc herniations at the C5-C6 and C6-C7 levels and a postero-central disc protrusion at the C4-C5 level with anterior indentation of the thecal sac are noted. The lower cervical intervertebral discs show loss of water content.






Hypointense areas are seen within the C2 and C3 vertebral bodies on the T1 Weighted images which are seen to turn hyperintense on the T2 Weighted images and would represent post-operative edema/bruise.

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

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

IMPRESSION :

The MRI features are suggestive of :

1. Post-operative status with edema/bruise in the C2 and C3 vertebral bodies as described.

2. Large apparent disc herniations at the C2-C3 and C3-C4 levels with cord edema/ischemia/myelomalacia at these levels.

3. Small posterior disc herniations at the C5-C6 and C6-C7 levels.

4. A postero-central disc protrusion at the C4-C5 level.

sb/ke/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzbi Shlmn / F / 48 yrs.
Referred by : Dr. Abc Xyzhah.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to BLE with paresthesias 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 sacralization of the L5 vertebra and the L1 vertebral body is as marked on the film.

A posteriorly bulging disc is noted at the L4-L5 level with bilateral neural foraminal narrowing. Hypertrophic facetal arthropathy is noted at this level with lateral recess stenosis and impingement of the left L4 nerve root in the left neural foramen at the L4-L5 level. Facet joint effusion is noted at the L4-L5 level. The L4-L5 intervertebral disc shows loss of water content.

Minimal posterior disc bulges are noted at the L2-L3 and L3-L4 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 conus medullaris terminates at the L1-L2 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
17.0 mm at L2-L3
12.0 mm at L3-L4
10.0 mm at L4-L5
6.0 mm at L5-S1.

IMPRESSION :

1. Sacralized L5 vertebra.

2. A posteriorly bulging disc at the L4-L5 level with bilateral neural foraminal narrowing. Hypertrophic facetal arthropathy is noted at this level with lateral recess stenosis and impingement of the left L4 nerve root in the left neural foramen at the L4-L5 level. Facet joint effusion is noted at the L4-L5 level.

ke/sb/rg.
Date : 00.00.00
Name of the Patient : Abc XyzMlmn / M / 60 yrs.
Referred by : Dr. Abc Xyz Shah. Examination : M.R.Cholangiogram.
CLINICAL PROFILE :
C/O abdominal pain since 1 week with jaundice (detected on 00.00.00). EXAMINATION :
MR Cholangiogram was performed. 7 mm thick T1 Weighted and T2 Weighted axial images. 7 mm thick T2 Weighted coronal images.OBSERVATION :
The gall bladder is distended and shows thickening of its wall, which measures approximately 5.0 mm. A focal hypointense area is seen in the fundus of the gall bladder (se/im 6/4) on the T2 Weighted images and may represent a small calculus. The cystic duct is tortuous and is also dilated and measures approximately 1.3 cms in its maximum transverse dimension. A focal hypointense area is seen within the cystic duct on the T2 Weighted images. This is of intermediate signal intensity on the T1 Weighted images and would represent a calculus.

The right lobe of the liver is small. Resultant hypertrophy of the left lobe is noted. There is no focal or diffuse area of altered signal intensity. There is no intrahepatic biliary radicle dilation. The intrahepatic venous architecture is normal.Both the visualized kidneys, pancreas, adrenals and spleen are normal in size and signal characteristics.

The visualized intrahepatic biliary radicles, hepatic ducts and cystic duct are normal in it's course and calibre. The common bile duct is well-visualized in it's entire course upto it's insertion into the duodenum and is of normal calibre. There are no intrinsic lesions in the common bile ducts. The visualized pancreatic duct is unremarkable.IMPRESSION :

The MRCP features are suggestive of calculus cholecystitis with a distended gall bladder and cystic duct. The CBD is unremarkable.

ke/bv/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzlmn / F / 25 yrs.
Referred by : Dr. Abc Xyzsra / Dr. Abc XyzShah.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE :

C/O neck pain radiating to the RUE with paresthesias.

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 :

The C7 vertebra is as marked on the film.

