ke/sb/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzen lmn / F / 81 yrs.
Referred by : Dr. Abc Xyznna / Dr. Abc Xyzah.
Examination : M.R.I. of the Right Shoulder.

CLINICAL PROFILE :

H/O fall 1 month back with pain in the right shoulder joint, swelling and inability to the lift the RUE since then.

EXAMINATION :

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

4 mm thick T1 Weighted and GRASS axial images.

4 mm thick T1 Weighted sagittal images.

4 mm thick T1 Weighted, Proton and T2 Weighted coronal images.

OBSERVATION :

There is a break in the cortex in the region of the greater tuberosity of the right humerus. Resultant avulsion fracture of the greater tuberosity is noted which is displaced slightly supero-laterally. Hypointense areas on the T1 Weighted images are seen in the greater tuberosity region which are seen to turn hyperintense on the proton, T2 Weighted and Gradient images and would represent bone edema/bruise in the given clinical setting. Fluid is seen in the subdeltoid and subacromion regions, within the right shoulder joint and along the bicipital tendon. Minimal fluid collection is also noted just anterior to the subscapularis muscle.

The supraspintous tendon is seen upto its insertion at the greater tuberosity. Intermediate signal on all the pulse sequences at its insertion may suggest tendinitis/tendon degeneration.

The visualized scapula appears normal. The glenoid labrum is unremarkable.
..2/.






Acromio-clavicular joint degeneration is noted.

The soft tissues around the right shoulder joint are unremarkable.

The visualized axilla is unremarkable.

IMPRESSION :

1. Avulsion fracture of the greater tuberosity.

2. Altered signal in the greater tuberosity region would represent bone edema/bruise in the given clinical setting.

3. Fluid in the subdeltoid and subacromion regions, within the right shoulder joint and along the bicipital tendon and minimal fluid collection just anterior to the subscapularis muscle.

4. Intermediate signal in the supraspinatous tendon would suggest tendinitis/tendon degeneration.

sb/ke/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyz lmn / F / 45 yrs.
Referred by : Dr. Abc Xyzlkarni / Dr. Abc Xyzhah.
Examination : M.R.I. of the Dorso-lumbar Spine.
(Post-contrast Study).
CLINICAL PROFILE :

C/O backache radiating to the LLE with paresthesias since 3-4 months.

EXAMINATION :

M.R.I of the dorso-lumbar spine was performed after administration of contrast, using the following parameters :

4 mm thick T1 Weighted sagittal images (with and without fat saturation).

3 mm thick T1 Weighted coronal images.

5 mm thick T1 Weighted axial images.

4 mm thick T1 Weighted sagittal images through the cervico-dorsal and lumbo-sacral regions.

OBSERVATION :

After contrast administration, there is seen linear enhancement along the posterior margin of the lower dorsal spinal cord over about D9 to D11 vertebral levels. A syrinx is noted in the lower dorsal spinal cord over the D9 to D11 levels, centrally, with irregularity of the margins over these levels. No enhancement is noted within the syrinx on this study.

The dorsal spinal cord proximal to the syrinx appears slightly smaller in calibre.





There is no focal area of abnormal enhancement in the cervico-dorsal spinal cord, in the lumbar region or along the meninges in these regions.

IMPRESSION :

Syrinx in the lower dorsal spinal cord over the D9 to D11 vertebral levels, centrally with irregularity of the margins of the cord and linear enhancement along the posterior margin of the cord over these levels (? enhancement along the posterior meninges over the D9 - D11 levels). Arachnoiditis is a likely possibility.

hs/ke/rg/nl
Date : 00.00.00

Name of the Patient : Abc XyzHlmn / F / 32 yrs.
Referred by : Dr. Abc Xyzlkaka.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O stress and (progressive) aggressive behaviour over the last 2 years.
H/O hypothyroidism since 5 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.

5 mm thick FLAIR coronal 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, 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 left maxillary sinus.

IMPRESSION :

Normal study of the Brain.

hs/sb/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzlmn / M / 20 yrs.
Referred by : Dr. Abc Xyzapadia.
Examination : M.R.I. of the Dorsal Spine.

CLINICAL PROFILE :

Known C/O Ewings sarcoma involving the pelvic bones.

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.

The lumbar spine was screened with 5 mm thick T1 Weighted sagittal images.

OBSERVATION :

There is evidence of a space-occupying lesion within the posterior epidural space over the D3-D4 to the D5-D6 levels. This lesion is of intermediate signal characteristics on the T1 Weighted images and shows mixed signal characteristics on the T2 Weighted images. It is seen to communicate with a larger lesion in the posterior mediastinum on the left side and the prevertebral region (in the upper and mid dorsal region) via the neural foramina at the D4-D5 and D5-D6 levels. The trachea, esophagus and aorta are displaced anteriorly and to the right. Also seen is involvement of the pedicles and articular pillar of the D4 and D5 vertebrae on the left side as well as the D4 and D5 vertebral bodies and the left D5 transverse process.

