ke/sb/rg/nl
Date : 00.00.00

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

CLINICAL PROFILE :

C/O seizures since 6-7 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.

3 mm thick T1 Weighted and T2 Weighted coronal images.

OBSERVATION :

There is a small hypointense speck in the left high frontal region (se/im 108/9-10) on the proton and T2 Weighted images. This is hypointense to normal white matter on the T1 Weighted images.

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 bilateral maxillary sinusitis and inflammatory changes in the ethmoidal air cells and left mastoid air cells.

IMPRESSION :

1. A small hypointense lesion on all the pulse sequences in the left high frontal region may represent a calcified granuloma.

2. Mild dilatation of both the lateral ventricles.

ke/sb/rg.
Date : 00.00.00

Name of the Patient : Abc XyzKlmn / M / 45 yrs.
Referred by : Dr. Abc Xyzvani
Examination : M.R.I. of the Dorso-lumbar Spine.

CLINICAL PROFILE :

C/O acute leukemia detected 4 weeks back.
C/O generalized weakness with backache.

EXAMINATION :

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

4 mm thick T1 Weighted and T2 Weighted (with fat saturation) sagittal images.

7 mm thick T1 Weighted and T2 Weighted axial images.

OBSERVATION :

There are ill-defined, hypointense areas on the T1 Weighted images, replacing the normal fatty marrow of the visualized dorsal vertebrae. These appear isointense to normal vertebrae
on the T2 Weighted images.

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

The visualized dorso-lumbar spinal cord reveals normal signal intensity.

The conus medullaris terminates at the D12-L1 level.

Similar signal intensity changes are noted in the visualized lumbar vertebrae and the pelvic bones. A small posterior disc herniation is seen at the L5-S1 level.
- 2 - Scan-00001

IMPRESSION :

Altered signal of the visualized dorsal and lumbar vertebral bodies and pelvic bones as described, in a known C/O acute leukemia, is not specific for a single etiology. These changes may either be due to replacement of the normal fatty marrow by hematopoietic marrow or may represent leukemic infiltrates.

ke/sb/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyz K. Tlmn / M / 35 yrs.
Referred by : Dr. Abc Xyzannu.
Examination : M.R.I. of the Face.

CLINICAL PROFILE :

C/O RTA in July 0000 with multiple facial fractures and CSF leak.

EXAMINATION :

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

5 mm thick T1 Weighted, proton and T2 Weighted axial images.
5 mm thick T2 Weighted axial images with fat saturation.
4 mm thick T1 Weighted and STIR coronal images.
5 mm thick T1 Weighted sagittal images.

OBSERVATION :

There appears to be old fractures in the frontal bones bilaterally in the region of the lamina papyracea on the right side. The inferior wall of the right orbit is seen to be bulging into the right maxillary antrum. There is discontinuity of the superior wall of the orbit. Hyperintense signal is seen in the frontal sinuses bilaterally on all the pulse sequences.

Hyperintense areas are seen in the soft tissues around the right orbit on the T2 Weighted images (se/im 106/11).

Old fractures of the nasal bone is also noted.

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








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.

The optic nerves show normal signal intensity.

IMPRESSION :

The MRI features are suggestive of old fractures of the frontal bone, right orbit and nasal bone as described.

No intracranial lesion is detected.

ke/sb/rg/nl
Date : 00.00.00

Name of the Patient : Abc XyzLakhlmn / F / 52 yrs.
Referred by : Dr. Abc Xyzdi.
Examination : M.R.I. of the Dorso-lumbar Spine.

CLINICAL PROFILE :

C/O backache since 3-4 months which has increased since 1 month,
with occasional tingling in the LLE.

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 D12 and the L1 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 these vertebrae are involved by this pathologic process. There is prevertebral soft tissue extension over the D12 and L1 vertebral levels with involvement of the left psoas muscle at the L1 level which shows a hyperintense signal with a hypointense centre on the T1 Weighted images and turns hyperintense on the T2 Weighted images. Very minimal left antero-lateral epidural extension is seen at the D12-L1 and the L1 levels. The D12-L1 intervertebral disc is reduced in height and is also involved.

The rest of the visualized dorso-lumbar vertebral bodies and remaining intervertebral discs reveal normal signal intensity. The facet joints and the visualized paravertebral soft tissues are unremarkable.
Scan-00009

The visualized dorso-lumbar spinal cord reveals normal signal intensity.

The conus medullaris terminates at the L1-L2 level.

