hs/sb/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyz.Nasir Shlmn / M / 5 yrs.
Referred by : Dr. Abc Xyzwant.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O TBM with hydrocephalus. VP shunt done 1 month back.
C/O rigidity of BUE and BLE since 1 month.

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 a ventriculostomy tube coursing through the right parietal lobe with the tip lying within the frontal horn of the left lateral ventricle.

Concavo-convex shaped lesions are seen to overlie both the cerebral hemispheres. These lesions are hyperintense to CSF on all the pulse sequences. Also seen are areas of hyperintensity on all the pulse sequences within these lesions. These lesions would represent extracerebral (subdural) collections of fluid and blood. There is resultant indentation upon the underlying brain parenchyma. Multiple hypointense areas with susceptibility artifacts and fluid level on all the pulse sequences are seen within the extracerebral collection on the right side and these would represent air.

Multiple hypointense lesions on the proton, T2 Weighted and FLAIR images are seen within both the cerebellar hemispheres and these may represent granulomas. A hyperintense lesion on the proton and T2 Weighted images is seen in the region of the left peripontine cistern with resultant indentation upon the pons.



There is evidence of a lesion which is hypointense with a hyperintense rim on the T1 Weighted images and predominantly hyperintense on the T2 Weighted images within the left frontal lobe and this would represent a subacute hematoma. There is mild perilesional edema with indentation upon the frontal horn of the left lateral ventricle.

An area of hypointensity on the T1 Weighted images which turns hyperintense on the proton, T2 Weighted and FLAIR images is seen within the left lentiform nucleus and head of the left caudate nucleus. This is most likely ischemic in etiology.

Lacunar infarcts (iso to hyperintense to CSF) are seen within the region of the anterior limb and genu of the right internal capsule and the right lentiform nucleus.

The frontal horn, body and atrium of the right lateral ventricle are seen to be compressed as a result of the right extracerebral collection of fluid/blood. There is a mild shift of the midline structures to the left side. There is mild fullness of the left lateral and fourth ventricles and the temporal horn of the right lateral ventricle.

IMPRESSION :

1. Post-shunt status.

2. Bilateral (right more than left) extracerebral (subdural) collection of fluid/blood overlying both cerebral hemispheres.






- 3 - Scan-00007


3. Space-occupying lesions within both the cerebellar hemispheres and in the region of the left peripontine cistern indenting upon the pons may represent tuberculomas in the given clinical setting of tuberculous meningitis.

4. Subacute hematoma in the left frontal lobe.

5. Areas of altered signal within the left lentiform nucleus and head of the left caudate nucleus most likely is ischemic in etiology.

6. Lacunar infarcts within the region of the anterior limb and genu of the right internal capsule and the right lentiform nucleus.

7. Air within the extracerebral collection on the right side.

hs/sb/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyzkant Belmn / M / 43 yrs.
Referred by : Dr. Abc Xyzchale.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O giddiness since 8-10 days.
C/O left UMN facial palsy with left sided hemiplegia since 4 days.
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.

5 mm thick T1 Weighted sagittal images.

OBSERVATION :

There are small areas of hyperintensity on the proton, T2 Weighted and FLAIR images within the pons, left middle cerebellar peduncle and both cerebral peduncles. These are iso to hypointense to normal white matter on the T1 Weighted images and are most likely ischemic in etiology.

Prominent perivascular spaces are noted within the brainstem and both cerebral hemispheres. Also seen is mild prominence of the cerebral cortical sulci bilaterally.

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.
Scan-00006


Inflammatory changes are seen within the right maxillary sinus, ethmoidal air cells and frontal sinus.

IMPRESSION :

Areas of altered signal within the pons, left middle cerebellar peduncle and both cerebral peduncles are most likely ischemic in etiology.

hs/sb/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyz Salmn / F / 13 yrs.
Referred by : Dr. Abc Xyzwant.
Examination : M.R.I. of the Brain and Spine.

CLINICAL PROFILE :

C/O fever since 2 1/2 months.
C/O headaches and seizures 1 1/2 months back.
H/O Pulmonary kochs since 00.00.00. On AKT since then.
H/O VP shunt 18 days back.

EXAMINATION :

The brain was scanned as requested using 5 mm thick T2 Weighted axial images.

The cervico-dorsal spine was scanned as requested using 4 mm thick T1 Weighted and T2 Weighted sagittal images.

The dorso-lumbar spine was scanned as requested using 5 mm thick T1 Weighted and T2 Weighted sagittal images and 5 mm thick T2 Weighted axial images.

OBSERVATION :

BRAIN :

There is a focal hyperintensity on the T2 Weighted images within the right cerebral peduncle.