The posterior epidural lesion is seen to compress and displace the spinal cord anteriorly and to the right over the D3-D4 to the D5-D6 levels. The cord over these levels shows a hyperintense signal on the T2 Weighted images suggestive of cord edema/ischemia. There also appears to be involvement of the costo-vertebral joints and rib on the left side at the D4-D5 and D5-D6 levels.
..2/.






The left pedicle of the D12 vertebra is seen to be expansile and shows a hypointense signal on the T1 Weighted images.

The rest of the visualized dorsal vertebral bodies and intervertebral discs reveal normal signal intensity. The facet joints are unremarkable.

The conus medullaris terminates at the D12 level.

IMPRESSION :

In a known C/O Ewings sarcoma the MRI features are suggestive of secondary involvement of the D4 and D5 vertebrae with a posterior epidural component with cord compression and cord edema/ischemia over the D3-D4 to the D5-D6 levels. Also seen is a large mass lesion in the posterior mediastinum on the left side as described.

ke/sb/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyzi Plmn / F / 34 yrs.
Referred by : Dr. Abc Xyzrdhaman.
Examination : M.R.I. of the Sella & Perisellar Region.

CLINICAL PROFILE :

C/O acromegaly with pituitary adenoma. Operated on 00.00.00. Received 30 sittings of radiotherapy.

EXAMINATION :

M.R.I of the sella and perisellar region was performed using the following parameters :

3 mm thick T1 Weighted and T2 Weighted coronal images.

3 mm thick T1 Weighted sagittal images.

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

OBSERVATION :

There is still seen ballooning of the sella. The pituitary gland is seen along the floor of the sella and measures approximately 6.0 mms in height. An approximately 5.0 mms sized extra tissue is noted in the close relation to the optic chiasm and right optic nerve in the suprasellar cistern. The pituitary stalk is minimally pulled to the left. There is slight herniation of the suprasellar cistern and optic chiasm into the sella. The cavernous sinuses are unremarkable. The cavernous segment of the internal carotid arteries show normal flow void signal.

Inflammatory/post-operative changes are noted in the sphenoid sinus and nasal cavity.






A hyperintense signal is seen on the T1 Weighted images in the region just adjacent to the body of the right lateral ventricle and the head of the caudate nucleus on the right side. This is seen to remain hyperintense on the T2 Weighted images and may represent altered blood/paramagnetic substances.

Inflammatory changes are noted in the left middle ear cavity/tympanic membrane.

IMPRESSION :

1. Post-operative status.

2. The pituitary gland is seen along the floor of the sella which is ballooned.

3. Altered blood/paramagnetic substances in the region just adjacent to the body of the right lateral ventricle and the head of the caudate nucleus on the right side.

As compared to the previous MRI (study no:908) dated 00.00.00, there is now altered blood/paramagnetic substances in the region just adjacent to the body of the right lateral ventricle and the head of the caudate nucleus on the right side. There is no significant change in the sella/perisellar region. There is no significant change in the sella/perisellar region.

hs/ke/rg/nl
Date : 00.00.00

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

CLINICAL PROFILE :

C/O backache radiating to the RLE since 1 month.

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 it is as marked on the film. Please correlate with plain radiographs.

There is mild forward translation of the L5 vertebra over the S1 vertebra. The L5-S1 intervertebral disc shows loss of water content.

A posterior disc bulge with small peridiscal osteophytes is noted at the L5-S1 level. There is a posterior disc bulge at the L4-L5 level.

There appears to be spina bifida at the L5 level.

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 D12 level and the thecal sac terminates at the S1 level.
- 2 - Scan-00009


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

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

The sacro-iliac joints were screened with 5 mm thick STIR coronal images. Hyperintense signal is seen within the bones adjacent to the right sacro-iliac joint with involvement of the joint per se.

IMPRESSION :

The MRI features are suggestive of :

1. Sacralization of the L5 vertebra and it is as marked on the film. Please correlate with plain radiographs.

2. Posterior disc bulges at the L4-L5 and L5-S1 levels
with small peridiscal osteophytes at the L5-S1 level.

3. Altered signal within the bones adjacent to the right sacro-iliac joint with involvement of the joint per se most likely represents sacro-ilitis. A dedicated study of the sacro-iliac joint may be worthwhile.

ke/sb/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyz D. Palmn / M / 25 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O headaches and tremors of BUE and BLE since 2 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.

5 mm thick FLAIR coronal images.

MR cisternogram in the coronal plane through the region of interest.

