ke/bv/rg.
Date : 00.00.00

Name of the Patient : Abc XyzAli Slmn / M / 35 yrs.
Referred by : Dr. Abc Xyzannu.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache since 2 years.

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 mild scoliosis of the lumbar spine with convexity to the right.

The L5-S1 intervertebral disc shows loss of water content.

There are right postero-lateral disc herniations at the L4-L5 and L5-S1 levels with right neural foraminal narrowing. The right S1 nerve root appears to be of larger calibre ? baggy nerve root sleeve ?? inflammation (scans 104.1-2).

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-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 D12-L1
16.0 mm at L1-L2
15.0 mm at L2-L3
13.0 mm at L3-L4
11.0 mm at L4-L5
12.0 mm at L5-S1.

IMPRESSION :

The MRI features are suggestive of right postero-lateral disc herniations at the L4-L5 and L5-S1 levels with right neural foraminal narrowing.

ke/hs/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyz Otlmn / F / 32 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 (left more than right) 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 scoliosis of the lumbar spine with convexity to the right.

There is slight retroplacement of the L4 over the L5 and L5 over the S1 vertebrae.

A right paracentral and postero-lateral disc herniation is noted at the L4-L5 level with right neural foraminal narrowing.

A postero-central disc herniation, more to the left of the midline is noted at the L5-S1 level with mild indentation upon the traversing left S1 nerve root.

A right far lateral (extraforaminal) disc protrusion is seen to indent the extraforaminal portion of the exiting right L4 nerve root at the L4-L5 level.

The L4-L5 and L5-S1 facet joints show degenerative changes.

Small posterior peridiscal osteophytes are seen at the L4-L5 and L5-S1 levels. The L4-L5 and L5-S1 intervertebral discs show loss of water content.

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 :

18.0 mm at L1-L2
16.0 mm at L2-L3
15.0 mm at L3-L4
11.0 mm at L4-L5
10.0 mm at L5-S1.

IMPRESSION :

The MRI features are suggestive of :

1. Slight retroplacement of the L4 over the L5 and L5 over the S1 vertebrae.

2. A right paracentral and a postero-lateral disc herniation at the L4-L5 level.

3. A postero-central disc herniation, more to the left of the midline at the L5-S1 level with mild indentation upon the traversing left S1 nerve root.

4. A right far lateral (extraforaminal) disc protrusion indenting the extraforaminal portion of the exiting right L4 nerve root at the L4-L5 level.

5. Facetal arthropathy at the L4-L5 and L5-S1 levels.

ke/hs/rg/nl
Date : 00.00.00

Name of the Patient : Abc XyzB. Mhlmn / M / 51 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O headaches since 30-35 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.

5 mm thick T1 Weighted sagittal 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.

Incidental note is made of left maxillary sinusitis.

IMPRESSION :

Normal study of the Brain.

ke/hs/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyzlmn / M / 35 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O headaches with seizures since 3 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 T2 Weighted and Fast SCan (T2 *) coronal images.
4 mm thick FLAIR coronal images.
5 mm thick T1 Weighted sagittal images.

OBSERVATION :

There is evidence of a subcentimeter diameter sized lesion in the region of the cortex of the left frontal lobe. It is hypointense on the proton, T2 Weighted, FLAIR and Fast Scan (T2 *) images (se/im: 102/17, 103/17, 106/9 and 107/7).

The hippocampus is unremarkable on either side.

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.

Incidental note is made of inflammatory changes in the sphenoid sinus and the ethmoidal sinus on the left side.

IMPRESSION :

The MRI features are suggestive of a subcentimeter diameter sized lesion in the region of the cortex of the left frontal lobe and this may represent a calcified granuloma.

ke/hs/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyzp Asalmn / M / 27 yrs.
Referred by : Dr. Abc Xyzorude.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O seizures since 00.00.00.

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 T2 coronal images.

5 mm thick FLAIR coronal images.

5 mm thick T1 Weighted sagittal images.

OBSERVATION :

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

The hippocampus is unremarkable on either side.

The left lateral ventricle appears prominent as compared to the right and may be a normal variant. 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 :

No significant abnormality is detected within the brain on this study.

ke/hs/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyzlmn / F / 38 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O limp in the right leg since 2 months.
H/O neurogenic bladder and saddle back anesthesia.

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 :

Open sacral canal is noted with probable absence of the posterior appendages on the left side at the S2 and S3 vertebral levels. The left side of the sacral ala is seen to be deformed.

There is tethering of the spinal cord into a hyperintense lesion on the T1 Weighted images which is intradural in location at the S2 vertebral level and follows fat signal intensity characteristics and represents a lipoma. This lipoma is seen to have a large extradural component on the left side at the S2 and S3 vertebral levels. Syrnix (isointense to CSF) is noted within the spinal cord over the L4 to S2 vertebral levels.