Areas of hyperintensity are noted within the left lentiform nucleus and the white matter adjacent to the left frontal horn.

There is mild fullness of the ventricular system.

A ventriculostomy shunt tube is seen to course through the right parietal lobe with the tip of the tube lying within the right frontal horn.



There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.

Hypointense areas with susceptibility artifacts and fluid level on all the pulse sequences are seen within the frontal horns of both the lateral ventricles and these would represent air.

SPINE :

A small postero-central disc herniation is seen to indent the thecal sac at the L1-L2 level.

The L1-L2, L2-L3 and L3-L4 intervertebral discs show loss of water content.

The rest of the cervico-dorso-lumbar intervertebral discs show normal signal intensity.

The cervico-dorso-lumbar vertebral bodies show normal signal intensity.

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.

IMPRESSION :

1. Post-shunt status.

2. Mild fullness of the ventricular system.
..3/.











- 3 - Scan-00005



3. Areas of altered signal within the right cerebral peduncle, the left lentiform nucleus and the white matter adjacent to the left frontal horn may represent ischemic changes.

4. A small postero-central disc herniation at the L1-L2 level.

5. Air within the frontal horns of both the lateral ventricles.

hs/sb/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyzchal Palmn / M / 6 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O GTC seizures since the age of 1 year.
Known C/O neurocysticercosis.
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.
3 mm thick T1 Weighted and T2 Weighted coronal images.
5 mm thick T1 Weighted sagittal images.

OBSERVATION :

There is seen an approximately 2.0 x 10.0 x 7.0 mms diameter sized well marginated, hyperintense lesion with a hypointense rim on the proton and T2 Weighted images in the right fronto-parietal, parafalcine region. This lesion is hypointense centrally, with a rim which is isointense to white matter on the T1 Weighted images. The margin is crenated. There is perilesional edema with effacement of the adjacent cortical sulcal spaces.

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 :

An approximately 2.0 x 10.0 x 7.0 mms diameter sized lesion in the right fronto-parietal, parafalcine region as described, follows the signal characteristics of a neurocysticercus in the colloid-vesicular stage.

As compared to the previous MRI (study no:00007) dated 00.00.00, there is a slight decrease in the size of the lesion.

hs/sb/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyza Glmn / F / 52 yrs.
Referred by : Dr. Abc Xyzatt.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE :

C/O neckpain radiating to BLE with tingling in the fingers of both hands.

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 :

Susceptibility artifacts due to dentures are noted.

There is loss of normal cervical lordosis.

A small postero-central disc herniation is seen to indent the thecal sac at the C4-C5 level.

Mild posterior disc bulges are noted at the C3-C4 and C5-C6 levels.

There appears to be an enlarged right paratracheal lymph node. The right lobe of the thyroid gland is larger than the one on the left.

The cervical intervertebral discs show loss of water content.




The cervical vertebral bodies show areas of replacement of fatty marrow.

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 :

A small postero-central disc herniation at the C4-C5 level.

hs/sb/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyzra Walmn / F / 36 yrs.
Referred by : Dr. Abc Xyzwhale.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to BLE with paresthesias since 00.00.00.

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.

FEW IMAGES SHOW PATIENT MOTION.

OBSERVATION :

A small postero-central disc herniation is seen to indent the thecal sac at the L2-L3 level. This intervertebral disc shows loss of water content.

There are minimal posterior disc bulges at the L3-L4, L4-L5 and L5-S1 levels.

The L4-L5 and L5-S1 facet joints show degenerative changes.

The L3-L4, L4-L5 and L5-S1 intervertebral discs show slight loss of water content.

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

IMPRESSION :

1. A small postero-central disc herniation at the L2-L3 level.

2. Minimal posterior disc bulges at the L3-L4, L4-L5 and L5-S1 levels.

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

hs/sb/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyzo Blmn / M / 65 yrs.
Referred by : Dr. Abc Xyz Mehta.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O headaches, giddiness, gait imbalance since 15 days.
Also C/O fever with chills since June 0000.
Known hypertensive & diabetic. On Rx.
H/O Pulmonary Kochs detected 00.00.00. On AKT 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 foci of hyperintensity on the proton, T2 Weighted and FLAIR images within corona radiata and centrum semiovale bilaterally. These are iso to hypointense to normal white matter on the T1 Weighted images and are most likely ischemic in etiology.

Small areas with similar signal characteristics are noted in the periventricular white matter bilaterally.

There is mild fullness of the ventricular system. There is prominence of the cerebral cortical sulci and cerebellar folia bilaterally.