5 mm thick T1 Weighted sagittal images.

OBSERVATION :

There is a well-defined mass lesion in the right parieto-occipital region just lateral to the occipital horn of the right lateral ventricle. This lesion is predominantly hypointense on the T1 Weighted images with few intermediate signal intensity areas in the right lateral and posterior aspect of the lesion. This lesion is seen to turn hyperintense on the proton and T2 Weighted images with the intermediate signal portion turning hypointense on the proton and T2 Weighted images and hyperintense on the FLAIR images. There is no mass effect or perilesional edema. The lesion measures approximately 2.0 x 2.1 x 2.0 cms.

The left 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-00008



IMPRESSION :

The MRI features are suggestive of a mass lesion in the right parieto-occipital region just lateral to the occipital horn of the right lateral ventricle measuring approximately 2.0 x 2.1 x 2.0 cms. The differential diagnosis would include :

1. Astrocytoma.

2. Demyelinating plaque - less likely.

A contrast enhanced scan would be worthwhile.

hs/ke/nl/rg.
Date : 00.00.00

Name of the Patient : Abc XyzJlmn / M / 56 yrs.
Referred by : Dr. Abc Xyzah.
Examination : Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O 3-4 episodes of giddiness with gait ataxia on 00.00.00 & 00.00.00.

EXAMINATION :

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

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

OBSERVATION :

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

There is mild fullness of both the lateral ventricles. The third and the fourth ventricles are normal. There is mild prominence of the cerebral cortical sulci and cerebellar folia bilaterally.
The basal cisternal spaces are unremarkable. There is no shift of the midline structures.

INTRACRANIAL MRA :

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

NECK MRA :

The common carotid arteries and their extracranial branches appear normal bilaterally. There are no vessel wall irregularities or stenosis of the vessels noted.
..2/.







IMPRESSION :

The MRI features are suggestive of :

1. Mild cerebral and cerebellar atrophy.

2. No significant abnormality is detected on the intracranial and neck MRA on this study.

ke/bv/nl.rg.
Date : 00.00.00

Name of the Patient : Abc XyzSulmn / F / 39 yrs.
Referred by : Dr. Abc XyzV. Shah.
Examination : M.R.I. of the Left Knee Joint.

CLINICAL PROFILE :

C/O pain and swelling over the left knee since 1 1/2 months.

EXAMINATION :

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

4 mm thick T1 Weighted, proton and GRASS sagittal images.

4 mm thick T1 Weighted and T2 Weighted coronal images.

5 mm thick GRASS axial images.

OBSERVATION :

Menisci :

A curvilinear hyperintense signal is seen in the posterior horn of the medial meniscus on all the pulse sequences not reaching upto the articular surface and would represent Grade II meniscal signal (meniscal degeneration).

The anterior and posterior horns of the lateral menisci and the anterior horn of the medial meniscus reveal normal configuration and signal characteristics.

Cruciate Ligaments :

The anterior and posterior cruciate ligaments show normal contour and signal characteristics.
Scan-00006



Collateral Ligaments and Patellar tendons :

The medial and lateral collateral ligaments and the patellar tendon are normal.

Hoffas Fat Pad :

The Hoffas fat pad is normal.

Articular cartilage and bones :

The articular cartilage overlying the patella, tibia and femur appears normal.

Minimal fluid is seen just lateral to the lateral condyle. Tortuous vessels are seen in the popliteal region.

Patella and Patellar Tracking :

There is lateral tilt of the patella bilaterally with a large lateral patellar facet suggestive of Wiberg Type II patella.

Patellar tracking was performed from 0 (extension) to 80 degrees (flexion) at the knee joint. There is lateral tilt of the patella bilaterally which is seen to subluxate medially and is in normal position at 60 degrees. This would be suggestive of lateral - medial subluxation.

IMPRESSION :

1. Grade II meniscal signal (meniscal degeneration) of the
posterior horn of the medial meniscus.

2. Lateral - medial subluxation of the Patella.

ke/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyz Kulilmn / F / 10 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O seizures with MR.
Known C/O tuberous sclerosis.

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 T1 Weighted and T2 Weighted coronal images.

OBSERVATION :

There is thickening of the gyri in the frontal parafalcine region bilaterally. This is hypointense to normal grey matter on the T1 Weighted images and turns hyperintense on the proton, T2 Weighted and FLAIR images.

Similar lesions are seen in the left parietal region, bilateral frontal region and right temporal lobe.

Both the lateral ventricles show fullness. 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.

IMPRESSION :

In a known C/o tuberous sclerosis, altered signal in the frontal parafalcine region bilaterally, in the left parietal region, bilateral frontal regions and right temporal lobe can be seen with cortical tubers.