The lumbar vertebral bodies and the intervertebral discs reveal normal signal intensity. The facet joints and the visualized pre and paravertebral soft tissues are unremarkable.
- 2 - Scan-00006



IMPRESSION :

The MRI features are suggestive of :

1. Spinal dysraphism with tethering of the spinal cord at the S2 vertebral level into a lipoma as described.

2. Syrinx within the spinal cord over the L4 to S2 vertebral levels.

As compared to the previous MRI dated 00.00.00 (study no.0000) a syrnix is now seen to extend upto the L4 vertebral level.

hs/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyz Kaplmn / F / 20 yrs.
Referred by : Dr. Abc Xyzauhan.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache with pain radiating to the LLE since 1 year which has increased since 4 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.

4 mm thick T1 Weighted coronal images.

OBSERVATION :

There is evidence of a well-defined, extramedullary/ intradural mass lesion within the spinal canal at the L1/L2 levels and measuring approximately 1.5 x 1.8 x 2.1 cms. This lesion is iso to hypointense to normal cord on the T1 Weighted images and is iso to hyperintense to normal cord on the T2 Weighted images. This lesion is seen to indent the tip of the conus medullaris which is displaced anteriorly and slightly to the right.

A postero-central disc protrusion is noted at the L5-S1 level. This intervertebral disc shows loss of water content.

There is a mild posterior disc bulge at the L4-L5 level.
Scan-00005


Mild facetal hypertrophy is evident at the L4-L5 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 S1 level.

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

18.0 mm at D12-L1
15.0 mm at L1-L2
18.0 mm at L2-L3
15.0 mm at L3-L4
14.0 mm at L4-L5
11.0 mm at L5-S1.

IMPRESSION :

The MRI features are suggestive of a well-defined, extramedullary/intradural mass lesion within the spinal canal at the L1/L2 levels and measuring approximately 1.5 x 1.8 x 2.1 cms. This may represent a neoplastic process like:

1. A neurofibroma.

2. A meningioma.

A contrast enhanced scan may be useful if clinically indicated.

hs/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzek Mlmn / M / 23 yrs.
Referred by : Dr. Abc Xyzpadia.
Examination : M.R.I. of the Right Knee Joint.

CLINICAL PROFILE :

C/O pain in the right knee (on and off) since 1 year.

EXAMINATION :

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

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

4 mm thick T1 Weighted and STIR coronal images.

5 mm thick GRASS axial images.

OBSERVATION :

Menisci

The anterior and posterior horns of the lateral and medial 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 :

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

IMPRESSION :

No abnormality is detected within the right knee joint.

hs/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc XyzShlmn / F / 23 yrs.
Referred by : Dr. Abc Xyz
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE :

C/O neckpain.

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.

OBSERVATION :

Subtle hypointense signal is noted in the C5 and C6 vertebral bodies on the T1 Weighted images. This signal appears isointense on the T2 Weighted images (scans 102.4).

The rest of the cervical vertebral bodies and the 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.

IMPRESSION :

Subtle altered signal in the C5 and C6 vertebrae may represent early changes of osteitis.

A follow up scan would be worthwhile.

hs/ke/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzram Almn / M / 9 yrs.
Referred by : Dr. Abc Xyzgrawal.
Examination : Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O seizures since 4 years.
H/O right hemipareses on 00.00.00.

EXAMINATION :

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

5 mm thick T1 Weighted and T2 Weighted axial images.

5 mm thick FLAIR coronal images.

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

FEW IMAGES (NECK MRA) SHOW PATIENT MOTION.

OBSERVATION :

BRAIN :

There is a diffuse area of hyperintensity on the T2 Weighted and FLAIR images within the left cerebral hemisphere with slight effacement of the cerebral cortical sulci.

Areas of similar signal characteristics are seen within the midbrain (red nuclei), pons and deep white matter in the fronto-parietal lobes bilaterally.

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

There is no shift of the midline structures.
..2/.








INTRACRANIAL MRA :

There is apparent narrowing of the posterior aspect of the left internal carotid artery (artifactual).

The petrous, cavernous and supraclinoid segments of the right internal carotid artery 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.

IMPRESSION :

The MRA features are suggestive of :

1. Areas of altered signal within the left cerebral hemisphere, midbrain (red nuclei), pons and deep white matter in the fronto-parietal lobes bilaterally is not specific for a single etiology. The differential diagnosis would include,

a. Areas of ischemia/infarction (? vasculitis).

b. Demyelination.

c. Metabolic disorders like motachondrial disorders (eg. MELAS)

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