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 areas of altered signal intensity within the corona radiata, centrum semiovale and in the periventricular white matter bilaterally and these are most likely ischemic in etiology.

hs/sb/rg/nl
/21 Date : 00.00.00

Name of the Patient : Abc Xyz Shlmn / F / 21 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O seizures with mild MR since childhood.

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 are multiple small areas of hyperintensities on the proton and T2 Weighted images within the white matter in the fronto-parietal lobes bilaterally. These are iso to hypointense to normal white matter on the T1 Weighted images.

Note is made of a cavum septum pellucidum and vergae.

There is mild prominence of cerebellar folia bilaterally.

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 sphenoid sinus, ethmoidal air cells and both maxillary sinuses.








IMPRESSION :

The MRI features are suggestive of multiple areas of altered signal intensity within the white matter in the fronto-parietal lobes bilaterally and these are not specific for a single etiology (?? ischemic foci).

A contrast enhanced scan would be worthwhile, if clinically indicated.

hs/bv/rg.
Date : 00.00.00

Name of the Patient : Abc Xyz Khlmn / M / 50 yrs.
Referred by : Dr. Abc Xyzni.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to BLE with paresthesias since 6 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 :

There is mild retroplacement of the L5 vertebra over the S1 vertebra.

The lumbar intervertebral discs show loss of water content.

The L5-S1 intervertebral disc appears reduced in height.

A large postero-central disc herniation is seen to indent the thecal sac at the L2-L3 level. There is facetal and ligamentum flavum hypertrophy at this level with canal stenosis.

A small posterior disc herniation is seen to indent the thecal sac and narrow both neural foramina at the L5-S1 level.

A small posterior disc bulge is seen to indent the thecal sac and narrow both neural foramina at the L4-L5 level.

Small postero-central and left postero-lateral disc herniations are seen to indent the thecal sac and narrow the left neural foramen, respectively at the L3-L4 level.
..2/.




>

There is a left paracentral disc protrusion indenting the ventral aspect of the thecal sac at the L1-L2 level.

Bilateral far lateral (extraforaminal) disc herniations are noted at the L2-L3, L3-L4, L4-L5 and L5-S1 levels.

The remaining lumbar facet joints show degenerative changes. Mild ligamentum flavum hypertrophy is noted in the lumbar region.

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

Multipe Schmorls nodes are noted in the lumbar region. Focal fatty changes/Type II degenerative changes are seen within the S1 and lumbar vertebral bodies.

Small anterior disc herniations are seen in the lumbar region.

A cortical renal cyst is noted on the right side.

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-S2 level.

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

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








- 3 - Scan-00008


IMPRESSION :

The MRI features are suggestive of :

1. A large postero-central disc herniation at the L2-L3 level with canal stenosis.

2. A small posterior disc herniation at the L5-S1 level.

3. A small posterior disc bulge at the L4-L5 level with a tight canal.

4. Small postero-central and left postero-lateral disc herniations at the L3-L4 level with a tight canal.

5. A left paracentral disc protrusion at the L1-L2 level.

6. Facetal arthropathy and mild ligamentum flavum hypertrophy in the lumbar region.

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

hs/sb/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyzli Shlmn / M / 35 yrs.
Referred by : Dr. Abc Xyzngsarkar.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache with pain radiating to LLE and left gluteal region since 7 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 :

There is loss of normal lumbar lordosis. There slight retroplacement of the L5 vertebra over the S1 vertebra.

A large postero-central disc herniation with a peridiscal osteophyte is seen to indent the thecal sac at the L5-S1 level. A disc portion is seen to lie within the left lateral recess of the S1 vertebra with impingement of the traversing left S1 nerve root. A left postero-lateral (foraminal) disc herniation is seen to narrow the left neural foramina at the L5-S1 level. This intervertebral disc shows loss of water content.

Bilateral (left more than right) postero-lateral (foraminal) disc herniations are seen to narrow the neural foramina at the L4-L5 level.

Bilateral far lateral (extraforaminal) disc bulges are seen at the L3-L4, L4-L5 and L5-S1 levels.

The pedicles of the lower lumbar vertebrae appear to be congenitally short in their antero-posterior dimensions.
..2/.






The facet joints at the L4-L5 and L5-S1 levels appear slightly 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 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 :

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

IMPRESSION :

The MRI features are suggestive of :

1. A large postero-central disc herniation with a peridiscal osteophyte and canal stenosis at the L5-S1 level. A disc portion is seen to lie within the left lateral recess of the S1 vertebra with impingement of the traversing left S1 nerve root.

2. A left postero-lateral (foraminal) disc herniation
at the L5-S1 level.

3. Bilateral (left more than right) postero-lateral (foraminal) disc herniations at the L4-L5 level.

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

5. Slight facetal hypertrophy at the L4-L5 and L5-S1 levels.