ke/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzen Sagalmn / F / 44 yrs.
Referred by : Dr. Abc XyzV. Shah.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to the LLE with tingling.
H/O fall prior to this.

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 L1-L2, L3-L4 and L4-L5 intervertebral discs show loss of water content.

There is scoliosis of the lumbar spine with convexity to the left and clockwise rotational anomaly of the upper lumbar vertebrae.

Postero-central disc herniations are seen at the L3-L4 and L4-L5 levels with anterior indentation of the thecal sac. The L3-L4 facet joints bilaterally and the L4-L5 facet joint on the left side show degenerative changes.

A small left far lateral disc bulge is seen at the L2-L3 level and a postero-central disc protrusion at the L5-S1 level.

Schmorls node is seen in the superior aspect of the L2 vertebral body.


Hypointense area is seen in the left sacral ala on the T1 Weighted images which is seen to turn heterogeneously hyperintense on the T2 Weighted images ? inflammatory. The left sacro-iliac joint appears spared by the pathology.

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 :

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

IMPRESSION :

1. Scoliosis of the lumbar spine with convexity to the left side.

2. Postero-central disc herniations at the L3-L4 and L4-L5 levels with degenerative changes of the L3-L4 facet joints bilaterally and the L4-L5 facet joint on the left side.

3. A small left far lateral disc bulge at the L2-L3 level.

4. Altered signal in the left sacral ala with sparing of the left sacro-iliac joint, ? inflammatory.

ke/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyz Nlmn / F / 42 yrs.
Referred by : Dr. Abc Xyzwhale.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to the LLE with paresthesias since 5-6 years.
H/O evening fever since 1-2 years.
H/O L5 laminectomy with discectomy of L5-S1 in September 0000.

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 L5-S1 intervertebral disc shows loss of water content.

There are post-operative changes in the posterior soft tissues at the L5 and S1 levels with laminectomy of the L5 vertebra.

A postero-central disc herniation is seen at the L5-S1 level with anterior indentation of the thecal sac and the S1 nerve roots bilaterally.

A posterior and a left postero-lateral disc herniation is noted at the L4-L5 level with anterior indentation of the thecal sac and left neural foraminal narrowing. The L4-L5 facet joint on the left shows mild degenerative change.

A small posterior disc bulge is seen at the L3-L4 level. This intervertebral disc shows slight loss of water content.
..2/.






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-S2 level.

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

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

IMPRESSION :

1. Post-operative status.

2. A postero-central disc herniation at the L5-S1 level with indentation upon the S1 nerve roots.

3. A posterior and a left postero-lateral disc herniation at the L4-L5 level with tight lumbar canal at this level.

ke/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzi Shlmn / M / 27 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Dorsal Spine.

CLINICAL PROFILE :

C/O loss of sensation in the LLE since 1 month with dragging of the LLE.

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.

OBSERVATION :

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

The visualized dorsal spinal cord reveals normal signal intensity.

The conus medullaris terminates at the L1 level.

IMPRESSION :

Normal study of Dorsal Spine.

hs/bv/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyzl Palmn / M / 55 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O right hemiparesis with slurred speech since 15 days with decreased hearing since 6 years.
Known hypertensive. On Rx.

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 evidence of a well-defined wedge shaped area which is isointense to CSF on all the pulse sequences within the left temporal lobe. This is surrounded by hypointense areas on the T1 Weighted images 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.

Multiple areas which are iso to hyperintense to CSF on all the pulse sequences are noted within the right periatrial white matter, left corona radiata, head of the caudate nuclei, pons and the lentiform nuclei. These would represent lacunar infarcts. A few of these are surrounded by hyperintense areas on the proton, T2 Weighted and FLAIR images which would represent gliotic changes.

Areas of hyperintensity on the proton, T2 Weighted and FLAIR images are seen within the periventricular white matter and the white matter in the fronto-parietal lobes bilaterally. These are iso to hypointense to normal white matter on the T1 Weighted images and are most likely ischemic in etiology.
..2/.







