SB/BV/RG.
Date : 00.00.00

Name of the Patient : Abc Xyzth Glmn / M / 61 yrs.
Referred by : Dr. Abc Xyzenoy / Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O diminished vision of both eyes since childhood (retinitis pigmentosa with optic atrophy). Also C/O headaches, giddiness and tinnitus since many year.

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.

5 mm thick T1 Weighted sagittal images.

OBSERVATION :

There are small bright foci on the T2 Weighted and STIR images in the left frontal subcortical and deep white matter, which may represent ischemic changes.

There is mild fullness of both the lateral ventricles. The third and the fourth ventricles are normal. There is slight prominence of the cerebral cortical sulci bilaterally. A mega cisterna magna is noted. The rest of 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 on either side show normal signal characteristics. However they are slightly smaller in calibre than normal.
..2/.









- 2 - Scan-00002


IMPRESSION :

1. Altered signal in the left frontal subcortical and deep white matter may represent ischemic foci.

2. Mild optic atrophy bilaterally.

As compared to the previous MRI dated 00.00.00 (scan no.0000), there is no significant change noted.

sb/bv/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyzben Mitlmn / M / 53 yrs.
Referred by : Dr. Abc Xyzoctor.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O headaches (right sided) with nausea since 2-3 years.
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 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 left maxillary sinus and mastoid air cells bilaterally.

IMPRESSION :

Normal study of the Brain.

Inflammatory changes in the left maxillary sinus and mastoid air cells, bilaterally.

sb/bv/rg/nl
Date : 00.00.00

Name of the Patient : Abc XyzBagayalmn / M / 42 yrs.
Referred by : Dr. Abc Xyzmpat.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

H/O right sided opthalmoplegia 2 months back.
C/O left hemiparesis since 2 days. Also C/O drooping of the right eye with diplopia since 2 months.
Known hypertensive/diabetic.

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 an ill-defined, hyperintense signal on the proton, T2 Weighted and FLAIR images in the right paraatrial region, right frontal periventricular and deep white matter, right corona radiata, right high parietal, parafalcine cortex and in the splenium of the corpus callosum on the right. These lesions appear iso to hypointense to normal white matter on the T1 Weighted images and most likely represents ischemic lesions.

There is a wedge shaped CSF signal intensity lesion on all the pulse sequences in the left cerebellar hemisphere, inferiorly. Perilesional hyperintense signal may represent gliotic changes.

There is mild fullness 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.



IMPRESSION :

1. Altered signal in the right paraatrial region, right frontal periventricular and deep white matter, right corona radiata, right high parietal parafalcine cortex, in the splenium of the corpus callosum on the right are most likely represents ischemic lesions, probably recent in the given clinical setting.

2. Area of cystic encephalomalacia in the left cerebellar hemisphere, inferiorly is most likely the sequelae of previous vascular insult.

As compared to the previous MRI dated 00.00.00, the lesions in the right cerebral hemisphere are recent lesions and were not identified on the previous study.

sb/bv/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyzha Salulmn / F / 53 yrs.
Referred by : Dr. Abc Xyzrankar / Dr. Abc Xyzkar.
Examination : M.R.I. of the Dorsal Spine.

CLINICAL PROFILE :

C/O backache with tingling in BLE since 2 months.
H/O cervical lymphadenopathy 18 yrs back. Received AKT.

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.

5 mm thick Fast Scan (T2 *) coronal images.

OBSERVATION :

There is seen an expansile lesion involving the left pedicle and the posterior elements of the D9 vertebra. This lesion is of intermediate signal on the T1 Weighted images and appears hyperintense on the T2 Weighted images. Involvement of the left costo-transverse and costo-vertebral joints at this level is noted. Altered signal is also noted in the body of the D9 vertebra, pedicles of D10 vertebra and the base of the spinous process of the D9 vertebra. There is resultant cord compression at the D9 and D10 vertebral levels. The dorsal spinal cord at these levels shows a hyperintense signal on the T2 Weighted images which suggests cord edema/ischemia. There is also encasement of the D8 nerve root within the neural foramen by the lesion.

