sb/ke/nl/rg.
Date : 00.00.00 Name of the Patient : Abc Xyzao Plmn / M / 57 yrs.Referred by : Dr. Abc Xyzrani.Examination : M.R.I. of the Brain.
CLINICAL PROFILE : H/O craniotomy for left high parietal parafalcine SOL. Partial excision of SOL done 00.00.00. Detected to have glioblastoma multiforme. Received radiotherapy from 00.00.00 to 00.00.00. Follow-up MRI on 00.00.00 revealed a communicating hydrocephalus with periventricular CSF ooze. VP shunt done on 00.00.00.
Now admitted with altered sensorium with right hemiplegia.

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.
SOME IMAGES SHOW PATIENT MOTION.
OBSERVATION :There is evidence of a left high parietal craniectomy.
There is seen a cystic lesion in the left posterior parietal and left deep parietal region, which follows CSF signal on all pulse sequences. This lesion is just deep to the craniectomy site and extends nearly upto the left lateral ventricular wall and may represent the site of previous surgery. This lesion shows focal hyperintense signal on all the pulse sequences which may represent extracellular methemoglobin.
Scan-00003

There is diffuse, hyperintense signal on the proton, T2 Weighted and FLAIR images in the white matter in the left fronto-temporo-parietal region and in the left thalamus, subthalamic region and in the left cerebral peduncle. This signal appears hypointense on the T1 Weighted images. Resultant sulcal space effacement is noted with compression of the left lateral and the third ventricles, effacement of the left ambient cistern and mild shift of the midline structures to the right. No focal lesion is identified within the above described diffuse signal change. Involvement of the body of the corpus callosum is noted.

There is mild dilatation of the right lateral and fourth ventricles. Periventricular white matter hyperintense signal
on the T2 Weighted images may represent periventricular CSF ooze. The tip of the shunt tube is noted in the body of the right lateral ventricle.
No obvious vascular anomaly is identified on this study.IMPRESSION :
1. Post-operative, post-shunt status.

2. An area of cystic encephalomalacia in the left posterior parietal and left deep parietal region which may be the sequelae of previous surgery.

3. Diffuse altered signal in the left fronto-temporo-parietal white matter and in the left thalamus, subthalamic region and left cerebral peduncle as described, is not specific for a single etiology. This may either represent post-radiation changes or diffuse infiltrative tumor tissue. Involvement of the body of the corpus callosum is noted.
..3/.











- 3 - Scan-00003




4. Mild dilatation of the right lateral ventricle with periventricular hyperintense signal may represent periventricular CSF ooze - ? malfunctioning shunt. The tip of the shunt tube is noted in the body of the right lateral ventricle.

5. Dilated fourth ventricle.

A contrast enhanced scan would be worthwhile.

As compared to the previous MRI (study no:00000) dated 00.00.00, the patient is now status post-shunt. Right lateral and fourth ventricle still appear dilated with periventricular CSF ooze. The left lateral and third ventricles are compressed and effaced by the altered signal in the white matter in the left temporo-parietal region. This signal change may either represent post-radiation changes or may represent infiltrative tumor tissue. Body of the corpus callosum is now involved.

hs/sb/rg.
Date : 00.00.00

Name of the Patient : Abc Xyz lmn / F / 32 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O severe backache radiating to the LLE since 2 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 are very mild posterior disc bulges at the L3-L4, L4-L5 and L5-S1 levels.

The L3-L4 intervertebral disc shows slight loss of water content.

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

The uterus is retroverted and slightly bulky.

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 :

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

IMPRESSION :

The MRI features are suggestive of very mild posterior disc bulges at the L3-L4, L4-L5 and L5-S1 levels.

ke/hs/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzjprasad Palmn / M / 40 yrs.
Referred by : Dr. Abc Xyzhtekar.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O radicular pain to the LLE since 2 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 sacralization of the L5 vertebra and the L1 vertebral body is as marked on the film

There is a left paracentral disc extrusion at the L4-L5 level with left antero-lateral indentation of the thecal sac. There is inferior migration of the extruded disc portion which is seen to lie in the left lateral recess of the L5 vertebra with impingement of the traversing left L5 nerve root. This disc shows loss of water content. Small posterior peridiscal osteophytes are also noted at this level.

A posterior disc herniation is seen at the D12-L1 level. A Schmorls node is noted at the postero-superior asepct of the D12 vertebral body.

Type II degenerative changes are seen in the antero-superior portion of the L5 vertebra.
Scan-00001



The rest of the lumbar vertebral bodies and the remaining 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 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 :

19.0 mm at L1-L2
18.0 mm at L2-L3
17.0 mm at L3-L4
11.0 mm at L4-L5
13.0 mm at L5-S1.

IMPRESSION :

1. Sacralization of the L5 vertebra.

2. A left paracentral disc extrusion at the L4-L5 level with inferior migration of the extruded disc portion which is seen to lie in the left lateral recess of the L5 vertebra with impingement of the traversing left L5 nerve root.