There is slight scoliosis of the cervical spine with slight convexity to the right. Anti-clockwise rotational anomaly of the upper cervical vertebrae is noted. Probable fusion of the posterior elements of C2 and C3 vertebrae is noted with a hypoplastic left lamina of C2. A congenital block, C5/C6 vertebra is noted.

Minimal posterior disc bulges are noted at the C3-C4 and C4-C5 levels. Slight degenerative changes of the joints of Luschka at C3-C4 and C4-C5 levels is noted bilaterally.

The cervical intervertebral discs show slight loss of water content.

The cervical vertebral bodies show normal signal intensity. The rest of 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.

Incidentally noted is inflammatory changes in the sphenoid sinus.

IMPRESSION :

1. Slight scoliosis of the cervical spine with slight convexity to the right.

2. Probable fusion of the posterior elements of C2 and C3 vertebrae with a hypoplastic left lamina of C2.

3. A congenital block, C5/C6 vertebra.

4. Slight mild degenerative changes of the joints of Luschka at C3-C4 and C4-C5 levels bilaterally.

sb/ke/rg/nl
/31 Date : 00.00.00

Name of the Patient : Abc Xyzchalmn / M / 67 yrs.
Referred by : Dr. Abc Xyzah / Dr. Abc Xyzmpat.
Examination : M.R.I. of the Brain and
Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O gait ataxia, speech disturbances and memory impairment.
Known 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 and Fast Scan (T2 *) coronal images.
Intracranial and neck MRA were performed with 3D TOF and 2D TOF sequences, respectively.

OBSERVATION :

BRAIN :

Lacunar infarcts are noted in the pons, periatrial regions bilaterally, bilateral lentiform nuclei and thalami and in the corona radiata and centrum semiovale bilaterally.

There are ill-defined, hyperintense areas on the proton, T2 Weighted and FLAIR images in the periventricular white matter bilaterally and in the bilateral centrum semiovale. These lesions appear hypointense to normal white matter on the T1 Weighted images. Volume loss is noted in the right high frontal region with an area of cystic encephalomalacia in that region, probably the sequelae of a previous vascular insult.

There is mild dilatation of both the lateral, third and the fourth ventricles. There is prominence of the cerebral cortical sulci, cerebellar folia and the basal cisternal spaces bilaterally. There is no shift of the midline structures.
..2/.





- 2 - Scan-00009/31

INTRACRANIAL MRA :

There is slight narrowing of the distal segment of the left vertebral artery and the distal segments of the middle cerebral artery bilaterally.

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

The left vertebral artery in the neck appears slightly smaller in diameter as compared to the right.

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, periatrial regions bilaterally, bilateral lentiform nuclei and thalami and in the corona radiata and centrum semiovale bilaterally.

2. Altered signal in the periventricular white matter bilaterally and in the bilateral centrum semiovale represents ischemic changes.

3. Volume loss in the right high frontal region with an area of cystic encephalomalacia in that region, probably the sequelae of a previous vascular insult.

4. Slight narrowing of the distal segment of the left vertebral artery and the distal segments of the middle cerebral artery bilaterally, may be atherosclerotic in etiology.

hs/sb/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyzhi Shlmn / M / 50 yrs.
Referred by : Dr. Abc Xyzwant.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O left sided hemiplegia 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.

5 mm thick T1 Weighted sagittal images.

OBSERVATION :

There is evidence of gyral thickening in the right fronto-parietal lobes. These are hyperintense on all the pulse sequences and there is involvement of the cortex and subcortical white matter. This lesion is parafalcine in location and would represent a haemorrhagic infarct (? venous).

There are fairly well-defined areas which are nearly isointense to CSF on all the pulse sequences within the right fronto-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. This lesion in toto would represent an area of cystic encephalomalacia. Resultant volume loss is noted.

There are multiple small areas of hyperintensity on the proton, T2 Weighted and FLAIR images in the fronto-parietal white matter and these are ischemic in etiology.
Scan-00008



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

There is a suggestion of thrombosis with recanalization of the sigmoid and transverse sinuses on the right side and lower aspect of superior sagittal sinus.

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.

IMPRESSION :

Haemorrhagic infarct in the right fronto-parietal parafalcine lobes, ? venous, with probable thrombosis with recanalization of the sigmoid and transverse sinuses on the right side and lower aspect of superior sagittal sinus.