The rest of the visualized dorsal vertebral bodies
show spotty fatty marrow changes. The dorsal intervertebral discs reveal normal signal intensity. The facet joints and the visualized pre and paravertebral soft tissues are unremarkable.
- 2 - Scan-00009


The conus medullaris terminates at the L1 level.

Note is made of paraaortic and paracaval lymph nodes in the lumbar region and mediastinal lymphadenopathy.

T1 Weighted sagittal images of the cervical and lumbar spines reveal spotty fatty marrow changes. No other significant abnormality is detected.

IMPRESSION :

An expansile lesion involving the left pedicle and the posterior elements of the D9 vertebra with altered signal in the body of the D9, pedicles of the D10 vertebra and the spinous process of the D9 vertebra as described is not specific for a single etiology. Round cell tumor or metastasis may be considered as differential diagnosis. Tuberculosis may also be considered as a differential diagnosis in view of the past H/O tuberculous cervical lymphadenitis and pulmonary Kochs.

There is resultant cord compression and cord signal alteration at the D9 and D10 levels suggesting cord edema/ischemia.

sb/bv/rg.
Date : 00.00.00

Name of the Patient : Abc Xyz Jhalmn / M / 49 yrs.
Referred by : Dr. Abc Xyzsrani / Dr. Abc Xyzah.
Examination : M.R.I. of Both Hips.

CLINICAL PROFILE :

C/O pain in the right hip and knee with difficulty in bending with limp since 1 1/2 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 axial images.

5 mm thick Proton density sagittal images.

OBSERVATION :

The femoral head and the acetabulum reveal normal signal intensity bilaterally (Prominent femoral pit is noted on the right side). There is no obvious bony destruction or erosion noted. The articular cartilages are unremarkable. There is no effusion within both the hip joints.

The musculature surrounding both the hip joints and the visualized pelvis is normal.

IMPRESSION :

Normal study of both the Hip joints.

sb/bv/rg/nl
Date : 00.00.00

Name of the Patient : Abc XyzGhanshyalmn / F / 22 yrs.
Referred by : Dr. Abc Xyz.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE :

C/O neck pain radiating to the LUE since 3 years and in the RUE since 7-8 months.

EXAMINATION :

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

5 mm thick T1 Weighted and T2 Weighted sagittal images.

5 mm thick T1 Weighted and Fast Scan (T2 *) axial images.

4 mm thick T1 Weighted and STIR coronal images.

OBSERVATION :

There is loss of normal cervical lordosis and loss of water content of the C3-C4, C4-C5 and C5-C6 intervertebral discs.

Small, postero-central protruded discs with small peridiscal osteophytes are noted at the C3-C4, C4-C5 and C5-C6 levels.

A posterior disc bulge is identified at the C6-C7 level.

The cervical vertebral bodies and the remaining intervertebral discs 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 atlanto-axial region and the cervico-medullary junction are unremarkable.

There is no abnormality detected within the thoracic inlet.

IMPRESSION :

Small, postero-central protruded discs with small peridiscal osteophytes at the C3-C4, C4-C5 and C5-C6 levels.

sb/bv/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyz Mlmn / F / 24 yrs.
Referred by : Dr. Abc Xyzajan.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O intracranial tuberculoma detected in March 0000.
On AKT since then.
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.

4 mm thick FLAIR coronal images.

After administration of contrast, the following parameters were used :5 mm thick T1 Weighted axial and coronal images with magnetization transfer.5 mm thick T1 Weighted sagittal images.OBSERVATION :
There are multiple, small focal, hypointense lesions on the proton and T2 Weighted images scattered in the brain parenchyma, in the right temporo-parietal region, right posterior parietal region and in the left cerebellar hemisphere, near the midline. These lesions appear iso to hypointense to normal white matter on the T1 Weighted images. There is perilesional edema around these lesions. Effacement of the sulcal spaces in the right posterior parietal region is noted with minimal indentation upon the occipital horn of the right lateral ventricle.