3. A posterior disc herniation at the D12-L1 level.

ke/sb/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzra Palmn / M / 35 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to BLE with 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.

OBSERVATION :

There is a small left postero-lateral disc herniation with peridiscal osteophytes at the L5-S1 level with indentation upon the exiting left S1 nerve root.

A large right postero-lateral disc herniation is seen at the L2-L3 level with antero-lateral indentation of the thecal sac. An extruded disc portion is seen to migrate superiorly and inferiorly into the right lateral recess of the L2 and L3 vertebral bodies impinging the right L2 and L3 nerve roots. The L2-L3 intervertebral disc shows loss of water content.

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

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

The conus medullaris terminates at the D12-L1 level and the thecal sac terminates at the S2 level.
..2/.






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

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

IMPRESSION :

The MRI features are suggestive of :

1. A small left postero-lateral disc herniation with peridiscal osteophytes at the L5-S1 level with indentation upon the exiting left S1 nerve root.

2. A large right postero-lateral disc herniation at the L2-L3 level with an extruded disc portion seen to migrate superiorly and inferiorly into the right lateral recess of the L2 and L3 vertebral bodies impinging the right L2 and L3 nerve roots.

ke/sb/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzkant Shelmn / M / 47 yrs.
Referred by : Dr. Abc Xyzhta.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE :

C/O neckpain with swelling on the left side of the neck.
C/O neckpain with stiffness of the neck since 3 months.

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 a fairly large, well-defined lesion in the posterior triangle of the neck on the left side, laterally measuring approximately 3.0 x 3.5 x 5.2 cms. This lesion is seen to extend from the C2-C3 to C6-C7 levels. This lesion is hypointense in the centre, with hyperintense periphery on the T1 Weighted images. This is seen to turn hyperintense with a hypointense periphery on the Gradient images. Similar smaller lesions are noted anteriorly, posterior to the carotid sheath. There is resultant displacement of the carotid sheath anteriorly. Hyperintense signal is also noted in the soft tissues adjacent to the carotid sheath on the left side at the C1 to C3 levels.

The tip of the odontoid process appears hypointense on the T1 Weighted images and is seen to turn heterogeneously hyperintense on the T2 Weighted images. A small posterior disc bulge with peridiscal osteophyte is noted at the C5-C6 level with anterior indentation of the thecal sac. Small posterior disc bulges are seen at the C4-C5 and C6-C7 levels. The cervical intervertebral discs show loss of water content.
..2/.






The rest of 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 cervico-medullary junction is unremarkable.

Enlarged lymphnodes are noted deep to the sternocleidomastoid muscles, bilaterally.

IMPRESSION :

The MRI features are suggestive of :

1. A large abscess measuring approximately 3.0 x 3.5 x 5.2 cms. in the posterior triangle of the neck on the left side, laterally, with probable small necrotic nodes.

2. Altered signal in the odontoid process most likely is
infective in etiology, probably tuberculous.

3. A small posterior disc bulge with peridiscal osteophyte at the C5-C6 level.

4. Small posterior disc bulges at the C4-C5 and C6-C7 levels.

5. Enlarged lymphnodes deep to the sternocleidomastoid muscles, bilaterally.

ke/hs/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyz Setlmn / F / 50 yrs.
Referred by : Dr. Abc Xyzni.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O tinnitus in the left ear since 4 years.

EXAMINATION :

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

5 mm thick T1 Weighted, proton and T2 Weighted axial images.
MR cisternogram in the coronal plane.
5 mm thick T1 Weighted sagittal images.

OBSERVATION :

There is a small hyperintense focus in the right paraatrial white mater (se/im:102/13) on the proton and T2 Weighted images. This is iso to hypointense to the white matter on the T1 Weighted images and would represent an ischemic focus.

The seventh and eighth cranial nerve complex on either side are unremarkable.

There is mild prominence of the cerebral cortical sulcal spaces 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.

IMPRESSION :

The MRI features are suggestive of focus of altered signal intensity in the right paraatrial white matter is most likely ischemic in etiology.

ke/hs/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyza Sulmn / F / 25 yrs.
Referred by : Dr. Abc Xyzhtekar.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache with pain radiating to the RLE with 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.

OBSERVATION :

There is a transepiphyseal herniation at the antero-superior aspect of the L4 vertebral body. The L3-L4 intervertebral disc shows loss of water content.

Hypointense signal on the T1 Weighted images which turns hyperintense on the T2 Weighted images is seen within the pedicle and articular pillar of the L4 vertebra on the right side.

The rest of the lumbar vertebrae and the remaining 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 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 :

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

IMPRESSION :

1. Altered signal within the pedicle and articular pillar of the L4 vertebra on the right side as described. This is not specific for a single diagnosis (? inflammatory/infective or neoplastic).

2. A transepiphyseal herniation at the antero-superior aspect of the L4 vertebral body.

ke/sb/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzkar Mhlmn / M / 40 yrs.
Referred by : Dr. Abc Xyz.
Examination : M.R.I. of the Dorso-lumbar Spine.