Focal altered signal in the S1 body is ? Schmorls node, focal osteitis.

IMPRESSION :

The MRI features are suggestive of a pathologic process involving the D12 and L1 vertebral bodies with extensions as described. This most likely represents an infective etiology like tuberculosis.

The possibility of this being a neoplastic process like small cell tumor cannot be entirely ruled out though less likely.

ke/sb/rg.
Date : 00.00.00

Name of the Patient : Abc Xyz Mlmn / F / 54 yrs.
Referred by : Dr. Abc Xyzdial.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O swelling over the right eye since 1 1/2 months with pain and numbness.

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 STIR coronal images.

3 mm thick T2 Weighted axial images with fat saturation.

OBSERVATION :

There is a small focal hypointense area in the left corona radiata and left posterior parietal deep white matter on the T1 Weighted images which is seen to turn hyperintense on the proton and T2 Weighted images (se/im. 102/14, 103/14) and may represent an ischemic focus.

The fat superior and lateral to the eyeball on the right side shows hypointense signal on the T1 Weighted images which is seen to turn hyperintense on the T2 Weighted and STIR images. Similar signal is also noted in the subcutaneous tissue in the right periorbtial region.

The optic nerves show normal signal intensity.

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 :

1. Ischemic focus in the left corona radiata and left posterior parietal deep white matter.

2. Altered signal superior and supero-lateral to the right eyeball and in the right periorbital region as described, is not specific for a single etiology. This most likely is inflammatory in etiology. A lacrimal gland inflammatory lesion may be considered as a differential diagnosis.

ke/sb/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyz Kandlmn / F / 24 yrs.
Referred by : Dr. Abc Xyzonawalla.
Examination : M.R.I. of the Dorsal Spine.

CLINICAL PROFILE :

C/O backache with paresthesias in the LLE since 1 1/2 months.
Also H/O fever since 15 days.

EXAMINATION :

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

4 mm thick T1 Weighted and T2 Weighted sagittal images.

6 mm thick T1 Weighted and T2 Weighted axial images.

OBSERVATION :

There is wedging of the D8 vertebral body. There is replacement of the normal marrow of the D5, D6 and the D8 vertebral bodies by hypointense areas on the T1 Weighted images. The pedicles of these vertebrae bilaterally and the spinous process of the D6 and D7 vertebrae also appear to be involved. There is slight pre and paravertebral soft tissue extension over the D4-D5 to the D8-D9 levels. Anterior and left lateral epidural extension is seen at the D6 and D7 levels. Circumferential epidural extension is noted at the D5 and D6 levels. A small extrapleural lesion is noted on the left side at the D4-D5 level which is hypointense on the T1 Weighted images and turns hyperintense on the T2 Weighted images. Minimal soft tissue extension into the left paraspinal muscles is seen over the D2 to D4 levels.

Probable involvement of the D5-D6 and D7-D8 intervertebral discs is noted.

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



The visualized dorsal spinal cord over the D4 to D7 vertebral levels reveals a subtle hyperintense signal on the T2 Weighted images suggesting cord edema/ischemia.

The conus medullaris terminates at the D12-L1 level.

IMPRESSION :

The MRI features are suggestive of altered signal of the D5, D6 and D8 vertebral bodies with extensions as described. This most likely represents an infective etiology like tuberculosis. Prevertebral, paravertebral and epidural soft tissue lesion may represent granulation tissue/abscess. Altered cord signal may represent cord edema/ischemia.

The possibility of this being a neoplastic process like round cell tumor is less likely.

sb/hs/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyz Slmn / M / 70 yrs.
Referred by : Dr. Abc Xyzni.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache with pain radiating to BLE since 6-7 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 water content of the lumbar intervertebral discs. Slight retroplacement of the L3 vertebra over the L4 vertebra is noted.

Posteriorly herniated discs with peridiscal osteophytes are noted at the L2-L3, L3-L4 and L4-L5 levels, with thecal sac compression and bilateral neural foraminal narrowing. The facet joints at these levels appear hypertrophied with resultant canal stenosis.

A small posterior disc herniation with bilateral neural foraminal narrowing is noted at the L5-S1 level. Facetal hypertrophy is noted at the L5-S1 level.

Bilateral far lateral (extraforaminal) disc herniations are noted over the L2-L3 to L5-S1 levels.

A small posterior disc bulge is noted at the L1-L2 level.
Type I and Type II degenerative marrow changes are noted adjacent to the L2-L3 disc. Type II degenerative changes are noted adjacent to nearly all the remaining lumbar intervertebral discs.
..2/.