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

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 :

1. An area of cystic encephalomalacia within the left temporal lobe.

2. Lacunar infarcts within the right periatrial white matter, left corona radiata, head of the caudate nuclei, pons and the lentiform nuclei.

3. Altered signal within the periventricular white matter and the white matter in the fronto-parietal lobes bilaterally are most likely ischemic in etiology.

ke/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzh Gorvlmn / M / 34 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE :

C/O neckpain with paresthesias in BLE.
H/O neck manipulation prior to this (in a saloon).

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 C4-C5, C5-C6, C6-C7 and upper dorsal intervertebral discs.

There is a left postero-lateral disc herniation at the C5-C6 level with antero-lateral indentation of the cord and left neural foraminal narrowing. The joints of Luschka on the right side also show mild degenerative changes with mild right neural foraminal narrowing. There is also mild ligamentum flavum hypertrophy at the C5-C6 level.

Small posterior disc bulge is seen at the C4-C5 level and a small disc protrusion at the C3-C4 level. Posterior peridiscal osteophytes are noted at the C4-C5 and C5-C6 levels.

The spinal cord at the C1-C2 level shows a hyperintense signal on the T2 Weighted images and is isointense to cord on the T1 Weighted images. This may represent cord edema/contusion in the given clinical setting.


The cervical vertebral bodies and the remaining intervertebral discs show normal signal intensity. The rest of 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 :

1. Cord signal alteration at the C1-C2 level may represent cord edema/contusion in the given clinical setting.

2. A left postero-lateral disc herniation at the C5-C6 level with mild degenerative changes of the joints of Luschka at this level with a small posterior disc bulge at the C4-C5 level with posterior peridiscal osteophytes at the C4-C5 and C5-C6 levels.

sb/hs/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyz Obaid Mublmn / M / 47 yrs.
Referred by : Dr. Abc Xyzrma.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O headaches.

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 both the maxillary sinuses (left more than right).

IMPRESSION :

Normal study of the Brain.

sb/bv/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyza S. lmn / F / 30 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to the LLE with paresthesias 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.

SOME IMAGES SHOW PATIENT MOTION AS PATIENT WAS IN SEVERE PAIN.

OBSERVATION :

There is loss of water content of the L4-L5 intervertebral disc with scoliosis of the spine with convexity to the left side.

There is a fairly large, posteriorly extruded disc at the L4-L5 level with thecal sac compression and bilateral neural foraminal narrowing. Inferior migration of the disc is noted in the left lateral recess of L5. There is indentation on the traversing L5 nerve roots bilaterally. The L4-L5 facet joints show slight degenerative changes bilaterally.

A left postero-lateral (foraminal) disc herniation is noted at the L3-L4 level with left neural foraminal narrowing with indentation on the left L3 nerve root.

A small, left far lateral disc bulge is noted at the L2-L3 level.
..2/.








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 level and the thecal sac terminates at the L5 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
16.0 mm at L2-L3
16.0 mm at L3-L4
9.0 mm at L4-L5
9.0 mm at L5-S1.

IMPRESSION :

1. A fairly large, posteriorly extruded disc at the L4-L5 level with bilateral neural foraminal narrowing with inferior migration of the disc in the left lateral recess of L5 with indentation on the traversing L5 nerve roots bilaterally.

2. A left postero-lateral (foraminal) disc herniation at the L3-L4 level with indentation on the left L3 nerve root.

sb/bv/nl/nl
Date : 00.00.00

Name of the Patient : Abc XyzM. Plmn / M / 50 yrs.
Referred by : Dr. Abc Xyzcha.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to the RLE with numbness.

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 L3-L4, L4-L5 and L5-S1 intervertebral discs.

There is a postero-central and right paracentral disc herniation at the L5-S1 level indenting the traversing right S1 nerve root.