CLINICAL PROFILE :

Known C/O Hodgkins disease. Received chemotherapy.
C/O backache radiating to BLE since 2-3 months.
C/O paraplegia since 15-20 days.
H/O being hit by an object 45 days ago.

EXAMINATION :

M.R.I of the dorso-lumbar 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 replacement of the normal marrow of the L4, S1 and S2 vertebral bodies by hypointense areas on the T1 Weighted images. These are seen to turn heterogeneously hyperintense on the T2 Weighted images. The pedicles of the L4 vertebral body bilaterally and the left pedicle of the L1 vertebra also show altered signal. There is prevertebral soft tissue extension at the S1 and S2 levels. Epidural extension into the left lateral recess of the S1 vertebra is seen with encasement of the traversing left S1 nerve root.

Epidural extension is also noted posterior to the L4 vertebral body with encroachment into the left neural foramina at the L4-L5 level and encasement of the foraminal portion of the left L4 nerve root.

A large posterior epidural soft tissue lesion is seen at the L1 and L2 levels which measures approximately 4.4 x 1.2 cms. This is slightly hyperintense on the T1 Weighted images and turns heterogeneously hyperintense on the T2 Weighted images. There is resultant compression on the posterior aspect of the thecal sac. Involvement of the spinous process of the L1 is noted.
..2/.



A small posterior disc herniation is seen at the L5-S1 level. The lumbar intervertebral discs show slight loss of water content.

The rest of the lumbar vertebral bodies reveal normal signal intensity. The facet joints at the L5-S1 level appear hypertrophied.

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 :

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

The dorsal spine was screened with 5 mm thick T1 Weighted sagittal and axial images. There is replacement of the normal marrow of the D4 vertebral body by hypointense areas. Right paravertebral soft tissue extension is noted. A small right lateral epidural lesion is seen to displace the spinal cord to the left. The visualized spinal cord shows normal signal intensity. The iliac bone and the sacral ala on the right side also shows hypointense areas.

IMPRESSION :

In a known C/O lymphoma, the MRI features are suggestive of altered signal of the D4, L4, S1 and S2 vertebral bodies, iliac bone and sacral ala on the right side, with paravertebral and epidural soft tissue extensions as described.

These most likely represent lymphomatous deposits.

ke.hs/nl/rg.
Date : 00.00.00

Name of the Patient : Abc XyzPlmn / M / 53 yrs.
Referred by : Dr. Abc Xyzrekh.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache with pain radiating to the LLE and occasionally in the RLE.
Alleged H/O fall 1 month back.

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 large postero-central disc herniation at the L4-L5 level with anterior compression of the thecal sac and resultant canal stenosis. Posterior peridiscal osteophytes are also noted at this level.

Small postero-central disc herniations are noted at the L3-L4 and L5-S1 levels with anterior indentation of the thecal sac. A posterior disc bulge is noted at the L2-L3 level.

The L2-L3, L3-L4, L4-L5 and L5-S1 intervertebral discs show loss of water content.

Mild facetal hypertrophy is noted at the L4-L5 and L5-S1 levels.

The lumbar vertebral bodies reveal normal signal intensity. The rest of the facet joints and the visualized pre and paravertebral soft tissues are unremarkable.
..2/.








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
14.0 mm at L3-L4
7.0 mm at L4-L5
12.0 mm at L5-S1.

IMPRESSION :

1. A large postero-central disc herniation with posterior peridiscal osteophytes at the L4-L5 level with resultant canal stenosis.

2. Small postero-central disc herniations at the L3-L4 and L5-S1 levels.

3. A posterior disc bulge at the L2-L3 level.

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

ke/sb/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyz Awalmn / F / 35 yrs.
Referred by : Dr. Abc Xyzwhale.
Examination : M.R.I. of Both Hips.

CLINICAL PROFILE :

C/O pain in the left hip joint since 6 months.

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 a well-defined lesion in the neck of right femur near the greater trochanter (but sparing the same) measuring approximately 1.5 x 2.0 x 2.8 cms. This lesion is hypointense to normal marrow on the T1 Weighted images and is seen to turn hyperintense on the T2 Weighted and STIR images. The cortex appears to be intact. There is no surrounding edema. Similar lesion is noted in the roof of the acetabulum on the left, measuring approximately 2.0 cms in diameter.

The femoral heads and the right acetabulum reveal normal signal intensity. There is no obvious bony destruction or erosions noted. The articular cartilages are unremarkable. There is no effusion within both the hip joints.

Slight decrease in bulk of the muscles around the left hip joint is noted.

The visualized pelvis is normal.


IMPRESSION :

Lesion in the neck of the right femur, near the greater trochanter measuring approximately 1.5 x 2.0 x 2.8 cms and in the roof of the left acetabulum as described are not specific for a single etiology. The possibilities to be considered are simple bone cysts, fibrous dysplasia or brown tumors. The possibility of a malignant lesion seems less likely.