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 :

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

IMPRESSION :

1. Posteriorly herniated discs with peridiscal osteophytes at the L2-L3, L3-L4 and L4-L5 levels, with bilateral neural foraminal narrowing. Facetal hypertrophy is also noted over these levels with resultant canal stenosis.

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

3. A small posterior disc bulge at the L1-L2 level.

4. Bilateral far lateral (extraforaminal) disc herniations over the L2-L3 to L5-S1 levels.

sb/hs/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyzuleman Ghalmn / M / 38 yrs.
Referred by : Dr. Abc XyzParekh.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O neckpain radiating to all four extremities with paresthesias.
Past H/O anterior microdiscectomy at C4/C5 in March 0000.

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

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 maxillary sinuses and ethmoidal air cells bilaterally.

IMPRESSION :

Normal study of the Brain.

sb/hs/nl/rg
Date : 00.00.00

Name of the Patient : Abc Xyzuleman Ghalmn / M / 38 yrs.
Referred by : Dr. Abc XyzParekh.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE :

C/O neckpain radiating to all four extremities with paresthesias.
H/O anterior microdiscectomy of C4/C5 done in March 0000.

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 loss of water content of the cervical intervertebral discs. The C4-C5 intervertebral disc is not identified, the result of previous discectomy. The C4 and C5 vertebral bodies appar to be fused. The upper cervical vertebral bodies show spotty fatty marrow changes.

A postero-central disc herniation with peridiscal osteophyte is noted at the C3-C4 level, slightly more to the left of the midline with cord compression.

A posterior peridiscal osteophyte is noted at the C4-C5 disc level, indenting the dural theca anteriorly.

A left paracentral disc herniation with peridiscal osteophyte is noted at the C5-C6 level with left neural foraminal narrowing and probable indentation on the left C6 nerve root.

A small posterior peridiscal osteophyte is noted at the C6-C7 level.
..2/.






The facet joints at the C4-C5 and C5-C6 levels appear slightly hypertrophied.

The rest of the visualized cervical and upper dorsal vertebrae show a hypointense signal as compared to normal marrow on the T1 Weighted images, which remains isointense to normal marrow on the T2 Weighted images.

The joints of Luschka and the visualized pre and paravertebral soft tissues are unremarkable.

The cervical spinal cord at the C4-C5 disc level shows a hyperintense signal on the T2 Weighted images which may represent cord edema/gliosis.

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

IMPRESSION :

1. Post-operative status.

2. A postero-central disc herniation with peridiscal osteophyte at the C3-C4 level, slightly more to the left of the midline with cord compression.

3. A posterior peridiscal osteophyte at the C4-C5 disc level.

4. A left paracentral disc herniation with peridiscal osteophyte at the C5-C6 level with probable indentation on the left C6 nerve root.

5. A small posterior peridiscal osteophyte at the C6-C7 level.

6. Slight facetal hypertrophy at the C4-C5 and C5-C6 levels.
..3/.






- 3 - Scan-00004


7. Altered marrow signal in the visualized upper dorsal and lower cervical vertebrae suggests a preponderance of hematopoeitic marrow.

8. Cord signal alteration at the C4-C5 disc level may represent cord edema/gliosis.

sb/ke/rg.
Date : 00.00.00

Name of the Patient : Abc Xyz M. Rampuralmn / M / 37 yrs.
Referred by : Dr. Abc Xyzapadia.
Examination : M.R.I. of the Dorso-lumbar Spine.

CLINICAL PROFILE :

C/O backache radiating to BLE since 1 month.
H/O fall 4 years back.

EXAMINATION :

M.R.I of the dorso-lumbar 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 :

There is slight anterior wedging of the D12 vertebral body with focal fatty marrow changes, which may be the sequelae of previous trauma. The D11-D12 intervertebral disc shows loss of water content. Irregularity of the superior cortical margin of the D12 is noted. A small posterior disc bulge with peridiscal osteophytes is noted at the D11-D12 level. A schmorls node is also noted along the inferior margin of the D12.

The rest of the visualized dorso-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 visualized dorso-lumbar spinal cord reveals normal signal intensity.

The conus medullaris terminates at the L1-L2 level.
Scan-00002



IMPRESSION :

1. Slight anterior wedging of the D12 vertebral body with focal fatty marrow changes most likely the sequelae of previous trauma.

2. A small posterior disc bulge with peridiscal osteophytes at the D11-D12 level.