A posteriorly herniated disc is noted at the L4-L5 level with bilateral neural foraminal narrowing. Inferior migration of the disc fragment is noted, to the right of the midline, indenting the traversing right L5 nerve root. The facet joints at this level appear hypertrophied.

A small posterior disc bulge is noted at the L3-L4 level. Anterior disc herniation with anterior peridiscal osteophytes are noted at this level.






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 :

17.0 mm at L1-L2
18.0 mm at L2-L3
15.0 mm at L3-L4
12.0 mm at L4-L5
11.0 mm at L5-S1.

IMPRESSION :

1. A postero-central and right paracentral disc herniation at the L5-S1 level indenting the traversing right S1 nerve root.

2. A posteriorly herniated disc at the L4-L5 level with bilateral neural foraminal narrowing with inferior migration of the disc fragment, to the right of the midline and indentation on the traversing right L5 nerve root.

3. Slight facetal hypertrophy at the L4-L5 level with a tight canal at that level.

hs/ke/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyzarayan Slmn / M / 65 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O right sided hemiparesis with slurred speech since 12 days.

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 evidence of an area of hypointensity on the T1 Weighted images which turns hyperintense on the proton, T2 Weighted and FLAIR images within the left corona radiata and left centrum semiovale. This most likely represents an area of ischemia/infarction.

Lacunar infarcts (iso to hyperintense to CSF) are seen within the head of the left caudate nucleus, pons, both lentiform nuclei, corona radiata bilaterally, genu of the corpus callosum on the left side and in the deep white matter in the left frontal lobe. A few of these are surrounded by hyperintense areas on the proton, T2 Weighted and FLAIR images and these may represent gliotic changes.

Areas of hyperintensity on the proton, T2 Weighted and FLAIR images are seen within the pons, periventricular white matter in the fronto-parietal lobes bilaterally. These are iso to hypointense to white matter on the T1 Weighted images and these are most likely ischemic in etiology.
Scan-00004




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

Incidental note is made of an empty sella.

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 :

1. An area of altered signal within the left corona radiata and left centrum semiovale represents an area of ischemia/infarction.

2. Lacunar infarcts within the head of the left caudate nucleus, pons, both lentiform nuclei, corona radiata bilaterally, genu of the corpus callosum on the left side and in the deep white matter in the left frontal lobe.

sb/hs/nl/rg.
s Date : 00.00.00

Name of the Patient : Abc XyzGawkhalmn / M / 50 yrs.
Referred by : Dr. Abc Xyzdy.
Examination : M.R.I. of the Left Knee Joint.

CLINICAL PROFILE :

C/O pain in both the knees since 1 month.

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.

4 mm thick GRASS axial images.

OBSERVATION :

There is reduction in the medial tibio-femoral joint space.

Menisci

There is a linear, hyperintense signal on all the pulse sequences in the anterior and posterior horns of the medial meniscus of the left knee joint not reaching upto the articular margin. This suggests Grade II meniscal degeneration.

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

Cruciate Ligaments :

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


Collateral Ligaments and the Patellar Tendon :

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 :

There is slight thinning of the articular cartilage in the medial tibio-femoral joint with reduction in joint space. Marginal osteophytes are noted around the left knee joint. There is an ill-defined, hyperintense signal on the T2 Weighted and GRASS images in the medial tibial plateau adjacent to the medial tibio-femoral joint. This signal appears hypointense to normal marrow on the T1 Weighted images and most likely represents subchondral, degenerative changes.

The patellar cartilage is unremarkable.

A small, left knee joint effusion is noted.

IMPRESSION :

Osteoarthritic changes in the left knee joint with :

1. Reduction in the medial tibio-femoral joint space.

2. Grade II meniscal signal (meniscal degeneration) in the anterior and posterior horns of the medial meniscus of the left knee joint.

3. Marginal osteophytes around the left knee joint with altered signal in the tibia adjacent to the medial tibio-femoral joint suggesting subchondral degenerative changes.

4. Small effusion in the left knee joint.