On administration of contrast, there is a large conglomeration of ring enhancing lesions in the right temporo-parietal region which measures approximately 2.1 x 3.4 x 1.6 cms. Some enhancement of the dura adjacent to this lesion is noted. Smaller, disc and ring enhancing lesions are noted in the left cerebellar hemisphere near the midline and right posterior parietal region. There are few hypointense areas on the proton and T2 Weighted images which probably represent calcification.

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.
Inflammatory changes are noted in the ethmoidal air cells bilaterally.
IMPRESSION :Multiple, ring and disc enhancing lesions scattered in the brain parenchyma with signal characteristics as described, most likely represent tuberculous granulomas.

No previous investigations/scans were available for comparison.

sb/bv/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzth D. Klmn / M / 52 yrs.
Referred by : Dr. Abc Xyzvade.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to the RLE with tingling 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 loss of normal lumbar lordosis and loss of water content of the L1-L2, L3-L4 and L5-S1 intervertebral discs.

Slight retroplacement of the L5 over the S1 vertebra is noted.

There is a fairly large, right paracentral extruded disc at the L5-S1 level indenting the traversing right S1 nerve root.

Small posterior disc bulges are noted at the L4-L5 and L3-L4 levels, narrowing the left neural foramen at the L4-L5 level and bilaterally at the L3-L4 level.

Facetal hypertrophy is noted in the lower lumbar region.

Focal fatty marrow changes are noted in the L4 vertebral body adjacent to the L3-L4 disc anteriorly.
- 2 - Scan-00005


There is slight anterior wedging of the L3 and D12 vertebral bodies without change in signal intensity.

Anterior peridiscal osteophytes are seen in the lumbar region.

The rest of 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 L2 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 :

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

IMPRESSION :

1. Slight retroplacement of the L5 over the S1 vertebra.

2. A fairly large, right paracentral extruded disc at the L5-S1 level indenting the traversing right S1 nerve root.

3. Posterior disc bulges at the L4-L5 and L3-L4 levels.

4. Facetal hypertrophy in the lower lumbar region.

ke/hs/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyzd lmn / M / 56 yrs.
Referred by : Dr. Abc Xyzmpat.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O weakness of the left half of the body with slurred speech.

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 is no focal area of altered signal intensity in the brain parenchyma. (Hyperintense signal in the medulla on the proton and T2 Weighted images is most likely artifactual).

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 :

Normal study of the Brain.

ke/sb/rg.
Date : 00.00.00

Name of the Patient : Abc Xyz Gailmn / M / 47 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.
(Post-contrast study).

CLINICAL PROFILE :

C/O slow movements with difficulty in walking since 1 1/2 years.
Also C/O involuntary movements of the fingers of the right hand since 00.00.00 which has recovered now.

EXAMINATION :

After administration of contrast the following parameters were used :

3 & 5 mm thick T1 Weighted coronal images with magnetization transfer.
5 mm thick T1 Weighted axial images with magnetization transfer.
5 mm thick T1 Weighted sagittal images.

OBSERVATION :

After contrast administration, there is a disc enhancing lesion in the right cerebellar hemisphere near the midline measuring approximately 11.0 x 20.0 x 10.0 mms. Perilesional edema is noted on the FLAIR images.

There is no other area of abnormal enhancement in the brain parenchyma or along the meninges.

IMPRESSION :

The MRI features are suggestive of a disc enhancing lesion in the right cerebellar hemisphere near the midline, measuring approximately 11.0 x 20.0 x 10.0 mms. This lesion is not specific for a single etiology. The possibilities to be considered are,

1. Metastasis.

2. Granuloma (less likely).